Research has demonstrated that people with Complex Regional Pain Syndrome (CRPS) regularly exhibit changes in brain function. These changes can, in some cases, impact quite significantly upon day-to-day life, affecting short term memory, attention span, verbal fluency and what are known as the brain’s ‘executive functions’, which control a person’s behaviour.
Many people with CRPS refer to these types of symptoms as “Brain Fog”. Brain Fog affects people in different ways. Some people don’t seem to suffer it at all, whilst in others it can be almost as debilitating as other symptoms of CRPS.
Over many years of talking to people suffering CRPS, it seems that the one symptom of Brain Fog which is of most concern to them is poor memory. One client in his thirties told me that he felt he now had the memory of an eighty year old.
What causes these problems?
This is far from easy to answer. Perhaps the first issue to consider is whether these problems with brain function, including poor memory, are caused by actual structural changes within the brain, or are they instead symptomatic of other factors associated with CRPS?
Memory can be affected by factors such as lack of sleep and depression, both commonly experienced by those suffering CRPS and other chronic pain conditions. Poor memory is also a recognised side effect of a number of types of medication commonly prescribed to people suffering chronic pain, including opioids (eg Tramadol), antispasmodics (eg Gabapentin and Pregabalin) and NMDA receptor blockers (eg Ketamine).
However, over and above these associated factors, there has been speculation in the medical profession that memory loss for those suffering CRPS may also be the result of a malfunction in a part of the brain known as the Limbic System, which is involved in the control of our mood and instinct.
Further, in terms of structural changes more generally, specialist imaging of people suffering CRPS has now found evidence of altered function in a number of areas of the brain. In particular, there is evidence of dysfunction of the motor cortex, which is a part of the brain involved in voluntary movement. Perhaps unsurprisingly, this evidence is particularly strong in people who suffer CRPS dystonia.
So there is certainly some evidence of a link between CRPS and structural changes within the brain. However, as with so many aspects of CRPS, the exact nature of this link remains unknown.
Is there anything that can help?
Everyone develops their own coping mechanisms and strategies, whether it be simply making notes of everything through the day or engaging in activities that some believe can help memory such as meditation, Yoga or Tai Chi.
It is also thought that some supplements can aid brain function. Common examples are Ginkgo Biloba, Magnesium and Citicoline.
The brain is also very adept at healing itself, adapting to new situations and compensating for acquired limitations. Evidence suggests that this natural healing ability can be helped along by brain training activities and many examples are now available in the form of phone apps, computer programmes or books.