Which factor tends to aggravate CRPS and extend beyond the original injury?

• A. Immobilization
• B. Activity and extending distal to the original injury
• C. Rest
• D. Cold exposure

Answer: (B)

In CRPS, ongoing abnormal signaling between nerves and the autonomic system can cause the pain pattern to grow beyond the initial injury and involve distal areas. The factor that most tends to aggravate CRPS and push symptoms to extend beyond where the injury started is activity and use of the affected limb. Movement and functional use maintain nociceptive input and can drive sustained sympathetic and central sensitization, leading the symptoms to spread to adjacent or distal regions.

Immobilization or rest are associated with worsening stiffness and deconditioning, but they’re not the primary driver of symptom spread. Cold exposure can worsen vasomotor symptoms, but it doesn’t typically explain why CRPS would extend beyond the original injury as readily as ongoing activity and use does.