A recent diagnosis of Complex Regional Pain Syndrome (CRPS) in a 10-year-old girl at Rambam Health Care Campus (Rambam) has highlighted a growing health concern among children in Israel. A poorly understood pain condition, CRPS is increasingly being identified in young patients, with stress-related factors playing a significant role in its onset.
Zohar, a young girl from Northern Israel, was evacuated from her home for over a year due to daily missile fire from Hezbollah. For six months, she suffered from severe and unexplained leg pain before finally receiving a diagnosis at Rambam’s Pain Medicine Institute. Her journey included visits to multiple doctors and hospitals across the country, undergoing numerous tests – including blood work, X-rays, and MRIs – all of which failed to identify a physical cause for her pain.
Her mother, Efrat, recalls the frustration and helplessness of the search for answers. “We saw so many specialists, from orthopedists to neurologists, but no one could explain why Zohar was in so much pain. Each visit ended with more questions than answers.”
After months of inconclusive consultations, Zohar was referred to Rambam and finally diagnosed with complex regional pain syndrome (CRPS). Many people, especially adults, live with the syndrome for many years, while others decide to avoid the severe pain and give up the limb in which the pain is concentrated. Children can also suffer from the syndrome, like Zohar, and after intensive treatment they can also recover. Dr. Ayelet Morag, a pediatric pain specialist at Rambam, explains: “CRPS is characterized by pain that is completely disproportionate to any injury—or occurs without an injury at all. It often affects the extremities, such as the hands or feet, and can be debilitating. When treated appropriately and in a timely manner, complete healing is possible, allowing individuals to forget it ever happened. However, without proper or timely treatment, the condition can progress to the point where the affected hand or foot becomes dysfunctional.”
Dr. Lihi Isidora Mansano, director of the Day Hospitalization Unit in the Azrieli Foundation Pediatric Rehabilitation Center at Rambam, notes a worrying rise in cases and links the increase to emotional distress from recent events, including the Swords of Iron War and the COVID-19 pandemic. “The emotional toll of these events has significantly increased CRPS cases in children,” she explains.
At Zohar's age, intensive and focused rehabilitation work can help prevent the CRPS from deteriorating quickly, as well as aid in recovery. Physicians at Rambam recommended that Zohar go to Sheba Tel Hashomer Hospital for intensive treatment, including daily physiotherapy, occupational therapy, and psychological support. After a month and a half, Zohar condition improved, and she was referred back to Rambam’s Pain Medicine Institute.
“Now I can do push-ups and splits, and I can touch my foot without pain. It’s really exciting,” Zohar shares, reflecting on her recovery.
Her case is not isolated. Just two months after her diagnosis, a close friend of hers was also diagnosed with CRPS. Thanks to Zohar’s experience, her friend was able to receive timely treatment.
Doctors warn that CRPS is becoming more prevalent in both children and adults worldwide. Dr. Mansano emphasizes the importance of early diagnosis: “The number of cases has risen globally, not just in Israel. The emotional and psychological impact of prolonged pain can worsen symptoms over time. Early diagnosis and proper rehabilitation are essential for recovery.”
Health professionals urge parents and caregivers to be aware of CRPS and seek medical attention if a child experiences severe, persistent pain that seems out of proportion to any injury or has no clear cause. Symptoms such as burning pain, sensitivity to touch, swelling, or changes in skin color and temperature should not be ignored. Early intervention is key to managing this complex condition and improving quality of life.
Based on a Hebrew language article from N12
