Complex Regional Pain Syndrome

Symptoms

Patients might experience pins and needles, burning or throbbing pain in the arm, hand, leg, or foot. The painful areas are sensitive to touch, temperature, and often swell in size. Joints can stiffen or swell, and muscles can spasm or be weak. A patient’s skin can be clammy or cold, white with red or blue spots, and tender, thin or shiny. CRPS patients often struggle with coordination, decreased mobility, abnormal posture, limb jerks, or tremors.

Causes

Complex regional pain syndrome is divided into two types: CRPS-1 (90%) and CRPS-2 (10%). CRPS-1 patients suffer an illness or injury and did not directly damage their nerves, while CRPS-2 patients have a distinctive nerve injury that is confirmed by a electromyography (EMG), or a nerve conduction study.

Treatments

Physicians use a variety of medications, therapies and procedures to treat CRPS.

Medications

Patients start with over-the-counter (OTC) pain relievers like aspirin, ibuprofen, and naproxen to reduce pain and inflammation. Physicians can also prescribe steroids (Prednisone) for inflammation, antidepressants (Amitriptyline) or anticonvulsants (Gabapentin) to relieve nerve pain.

Therapies

Patients can apply topical pain gels or creams to reduce sensitivity, and transcutaneous electrical nerve stimulation (TENS) to help relieve nerve pain. Gentle and supervised physical therapy can improve a patient’s strength and range of motion. Psychotherapy can help patients cope with depression, anxiety, or post-traumatic stress disorder that make pain worse.

Sympathetic Nerve Block Injection

Anesthesia is injected next to the spine to block sympathetic nerve activity, improve blood flow, and provide temporary pain relief.

Radiofrequency Ablation or Sympathectomy

Sympathectomy (cutting) or Radiofrequency ablation (burning) destroys nerves causing pain, and can be used favorably when sympathetic nerve blocks are only temporarily successful.

Spinal Cord Stimulation

Spinal cord stimulation (SCS) delivers mild electrical stimulation to nerves along the spinal column minimizing the sensation of pain. The treatment has been used successfully for 30 years, and includes a 3-10 day trial period to ensure success before surgically implanting in the body.

Pain Pump

A pain pump is surgically implanted to deliver medication directly to the spinal cord reducing the dosage required for pain relief, and limiting the side effects of oral medication.

Specialists

These doctors specialize in Complex Regional Pain Syndrome and can help diagnose, treat, and manage your condition.

Anesthesiologist

A doctor that administers medicine to put patients asleep during surgery, renders them numb for local procedures, or reduces chronic pain through injections. 

Physiatrist

A doctor specializing in physical medicine and rehabilitation that treats both acute and chronic pain with a variety of nonsurgical treatments.

Neurosurgeon

A surgeon that diagnoses and treats pain resulting from disorders of the spine, spinal cord, nerves, brain, intracranial, and intraspinal vasculature.

Orthopedic Surgeon

A surgeon that diagnoses and treats pain resulting from spinal disorders, arthritis, sports injuries, trauma, and fractures.