Complex Regional Pain Syndrome

What is Complex Regional Pain Syndrome (CRPS)?

CRPS is a chronic pain condition (extending past six months) that most often affects the limbs (arms, legs, feet, or hands). CRPS has typically developed in patients after an injury, a surgery, or a stroke. Living with a chronic, painful condition like CRPS can be challenging. The healing process starts with talking with your doctor about ways to improve your quality of life. Treatment is most effective when started early.

What are the two types?

Type 1: Reflex Sympathetic Dystrophy Syndrome (individuals without confirmed nerve injury)

Type 2: Causalgia (individuals with confirmed nerve injury)

What are some symptoms?

• continuous burning or throbbing pain
• sensitivity to touch or cold
• joint stiffness, swelling and damage
• decreased ability to move the affected body part
• abnormal sweating pattern in affected area

Steps in Diagnosing & Managing your CRPS:

1. Clinical Examination
2. Diagnostic Nerve Block (Ultrasound-Guided): To identify the nerve involved

What treatments are available?

• Sympathetic Nerve Blocks (Stellate Ganglion Block/Lumbar Sympathetic Block)
• Continuous Nerve Catheters
• Peripheral Nerve Blocks
• Intravenous Ketamine
• Peripheral Nerve Stimulation
• Radio Frequency Ablation
• Cryoanalgesia
• Physical Therapy / Medications

Complex Regional Pain Syndrome (CRPS) Q & A

What is complex regional pain syndrome?

CRPS is a chronic condition involving damage to or the malfunction of the peripheral and central nervous system. Your central nervous system is made up of your brain and spinal cord, while your peripheral nervous system comprises all the other nerves in your body, which send and receive signals from the central nervous system.

There are two types of CRPS:

1. CRPS-I: Once called reflex sympathetic dystrophy syndrome, CRPS-I occurs when there is no confirmed injury that could have damaged your nervous system.
2. CRPS-II: Previously called causalgia, in cases of CRPS-II, you have experienced a confirmed injury associated with nerve injury.

What causes complex regional pain syndrome?

Experts don’t know why some people develop CRPS and others don’t. About 90% of cases of CRPS are categorized as CRPS-II and are associated with a previous injury. Injuries that can lead to CRPS are varied and include:

• Fracture
• Sprain or strain
• Soft tissue injuries like bruises, cuts, or burns
• Being in a cast
• Surgery
• Minor procedures (even a needle stick)

Anyone at any age can develop CRPS, but it is more common in women and people around the age of 40; it is least common in elderly people and children.

What are the symptoms of complex regional pain syndrome?

Constant pain is the most common symptom of CRPS, especially in your arm, leg, hand, or foot. Other symptoms include:

• Muscle spasms, tremors, or weakness
• Changes in skin color, texture, or temperature
• Sensitivity to cold or to touch
• Swelling in the area that hurts
• Changes in hair or nail growth
• Reduced ability to move the part of the body that hurts

What treatments are available for complex regional pain syndrome?

There is no cure for CRPS, but there are treatments that can address the symptoms and relieve the pain.

Physical therapy, psychotherapy, and pharmacological treatments are successful for some people. If those approaches are unsuccessful, Dr.Gin-Ming Hsu, MD may suggest:

• Nerve blocks: an injection that numbs the nerve and prevents it from sending pain signals to the brain
• Implanted drug pump: a device that delivers medication that disrupts pain signals sent to the brain
• Spinal cord stimulator implant: sends electrical pulses that prevent pain signals from reaching the brain

In serious cases, Dr.Gin-Ming Hsu may recommend other nonsurgical treatment options.

If you’re living with unexplained, debilitating pain, book an appointment with Dr.Gin-Ming Hsu,MD for a consultation to start down a path to a more comfortable life.