Complex Regional Pain Syndrome

Complex regional pain syndrome (CRPS) is a debilitating, chronic pain condition that usually affects an arm or leg following an injury, surgery, or stroke. CRPS is believed to be a disorder of the nervous system. Specifically, a dysfunctional interaction between your central and peripheral nervous systems and inappropriate inflammatory responses. CRPS is classified into two types:

⦁ Type 1 CRPS, formerly called reflex sympathetic dystrophy (RSD), usually follows a minor injury that doesn’t cause nerve damage, like a sprained ankle or surgery. This accounts for 90% of cases.

⦁ Type 2 CRPS, formerly called causalgia, develops after a more severe injury or an infection that damages a nerve.

Hallmark symptoms and signs of CRPS were defined in the Budapest Criteria below:

⦁ Persistent, severe pain, disproportionate to the inciting event

⦁ Often CRPS is progressive and worsens over time.

⦁ Hypersensitivity or allodynia (severe pain with stimuli that would otherwise not be painful, like light touch)

⦁ Temperature difference, skin color changes

⦁ Swelling or edema

⦁ Decreased range of motion, stiffness, weakness, withering of the extremity

Early diagnosis and treatment of CRPS is critical in successful treatment. The Interventional Pain Doctors team of orthopedic and pain management specialists can diagnose CRPS during a comprehensive history and physical examination. In addition, we may also request diagnostic tests such as an MRI, blood tests, EMG/NCS. 

Early diagnosis and treatment of CRPS is critical in successful treatment.

⦁ In mild cases of CRPS, physical therapy +/- medications may be sufficient to overcome symptoms and regain function.

⦁ In more severe cases, the Interventional Pain Doctors team of orthopedic and pain management specialists may employ special injections, called sympathetic nerve blocks to reset the body’s malfunctioning nervous system in addition to physical therapy.. 

⦁ In severe, refractory cases we may recommend a trial of neuromodulation (SCS) to change how your body is perceiving pain in addition to physical therapy.

Studies have shown that high dose vitamin C after a wrist fracture may have a lower risk CRPS compared with those who did not.