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Beverly A. Whittenberg, MD
Treating Chronic Regional Pain Syndrome
National Spine & Pain Centers
. http://www.treatingpain.com

Treating Chronic Regional Pain Syndrome

Treating Chronic Regional
Pain Syndrome

Complex regional pain syndrome (CRPS) is a pain disorder that affects the musculoskeletal and nervous systems in one or more extremities. This condition almost universally follows trauma to the involved extremity; usually in the wrist, hand, ankle or foot.

Potential causes of this condition range from minor injuries such as a sprain to severe injuries such as direct nerve damage or fractures.

The syndrome can occasionally occur following orthopedic surgery, particularly arthroscopy. Rarely, the syndrome occurs spontaneously without any known inciting event.

One of the unique characteristics of CRPS relates to the presence of pain appearing out of proportion to what one would expect from the original traumatic event.

In this instance, a person may have sprained their ankle or suffered a fracture but, nonetheless, developed prolonged or severe pain. In addition, there are other unusual features of CRPS including hypersensitivity to touch in and around the area of injury, temperature changes (hot or cold), excessive sweating, and swelling.

If CRPS is left untreated, it can lead to muscle weakness, stiffness, and impaired use of the limb. Therefore, it is important to embark on treatment when symptoms first present themselves in order to prevent worsening of the pain cycle and to limit the development of weakness or restriction in range of motion.

The diagnosis of CRPS is primarily based on the presenting symptoms and physical examination findings. However, a three-phase bone scan may on occasion be used to confirm the diagnosis. In some instances, other types of sympathetic nervous system tests can be utilized.

Treatment outcomes are variable but are best accomplished with early intervention. Typically, patients will receive some form of local anesthetic injection such as an epidural nerver block or sympathetic nerve block.

These injections performed under fluoroscopic (x-ray) guidance interrupt the pain cycle and also improve circulation to the involved extremity. There are also a variety of medications that can be employed including analgesics, anticonvulsants, and even antidepressants. Physical therapy helps to improve range of motion and strength.

In the most resistant cases, spinal cord stimulation is often very effective. Spinal cord stimulation (SCS) is an innovative technology that addresses some of the most difficult pain problems experienced, such as CRPS. If you suffer from CRPS, spinal cord stimulation (SCS) may enable you to control and relieve your pain.

Early, aggressive, and comprehensive treatment of CRPS is critically important in achieving a successful outcome.

Board certified pain specialists have experience in identifying CRPS and can get you started with the numerous treatment options available to relieve your symptoms and help stop pain from interfering with your life.

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