Complex Regional Pain Syndrome (CRPS) is a disproportionate response of the body to trauma, with or without an obvious nerve injury, and usually affects the arms or legs. It is characterized by severe pain, swelling, limited range of motion, temperature changes, sweating, skin changes, and regional osteoporosis. It is also known as reflex sympathetic dystrophy (RSD).
CRPS affects people at a rate of 5 to 25 per 100,000 people. It is two to four times more common in females than males. Post-menopausal females tend to be affected more than anyone else.
Causes of Complex Regional Pain Syndrome
There are Two Types of CRPS
Type I is usually caused by some type of injury without a definable lesion to a nerve in a limb, such as your hand, arm, foot or leg. Examples of injuries that can cause CRPS Type I include fractures, sprains, crush injuries, or even surgeries.
Type II (previously known as “causalgia”) is caused by a definable nerve injury. While the exact cause of CRPS is unknown, it is likely secondary to inflammation and involves maladaptive responses to pain by the central nervous system (the brain and spinal cord).
CRPS can be diagnosed based on:
Symptoms, including pain, swelling, limited range of motion, color changes, and even changes in the hair or nails of the affected limb
Physical examination of the effected part of your body
Imaging studies, including X-rays and bone scintigraphy
Tests to look at the health of your nervous system, like Autonomic Battery Testing and QSART
Confirming a diagnosis of CRPS by a doctor is very important because there are other conditions that can look a lot like CRPS. It is important that your doctor rules out other potential causes of your pain. These can include infection, blood clots, and problems with your circulation. If you are diagnosed with one of these conditions, your treatment plan will look very different than the treatment for CRPS.
Treatment for Complex Regional Pain Syndrome (CRPS)
At the Denver Spine and Pain Institute, we recommend conservative treatments whenever possible. In treating CRPS it is very important to start treatment as soon as possible after the diagnosis is made. Patients who are treated earlier have a higher likelihood of remission. It is also very important to use a multidisciplinary approach, in an effort achieve the best possible outcome. Treatment options include:
Physical therapy – The goals of physical therapy are to improve mobility and decrease pain.
Medication – Anti-inflammatory medications, anticonvulsants, antidepressants, muscle relaxants, and other medications can provide relief of symptoms, making it easier for you to participate in physical therapy.
Injections – If the combination of physical therapy and medications do not provide enough relief, injections may deliver longer-term relief of your symptoms. Common injections for the treatment of CRPS include stellate ganglion blocks if you have pain in your arm or hand, and lumbar sympathetic plexus blocks if the pain is in your leg, ankle, or foot. Image guidance is necessary to precisely target the nerves that are creating your pain. Our doctors will use either ultrasound or fluoroscopy (x-ray) to perform the injection. The injections include both corticosteroids (anti-inflammatories) and local anesthetics (numbing medication).
Behavioral Health Treatments – CRPS and other chronic pain conditions not only affect your body, but they can affect your mind as well. They have an impact on the way you interact with your family, your ability to perform your job, and participate in leisure activities you previously enjoyed. Behavioral health can be an effective and valuable part of your treatment plan. Pain psychologists and therapists can help you navigate through these struggles and provide support on your journey to recovery.
Neuromodulation – When other treatments such as physical therapy, medications, and injections fail to provide adequate relief of your symptoms, neuromodulation can be an excellent treatment option. Neuromodulation involves placing small electrodes over nerves and/or the spinal cord. Energy is then delivered to the intended target to help block pain signals from the affected area. This can provide profound relief for patients whose pain is refractory to other treatments.
CRPS can significantly impact the quality of your life, making it hard to perform routine daily tasks and participate in your favorite activities. Fortunately, you don’t have to live with this pain any longer. At the Denver Spine and Pain Institute, we offer the most advanced treatments to alleviate your pain, helping you enjoy life again.
We’re the only sports, back and pain specialists in the country providing a Connected Care Approach™ specifically designed to get you back to enjoying life faster. This approach involves:
A full spectrum of care, including physicians, physical therapy, massage, diet and lifestyle coaching, behavioral health, research, and cutting edge treatment options
Developing caring and therapeutic relationships that address your unique needs
Discussing options and providing the guidance you need from a dedicated healthcare partner
Mobilizing an experienced team who coordinates your care program
Schedule an Appointment
Please contact us today to schedule an appointment. The Denver Spine and Pain Institute serves patients in Denver and the surrounding areas of Colorado.