At Modern Pain Consultants, we treat a variety of conditions that cause extremity pain including achilles tendinitis, cervical or lumbar radiculopathy, complex regional pain syndrome, diabetic neuropathy, heel spurs, phantom limb pain, plantar fasciitis, and sacroiliac joint pain. One of the most common of these disorders is Complex Regional Pain Syndrome (CRPS), also known as Reflex Sympathetic Dystrophy (RSD), and Causalgia.
What is Complex Regional Pain Syndrome (CRPS)?
Complex Regional Pain Syndrome (CRPS) is defined by the International Association for the Study of Pain as “describing a variety of painful conditions following injury which appears regionally having a distal predominance of abnormal findings, exceeding in both magnitude and duration the expected clinical course of the inciting event, often resulting in significant impairment of the motor function, and showing variable progression over time.”
What causes CRPS?
CPRS can occur spontaneously or following an injury. However, unlike the normal process of an acute injury, the symptoms of CRPS become chronic and can progress in intensity. The exact causes of CPRS are still being researched, but the development of its clinical manifestations have been attributed to disturbances in the body’s inflammatory responses, the remodeling of the central processing of pain sensation, sympathetic nervous system dysfunction, and impaired motor functioning.
What are the symptoms of CRPS?
Although the hallmark symptom of CRPS is continuing pain in an extremity disproportionate to any inciting event, there are several additional clinical features to the disorder. Clinical symptoms can be divided into 4 subgroups:
- Sensory- hypersensitivity to stimuli
- Vasomotor- temperature and skin color changes
- Sudomotor- edema, dry skin, sweating
- Motor- weakness, stiffness, loss of use, tremor, decreased muscle tone, loss of hair, dystrophic nails, and skin changes
How is CRPS Diagnosed?
Proper diagnosis of CRPS starts with an experienced pain management specialist. Our team at Modern Pain Consultants will perform a detailed history and thorough physical exam to diagnosis CRPS. Testing may include x-rays, MRI and/or CT scans, and EMG.
How is CRPS treated?
CRPS must be treated with a multidimensional approach including conservative measures, therapy, medication, and intervention techniques. Rehabilitation and psychotherapy will improve functional activity and well being. Medication therapies such as anti-inflammatory, antidepressant, anti-seizure, and analgesic drugs may be implemented to decrease inflammation and pain.
Intervention Techniques for CRPS include:
- Sympathetic Nerve Blocks offer a diagnostic and therapeutic role in treatment of CRPS. Stellate ganglion (arms and hands) and lumbar sympathetic (legs and feet) are common sites used to control pain in the upper and lower limbs.
- Neuro-modulation with spinal cord stimulation implantation has been proven to provide pain relief in two-third of patients suffering from CPRS.
- Intracthecal Pain Pump for administration of baclofen (for spasicity) or pain medication has been shown to improve dystonia, pain, and quality of life.
CRPS pain no longer has to be debilitating thanks to Modern Pain Consultants. Our pain team will work with you to decrease your overall pain, increase functionality, and overall outcomes!
We offer on-site Spinal Cord Stimulator (SCS) trails for the treatment of CRPS. A SCS trail allows the patient to determine if the therapy is right for them after living with a temporary device and evaluating its effectiveness. We understand that not every treatment is best for every patient, but we are dedicated to customizing the right therapies for you.