Complex regional pain syndrome (CRPS) affects 2-5% of people with a peripheral nerve injury in the U.S. It is the most painful chronic condition that exists ranking higher than amputation and natural childbirth.
There are many options for complex regional pain syndrome treatment. Read further to learn more about available therapies.
What Is CRPS?
The National Organization for Rare Disorders (NORD) recently designated CRPS as a rare disease, which are conditions that affect less than 200,000 people in the U.S. You may have also heard it called reflex sympathetic dystrophy (RSD).
CRPS (or RSD) is a chronic and debilitating condition that often occurs after trauma to an extremityIt usually begins in a foot or hand, but it can spread to other parts of the body.
There are two types of CRPS:
- Type I – the initial injury is unknown (90% of cases)
- Type II – the initial injury to the nerve is known
There is no cure for this disease but there is effective management. The hallmark of which is early treatment because this leads to a better outcome and prognosis. CRPS can happen to anyone at any age, but it peaks at age 40. It is also more common in women. CRPS is rarely found in the elderly and children under the age of 10.
Signs That You May Have CRPS
The main symptom seen in CRPS is a long-term, severe, and persistent pain. People who have CRPS describe the pain as a “burning” or “pins and needles” sensation. This tends to be out of proportion to the injury. Due to the pain, patient’s will start to restrict using the affected limb. This leads to a loss of range of motion in addition to the severe pain.
You may have other symptoms such as sweating, swelling, thin skin, and abnormal hair growth. Interruption of the perception of your “body scheme” can also occur. This happens when there is confusion over your perception of how your body moves and feels. An example is not being able to touch your finger to your nose during a neurological exam.
Complex Regional Pain Syndrome Treatment
You may feel overwhelmed or feel unable to cope with the excruciating pain of this condition. But there are effective treatment options. These include:
- Physical Therapy
- Medications including nerve pain medications
- Nerve blocks
- Neuromodulation including Spinal cord stimulation, Dorsal Root Ganglion Stimulation, Peripheral Nerve stimulation. Drug pumps
- Ketamine Infusions
There is no one-size-fits-all treatment plan for CRPS. You should receive a personalized treatment plan that is the right fit for you and your symptoms. Early treatment increases the likelihood of its success.
Spinal Cord Stimulation
The placement of a spinal cord stimulator may be a more suitable treatment option for you if conservative treatment has failed. Due to the opioid crisis in the U.S., this may be a better choice for controlling your severe pain.
Research shows that spinal cord stimulation is more effective than opioids for nerve pain. But these medications are often prescribed, and spinal cord stimulation isn’t used as frequently as it should be.
The decision to have a spinal cord stimulator implanted may be the answer to a reduction or resolution of your pain.
The procedure involves a small incision in the upper buttocks to implant the pulse generator. Your doctor will place a needle in your back near the spinal cord.
There are several types of spinal cord stimulators available.
- Fully implanted device with a pulse generator
- Devices with a rechargeable pulse generator that charge through the skin
- Fully implanted devices that don’t need recharging
- External devices with internal wires
You can adjust the intensity of the electrical current or turn it on and off if you experience any side effects on some devices.
What Are the Pros and Cons of a Stimulator?
One of the major advantages is that a spinal cord stimulator is minimally invasive and reversible if necessary. Side effects are minimal when compared to CRPS treatment medications. Additionally, being able to adjust the amount of pain relief gives patients control over their condition.
As with any medical procedure or treatment, there are risks involved. With a spinal cord stimulator, these can include:
- Effectiveness varies for each person
- Pain or infection at the implantation site
- Rarely, hemorrhage, nerve damage, and paralysis
Overall, these devices are safe treatment alternatives. Serious problems are rare. Most issues involve the device itself.
What Does the Future Hold?
The National Institute of Neurological Disorders and Stroke (NINDS) currently has ongoing research studies regarding CRPS. Some of the studies concern the ways that CRPS develops, the role of inflammation, and the ability of the nervous system to form new nerve cells.
Future research may include the study of patients who would most benefit from available treatments. The future of treatment options for CRPS may involve a combination of therapies as seen with other chronic diseases.
The Bottom Line
The prognosis of CRPS varies. Approximately 70% of patients will improve within a year but only 5% will see a complete resolution.
Some people may find it hard to cope with CRPS because of the severity and persistence of pain. Depression, insomnia, and anxiety are common. The inability to perform certain activities of daily living can also cause emotional stress.
You may need more support at certain times to deal with your condition. Finding a therapist that you can talk with to help you put your feelings into perspective is very helpful. You can learn coping skills and techniques such as progressive muscle relaxation or mindfulness meditation. Joining a support group where others face the same disabilities is helpful for many with this disease.
Complex regional pain syndrome treatment can be a trial-and-error process. What works for one person may not work for you. Having a trusting relationship with your doctor will go a long way towards a mutual agreement on a treatment plan that is right for you.
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