Complex Regional Pain Syndrome
Complex regional pain syndrome (CRPS), also known as reflex sympathetic dystrophy (RSD), is a chronic condition that typically worsens with time. It is characterized by severe pain and sensitivity, swelling, and changes in the skin. In most cases, CRPS affects one limb at first, after which it spreads throughout the body.
While the exact cause of CRPS is not known, it is associated with dysregulation of the central nervous system and autonomic nervous system resulting in multiple functional loss, impairment and disability. Often it is injury and/or surgery that precipitate the condition, though the cause is not always obvious.
CRPS usually manifests near the site of an injury. The most common symptoms are pain sensations, including burning, stabbing, grinding, and throbbing. The affected limb becomes hypersensitive, and often cannot be moved without significant pain. Symptoms can also include;
- Muscle spasms
- Local swelling
- Extreme sensitivity to sensations such as wind and water, touch and vibrations
- Abnormally increased sweating
- Changes in skin temperature (usually hot but sometimes cold) and color (bright red or a reddish violet)
- Softening and thinning of bones
- Joint tenderness or stiffness
- Changes in nail and hair growth
- Restricted and/or painful movement.
At Restore Medical Partners, your physician will perform a physical examination demonstrating tenderness over certain areas as well as assessing limitations in movement. The doctor will evaluate the extent of your restricted movements, the amount of pain produced, and your sensory function. Your physician may also order radiological imaging such as X-ray, CT scan, MRI, EMG or bone scan depending on their clinical suspicion and the history obtained.
There are two types of CRPS:
- Type I, also known as reflex sympathetic dystrophy (RSD), does not exhibit demonstrable nerve lesions. As the vast majority of patients diagnosed with CRPS have this type, it is most commonly referred to in medical literature as Type I.
- Type II, formerly known as causalgia, has evidence of obvious nerve damage. Type II CRPS tends to feature the more painful and difficult-to-control symptoms of CRPS.
At Restore Medical Partners, our physicians are the premier choice for diagnosis and treatment of complex regional pain syndrome (CRPS). We offer treatments not found anywhere else in Sarasota County including:
- Sympathetic Nerve Blocks: The procedure involves inserting a small, fine needle through the skin to the origins of the sympathetic nervous system. When the nerves are blocked, pain relief can be dramatic for some individuals. Procedures that focus on the face and upper extremities include the stellate ganglion block and brachial plexus nerve block. Lumbar sympathetic nerve blocks are commonly performed for CRPS in the lower extremities.
- Infusions Techniques: We offer ketamine infusions to re-program the central nervous system, and pain relief can be dramatic and long-lasting.
- Spinal Cord Stimulation: This method involves tiny electrodes being placed within the epidural space close to the spinal cord. The electrodes release a small electrical current to the spinal cord that inhibits pain transmission, thereby providing pain relief.
- Peripheral Nerve Stimulation: This method involves tiny electrodes being placed close to the affected nerves. The electrodes release a small electrical current that inhibits pain transmission and provides pain relief.
- Medical management: Important, pharmacological treatments for medical management of CRPS can be membrane stabilizing drugs, NSAIDs, or opiate-like medications.
- Physical therapy: In order to decrease or prevent functional limitations, physical therapy and occupational therapy are recommended in combination with medical treatments.