An extremely uncommon condition, complex regional pain syndrome typically affects the extremities, starting in the foot or hand and spreading proximally to the leg or arm. Historically CRPS has gone by other names such as RSD – reflexive sympathetic dystrophy, Sudecks atrophy, shoulder-hand syndrome in stroke patients, and reflex neurovascular dystrophy. CRPS that occurs after a traumatic event and is termed causalgia or type II, otherwise it may occur without known factors and this is termed as CRPS type I. Once other potential factors have been eliminated as the cause of the pain and using specific diagnostic criteria one can make CRPS diagnosis. There are also different stages (stage 1-3) that exhibit various symptoms that may include intense burning or aching pain, swelling, skin discoloration, temperature changes, hair changes, atrophic changes and excessive sweating. Although it may spontaneously resolve it often mistaken for other diagnosis early on, the key to optimizing relief and function is early diagnosis by a physician trained in managing CRPS and an aggressive multidisciplinary treatment program. At Salem Pain & Spine Specialists, we have many different treatment options available depending on the stage and effects of CRPS.
There are certain tests that may aid in the diagnosis and may also help exclude other diseases such as radiculopathy, peripheral neuropathy or entrapment neuropathy. Additional testing may be ordered to help aid the diagnosis. The diagnosis of CRPS is often made based on clinical history and physical exam along certain diagnostic criteria.
Early diagnosis and treatment will bring better outcomes. Physical therapy plays a strong role in helping return to function in this stage of the diagnosis and prevent further damage and disuse atrophy. There are many different medication choices that can be tried. There is not a single “fix all” medication, in as much as a combination of different medications that may be tried in order to combat this painful condition. Support groups and counseling therapy are also helpful in helping to cope with chronic pain. Minimally invasive injections like sympathetic blocks are diagnostic and may be recommended in a series to stop the pain if caught early enough. Others may benefit from Spinal Cord Stimulation therapy. If you have questions if you are a candidate for spinal cord stimulation therapy (neuromodulation) as an option please let us know.