Chronic regional pain syndrome (CRPS)
Chronic regional pain syndrome (CRPS)
What is complex regional pain syndrome?
Complex regional pain syndrome (CRPS) is a pain syndrome that can develop spontaneously or after injury. CRPS is characterized by local and widespread pain, skin color changes and swelling. It is also very difficult to treat. Conventional treatments include NSAIDs, anticonvulsants, physical therapy, or nerve blocks.
What are typical symptoms of CRPS?
Persistent, severe pain is the primary symptom of complex regional pain syndrome. It may spread to the entire arm or leg even when the injury and pain began in your hand or foot. The affected area may be so hypersensitive that the gentlest touch feels painful.
You may also experience:
- Changes in skin temperature, color, or texture
- Swelling of the affected limb
- Changes in hair or nail growth
- Stiff joints in the affected area
- Decreased movement in the affected limb
- Tremors or jerking in the affected limb
When CRPS goes untreated, it can worsen, causing tissue deterioration or muscles that tighten and freeze into a fixed position.
Types of CRPS
CRPS is typically divided into 2 types
Type I: Type I CRPS occurs after an illness or injury that didn’t directly cause nerve damage.
Type II: Type II CRPS develops after observable nerve damage.
Both types can be either chronic (long-lasting) or acute (short-term).
Treatment options
At Libertas Mind we recognize CRPS as a disease process with emotional and physical components. We offer treatments to address both.
Nearly 40% of chronic pain patients also have a clinical diagnosis of Major Depression or MDD. Our treatments focus on long term change by targeting neuroinflammation and glial cell activation, which are implicated in the development of chronic pain conditions as well as depression.
If your not satisfied with your treatment options for depression or pain, consider the options below.
1 - Ketamine as an Option for CRPS
At Libertas Mind we find ketamine to be a helpful option for CRPS particularly to control “flares” or acute worsening of the condition. The mechanism by which Ketamine improves pain is still being researched, here are some things we do understand:
Ketamine blocks N-methyl-D-aspartate (NMDA) receptors. These receptors are involved in the amplification of pain signals and are overactive in patients with chronic pain. By inhibiting NMDA receptors, ketamine reduces abnormal pain signaling and may help “reset” dysfunctional pain pathways.
2- Esketamine or Spravato to help your mood
Esketamine or Spravato is a derivative of ketamine and is covered under most plans to treat major depression. Because major depression is common in patient’s suffering chronic pain, patients should be screened for mental health and treated accordingly. If you looking for a new option to treat depression consider esketamine. Esketamine is not approved for the treatment of pain. It does have a unique of action and works differently than traditional antidepressants. It doesn’t cause weight, sexual function but can only be administered in a providers office.
Major depression is common in patient’s suffering chronic pain. Patients should be screened for their mental health and treated accordingly.
Esketamine is not approved for the treatment of pain. It does have a unique of action and works differently than traditional antidepressants. It doesn’t cause weight, sexual function but can only be administered in a providers office.
3 - Pain management Options for CRPS
Research consistently shows that prompt diagnosis and treatment improve long-term outcomes and significantly lower the risk of disability.
Specialists in our pain division offer advanced interventional pain management for CRPS 1 & 2. Our goal is to provide long-lasting relief for patients struggling with chronic nerve pain, particularly when conventional treatments have failed.
Peripheral Nerve Stimulation (PNS)
Peripheral Nerve Stimulation is a minimally invasive procedure that delivers mild electrical pulses to targeted nerves, interrupting pain signals before they reach the brain.
We offers a short-term trial to assess effectiveness—if the patient experiences at least 50% pain relief, a permanent device is implanted for long-term pain management.
Spinal Cord Stimulation (SCS)
Spinal Cord Stimulation is a well-established treatment for chronic nerve pain conditions like CRPS.
This therapy involves implanting a small device that sends electrical impulses to the spinal cord, effectively blocking pain signals.
Like PNS, SCS begins with a trial phase, ensuring that the patient experiences significant relief before permanent implantation.
Sympathetic Nerve Blocks
For patients with CRPS-related nerve dysfunction and pain, sympathetic nerve blocks can provide significant but temporary relief, often as part of a comprehensive treatment plan.
These injections target the sympathetic nervous system, reducing pain and improving mobility. Many patients experience progressive relief after a series of injections.
Dorsal Root Ganglion (DRG) Stimulation
A specialized neuromodulation therapy that targets nerve clusters responsible for CRPS, providing precise and lasting relief.
Advanced Epidural Injections
Delivers anti-inflammatory medication precisely to affected nerves, reducing swelling and pain with enhanced accuracy.
Medication Management for CRPS
We use evidence-based medication strategies for CRPS-specific nerve pain. Unlike general pain clinics, we focus on neuropathic pain relief, using medications such as:
- Nerve pain modulators (e.g., gabapentin, pregabalin)
- Topical anesthetics (e.g., lidocaine patches)
- Selective muscle relaxants for targeted symptom control.
We carefully monitor medication plans to minimize side effects while maximizing relief for patients with treatment-resistant CRPS.
