Welcome to Pain and Spine Clinics

Complex regional pain syndrome (CRPS) is a chronic pain condition characterized by inflammation of a specific area often with color changes (redness or paleness) in the skin. The area could also undergo temperature changes, hot or cold. Lasting six months or more, CRPS often occurs in a leg or an arm. It can also be limited to a hand or a foot.


Other symptoms include:

— Joint stiffness

— Muscle spasms

— The ability for the condition to spread, even to non-adjacent areas (from one arm to the other, for example)

— changes in nail and hair growth

There are many options for treating CRPS. They include physical, occupational or rehabilitative therapy

The condition appears after an injury or a surgical procedure, but it can also appear after an event such as a needle insertion (like when you get a vaccination) or having a cast removed from a healed limb.


Pain Not Directly Associated With Original Injury


The pain, however, is not associated with the injury. Instead, the condition is thought to be caused by an injury to either the central or peripheral nervous system. The central nervous system is the spinal cord and the brain. The peripheral nervous system is made up of the nerves that connect to the rest of your body.


Type I CRPS and Type II CRPS


When there is no known nerve damage or injury, the diagnosis given is Type I CRPS. When specific nerve damage is identified, the diagnosis given is Type II CRPS. However, the treatment is often the same for each type.


The condition is also associated with middle age, occurring most often near the age of 40 and more often with women than men. Children can also be affected, but this is rare and it is almost unheard of for children under five.


There are many options for treating CRPS. They include physical, occupational or rehabilitative therapy.


Other options include:

Medication: including bisphosphonates, non-steroidal anti-inflammatory drugs, corticosteroids, antidepressants, anti-seizure medication, botulinum toxin injections, opioids, N-methyl-D-aspartate receptor antagonists and topical anesthetic creams.


Neural modulation: also known as high-frequency stimulation, this involves placing electrodes close to the spinal cord or the afflicted nerves and sending high frequency (10 kHz) pulses to the area. This does not treat the pain, but it disrupts the pain signals from going to your brain. A recent study by Boston PainCare found that patients with high-frequency stimulation implants used significantly lower doses of opioid medication to manage pain a year after starting the treatment.


Sympathetic nerve block: This involves injecting an anesthetic close to the spine to block the pain from reaching your brain.

Intrathecal Drug Pumps: A pump is used to administer analgesic drugs directly into spinal cord fluid, allowing for faster relief than oral medication. In addition, far less of the drug is required, which reduces the likelihood of side effects, such as drowsiness.