What is Complex Regional Pain Syndrome and How is it Treated

What is Complex Regional Pain Syndrome and How is it Treated

You may sprain your wrist or ankle, or drop something heavy on your foot, but after routine treatment, your injury is fully healed. That’s the end of that problem, right? Maybe not. For some, the pain continues, turning into an intense pain that doesn’t go away. If this sounds familiar, chances are you have complex regional pain syndrome (CRPS).

The pain that complex regional pain syndrome causes is often hard to treat with conventional therapies. At Neurological Associates of West Los Angeles, we’ve helped many patients obtain pain relief with a variety of interventional procedures.

Complex regional pain syndrome fits its name

The name says it all. Complex regional pain syndrome is a complex nerve condition, it affects a region such as one arm, leg, hand, or foot, and it definitely causes pain. This ongoing pain originally begins with a trauma or an injury, but then CRPS develops when your pain continues long after the initial injury heals.

There are two types of CRPS, based on the triggering event:

Type I CRPS, originally called reflex sympathetic dystrophy, occurs after you suffer an injury such as a fracture, sprain, cut, or burn. Surgery, a needle stick, or a tight cast can also trigger Type 1 CRPS.

Type 2 CRPS, originally called causalgia, occurs when your pain is due to a confirmed nerve injury.

With or without a confirmed nerve injury, all types of CRPS develop due to damaged nerves. The injured nerves affect blood vessels and lead to sensitization of the peripheral and central nervous systems, which means your nerves become overly sensitive to sensations that shouldn’t cause pain.

Complex regional pain syndrome symptoms

CRPS cause a wide range of symptoms, including:

Chronic pain

The pain often feels worse than the original trauma. Many patients describe their pain as intense and burning.

Skin changes

The skin in the affected area becomes red, swollen, and hypersensitive to touch and temperature. You may also experience changes in skin color, temperature, and texture. Hair and nail growth in the area may also change.

Muscle and joint problems

CRPS often causes poor coordination and limits your ability to use the affected limb. Patients often develop muscle and joint pain, muscle weakness, tremor, or uncontrollable muscle contractions called dystonia.

Interventional treatments relieve complex regional pain syndrome

A complex condition like CRPS — which affects your nerves, skin, joints, and muscles — requires a multimodal approach. The first line of treatment typically begins with pain-relieving medications and physical therapy. A well-structured exercise program that promotes movement of the affected limb is important because it improves circulation, flexibility, strength, and function.

But let’s face it, first-line medications may not relieve your pain. Additionally, it’s a challenge to stick with physical therapy when you’re in pain. That’s where we can help.

At Neurological Associates of West Los Angeles, we specialize in interventional pain medicine, which includes numerous treatments that effectively relieve CRPS pain by targeting the nerves responsible for sending pain signals to your brain.

Here are a few examples of the diverse interventional treatments we provide for CRPS:

Sympathetic nerve block

We perform a sympathetic nerve block by injecting an anesthetic next to the spine, where the nerve responsible for your pain enters the spinal cord. As the anesthetic surrounds the nerves, it blocks nerve transmission. Your brain doesn’t receive the pain message, so you can’t feel the pain. In many cases, we also add steroids to the injection to reduce swelling.

Spinal cord stimulator

A spinal cord stimulator is a medical device that’s implanted under your skin, where it’s attached to wires placed along your spine, next to the nerves causing your pain. The device sends a mild electrical current through the wires to the nerves, which blocks or masks the pain signals going to your brain.

Ketamine infusion

Ketamine is an anesthetic used during surgical procedures, where it has such a proven safety record that it’s often recommended for children. But when we use a low dose, or sub-anesthetic dose, of ketamine, it becomes a highly effective pain reliever.


Chemodenervation refers to injecting botulinum to alleviate the pain that muscle spasms cause, as well as neuropathic pain.

If you have CRPS and conventional treatments haven’t helped, call Neurological Associates of West Los Angeles to learn about interventional treatment options that can relieve your pain and help restore optimal function.

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