Understanding complex regional pain syndrome (CRPS) is the first step if you or someone you love is living with this difficult condition. CRPS is a chronic nerve disorder that usually develops in an arm or a leg after a severe injury, surgery, or sometimes even a mild trauma. This condition is so painful that it’s colloquially referred to as the “suicide disease” in some cases. Early diagnosis and prompt treatment give patients the best shot at easing symptoms and managing the condition effectively.

Common treatments for CRPS

Treating CRPS almost always requires a plan that adjusts as your needs change. There is no single “fix” or cure, but the earlier care begins, the better the outlook. Treatment is often comprehensive and varied.

Medications commonly used

Doctors use a range of medicines to treat pain, inflammation, and specific nerve changes associated with CRPS.

• NSAIDs/Anti-inflammatories: NSAIDs and anti-inflammatory drugs like ibuprofen can relieve minor pain and swelling, though they rarely control the deeper nerve symptoms associated with CRPS.
• Nerve Pain Medication: Nerve pain medications such as gabapentin or pregabalin work directly on nerve signaling and can be effective for burning or shooting pain.
• Antidepressants: Certain antidepressants are used off-label to relieve neuropathic pain. They don’t cure CRPS, but can bring meaningful symptom
• Steroids: Corticosteroids may be considered early in the inflammatory phase of CRPS; they help reduce swelling, heat, and inflammation.
• Opioids: Opioids are reserved for severe cases where function is extremely limited and pain is overwhelming. Any use is generally short-term and closely watched due to the risk of dependency or limited results for this type of pain.

In some cases, more than one of these medications will be used.

Physical and occupational therapy

Using the affected limb may feel impossible, but failing to use it often makes the condition worse. Daily movement plays an enormous role in preventing, as much as possible, muscle wasting, loss of flexibility, and stiffness. 

• Range of motion: These exercises involve slowly moving the affected joint or limb through controlled motions that stretch it just beyond its regular limit, while carefully avoiding pain. Practicing this over time can keep the joint loose and combat a gradual loss in flexibility and movement.
• Desensitization: This process helps retrain your nerves by gradual exposure to gentle, soft materials, such as different fabrics, brushes, water, or vibration, on the sensitive area. This can teach the nerves to respond less strongly, making routine touch less painful.
• Mirror therapy: This is a specialized technique often used for people with CRPS. A mirror is placed so that the patient can see the reflection of their healthy limb moving as they perform exercises with the affected limb. The idea is that the brain is “tricked” into associating the normal movement and appearance of the unaffected limb with the affected side. This process can help reduce pain, remap nerve pathways, and encourage greater comfort with movement.
• Prevent atrophy: Focus in this area is on building healthy muscle by gently moving, stretching, or squeezing muscles in the affected area, even if only for a short period of time. The routine movement helps stimulate blood flow, strengthen weakened muscles, and maintain as much normal muscle function as possible.
• Energy conservation: Certain strategies in therapy can help you plan your daily activities so you don’t overdo it and end up in a significant flare. This includes tasks like pacing yourself, prioritizing chores, using rest breaks, or spreading out activities.

Short but frequent sessions of physical and occupational therapy can make a significant difference for those with CRPS.

Advanced and interventional treatments

Cases that are severe or long-lasting tend to call for advanced treatment options. These therapies require hands-on guidance from highly trained specialists, and can help when other options haven’t worked.

Nerve blocks

Doctors sometimes inject local anesthetics near specific nerves, often along the sympathetic nerve chain, to temporarily reduce pain signaling. Relief from these injections may last for hours, days, or even weeks, with one primary goal being to temporarily reduce or interrupt pain signaling pathways in a person’s body. In some cases, successful nerve blocks can make it easier to participate in physical therapy or allow for more comfortable movement.

Spinal cord stimulation

Spinal cord stimulators use electrical impulses along thin wires implanted near the spine. The goal is to block or mask these pain signals before they reach the brain and become incredibly painful. People with severe and treatment-resistant CRPS who have not responded to regular medications, blocks, or therapies may be good candidates for this type of treatment. For many people, this significantly reduces the level of pain they experience, though outcomes vary on an individual basis.

Ketamine infusions

For severe, spreading, and otherwise unresponsive CRPS, low-dose intravenous ketamine may be considered by specialists to reduce abnormal pain signaling and provide short-term pain relief. Ketamine infusions are typically considered when regular pain medications, therapy, or nerve blocks have provided little or only short-term relief. When done in a clinical setting by a specialist, many people experience a meaningful reduction in pain, sometimes enough to resume physical therapy or reclaim important parts of their daily lives.

Bisphosphonates

These drugs can reduce inflammation and slow the abnormal process involved in some CRPS patients, potentially lessening pain and swelling. They are best used early on, and generally become less effective if used too long after the condition develops. This is a particularly common treatment in Europe, with some patients even flying out of the country to get intravenous bisphosphonate infusions.

Each person’s journey with CRPS is incredibly individual and is often full of trial and error. Whether your CRPS is new or ongoing, being proactive about simple and advanced options is critical. If you have any questions about a possible CRPS legal case or what to do next in your journey, our team can help. At The CRPS Law Firm, we can review your situation and can point you in the right direction. Call us today to schedule a free consultation.