Complex Regional Pain Syndrome (CRPS)

Complex regional pain syndrome is a type of chronic pain thought to be the result of damage to the peripheral or central nervous system. The damage is usually the result of an acute injury to a limb. Furthermore, the malfunctioning nervous system results in continued pain after the injury has healed.

Two Types of Complex Regional Pain Syndrome:

There are two forms of complex regional pain syndromes: CRPS I and CRPS II. Complex Regional Pain Syndrome I was formerly called reflex sympathetic dystrophy, and is the name given to prolonged or excessive pain and changes in temperature or skin color accompanied sometimes by swelling in the absence of a confirmed nerve injury. CRPS II is characterized by the same symptoms, but the patients classified with CRPS II have confirmed nerve injuries.

Various Forms of Pain:

The syndromes are characterized by pain over a prolonged period that may often be constant and severe. Some patients describe the pain as burning or as a “pins and needles” sensation. The syndrome sometimes results in Complex Regional Pain Syndromeextreme sensitivity to touch. The sensory changes can extend beyond the area of the initial injury, to include the entire limb or even the opposite limb.

Other Symptoms:

Because the central nervous system affects the nerves that control temperature and blood flow, patients with CRPS may simultaneously experience temperature changes, changes in skin color, and changes in the texture of the skin. The syndrome may result in changes in sweating in the affected area, or in difficulty with movement of the affected limb or abnormal movements that include tremors or abnormal position.

Most cases of CRPS are mild and resolve gradually over time. However, some individuals experience severe symptoms and may have long-term disability as a result. There is uncertainty to the cause of CRPS, although some data suggest immune system involvement, and genetic predisposition. Both peripheral nerves and blood vessels are involved in causation of the pain associated with this syndrome.

Treating CRPS:

If you are experiencing unrelieved pain after an injury has healed, or if you notice abnormal skin changes in color, temperature or sensitivity to touch, you should contact us for an appointment to begin ruling out other causes. The diagnosis of complex regional pain syndrome is a diagnosis of exclusion in part, which means that testing will be done to rule out other serious conditions. Treatment is available, and evidence suggests early treatment is associated with a better prognosis. There are multiple treatment modalities in use for this complex and debilitating problem.

Spinal Cord Stimulation for CRPS:

Here at Metropolitan Pain Consultants, we offer two forms of stimulators: traditional spinal cord stimulation (SCS) and BurstDR stimulation.

While similar on many levels, SCS and BurstDR differ in their approach to transmitting signals. SCS therapy traditionally uses tonic stimulation to deliver electrical energy that interrupts the transmission of pain signals to the brain. As a result, patients often note a tingling sensation throughout their body as mild pulses are sent to the brain. This feeling is called paresthesia.

While traditional SCS is still very effect, researchers and physicians now understand that effective coverage of chronic pain needs alternative stimulation to achieve a higher level of success. BurstDR was built, in part, to fill this void.

BurstDR delivers rapid pulses of electrical energy to a patient’s spinal cord to manage chronic pain. This new form of therapy may be the best option for patients whose pain is not yet controlled by an SCS and for patients whose pain is not adequately controlled by their current SCS. BurstDR is also able to deliver therapy with little-to-no paresthesia and may be more effective than tonic stimulation.

Finally, please call today to make an appointment for evaluation by one of our physicians. We offer weekday and weekend appointments. You can find us at our conveniently located clinics in West OrangeAberdeen, and Lyndhurst.