Medications, Interventional Pain Management, and Counseling
Providing treatment early to complex regional pain syndrome (CRPS) patients is vital to delaying the damage and relieving the pain caused by CRPS. While there is no cure for CRPS (which used to be called reflex sympathetic dystrophy—RSD), there are a number of treatments. Your doctor will most likely refer you to a physical therapist and a psychological counselor, as well as administer or prescribe pain medications for CRPS.
Physical Therapy for CRPS/RSD
Physical and occupational therapy help CRPS patients maintain motion in their affected joints. There are also techniques that can reduce pain by rehabilitating damaged nerves.
The majority of CPRS patients use more than one pain medication. The medications that have performed well in clinical trials for CPRS include:
- oral steroids
- the anti-seizure drug gabapentin (for example, Neurontin)
- the hormone calcitonin (in a nasal spray)
- topical patches and creams
These medications help reduce the pain, inflammation, and damage from CRPS. Some tricyclic antidepressants, opioid pain relievers, and blood pressure medications also help patients beat back the symptoms. Patches containing lidocaine and similar pain-relievers work for some patients, while a few respond to over-the-counter pain relieving topical creams. In addition clonidine in a patch form may help with small areas of hyperalgesia.
IVs and Interventional Pain Management Treatments for CRPS
Doctors have been administering IVs, sympathetic nerve blocks, epidurals, and other related interventions for decades with the hope of relieving CRPS symptoms.
Spinal cord stimulation is also showing some promise as an experimental CRPS treatment.
While there are many cases of individuals responding well to these treatments, there is still little data about the true likelihood of their effectiveness. But when your symptoms are severe and other treatments are not working well, you may be willing to try some treatments that are still undefined.
Patients with severe CRPS symptoms should consider starting with a minimal risk procedure such as a nerve block.
Finally, experimental surgeries have a small chance of helping where no other treatments have. Some patients have achieved relief after a sympathectomy—a procedure that destroys painful nerves. A small minority of CRPS patients have neurosurgery to implant electrodes in their brain in an attempt to interrupt the constant pain signals registering there.
There is promising research being performed that uses mirror box therapy, in which patients are trained to move an unaffected limb front of a mirror. Injections and topical applications of ketamine has shown some promise, as have low-current electrostimulation therapy (Calmare).
Counseling and Social Support for CRPS
If you are living with CRSP, you know that the changes your life significantly. You will certainly need support from your families and friends, as well as from behavioral health professionals. Behavioral health professionals can help you learn techniques for confronting the changes in your life and strengthening your coping skills. Their treatments will help avoid anxiety or depression—conditions that could just make your CRPS/RSD more agonizing.