Severe Severitychronic

Complex Regional Pain Syndrome

Complex Regional Pain Syndrome (CRPS) is a form of chronic pain that usually affects an arm or leg and typically develops after an injury, surgery, stroke, or heart attack. The pain is out of proportion to the severity of the initial injury and is characterized by autonomic, sensory, and motor dysfunction.

Symptoms

Severe burning pain disproportionate to the inciting event
Allodynia (pain from light touch)
Edema and swelling of the affected limb
Skin color and temperature changes
Sudomotor changes (sweating abnormalities)
Motor dysfunction (weakness, tremor, dystonia)
Skin and nail changes

Causes

Post-traumatic (fracture, sprain, surgery)
Post-surgical
Post-stroke (central CRPS)
Idiopathic (no identifiable trigger)
Immobilization after injury

Diagnosis

Accurate diagnosis is essential for effective treatment. Clinicians typically use a combination of:

Budapest Clinical Criteria (2003, revised 2010)
Triple-phase bone scintigraphy (sensitivity 65-96%)
Thermography
Quantitative sensory testing
Sudomotor testing
X-ray for osteopenia

Treatment Approaches

Early aggressive physical therapy and graded motor imagery

Pharmacotherapy: Neuropathic agents (gabapentin, duloxetine), bisphosphonates

Interventional: Sympathetic nerve blocks, IVIG, spinal cord stimulation

Psychological support and pain neuroscience education

Related Procedures

Spinal Cord Stimulation

Spinal cord stimulation (SCS) delivers low-voltage electrical impulses to the dorsal columns of the spinal cord, masking pain signals before they reach the brain. Modern SCS systems include traditional tonic stimulation, high-frequency (10 kHz) stimulation, and burst stimulation patterns.

🚨 Red Flags

Seek urgent medical evaluation if you experience any of the following:

⚠️ Rapidly progressive tissue changes
⚠️ Skin ulceration or necrosis
⚠️ Severe unrelenting pain unresponsive to all treatments

Frequently Asked Questions

Dr. Shahnawaz F Shah

Interventional Spine & Pain Physician

Dr. Shah specializes in the diagnosis and management of complex regional pain syndrome using evidence-based approaches tailored to each patient's needs.

Book a Consultation

Medical Disclaimer: The information on this page is for educational purposes only and does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional for personalized evaluation and management.