How is complex regional pain syndrome (CRPS) treated?

Treatment for complex regional pain syndrome is designed to help people suffering from the disorder stop their pain. One treatment option is medicine. People with complex regional pain syndrome can take pills, like over-the-counter painkillers or prescription medications, to dull the pain they feel. Therapeutic treatment is also available to help stop pain. Some of the therapies doctors offer include slow exercise, the application of creams of hot and cold temperatures, and body relaxation, among others. Doctors can also teach individuals with complex regional pain syndrome how to change their lifestyles in such a way that they avoid pain.
Donna Hill Howes, RN
Family Medicine
Since there is no cure for complex regional pain syndrome (CRPS), treatment is aimed at relieving painful symptoms so that people can resume their normal lives. The following therapies are often used:
  • Physical therapy: A gradually increasing exercise program to keep the painful limb or body part moving may help restore some range of motion and function.
  • Psychotherapy: CRPS often has profound psychological effects on people and their families. Those with CRPS may suffer from depression, anxiety, or post-traumatic stress disorder, all of which heighten the perception of pain and make rehabilitation efforts more difficult.
  • Sympathetic nerve block: Some patients will get significant pain relief from sympathetic nerve blocks. Sympathetic blocks can administered in a variety of ways. One technique involves intravenous administration of phentolamine, a drug that blocks sympathetic receptors. Another technique involves placement of an anesthetic next to the spine to directly block the sympathetic nerves.
  • Medications: Many different classes of medication are used to treat CRPS, including topical analgesic drugs that act on painful nerves, skin, and muscles; antiseizure drugs; antidepressants, corticosteroids, and opioids. However, no single drug or combination of drugs has produced consistent long-lasting improvement in symptoms.
  • Surgical sympathectomy: The use of surgical sympathectomy, a technique that destroys the nerves involved in CRPS, is controversial. Some experts think it is unwarranted and makes CRPS worse; others report a favorable outcome. Sympathectomy should be used only in patients whose pain is dramatically relieved by selective sympathetic blocks.
  • Spinal cord stimulation: The placement of electrodes next to the spinal cord provides a pleasant tingling sensation in the painful area. This technique appears to help patients with their pain. Intrathecal drug pumps: These pumps are devices that administer drugs directly to the spinal fluid. With their help, opioids and local anesthetic agents can be delivered to pain-signaling targets in the spinal cord at doses far lower than those required for oral administration. This technique decreases side effects and increases drug effectiveness.
This answer is based on source information from the National Institute of Neurological Disorders and Stroke.

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