Complex regional pain syndrome (CRPS) is a difficult problem to treat, partly because the underlying mechanism is poorly understood. Several approaches are used to create a unique treatment plan for those affected by CRPS.

Medications

Several medications may be used to control pain. In some cases, narcotic pain relievers may be appropriate to manage unrelenting pain. Narcotics can be combined with anti-inflammatory medications to reduce nerve inflammation, which is the main culprit in CRPS pain. Other medications can include anticonvulsants that are used in pain management, such as gabapentin, and those used in conditions like diabetic neuropathy. Since CRPS is a chronic condition that often becomes worse over time, the ideal situation is to gain control over pain with fewer medications with a high addiction potential. Another option is the use of low doses of injectable ketamine, which are administered in a medical setting and may reduce or alleviate pain for several days with a single dose.

Minimally Invasive Procedures

Different types of minimally invasive procedures can help temporarily alleviate the pain of CRPS. One option is sympathetic nerve blocks. The doctor will need to perform nerve function testing to determine the specific nerves responsible for pain. Once the location is established, medication is injected into the nerve root to anesthetize the nerve. Like other pain-relieving options, the results are only temporary. Depending on the exact nerve that is causing pain, anesthetizing the nerve can cause new problems, such as problems with motor function.

Neurostimulation may decrease pain in some people with CRPS. The nerves can be stimulated at the spinal cord or peripheral level. The use of neurostimulation is similar to treating other types of pain with transcutaneous electrical nerve stimulation (TENS), but the patient has a device inserted to directly access the nerve. Pain can be reduced if another signal reaches the brain before a pain signal. With neurostimulation, the patient can adjust the intensity of the signal based on their level of pain.

Surgical Procedures

In rare cases, surgery may be performed on people with CRPS. There is no widely accepted surgical procedure to reduce pain; therefore, surgical options are often experimental. Severing of the sympathetic nerve that is causing pain can theoretically improve the problem. To determine whether this procedure is an option, the patient must experience a substantial reduction in pain when the nerve is anesthetized. Since cutting the nerve inflicts controlled damage, there is the possibility of causing more pain. Additionally, the nerves have some regenerative properties and the damaged ends could potentially grow back together.

Treating CRPS requires a multifaceted approach to reduce pain and improve functioning. With a greater understanding of the condition, better, more effective options are on the horizon. For more information, contact a medical center that specializes in neurological services and treatment.