Complex Regional Pain Syndrome (CRPS) Treatment in Castle Rock
What is CRPS?
Complex regional pain syndrome (CRPS) is a chronic pain condition that usually affects an arm or leg, typically after an injury, surgery, or other trauma. The pain is disproportionate to the original injury - what started as a sprained wrist, a fracture, or a surgical recovery develops into severe, persistent pain that does not resolve the way it should.
CRPS occurs because the nervous system begins processing pain signals abnormally. Instead of the pain fading as the injury heals, the nervous system continues sending amplified pain signals long after the tissue has recovered. The affected limb may become extremely sensitive to touch, change color or temperature, swell, or develop skin and nail changes.
Types of CRPS
CRPS Type 1 (formerly called reflex sympathetic dystrophy or RSD): Occurs after an injury or illness but without confirmed nerve damage. This is the more common type, accounting for about 90% of cases.
CRPS Type 2 (formerly called causalgia): Occurs after a confirmed nerve injury. The symptoms are similar to Type 1, but there is identifiable nerve damage.
What are the Symptoms of CRPS?
CRPS symptoms can vary in severity and may change over time. Common symptoms include:
Persistent burning, throbbing, or aching pain that is out of proportion to the original injury
Extreme sensitivity to touch - even light contact with clothing or a breeze can cause severe pain (called allodynia)
Changes in skin temperature - the affected limb may feel warmer or colder than the opposite side
Changes in skin color - the limb may appear red, blue, purple, or blotchy
Swelling in the affected area
Changes in skin texture - the skin may become thin, shiny, or sweaty
Changes in nail and hair growth on the affected limb
Joint stiffness and muscle weakness - reduced range of motion and muscle wasting over time
Difficulty using the affected limb for normal activities
What Causes CRPS?
The exact cause of CRPS is not fully understood. It appears to involve abnormal responses in both the peripheral and central nervous systems after an injury. Common triggers include fractures, sprains, surgery (especially wrist or ankle surgery), immobilization in a cast, and even minor injuries. In some cases, no clear trigger is identified.
Not everyone who has an injury develops CRPS. Risk factors may include being female, certain genetic predispositions, and having other inflammatory or autoimmune conditions. Early recognition and treatment are critical because CRPS tends to respond best when treated early in its course.
How is CRPS Diagnosed?
There is no single test for CRPS. Diagnosis is based on clinical criteria - the combination of your symptoms, physical findings, and the exclusion of other conditions that could explain the pain. Dr. Carrera's team evaluates the affected limb for pain patterns, temperature and color changes, swelling, skin changes, and motor dysfunction.
Imaging (MRI, X-ray) and nerve testing (EMG) may be ordered to rule out other conditions such as nerve compression, fracture, or infection. The Budapest criteria are commonly used to standardize the diagnosis.
When Should I Seek Evaluation?
If you have persistent pain after an injury or surgery that seems disproportionate to the original problem, especially if accompanied by color changes, temperature changes, swelling, or extreme sensitivity in the affected limb, seek evaluation promptly. CRPS responds best to early treatment. Waiting months before starting therapy can make the condition more difficult to manage.
How is CRPS Treated?
CRPS treatment requires a multidisciplinary approach. There is no single treatment that works for everyone, and most patients benefit from a combination of therapies.
Physical and occupational therapy: This is foundational for CRPS. Gentle, graded exercises help maintain range of motion, prevent muscle wasting, and gradually desensitize the affected limb. Mirror therapy - using a mirror to create a visual illusion of the unaffected limb moving in place of the painful one - can help retrain how the brain processes signals from the affected area.
Medications: Nerve-calming medications like gabapentin and pregabalin help reduce the amplified nerve signals. Topical treatments including lidocaine patches and capsaicin cream may provide localized relief. Low-dose naltrexone and certain antidepressants (duloxetine, amitriptyline) are sometimes used for their pain-modulating effects. NSAIDs and acetaminophen are generally less effective for CRPS because the pain is nerve-driven rather than inflammatory.
Sympathetic nerve blocks: Injections that temporarily block the sympathetic nerves (stellate ganglion block for upper extremity CRPS, lumbar sympathetic block for lower extremity CRPS) can provide relief and help confirm a sympathetic component to the pain. If blocks provide temporary relief, a series of blocks may be recommended.
Spinal cord stimulation (SCS): For patients with CRPS that has not responded adequately to medications, therapy, and nerve blocks, spinal cord stimulation is one of the most effective advanced treatments available. CRPS is one of the best-studied indications for SCS. The trial-first approach allows you to test the device for about 6 days before deciding on a permanent implant.
Peripheral nerve stimulation (PNS): For CRPS affecting a specific limb or nerve territory, peripheral nerve stimulation may target the affected nerve directly.
Can CRPS Get Better?
Yes - especially when treated early. Some patients achieve significant improvement or even remission with aggressive, early treatment. Others have a more chronic course that requires ongoing management. The key is starting treatment promptly and using a combination of physical therapy, medications, and interventional procedures. The longer CRPS goes untreated, the more the nervous system adapts to the abnormal pain state, making it harder to reverse.
Schedule an Evaluation
If you have persistent pain after an injury or surgery that is not improving the way it should, Dr. Carrera's team can evaluate for CRPS and develop a treatment plan. Early intervention makes a significant difference in outcomes.