Complex Regional Pain Syndrome (CRPS)

The Complex Regional Pain Syndrome (CRPS) is a highly debilitating and painful condition developed after a traumatic injury of varying lengths.

It was first described by Mitchell, in the year 1864, during the period of the American Civil War. This one reported a picture of painful edema in one of the extremities of the body, after a firearm injury, in association with vasomotor and trophic alterations.

The International Association for the Study of Pain has suggested dividing CRPS into two distinct types, based on the presence of nerve damage following the injury:

  • Type I: also called reflex sympathetic dystrophy (RSD), Sudeck’s atrophy, neurovascular reflex dystrophy or algoneurodystrophy, has no apparent nerve damage.
  • Type II: formerly called causalgia, shows evidence of nerve damage.

The etiology of this syndrome has not been very well elucidated. However, it is known that among the precipitating factors are injuries and surgeries, although there are reported cases that do not present any identifiable injury.

This syndrome can affect individuals of all ages but is commonly diagnosed after 40 years of age. Although it affects both sexes, it presents itself in a 3:1 ratio (female: male). Cases reported in adults and adolescents have increased.


The clinical manifestations presented by this pathology usually appear close to the lesion site. The most frequent symptoms are the sensation of persistent and intense pain; muscle spasms may be present; local swelling, intense sweating; changes in skin temperature (ranging from cool to warm) and color (intense red to a reddish violet); weakening of bones; joint tenderness or stiffness and/or restriction of movement due to pain.

Should I See a Doctor?

We always recommend seeing a doctor when you have pain that doesn’t improve. CRPS is rare, but it is important to have the correct diagnosis so that the appropriate treatment can be started. Studies show that treatment responds better when started early.

Causes and Diagnosis of Complex Regional Pain Syndrome

Both emotional and physical stress can aggravate the pain caused by CRPS. Moving or touching the affected limb often causes unbearable pain. Diagnosis is basically made by observing the symptoms presented by the patient since there is no specific test for CRPS. However, some tests, such as thermography, sweat test, radiographs, and bone scintigraphy, can be useful in building a picture of the pathology in question.

Treatment of Complex Regional Pain Syndrome

The treatment of this syndrome is multidisciplinary, including the use of drugs and therapies, such as:

  • Physiotherapy and exercises;
  • Psychotherapy;
  • Sympathetic nerve blocks, encompassing sympathectomy surgery;
  • Epidural Injections
  • Spinal cord stimulation;
  • Medications such as pain relievers, antidepressants, corticosteroids, and opioids.

Delay in the diagnosis and/or treatment of CRPS can lead to severe physical and psychological problems. Conversely, early recognition and treatment offer more significant opportunities for patient recovery. 

Combining over 18 years of experience, Dr. Munish Lal specializes in minimally invasive techniques to treat CRPS that includes intervention procedures, spinal cord stimulation, and a comprehensive array of traditional pain management services.

His expertise ranges from diagnosing complicated and rare cases to pinpointing the source of back, neck, and other chronic pain conditions. He is a leading practitioner of state-of-the-art techniques. Call now to book your appointment!

To schedule an appointment with Dr. Lal, visit our scheduling page or call 424-254-3592.