When I first began my practice of pain management, I once treated a patient for Complex Regional Pain Syndrome. My patient was in his mid-teens and had been suffering from CRPS since he was 12 years old. Then, he had a marble-sized cyst removed from his right posterior wrist. After his surgery, he began to experience intense neuropathic pain when the surrounding skin became more sensitive to touch. As his nerve pain progressively got worse, his family sought help at the pain management clinic. Due to his age, he was too young to be treated by narcotics. Both the physician and I recommended that he continue using Lyrica for his nerve pain. In addition, we referred him to a physical therapist to maintain mobility in his right hand and arm, and a psychiatric consult to discuss his feelings of depression.
Chronic Regional Pain Syndrome (CRPS)
● Complex Regional Pain Syndrome is chronic pain that tends to affect the arms and legs. After an injury, surgery, or stroke, pain develops from damage caused to the peripheral sensory neurons.
● Complex Regional Pain Syndrome (CRPS) consists of multiple symptoms of pain that includes allodynia (extremely sensitive to touch), hyperalgesia (abnormal response to pain, unusual sensitivity to pain), and possible loss of function.
● Very rare, CRPS is seen mostly in the lower extremities and occurs more in females than males.
● Symptoms may include difficulty using the affected area and spontaneous aching, throbbing, burning or tingling pain. In addition, there may be a change in skin temperature or numbness as the affected extremity may feel dull or fake.
● The most effective treatment plan for complex regional pain syndrome combines the following: physical therapy, the management of depression and anxiety that may accompany the condition, and the use of Gabapentin, Lyrica, or Amitriptyline for managing neuropathic pain.
References
Gupta, G. (2018). Complex Regional Pain Syndromes Clinical Presentation. Retrieved from
https://emedicine.medscape.com/article/1145318-clinical.
Pfieffer. (2021). [Illustration]. November is CRPS awareness month, background with ribbon. Retrieved
from https://www.shutterstock.com/image-illustration/november-crps-awareness-month-background-ribbon-1210712545.
Roa, T. (2021). Complex Regional Pain Syndrome Type 1 (Reflex Sympathetic Dystrophy). Retrieved from
https://emedicine.medscape.com/article/334377-overview.