Complex Regional Pain Syndrome

Diagnosis

Diagnosis of complex regional pain syndrome (CRPS) is based on a physical examination and review of medical history. There is no single test that can confirm the condition, but certain diagnostic procedures can provide helpful clues.

• Bone scan: Detects bone changes using a radioactive substance injected into a vein, viewed with a special camera.

• Sweat production tests: Measure the amount of sweat on both limbs; uneven sweating may indicate CRPS.

• X-rays: May show mineral loss from bones in later stages.

• MRI: Reveals tissue changes and helps rule out other conditions.

Treatment

Early diagnosis and treatment can improve outcomes. Most people require a combination of therapies tailored to their needs.

Medications
Several types of medicines may help manage symptoms:

• Pain relievers such as aspirin, ibuprofen or naproxen for mild pain.

• Prescription pain medicines, including low-dose opioids, for severe pain.

• Antidepressants and anticonvulsants such as amitriptyline or gabapentin for nerve pain.

• Corticosteroids like prednisone to reduce inflammation and improve mobility.

• Bone-loss medicines such as alendronate or calcitonin.

• Sympathetic nerve-blocking medications to relieve pain.

• Intravenous ketamine in low doses to ease chronic pain.

• Blood pressure medicines including prazosin, phenoxybenzamine and clonidine to help control pain.

Therapies
Various therapies can help improve function and reduce pain:

• Heat therapy to ease swelling and discomfort.

• Topical analgesics such as capsaicin cream or lidocaine patches.

• Physical or occupational therapy for movement and strength recovery.

• Mirror therapy to retrain the brain and improve limb function.

• Transcutaneous electrical nerve stimulation (TENS) to relieve chronic pain.

• Biofeedback techniques to manage pain through relaxation and awareness.

• Spinal cord stimulation using implanted electrodes for pain relief.

• Intrathecal drug pumps that deliver pain medicine directly into spinal fluid.

• Acupuncture to stimulate blood flow and ease discomfort.

CRPS can sometimes recur due to triggers such as cold exposure or emotional stress. Mild antidepressants or other medications may help prevent recurrences.

Coping and Support

Living with CRPS can be physically and emotionally challenging. Educating friends and family about the condition may help them understand your experience.

Helpful strategies include:

• Maintain normal activities as much as possible.

• Balance activity with adequate rest.

• Stay connected with loved ones and support networks.

• Continue hobbies that bring enjoyment and relaxation.

• Seek professional support from therapists or counselors for coping skills such as relaxation and meditation.

• Consider joining a support group for people living with chronic pain or CRPS.

Preparing for Your Appointment

To get the most from your appointment, prepare in advance.

What you can do:

• Write down symptoms, their severity and when they began.

• List questions for your healthcare provider, such as:

  • What is causing my symptoms?

  • What tests do I need?

  • Is this condition temporary or long-term?

  • What treatments do you recommend?

  • Are there alternative approaches or generic medicine options?

  • Where can I find more information or support?

What to Expect from Your Doctor

Your provider may ask questions such as:

• Have you had a recent injury, infection or surgery?

• When did your symptoms begin?

• Is the pain constant or intermittent?

• Does anything make your symptoms better or worse?

• Have you experienced similar symptoms before?

Being prepared with detailed answers can help your provider develop an effective treatment plan.