Complex Regional Pain Syndrome

Having chronic pain in your arms or legs can be debilitating and greatly decrease your enjoyment of life. It could also be a sign that you have complex regional pain syndrome or CRPS. A trip to Downtown Pain Physicians can determine if this is the cause of your pain symptoms and help you get on the road to recovery.

Let’s look a little deeper into what CRPS syndrome is, what causes it, the symptoms you might be experiencing if you have CRPS, and what the best course of treatment is.

What Is Complex Regional Pain Syndrome

Complex regional pain syndrome (CRPS) is a type of chronic pain that typically develops in a person’s arms or legs after a stroke, heart attack, surgery, or a significant injury. It’s a fairly uncommon condition that’s not completely understood. The good news is that with early care and treatment, improvement and possibly even complete relief is possible.

CRPS is also referred to as reflex sympathetic dystrophy syndrome. It’s believed that this condition happens when there is a disruption in the way the central or peripheral nervous system is working. When CRPS is present, nerve impulses are sent to the affected site, causing noteworthy and sometimes debilitating pain.

What Causes CRPS

It’s not completely understood what causes CRPS to begin. In many situations it seems to be brought on by an injury or an event that affects the peripheral and central nervous system. It is believed that it might be a disruption in the healing process and might lead to a slower recovery time from another medical condition. No matter exactly what the cause is, CRPS arises as a secondary condition when patients have the following as a primary condition:

• Heart attach
• Stroke
• Cancer
• Surgery
• Infections
• Neck problems
• Nerve pressure
• An accident or injury

Not everyone who has these conditions will develop CRPS and it’s known why the people that do develop it have CRPS. It’s also possible to have CRPS once and then have a similar primary condition occur again and not experience CRPS.

Types of CRPS

To try to understand CRPS better, it has been classified into two types. Both types have similar symptoms, but the causes are different.

CRPS Type 1: This is when you’re most likely to hear the term reflex sympathetic dystrophy (RSD). This type occurs after an illness or injury that didn’t directly damage nerves in the affected limb. This is the most common type of CRPS, and it affects about 90{05a8d96492cce27d71583af6205ade31ed6672395d6849035e9173443c5fe38c} of the people who are diagnosed with this condition.

CRPS Type 2: This version of CRPS was once referred to as causalgia. Unlike Type 1, in this situation the nerves that are injured or where an infection was involved are the ones causing the pain symptoms.

While both types of CRPS have different causes, direct and indirect, the symptoms are relatively similar with chronic pain being the biggest complaint.

Symptoms of CRPS

The symptoms of CRPS can be different, not only different from one individual to the next but they can change and present differently over time. Symptoms from CRPS have also been known to move around, sometimes even jumping from one limb to the opposite one. One overarching characteristic is that they seem to be an exaggeration of the pain that one would expect from the instigating illness or injury. Some symptoms include:

• Pain that has a burning feeling
• Sensitivity to cold or touch
• Swelling and related stiffness in joints
• Decreased range of motion
• Changes in hair or nail growth patterns
• Skin changes to include sensitivity, appearance, and texture
• Excessive sweating
• Muscle spasms and tremors
• Weakness or even atrophy

While these symptoms have been known to go away on their own, in some people, without any medical intervention, other people experience pain for long periods of time and can have permanent pain. This is why it’s very important to seek treatment early. The earlier care can begin, the better the prognosis is for recovery.

CRPS Diagnosis

Unfortunately, there is no easy way to diagnosis CRPS. It can’t be found by a blood test, bone scan, or an x-ray, but these types of tests can rule out other conditions. Your doctor at Downtown Pain Physicians may do a number of diagnostic tests to determine what is causing your pain. This is done to eliminate other potential causes.

You’ll also be asked to give a detailed history of any injuries, medical procedures, or conditions you’ve recently experienced. Expect to be able to detail your pain symptoms, when they started, where they’ve started, list the symptoms, and describe any changes in symptoms you’ve experienced. This data is very useful in making a CRPS diagnosis.

Treatment for CRPS

There is no specific cure for CRPS, the goal, instead, is to relieve and treat the symptoms. It’s very likely that a combination approach will be recommended to treat the symptoms and that can include psychological support, medication, and physical treatment to include physical therapy and other modalities. In most situations, treatment will have a four-pronged approach.

• Education and self-management techniques will begin the treatment program so each patient knows what to expect and how they can manage and improve their own symptoms.
• Pain relief may come in a variety of forms including medication and physical therapy or modalities to relax nerves, joints, and muscles.
• Physical rehabilitation works to relieve pain but it’s also necessary to prevent long-term physical problems or a progression of symptoms.
• Psychological support can help the patient accept the changes that have happened and manage life with chronic pain.

Going beyond the classifying your treatment, these treatment approaches may be recommended.

• Psychotherapy
• Physical Therapy
• Topical Analgesics
• Narcotics
• Corticosteroids
• Antidepressants
• Antiseizure medications
• Sympathetic nerve blocks
• Surgical sympathectomy
• Intrathecal drug pumps
• Spinal cord stimulation
• Treatments

Please understand that when you start your treatment journey at Downtown Pain Physicians, we will work with you to see what approach works best for you, giving you the most pain relief possible and ensuring the best long-term solution.

Meet Your Doctors

Dr. Raj Raval, M.D.

Top-Rated Interventional Pain and Musculoskeletal Medicine Specialist
Dr. Raj Raval is an Interventional Pain & Musculoskeletal Medicine Specialist. As part of the best rated team of pain management doctors in New York City, he uses the most effective pain management and pain control treatment options using the latest technologies available.

Dr. Raj Raval, M.D.

• Board certified
• Interventional Pain & Musculoskeletal Medicine Specialist
• Member of: AAPMR, Spine Intervention Society (SIS), North American Spine Society, American Society of Interventional Pain

Dr. Daniel P. Spunberg, M.D.

High-Ranking Specialist in Interventional Pain and Musculoskeletal Medicine
Dr. Daniel Spunberg is a triple board-certified physician in the specialties of Physical Medicine and Rehabilitation, Spinal Cord Injury Medicine, and Sports Medicine. Using the latest technology and modern state-of-the art care, he is a well-respected part of our team of pain management doctors in New York City. Working closely with his patients, he prides himself on developing rapport to help individuals find the pain solutions they seek.

Dr. Daniel P. Spunberg, M.D.

• Board certified
• Interventional Pain & Musculoskeletal Medicine Specialist
• Member of: AAPMR, AMA, Spine Intervention Society (SIS), North American Spine Society, NY State Society of Physical Medicine & Rehabilitation

Dr. Raphael Jaramillo, M.D.

Dr. Jaramillo is a fellowship-trained Interventional Physiatrist. He completed his residency at NYU Langone Medical Center and NYU Orthopedic Hospital in Physical Medicine and Rehabilitation where he managed a variety of neurological, rheumatologic, and orthopedic conditions. He went on to further subspecialty training in Interventional Spine, Sports, and Musculoskeletal Pain Medicine at Rutgers-NJMS University Hospital and the top nationally ranked Kessler Institute for Rehabilitation.

Dr. Raphael Jaramillo, M.D.

• Board certified
• Interventional Pain & Musculoskeletal Medicine Specialist
• Member of: AAPMR, AMA, Spine Intervention Society (SIS), North American Spine Society, NY State Society of Physical Medicine & Rehabilitation

Our Facilities Are State of the Art

Not only do we have the best doctors around, but we also believe we have one of the best facilities. Where you receive your care and the tools the doctor has at their disposal can mean a lot when it comes to a successful treatment plan. We’re quite proud of our well-appointed and modern facility, it makes the experience more comfortable for our patients and supplies our doctors with the equipment they need.

Our pain facilities are in Brooklyn and Manhattan and conveniently located for residents in Downtown Brooklyn, Lower, Midtown and upper East Side of Manhattan, the East Village, Greenwich Village, or Murphy Hill.

Our quality of care is considered among the finest in the country and with the technology and expertise to back it up, our patients find the relief they are seeking. Connect with one of our offices today to take the first step toward relieving neuropathic symptoms.

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What to Expect at Downtown Pain Physicians NYC

At your first visit to either of our offices, you can expect a thorough health examination and history so your doctor can get a good idea of your health concerns. This is especially important when dealing with a potential case of CRPS. There may be x-rays, blood tests, and other evaluation techniques necessary at your appointment to gain deeper understanding of your symptoms.

After a diagnosis is discovered, your doctor will have a thorough discussion of treatment options with you to make sure you know what steps are possible and you can make an informed decision. You will be informed of what to expect whether you have a diagnosis of CRPS or not. Our job is to help you recover as much as possible, no matter what the diagnosis.

In addition to discussing your condition and the possible treatment methods, you’ll also receive a detailed recovery plan, so you never have to question what to do next. It’s best if everyone understands that the future or treatment will look like and what to expect.

We want your visit to our offices to be as pleasant as possible from the moment you walk through our doors. Individual attention is part of the fabric of our practice and it’s a critical component of an effective treatment plan. Whether you have a diagnosis of CRPS or any other type of pain, we’re here to help you find pain relief and get back to living your life.