Complex Regional Pain Syndrome

CRPS often affects the peripheral nerves that extend to the arms and legs, causing symptoms such as: 

• Severe burning or throbbing pain in your arm, hand, leg or foot 
• Sensitivity to touch that causes intense pain 
• Changes in skin temperature, from cold to sweating 
• Changes in hair and nails 
• Swelling 
• Stiffness 
• Increased or decreased blood flow 
• Muscle spasms and tightening 
• Tapered fingers  

Diagnosis starts with a conversation about your symptoms and medical history, followed by an exam from a pain specialist. Once outward physical changes are visible, the condition may become irreversible. However, treatment can help relieve symptoms. 

Although no single test can definitively diagnose CRPS, Houston Methodist’s pain experts may order a combination of tests to rule out underlying causes of symptoms. Tests may include:  

• Bone scans to detect changes in the bone 
• Sympathetic nervous system tests to look for disruption in nerve signaling 
• Thermography to measure temperature differences across the affected limb 
• Sweat tests to compare the amounts of salt chemicals in the affected and non-affected limb 
• X-rays to determine loss of bone minerals 
• MRI to show any tissue changes 

There are two types of CRPS: 

• Type 1 (reflex sympathetic dystrophy syndrome) occurs when the nerves in the affected limb weren’t directly damaged by injury or illness.  
• Type 2 (causalgia) occurs when an injury or illness damages the affected nerve.  

Depending on the type and its severity, we will design a treatment plan to reduce symptoms and improve your quality of life. 

Pain specialists at Houston Methodist combine decades of pain management experience with unequivocable access to advanced treatment options. Your care team will collaborate to design a personalized care plan to address your symptoms.  

When treatment is started early, remission is possible. You may need a combination of medication, therapies or procedures to achieve the best outcomes.  

Medications that are often prescribed for CRPS include:  

• Over-the-counter pain relievers  
• Opioid medications   
• Antidepressants 
• Anticonvulsants (amitriptyline, gabapentin)  
• Intravenous ketamine  
• Corticosteroids (prednisone)  
• Bone-loss medications (alendronate)  
• Sympathetic nerve-blocking medications 

Pain management therapies include:  

• Acupuncture or massage therapy  
• Biofeedback 
• Desensitization therapy 
• Heat or ice therapy  
• Physical therapy  
• Psychotherapy  
• Topical analgesics  
• Transcutaneous electrical nerve stimulation (TENS) 
• Spinal cord stimulation