Complex regional pain syndrome (CRPS) is a rare condition that causes ongoing pain. It affects around 200,000 people in the United States every year and can cause debilitating pain. If you've been diagnosed with CRPS, the good news is that there are treatment options that can help.
One of them is spinal cord stimulation. This is a tried and tested method that has had good results in people who have not found relief in other forms of treatment.
Let's take a closer look at what CRPS is and how spinal cord stimulation can help.
CRPS is not fully understood, but it is known to affect women 3 to 4 times more often than men. It is also usually more severe in women. It is more common in people of European ancestry.
It's uncommon for children or young adults to develop it. It usually begins between the ages of 37 and 70.
The key symptom of CRPS is pain that is disproportionately more painful than it should be. For example, brushing against the skin shouldn't cause pain. But in a person with CRPS, even a light touch or brushing of the skin can cause extreme pain.
CPRS is usually preceded by a triggering event or injury. This could be a fracture, sprain, or surgery. Rarely, it occurs spontaneously, with no obvious trigger.
The syndrome takes two forms - type I and type II.
CPRS Type I
CPRS Type I is the most common form. In this form, there is no obvious nerve damage causing the pain. In the past, this was called reflex sympathetic dystrophy.
CPRS Type II
In this form of the syndrome, there is underlying nerve damage. This was known as causalgia in the past.
Symptoms of CRPS
The exact symptoms vary from person to person, but pain in one limb is the most common complaint. Some patients find that it spreads to other limbs, but this is usually rare. Some people are much more sensitive to mild stimuli than is usual, yet at other times may experience a loss of sensation.
Many patients also experience temperature changes in the affected limb. It is usually hot and swollen at first and then may become cold. There may also be changes in skin color.
Most people with CRPS find that their symptoms affect their mobility. It can limit their range of motion in affected limbs and can cause muscle weakness and spasms. This is known as dystonia.
Common Treatments for CRPS
The first line of treatment for CRPS is usually physiotherapy. Corticosteroids, pain relievers, antidepressants, and other pain management treatments may also be used.
What Causes CRPS?
The causes of CRPS are not fully understood. It is possible that the initial trauma and treatment cause changes to the nervous system of the body.
Many patients also have increased levels of inflammation during the early stages of the syndrome. The higher level of cytokines in the body may cause the disproportionate level of pain sufferers experience.
What Is Spinal Cord Stimulation?
This pain management technique involves implanting a small device into the spine. Small leads come out of the device and are carefully placed. They deliver an electrical impulse that can interfere with the pain signal from the affected limb to the brain.
The concept is that fewer pain signals reach the central nervous system and the pain in the affected limb is reduced. The location of the leads will vary depending on where you experience the most pain.
For example, a spinal cord stimulator for CRPS in the foot will be placed differently from one for pain in the arm. Some people report that they experience a tingling sensation rather than pain. Some patients experience a huge improvement in their pain levels and quality of life.
How Spinal Cord Stimulation - SCS for CRPS - Can Help
In the past, implanting a spinal cord stimulator for CRPS was seen as a last resort therapy. It is still best practice to try other therapies before spinal cord stimulation, given the fact that it requires surgery. But if other therapies do not work, it may be good to try SCS as early as three months.
It is not fully understood how and why SCS for CRPS helps. However, a 2010 article found that it can have "dramatic effects on painful, vascular, and motor symptoms of" CRPS.
Spinal Cord Stimulator Trial
Anyone interested in having a spinal cord stimulator for CRPS will need to undergo a physical and psychological assessment. If you are a good candidate, you will then have a trial. This uses a temporary SCS, with an external device.
This will test whether a spinal cord stimulator for CRPS works in your case. If you experience more than a 50% reduction in pain, you can consider having surgery to place a permanent device.
Living with a Spinal Cord Stimulator
Immediately after the surgery, you will need to take great care to allow the spinal cord stimulator to heal in the correct position. You will then control the stimulator using a handheld controller, which allows you to adjust the level of stimulation.
CRPS and a Spinal Cord Stimulator - What Results to Expect
For most people with CRPS, it's not realistic to expect that the spinal cord stimulator will remove all pain. Most people find that it reduces radiating pain to a gentle tingle. For most sufferers, this is a win and can help them to improve their quality of life.
It can also allow you to reduce your need to rely on medications for pain management.
Let Pain and Spine Specialists Manage Your CRPS
CRPS can be a debilitating condition, but Pain & Spine Specialists are here to help.
We are a dedicated team of doctors and nurse practitioners who specialize in treating pain. If you've been diagnosed with CRPS, we can explore treatments, including a spinal cord stimulator, that can help to improve your quality of life.