Complex Regional Pain Syndrome (CRPS) is a chronic neuropathic pain condition characterised by severe, disproportionate pain, sensory disturbances, autonomic dysfunction, and motor impairment, usually affecting a limb after injury or surgery.
Estimated incidence ranges from 5 to 26 cases per 100,000 people annually andfrequently develops after fractures, surgery, or soft tissue trauma, with upper limb involvement being slightly more common. The exact pathophysiology of CRPS is multifactorial and not fully understood, involving abnormal inflammatory, neurological, and autonomic responses.
Management is multidisciplinary and time-sensitive, with early diagnosis, Pharmacotherapy, Early physiotherapy/ mirror therapy, desensitisation therapy/pain and targeted interventions improving outcomes significantly. I offer following interventions tailored to individual need and requirement that can be complimentary to other treatment modalities, aiming towards reducing pain and improvement in quality of life-
- Sympathetic nerve blocks (stellate ganglion block for upper limb, lumbar sympathetic block for lower limb)
- Epidural infusions
- Spinal cord stimulation and Dorsal root ganglion stimulation (in refractory focal CRPS), which has very good evidence base
You can request your GP to arrange a named consultant referral to the Barts neuromodulation service to access these advanced treatment options if they are not available in your area.