“The pathophysiology of CRPS is equally as elusive,” he said. “Basically, there is an abnormality in the sympathetic nervous system with modulation of pain pathways in the central nervous system.”
Treatment modalities for CRPS include focusing on improvement of functional restoration through the use of occupational and physical therapy, as well as aquatic therapy.
Behavioral treatment modalities include mirror visual feedback therapy and relaxation techniques, although the latter option has not been shown to improve or reduce pain in individuals with CRPS. There has also been very little evidence of effectiveness with the use of acupuncture in these patients.
“The sooner interventional techniques—such as stellate ganglion or lumbar sympathetic blocks—are employed, the better the outcomes,” Dr. Pryzbylkowski remarked. “A misconception about the disease is that it is purely psychological in nature; it is not. The disease state is multifactorial in etiology. There are multiple physical examination findings and pain descriptors CRPS.
1. de Mos M, de Bruijn AG, Huygen FJ, Dieleman JP, Stricker BH, Sturkenboom MC. The incidence of complex regional pain syndrome: a population-based study. Pain. 2007;129(1-2):12-20.