Complex Regional Pain Syndrome (CRPS) is believed to originate from damage or impairment to the peripheral and central nervous systems. It is a chronic pain condition, which typically results in severe pain in an affected area of the body, which is typically the limbs, such as hands, feet, arms or legs. This pain is largely out of proportion to the initial injury in its severity.

 

CRPS is a chronic condition that generally affects individuals between ages 20 – 35.  There is no cure for CRPS and a single cause has not been established. Those who suffer from CRPS typically experience intense, burning, continuous pain that often spreads to other extremities, swelling and stiffness as well as restricted motion in the affected limb. There is often extreme sensitivity in the affected area so that even the slightest touch can result in pain. 

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There are two similar forms of this condition, CRPS-I and CRPS-II, with the same symptoms and treatments. CRPS-II (previously called causalgia) is the term used for patients with confirmed nerve injuries. Individuals without confirmed nerve injury are classified as having CRPS-I (previously called reflex sympathetic dystrophy syndrome). 

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There are a number of treatments that are used for CRPS, such as physical therapy, counselling, medication, sympathetic nerve block, spinal stimulation, neurostimulation, alternative therapies and ketamine infusions.

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At our clinic, we have had success in treating CRPS with nerve blocks, mindfulness and Ketamine infusions.

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Research Articles:

Correll GE, Maleki J, Gracely EJ, Muir JJ, Harbut RE. Subanesthetic ketamine infusion therapy: a retrospective analysis of a novel therapeutic approach to complex regional pain syndrome. Pain Med. 2004 Sep. 5(3):263-75.

Kiefer RT, Rohr P, Ploppa A, Dieterich HJ, Grothusen J, Koffler S, et al. Efficacy of ketamine in anesthetic dosage for the treatment of refractory complex regional pain syndrome: an open-label phase II study. Pain Med. 2008 Nov. 9(8):1173-201.

Sigtermans MJ, van Hilten JJ, Bauer MC, Arbous MS, Marinus J, Sarton EY. Ketamine produces effective and long-term pain relief in patients with Complex Regional Pain Syndrome Type 1. Pain. 2009 Oct. 145(3):304-11.

Schwartzman RJ, Alexander GM, Grothusen JR, Paylor T, Reichenberger E, Perreault M. Outpatient intravenous ketamine for the treatment of complex regional pain syndrome: a double-blind placebo controlled study. Pain. 2009 Dec 15. 147(1-3):107-15.