We don’t manage pain. We treat it.

Complex Regional Pain Syndrome (CRPS)

Sometimes, it’s easy to identify the source of chronic pain. For example, you may be able to link your pain to a recent car accident or sports injury. In other cases, you may experience chronic pain of mysterious origins. You may suspect you have developed a medical condition such as arthritis or a pinched nerve in your spine. There’s another source of chronic pain that’s more difficult to identify because it’s a condition that most people have never even heard of Complex Regional Pain Syndrome.

What is CRPS?

Complex Regional Pain Syndrome is a condition that causes arm, leg, hand, or foot pain that lasts more than 6 months. Some cases of CRPS are mild and go away on their own; other cases are severe and cause long-term pain and disability. Usually, CRPS develops after an injury to the affected limb that causes damage to the peripheral nervous system (which is responsible for nerve signals to the brain and spinal cord) and central nervous system (which involves nerve signals to the rest of the body). CRPS affects people of all ages and both sexes.

Symptoms of CRPS

If you suffer from long-term, excessive chronic pain in your arms, legs, hands, or feet and have one or more of the following symptoms, you should ask your spine doctor to screen you for Complex Regional Pain Syndrome. Symptoms pointing to CRPS include:

  • Pain that is severe, prolonged, and often constant
  • Pain accompanied by burning, squeezing, and/or pins-and-needles sensations
  • Pain that radiates to the entire limb (sometimes even to the opposite limb), even when the injury causing the pain only affects a small area
  • Joint stiffness
  • Difficulty coordinating muscle movement or moving the affected limb
  • Tremors in the affected limb
  • Increased sensitivity to normal skin contact
  • Skin texture in the affected area may become shiny and thin
  • Skin color on the affected limb may become blotchy, blue, red, or pale
  • The temperature of the affected limb may become warmer or cooler than usual
  • Abnormal sweating in the affected area
  • Changes to nail and hair-growth patterns in the affected area


It’s not known with certainty why some people develop Complex Regional Pain Syndrome after an injury and others do not. However, experts agree that people who do develop CRPS experience an exacerbated response to their initial injury. Just like some people can eat peanut butter or shellfish and have no negative reaction while others experience serious allergic reactions to those foods, some people experience a fracture, sprain, cut, or needle stick with no severe problems, while those with CRPS experience extreme pain and long-lasting symptoms from the same injuries. There is some evidence suggesting that in some cases, CRPS is passed on through the genes.


Currently, complex regional pain syndrome is usually treated with a combination of physical therapy, psychotherapy, and medication. Exercise improves blood flow, flexibility, strength, and function of the affected limb. Psychotherapy helps stave off depression, anxiety, and post-traumatic stress disorder that often develop in individuals experiencing chronic pain. Medications can help alleviate the symptoms of CRPS.

Less common CRPS treatment options include nerve block injections, surgeries to destroy pain-causing nerves, and electrode stimulation of the spinal cord. Research into CRPS and effective treatments continues. Promising treatments on the horizon include the use of intravenous immunoglobulin, intravenous ketamine, and mental exercises known as graded motor imagery.

Spinal Cord Stimulation