Doctors don’t yet know a lot about CRPS and there are no tests for it, so the diagnosis is made by listening to your history and complaints, and by watching for signs and symptoms. Since there isn’t a cure for the disorder, doctors concentrate on helping to ease the symptoms. The treatment will depend on what stage you are in and how you have responded to therapy.
No medication has been found to help everyone with CRPS nor to treat all the symptoms. Doctors may try different medications, alone or in combination with others, to see what is best for you. You may be given analgesics, or painkillers, to take by mouth such as NSAIDs (non-steroidal anti-inflammatory drugs) like Aspirin or ibuprofen, which are just two of many. You could be given narcotics or opioids like morphine or codeine. There are many types of analgesics that your doctor can try. You may also be given a topical medication, a cream or ointment that you spread on the skin. Some doctors have seen patients do well on anti-depressants, muscle relaxants, anti-anxiety medications, steroids and even medications for seizures.
Some patients have had success with alternative therapies such as acupuncture, biofeedback and visual imagery. A psychotherapist can often help with the anxiety or depression that can be associated with a chronic pain disorder.
Physical therapists can play a role in helping to relieve the pain. By exercising your injured limb, you may keep the joints from getting too stiff and painful. As well, many physiotherapists use electrical stimulation called TENS, or transcutaneous electrical stimulation, to help reduce pain.
Finally, your doctor may suggest a nerve block, spinal cord stimulation or a drug pump. With a nerve block, your doctor injects an anesthetic directly into the nerve that is causing the pain. With spinal stimulation, a surgeon places electrodes alongside your spinal cord and the electrodes give off impulses that block the pain. A drug pump provides you with a constant flow of analgesic directly into your spinal cord, providing pain relief.
Surgery, called a surgical sympathectomy, is controversial and not all doctors recommend it. A surgeon destroys the nerves that are causing the pain.
Not everyone responds to treatment in the same way and not all patients get full relief. Some may get partial relief and some may even go into remission, or have periods where they have no pain or symptoms.