The treatment of complex regional pain syndrome (CRPS) is centered around a multidisciplinary team-based approach to control pain and restore function. Early diagnosis and appropriate referral are crucial to improved outcomes.
Similar to other pain syndromes, multimodal pharmacotherapy can prove useful as well for treatment of symptoms. NSAIDs, Antidepressants, and Anticonvulsants have shown to have some benefit in CRPS. While opioids as well have shown some benefit in the short term, long term benefit has yet to be established. The use of bisphosphonates is an area of promise with significant benefit shown in several RCTs.
While physical therapy remains the frontline modality, interventional pain techniques (sympathetic blocks) can prove useful to improve compliance with physical therapy where significant pain is present. Stellate Ganglion blocks are used for the arms and Lumbar Sympathetic Blocks are performed for the legs prior to physical therapy which allows for more intense physical therapy and desensitization. For patients that fail physical therapy, pharmacotherapy, and interventional pain techniques, the use of spinal cord stimulation has shown to provide benefit in several RCTs.