Complex Regional Pain Syndrome (CRPS) Treatment in Tallahassee, FL

What Is Complex Regional Pain Syndrome?

Complex regional pain syndrome (CRPS) — formerly known as reflex sympathetic dystrophy (RSD) — is a chronic pain condition characterized by severe, burning pain that is disproportionate to any original injury, along with changes in skin color, temperature, sweating, and texture, swelling, and extreme sensitivity to touch or temperature. It most commonly affects an arm, hand, leg, or foot, and can spread over time to involve a larger area of the body.

CRPS Type 1 occurs without a confirmed underlying nerve injury — often developing after a fracture, surgery, or soft tissue injury. CRPS Type 2 (causalgia) involves a confirmed peripheral nerve injury. Both types involve abnormal activation of the sympathetic nervous system and a process of central sensitization in which the nervous system becomes hypersensitized to pain signals. Early diagnosis and treatment are critical — CRPS tends to become harder to treat the longer it remains unaddressed.

What Causes It

CRPS most commonly develops after an injury, surgery, stroke, or immobilization — but the hallmark of the condition is that the pain response is far greater than the original event would explain. A minor ankle sprain, a Colles fracture, or a routine surgical procedure can trigger a cascade of abnormal sympathetic activity and neuroinflammation that becomes self-sustaining. The exact reason why some people develop CRPS in response to an injury while others do not is not fully understood, but it involves an interaction between the peripheral nervous system, the sympathetic nervous system, and central pain processing pathways. Genetics, immune function, and psychological factors may all play a role.

How We Evaluate It

CRPS is a clinical diagnosis based on history, physical examination, and the Budapest Criteria — a standardized set of signs and symptoms used to confirm the diagnosis. We conduct a detailed history of the original injury or triggering event, the progression of symptoms, and all treatments that have been tried. Physical examination assesses the characteristic features of CRPS including allodynia, temperature asymmetry, skin changes, edema, and motor dysfunction. Electrodiagnostic testing, imaging, and laboratory studies may be ordered to rule out other conditions and identify any underlying nerve injury. An accurate diagnosis is essential before any treatment plan is developed.

How We Treat CRPS

CRPS requires a multidisciplinary approach that addresses both the sympathetic nervous system component and the central sensitization driving the ongoing pain. Sympathetic nerve blocks — lumbar sympathetic blocks for lower extremity CRPS and stellate ganglion blocks for upper extremity CRPS — interrupt the abnormal sympathetic activity that perpetuates the pain cycle and can provide meaningful diagnostic and therapeutic benefit. For patients who respond to sympathetic blockade or who have not achieved adequate long-term relief, neuromodulation offers more durable options. Dorsal root ganglion stimulation is FDA-approved for CRPS and causalgia and provides highly targeted stimulation to the specific spinal level responsible for the painful area — making it particularly effective for focal CRPS affecting the foot, knee, hip, or hand. Spinal cord stimulation is well-established for broader CRPS distributions, and peripheral nerve stimulation may be appropriate for specific nerve-territory involvement. For patients with severe, refractory CRPS, intrathecal drug delivery can provide superior pain control alongside other interventional approaches.

CRPS is a condition where the timing of treatment matters. Patients who receive appropriate interventional care early in the course of the disease tend to have better outcomes than those who wait. If you or your provider suspect CRPS, a prompt consultation is strongly encouraged.