The Link Between Trauma and Complex Regional Pain Syndrome

When you fall and bang your elbow on the pavement, you expect to feel pain. You also expect that pain to dissipate over the next few hours or days, depending on the severity of the impact.

Likewise, after a surgical procedure, you plan for post-op pain, but you also anticipate gradual relief and the eventual day when the pain is gone completely.

But sometimes the pain hangs on long after the injury has healed, a condition called complex regional pain syndrome (CRPS). Dr. Shachi Patel at Delmarva Pain and Spine Center in Newark, Delaware, specializes in pain management and helps patients suffering from this unusual type of pain. 

CRPS is a bit mysterious because no one knows exactly why it occurs, and there’s no cure for it. One thing we do know is that it’s usually related to trauma. Your symptoms and treatment depend on whether you have CRPS I or CRPS II.

Complex regional pain syndrome I

Once called reflex sympathetic dystrophy, CRPS I is the most common type. Although it’s diagnosed more frequently than CRPS II, its cause is harder to pin down because there’s no clear nerve damage to observe or treat.

For most people who suffer from CRPS, we can trace the problem back to a traumatic incident, such as a car accident or sports injury. Many times, the trauma is not very traumatic, meaning it could be a pinprick or a small cut. 

Some cases of CRPS I stem from traumatic illnesses such as a heart attack or stroke.

In all cases, the pain you feel far exceeds what’s typically warranted by the illness and persists long after the injury has healed.

Complex regional pain syndrome II

Once called causalgia, CRPS II also occurs after a traumatic event, but this time there’s evidence of nerve damage. 

This neurological disorder typically causes intense pain near the location of the nerve damage, often in your feet, legs, hands, or arms. You may notice a burning sensation or pins and needles and tingling. 

You might feel hypersensitive to the slightest touch — even clothing hurts. Some people with CRPS II also have abnormal sweating and see color changes in their skin.

CRPS II can be the result of a crushing blow, like hitting your thumb with a hammer, or a severe burn. Amputees often experience phantom pain in their lost limb, an example of CRPS.

How technology can alleviate CRPS symptoms

Although we can’t cure CRPS, we can usually provide significant and lasting relief through a technological treatment called spinal cord stimulation. 

During this minimally invasive procedure, we place a tiny generator under the skin near your buttocks or abdomen with small wires that branch out to the location of your painful nerves. 

When activated, this device emits low-level electricity that interrupts the pain messages sent from your nerves to your brain, so your brain never gets the message and you feel no pain.

Dr. Patel runs a weeklong trial first using an external device you wear on a belt to make sure you feel adequate pain relief to warrant implanting the device permanently. If you get at least 50% pain relief, she implants the device and positions the leads with precision using fluoroscopy to guide her instruments. 

To learn more about spinal cord stimulation for CRPS and find out if it’s right for you, call us to schedule an appointment.