Complex Regional Pain Syndrome Treatment Clinic in Mumbai

Complex regional pain syndrome

Complex regional pain syndrome

Complex Regional Pain Syndrome (CRPS I & II)–Previously RSD

What is complex regional pain syndrome (CRPS)?

Most Injuries heal by itself. Sometimes post injury pain may remain for more than 3 months and is associated with swelling, redness and skin changes. this is called Complex regional pain syndrome or CRPS. This is also called as Reflex sympathetic syndrome or RSD.

CRPS may also develop after surgery, a heart attack, a stroke or other medical problem.

The pain may be burning sensation and is out of proportion to what is expected for the injury. 

Symptoms include -

"Burning" pain in your arm, leg, hand or foot.

Skin sensitivity.

Some other features are changes in skin temperature, color and texture. Skin may be sweaty, cold or warm than normal. Skin color changes are also commonly seen and may be white or mottled to red or blue. Skin is hypersensitive (allodynia) sensitive to touch, gush of air, movements may be painful.  Skin may be thin or shiny in the affected area. 

There are changes in hair and nail growth.

We also see joint stiffness, swelling and damage. Along with these muscle spasms, weakness and  muscle loss (atrophy) is also seen.

CRPS can be

  • Type I (RSD) - No direct injury to nerves
  • Type II (Causalgia) - following a distinct nerve injury.

When to see Pain Physician at PCI

When you experience constant, severe pain with all or few of the signs and symptoms mentioned above.

It's important to treat complex regional pain syndrome early. Early treatment can reverses the condition.

Rarely we see Complex regional pain syndrome spreading from its original affected area to other parts of the body and is called Continuity type CRPS. 

Diagnosis - It's important to note that diagnosis is based on a physical exam and medical history. 

Investigations that may help in diagnosis are 

Bone scan.

Sympathetic blocks for diagnostic purpose - We have sympathetic nerves in the body running along the vertebral column. An image guided injection of local anaesthetic can relieve the pain and reverses the symptoms of CRPS. It helps in improving the blood flow and improving the temperature. Once diagnostic test is positive, radiofrequency ablation of these nerves may be planned for longer term relief.

X-rays - In late stages the bones look fragile and transperent due to loss of minerals.


Early treatments may provide dramatic relief.  Best approach is a combination of various treatments. Treatment options include:


  1. Nonsteroidal anti-inflammatory drugs (NSAIDs) - relieve pain and inflammation
  2. Antidepressants and anticonvulsants - for pain coming from a damaged nerve (neuropathic pain)
  3. Corticosteroids - may reduce inflammation. Y
  4. Alendronate and calcitonin
  5. Opioid medications for severe pain


  1. Applying heat and cold
  2. Topical analgesics 
  3. Physical therapy
  4. Sympathetic nerve-blocking medication
  5. Biofeedback. In some cases, learning biofeedback techniques may help. In biofeedback, you learn to become more aware of your body so that you can relax your body and relieve pain.
  6.  Spinal cord stimulation

Fellowship Training For Doctors at PCI

Spine specialist in Mumbai

Eligibility - Post graduation in Anesthesiology, Orthopedics, Neurosurgery, and Radiology

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Pain is a way your body reacts to injury or illness. Everybody reacts to pain differently. Schedule an appointment for the pain you suffer.  

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