Treatments
Treatment for CRPS/RSD must be individualized. No one treatment will work for everyone. Most treatments and medications were developed to treat other chronic pain syndromes and may not be covered by your insurance.
Treatment for CRPS may be difficult. The goal is to seek pain relief and to restore function.
Treatment methods are continuously evolving as research and clinical practice provides new evidence and insights. For example, it was once thought that sympathetic nerve blocks were a diagnostic tool and a curative procedure. This has been disproven over time.
Some current treatment methods that may work for you are:
- Use of anti-convulsants
- Use of TCA antidepressants
- Physical and occupational therapy (including graded motor imagery and mirror box therapy)
- The anesthetic Ketamine
- Steroids in the acute phase
- Nerve blocks
- Spinal cord stimulator
- Warm water therapy
- Calmare therapy
- Hyperbaric oxygen therapy
- Use of opiates (may be considered controversial)
- Bisphosphonates
There are some emerging treatments that are receiving increased attention including Kinesio Taping and low-dose naltrexone. RSDSA is funding a pilot study of this medication at Stanford University.
For a library of articles with detailed information about these and other treatments, including guidelines for dental procedures in CRPS/RSD patients, visit our Resources page.
To keep up with the latest and most effective treatments, subscribe to our newsletter and read the RSDSA blog weekly.
Treatment/Support
- Ask the Doctor: CRPS and Sleep Disorders
By R. Norman Harden, MD - Biofeedback for CRPS: Why Haven’t I Tried That?
By Kenneth R. Lofland, PhD - Cannabis and CRPS
By Jim Doulgeris - Clinical Corner: How are bone scans used in the diagnosis and treatment of CRPS?
By Angela Mailis-Gagnon, MD, MSc - Hyperbaric Oxygenation Therapy: Can it Relieve Your Pain?
By Patricia McAdams - Ketamine and CRPS
By Jim Doulgeris - Lessons from the Front: Questions for Lt. Col. Chester C. Buckenmaier, III
- Low Dose Naltrexone
By Jim Doulgeris - My doctor says they have to lower my long-term opioid medicine. “What can I do? What do I say?”
By Stefan Kertesz, MD, MSc - Pregabalin and Gabapentin for Neuropathic Pain and CRPS
By Brett R. Stacey, MD, and Pamela Campbell, MD - Spinal Cord Stimulation and Neuromodulation
By Jim Doulgeris - Vagus Nerve Stimulation
By Jim Doulgeris - What is the Difference between Peripheral Neuropathy and Complex Regional Pain Syndrome?
By Elliot T. Udell, DPM - Ziconotide in Complex Regional Pain Syndrome
By Lynn R. Webster, MD, FACPM, FASAM
Physical and Occupational Therapy
- Using Physical Therapy Management of Patients with Complex Regional Pain Syndrome: A Pilot Study
- Aqua Therapy: A Key Ingredient in Treating CRPS, shows the important role that aqua therapy plays in the interdisciplinary treatment of people with CRPS. Lee Rosenzweig, DPT, PT, CT, of the Hospital for Special Surgery, demonstrates teaching techniques for individuals with upper and lower extremity CRPS. Aqua therapy may help people with CRPS who have limited movement and/or have low tolerance for resistive therapeutic activities.
- Authors: Jan-Willem Ek, Jan C van Gijn, Han Samwel, Jan van Egmond, Frank PAJ Klomp
Title: Pain exposure physical therapy may be a safe and effective treatment for longstanding complex regional pain syndrome type 1: a case series - Author: Rodda B, Huss R, Carbajal-Rowland C, Elhosseine L, Kinsley L, Sanders K
Title: Using Physical Therapy Management of Patients with Complex Regional Pain Syndrome: A Pilot Study - Author: Phillips ME, Katz JA, Harden RN
Title: The Use of Nerve Blocks in Conjunction With Occupational Therapy for Complex Regional Pain Syndrome Type I
Source: Am J Occupat Ther. 2000;54:544-549 - Author: Catherine Pollard BSc (Honours), Physiotherapy, Diploma Orthopaedic Medicine, Senior Physiotherapist, The Auckland Regional Pain Service, Auckland District Health Board
Title: Physiotherapy management of complex regional pain syndrome
Source: New Zealand Journal of Physiotherapy - Author: Andrea Wolkenberg, PT, MA, CKTI
Title: Q&A: The Kinesio Taping® Method and the treatment of CRPS
Source: RSDSA Review: 2012 Vol. 25, Issue 4 - Author: Lori Brake, PTA; Jennifer Sherker, PsyD; David Sherry, MD; Kathy Fash, PT, DPT, CSCS, CBIS
Title: Amplified Abdominal Pain in Children - Author: Melanie E. Swan, OTR/L
Title: CRPS Treatment: Desensitization - Author: Melanie E. Swan, OTR/L
Title: When the shoe is on the other foot… - Author: Melanie E. Swan, OTR/L
Title: Aquatic Therapy - Author: Melanie E. Swan, OTR/L
Title: The Skinny on Home Exercise Programs
Mirror Therapy
- Authors: Jim Doulgeris
Title: Mirror Box Therapy - Authors: Emilie Lagueux, Joelle Charest, Eve Lefrancois-Caron, Marie-Eve Mauger, Emilie Mercier, Kim Savard and Yannick Tousignant-Laflamme
Title: Modified graded motor imagery for complex regional pain syndrome type 1 of the upper extremity in the acute phase: a patient series
Source: International Journal of Rehabilitation Research 2012: 35; 138-14 - Author: G. Lorimer Moseley, PhD
Title: Reflections, imagery, and illusions: the past, present and future of training the brain in CRPS
Source: RSDSA Review, Winter 2009
Additional Articles
- Author: Ahmet ÖZGÜL, Dilek VURAL, Mehmet Ali TAŞKAYNATAN
Title: Case Report: Blocking TNF-a in Complex Regional Pain Syndrome Type I: A Case of Reflex Sympathetic Dystrophy Resolved with Etanercept in a Patient with Ankylosing Spondylitis
Source: Turk J Rheumatol 2011;26(3):239-242 doi: 10.5152/tjr.2011.037 - Author: Daly AE, Bialocerkowski AE.
Title: Does evidence support physiotherapy management of adult Complex Regional Pain Syndrome Type One? A systematic review.
Source: Eur J Pain. 2008 Jul 9. Abstract - Author: Sherry DD, Wallace CA, Kelley C, Kidder M, and Sapp Lyn
Title: Short-and Long-term Outcomes of Children with Complex Regional Pain Syndrome Type I Treated with Exercise Therapy
Source: Clin J Pain. 1999;15:218-223