Five Minutes That Changed Everything

Written by Mia Lane for the RSDSA blog.

My daughter was just 13 years old when she developed Complex Regional Pain Syndrome.

It began in late February 2014 with what seemed like a simple accident. She slipped on a puddle of water on the kitchen floor and injured her right foot. At the time, we had no idea that this minor incident would mark the beginning of one of the most challenging journeys of our lives.

What made her case truly extraordinary, however, was the speed of her diagnosis. Our general practitioner recognized CRPS almost immediately, diagnosing her within five minutes. In hindsight, and after everything I have since learned about CRPS, I realize how rare this is. Many patients around the world go undiagnosed for months, even years, enduring unimaginable pain without answers.

The suffering caused by CRPS extends far beyond the patient. Watching a loved one endure such intense, relentless pain is deeply distressing. Traumatizing, even. As a caregiver, the helplessness you feel, knowing there is little you can do to ease their suffering, is something that cannot truly be put into words.

We live in a coastal city in South Africa, and I can say with complete gratitude that my daughter received exceptional medical care. Our doctor worked alongside a physiotherapist within the same practice, and treatment began within 24 hours of her diagnosis.

Her medical team consisted of just two individuals: a general practitioner and a physiotherapist. They were not specialists in CRPS, but they were dedicated, compassionate, and willing to go the extra mile. Researching, adapting, and committing themselves fully to her recovery.

From the outset, we made a conscious decision regarding her treatment approach. While medication was prescribed, my daughter, remarkably at just 13 years old, was determined not to rely on it entirely. Together, we chose a balanced approach: using medication in moderation, while focusing primarily on holistic and rehabilitative therapies.

Because of her age, she was able to actively participate in her own care, communicating her pain and progress clearly – something that proved invaluable throughout her recovery.

When treatment began, her pain levels were at a 10 out of 10. Her recovery plan included a combination of therapies, such as (but not limited to):

– Graded Motor Imagery (GMI) (Later during treatment, when pain levels dropped below 10/10)

– Mirror therapy

– The use of a TENS machine (also introduced later, once pain levels had decreased)

– A balanced, nutrient-rich diet – an essential component of healing

As expected, our daily lives were significantly impacted. She relied on crutches and was initially unable to bear any weight on her foot. Even the sensation of a sock touching her skin was unbearable, let alone wearing a shoe.

Explaining her condition to others (especially friends at school) was incredibly difficult. How do you describe something as complex (pun intended!) as CRPS to someone who has never heard of it?

The nights were the hardest. I would hear her quietly crying, knowing she was in excruciating pain. I often couldn’t even sit beside her on the bed, as the slightest movement of the mattress would intensify her discomfort. The sense of helplessness in those moments is something I will never forget.

And yet, despite it all, she recovered.

After approximately five months, my daughter reached remission. I firmly believe this was due to the combination of early diagnosis, a dedicated medical team, and most importantly, her own unwavering determination. She was resolute in her goal to reclaim her life.

Then, in August 2018, almost exactly four years after reaching remission the first time, CRPS returned. She was 17 at the time. But this time, we were prepared.

We understood the condition, recognized the symptoms, and immediately implemented the same treatment approach. By the end of September, going into October 2018, she reached remission once again.

Today, my daughter is a thriving young adult, living a full and pain-free life. She is a qualified personal trainer, holds a certification in nutrition, and has recently completed her studies in sport psychology. Her journey is one of resilience, courage, and hope. And that is the message I want to leave you with:

There is hope. Remission is possible. With the right medical support, early intervention, and determination, recovery can happen.

I share our full story in my e-book, Five Minutes, published under the pen name Mia Lane. It is currently available on Amazon. The cost is under $6 or free to read in Kindle Unlimited.  A paperback version is also coming soon. The book also includes resources for those seeking reliable CRPS support, particularly in the United States.

If you would like to follow my journey, you can find me on Instagram or by reaching out via email at [email protected].

Ketamine-Assisted Therapy: A New Paradigm for CRPS Treatment

Written for RSDSA by Benjamin Mati, MD – Owner & Medical Director of Horizon Healing

Complex Regional Pain Syndrome (CRPS) is a partially understood condition that can profoundly affect the physical, emotional, and spiritual quality of life of those who suffer from it. Anxiety and depression are often intertwined with myriad physical symptoms, creating a complex constellation of suffering.

While the standard of care involves a multimodal approach—ranging from neuropathic pain medications and nerve blocks to spinal cord stimulation—treatment failure remains very common. Ketamine has emerged as a medical whose unique properties show potential for treating both the physical and non-physical symptoms of CRPS.

What is Ketamine?

Ketamine is an FDA Schedule III medication, placing it in the same class as Tylenol with codeine. Known as a “dissociative anesthetic,” high doses temporarily reduce the brain’s awareness of the senses, creating a dissociation between mind and body.

Since the 1970s, it has been a staple in emergency medicine, anesthesia, and hospital medicine. It is considered so safe and effective that it is the World Health Organization’s (WHO) Essential Medicines List for all health care systems. Since the late 1990s, research has shown it to be a rapid, effective, and safe therapy for depression, PTSD, anxiety, and pain disorders. While these uses are “off-label” (not officially sanctioned by the FDA), they are allowed and supported by studies indicating safety and efficacy.

How Does Ketamine Work?

The human brain is complex, and we are only beginning to understand how substances interact with consciousness. However, we know that Ketamine acts on many receptors and areas of the body and brain. One important action is as an N-methyl-D-aspartate (NMDA) receptor antagonist which seems to do several things:

  • Releasing the Brakes: Essentially, it “takes the foot off the brakes,” stopping brain cells that usually inhibit activity and allowing specific brain cells to become more active.
  • New Connections: This increased activity can create new connections between brain areas. Ketamine stimulates the growth of brain cells and enhances neuroplasticity—the brain’s ability to change its structure and connections.
  • Network Reset: It appears to turn down activity in the “default mode network” while promoting connectivity elsewhere

For CRPS specifically, ketamine decreases the activity of inflammatory cells and pain centers in the brain, interrupting the feedback loops associated with pain interpretation.

Methods of Delivery

Ketamine can be delivered in several ways, each with unique characteristics regarding onset and depth of experience.

MethodAbsorptionSetting & Description
Intravenous (IV100% (Direct to vein)Medicalized Setting: Requires a tiny catheter, continuous vital sign monitoring, pumps, and tubing. Common in hospitals and pain clinics.
Intramuscular
(IM)
93%Therapeutic Setting: Injection into the muscle (usually the shoulder). No need for pumps or IVs, allowing for a more therapeutic environment.
Mucous
Membranes
25–30%Oral/Nasal: Absorbed through the mouth or nose. Requires a higher dose for a similar effect compared to IV.

Ketamine Therapy vs. Ketamine-Assisted Therapy (KAT)

It is important to distinguish between two different models of care.

  • Ketamine Therapy (The Biomedical Model)
    • This model views ketamine primarily as a pharmacological intervention for “disorders”.
    • Focus: Treating symptoms and improving brain function
    • Limitations: It often assumes the mind and body are separate and may overlook social, emotional, and spiritual dimensions
    • Support: Often offered with minimal or no therapeutic support, and practitioners may lack specialized training in psychedelic-assisted therapy
  • Ketamine-Assisted Therapy (KAT)
    • KAT draws from healing traditions that prioritize self-discovery and personal agency.
    • Focus: Ketamine is viewed not as a cure, but as a catalyst for accessing inner healing resources.
    • The Container: Providers are usually licensed professionals trained in creating a safe “container” for the experience.
    • The Process: Includes preparatory sessions to lay a foundation and integration sessions to help clients incorporate insights into daily life over weeks or months.

Ketamine for the CRPS

NMDA receptor overactivity is thought to play a key role in central sensitization, a process where the nervous system amplifies pain signals. By dampening this pathway, ketamine may help “reset” abnormal pain signaling. Current research suggests that ketamine therapy decreases pain symptoms in those suffering from severe CRPS. However, most studies focus on the biomedical IV model, using pain scores as the only endpoint.

Ketamine-Assisted Therapy seeks to meet patients where they are—addressing physical, emotional, psychological, and social symptoms simultaneously. While ketamine addresses physical symptoms, KAT does not hold that there is something to “fix”. Instead, it helps uncover new perspectives and reveal habitual ways of thinking. With the support of trained staff, KAT provides more than just medicine; it creates a holistic healing environment.

A Journey of a Thousand Miles Begins With a Single Step

Written by CRPS Warrior Erikka Elsbury. This blog first appeared in the April edition of In Rare Form.

Photo by @aterrormusical.
Used with permission

In 2007, my family and I traveled to New York City for the Achilles Hope and Possibility Walk. I saw the motto, “A journey of a thousand miles begins with a single step,” on the shirts RSDSA had for their team. I quickly knew that quote applied to my life and my journey with RSD/ CRPS.

Just five years prior, at the age of 12, I had been diagnosed with a condition so incredibly painful and debilitating that the average person and physician cannot comprehend it.

I had a very normal, happy childhood. I was surrounded by family, friends, and my dogs. One evening, a friend and I were goofing off when I fell in the hallway of my home and sprained my left wrist. I was accident prone. I had broken several bones and sprained multiple ankles and wrists throughout the years, so my parents and I did not think much of it. My dad helped me wrap it with an ACE bandage, and I went to bed.

The next morning, we had a snow day. It may have been the end of March, but in Ohio, blizzards are still possible! My wrist had turned purple and blue and was becoming increasingly painful. My mom took me to the ER where I was diagnosed with a sprain and sent home with Tylenol and ibuprofen. That night, CRPS set in. Over the next few weeks, I saw orthopedic doctors and hand specialists. Every one of them told us that nothing was wrong. They concluded I was exaggerating the pain for attention.

Living 45 minutes from Cleveland, we had access to excellent hospitals. My mom took me to an orthopedic doctor at the Cleveland Clinic. That day, I was diagnosed with Reflex Sympathetic Dystrophy. He immediately called one of his colleagues in Pain Management, Dr. Michael Stanton-Hicks, who I believe saved my life.

The next morning at 8 a.m., my mom and I met him. After speaking with him briefly, he asked what I had eaten and drank that morning. Since I had only taken a few sips of a hot chocolate, he had me change into a hospital gown and whisked me into a procedure room for a stellate ganglion block. For the first time in seven weeks, I felt relief. I completed a series of three nerve blocks over several weeks, along with physical therapy and medication.

Gradually, my pain decreased and became manageable.

During my sophomore year of high school, I sprained my right ankle and my RSD/CRPS spread immediately. I was registered to attend camp with my youth group and didn’t want to go on crutches, so I forced myself to walk. It probably saved me. While at camp, my foot doubled in size, my spasms returned, and the pain was unbearable. I knew my RSD was back, but I was four hours from home and couldn’t do much.

When I returned, Dr. Stanton-Hicks gave me two options: resume medications or continue swimming on the high school team and use it as physical therapy. I chose the swim team. I became a lifeguard and learned how to hide my pain when I was on my ankle and leg for too long. I maintained an active social life, and for a while, RSD/CRPS didn’t hold me back—until my junior year.

On a particularly cold and snowy day, I crushed my pointer finger in my car door while trying to warm up. On the drive home, I felt the familiar, fiery, shooting pain down my right arm. By the end of the night, my right hand was atrophied. Dr. Stanton-Hicks attempted multiple nerve blocks and even an epidural with a rehabilitation stay in a pediatric rehab hospital to stop the spread, but unfortunately, my RSD/CRPS was here to stay.

I am now in my 30s and have lived over half my life in severe, excruciating pain. At 18, during my senior year of high school, I had a spinal cord stimulator implanted because medication and physical therapy alone was not enough in terms of pain relief. I am currently on my third battery and will need surgery next year to get my battery switched out.

My spinal cord stimulator gave me my life back. I was able to go to college and became a registered nurse. I worked as a floor nurse up until two years ago when I realized my body couldn’t handle it anymore. My RSD/CRPS slowly worsened, and last year I began monthly low-dose ketamine infusions, which help my body and brain reset. It is an incredible feeling to get even a small break when it feels like your body is being assaulted 24/7. It has always been hard for me to describe what RSD/CRPS feels like. I describe the pain as dousing your arm in gasoline and lighting it on fire while lightning bolts shoot up and down your limb. Most people would be bedridden or in the ER with the amount of pain people with RSD/CRPS manage daily, yet we keep pushing through.

Pain is not only physically exhausting but mentally exhausting as well. For a long time, I was ashamed of my condition. I was told not to talk about my RSD/CRPS, so when it returned in high school, many of my friends were shocked to learn I had been suffering for years. I now work full-time and often feel I have more to prove, even though I know that isn’t true. There are days when I wish I could hand the mental burden to someone else.

RSD/CRPS has taught me many lessons. I learned to advocate for myself and others. Despite my condition, I graduated with my nursing degree and currently work in a doctor’s office. As a floor nurse, I made it a priority to advocate for adequate pain control for my patients.

I’ve learned that not everything is as it seems. On the outside, I look like a healthy 30-year-old. No one sees the medications I take daily, my schedule for charging my spinal cord stimulator, my ketamine infusion routine, the multiple medical appointments, or how carefully I arrange my bed just to get a few hours of sleep. Society often assumes pain comes with age—that young people cannot be chronically ill. I am constantly told, “Just wait until you’re older.” People assume I’m healthy simply because I’m young. It took seven doctors and seven weeks for me to be diagnosed. If not for my mom’s insistence, my pain may have been dismissed as teenage attention-seeking. Sadly, I know warriors who waited months or even years for a diagnosis.

I’ve learned that boundaries are healthy. I love helping others. I love family gatherings and having my nephews over. But I’ve had to accept that my health comes first. I used to push myself until I collapsed from exhaustion. Now, I reserve Saturdays as rest days. I sleep in as long as my body allows. I lounge. I binge-watch TV. I’ve learned that I cannot truly enjoy birthdays, holidays, or time with family if I am barely functioning.

From a young age, I learned the use it or lose it philosophy. Dr. Stanton-Hicks explained how important it was to use my affected limbs daily. Now, doing hand isometric exercises when stiffness sets in is second nature. My dog, Oliver, also motivates me to keep moving. We love exploring the beautiful parks near us.

My biggest advice to both new warriors and those who have lived with this for years: educate yourself and advocate for yourself. Though this disease is incurable, new treatments continue to emerge. If you feel unheard, seek a second opinion. I changed physicians last year after feeling dismissed, and I am finally receiving proper treatment and relief again.

Fortunately—and unfortunately—no one truly understands this life unless they live it. That’s why having someone you can talk to is essential. I met several girls through support groups and in waiting rooms. We quickly became friends. I was terrified before my first ketamine infusion, but they reassured me and checked in afterward. We support each other because we understand what the other is going through.

Just remember: none of us are alone.

Do Not Let This Define Who You Are

Written by Jamie Sparbel for the RSDSA blog

How and when did you develop CRPS?

My CRPS started January 3, 2013, or at least that is when I was injured. I was diagnosed roughly about six months later. I was an EMT and I slipped on ice heading into a patient’s house and originally thought I had broken my wrist so I put a cast on my arm. After more x-rays, they determined it was not broken and they put my arm in a soft splint. I went to PT and massage therapy and nothing was working. Soon after, my ortho sent me to a pain management physician. My pain management physician walked in the room and said, “Yes you have CRPS and we need to stop it from spreading.”

What has daily life been like since your diagnosis?

I was a wreck when I was first diagnosed! I was young, just married and did not have any kids of my own yet. I was worried that this would restrict my life going forward. After about a year with CRPS I have learned to live with it. There are days where the pain is so bad I do not talk to anyone. I cry, I take hot showers, and I just want to cut my arm off. Other days the pain is tolerable and I go about my day where I am fine. I have always told myself, “do not let this define who you are.”

What is one thing you wish those without CRPS could understand?

You will have bad days! This can spread and it will at times be so defeating. But take the good days and remember that yes, this pain is the worst pain you have ever felt, but there is support out there and community that will support each other.

What advice would you give to newly diagnosed Warriors?

Get treatment ASAP. Do not wait! Go get second opinions and fight for your health!

What encouragement would you give to Warriors who have had CRPS for many years?
My CRPS is spreading down my left leg, so I really focus on the good days and what I can do now like spending time with my family, my daughter, and my friends. Sometimes I limp or my arm is in a sling, but I remember that the love I have for everyone is the same love they have for me. I would never wish it on anyone, but I will never let it define who I am, or have anyone remember me like this.

What activities or treatments have helped you find temporary or long term relief?

I am on medication. I find compression really helps in the winter. I also have a spinal stimulator that I love! Honestly, going to the gym really has helped in a weird painful way, lol. 

Anything else you would like to add?

Stay strong! I know it’s easier to say than to do, but that is what will get you through the bad days, weeks, and years. And don’t forget that it is okay to cry!

If you want to connect with Jamie, feel free to send her an email.

Every Day Is Challenging, but She Tries to Remain Positive

Written by Pennie A. for the RSDSA blog.

Hello my name is Pennie and I help my daughter Jess. She has CRPS Type 2 and we live in Sydney, Australia.

Jess was a dancer and was injured by a dance teacher. She had years of surgeries to try and preserve her hip, but unfortunately at 24 she needed a hip replacement. Six months after the replacement she was not recovering as she should have been so then she needed hip revision surgery for the replacement. This is where our nightmare started six years ago. Six days after the revision surgery, Jess was in excruciating pain in the hospital. Her leg from the knee down was purple and paralyzed.

Soon after, the surgeon took her back to the operating theatre. They found adhesions had formed due to years of inflammation that had crushed and adhered her sciatic nerve to two sections of her pelvis. This damage caused CRPS Type 2. Jess had lost the use of her lower leg.

One year down the track a nerve study showed that the sural and tibial nerves had been killed from the crush injury to the sciatic nerve. Her lower leg would never recover. Jess wanted an amputation with the hope to walk once again. We went to see a world renowned surgeon who performed osseointegration here in Australia as Jess could not have anything touching her leg due to hypersensitivity, so a normal prosthetic over her stump was not an option. The surgeon made it quite clear that the amputation would not take away her CRPS pain, but it would give her the ability to walk again as her leg was necrotic (dying). Jess had a below knee amputation at 25 years old with osseointegration. She can walk only short distances, but that beats being confined to a wheelchair.

Jess has a spinal cord stimulator, a bladder stimulator and can’t control her body temperature. She is in constant pain 24/7. Every day is challenging for her, but she tries so hard to remain positive. CRPS has changed her life forever, but she fights this ugly disease every single day. We both hold on to hope that someday, somehow there will be more that can be done to help her pain.

One of the biggest issues Jess and I find is that people look at her and say how great she looks, but my girl wears an excellent mask. The mask comes off around me and I see the hell she lives every day.

The other thing is extended family. They do not understand how hard each day really is for her and they do not make any effort to find out either which is so hard on us both.

My advice to other newly diagnosed Warriors is to learn all you can about CRPS and ask a lot of questions. Try to stay positive and don’t give up. Hold onto hope and find a pain specialist that will listen to you and understands this terrible, life-altering disease.

Bless you all xx

Pennie – A Carer and Mum

When No One Believed Him: A Mother’s Fight and a Son’s Strength

Written by Natalie Mosley Klenotic for the RSDSA blog.

My son developed CRPS as an 11 year old when another child knocked him down at school. The unbearable pain was nearly instant. He thought that he’d somehow broken a bone in his foot. By the time dinner rolled around, he had removed his sock and shoe. As he began homework after dinner, he casually sat with his legs crossed, bumping his foot and the pain increased tenfold.

My son, Gage Klenotic, suffered with CRPS for 3 1/2 years. It was nearly a solid year before a physician diagnosed him. Daily life had us searching for an answer. Our podiatrist knew what Gage had and I knew what Gage had, because sadly I had a friend online, whose little girl suffered with CRPS, but no one else would diagnose him with CRPS.

I began researching all about CRPS. Life during that first year was hellish. I wanted to help my son, so we went to a dozen neurologists, pain physicians and doctors. Luckily, one prescribed physical therapy, so he began it in the hopes of something changing his pain. He completed physical therapy with zero pain medication for six months. Navigating an invisible illness with physicians calling your son a liar was unbelievably difficult during the first months of CRPS and it hurt our whole family. Those 3 1/2 years were traumatic and PTSD-causing.

I advocate and attempt to educate anyone who does not understand illness that can’t always be seen. Invisible Illness is not any less painful than an illness that can be seen with the naked eye. 

To anyone who is the caregiver for someone with CRPS, it is hugely important to listen, support, and help the CRPS patient feel safe and comfortable as they share their painful journey with you. And to anyone newly diagnosed, this community believes you. There is hope. There is hope for you to get better. There is hope to live with it and find a new path.

To anyone living with CRPS, you are an inspiration! I applaud you and anything you insightfully share is appreciated. 

My son found assistance through fludiotherapy. It is a warm sensation created with ground up corn husks being blown around the CRPS appendage. It didn’t cure it, but it was a pleasant sensation. Gage also had capsaicin cream used on his foot while he was under anesthesia. This cream is made from the hottest peppers and it burnt off his nerve endings and helped to reboot his nerves. It took months of recovery, but later he began to experience less pain when he coupled this with mental distractions via his psychiatrist. 

Thank you for this opportunity to advocate. I wrote about my son’s CRPS journey in a children’s book and an adult companion book. The children’s book is being given to newly diagnosed children by my son’s former pain physicians at the children’s hospital. I have also been interviewed on a podcast, because I want CRPS to be better understood. The CRPS community needs more information shared about them. A cure needs to be found. 

You can contact Natalie via Nataliemosleyklenoticbooks.com and [email protected].

A Journey To Relief: Tony’s Story


Abbott is an annual sponsor of RSDSA.

Living with complex regional pain syndrome (CRPS) can bring daily challenges as individuals navigate life under the weight of persistent, severe pain. For Tony, his journey with severe pain started when he was diagnosed with rheumatoid arthritis at 19. Despite the physical toll, he built a remarkable career as a top chef at restaurants across the country.

“My attitude was always: Keep moving through [the pain],” said Tony. Yet he had numerous surgeries and fusing procedures to try and control his pain. And nothing really worked.

“After I [had fusion surgery on] my ankle in 1991, I was never really that mobile. I dragged my leg around,” Tony explained.

“If you want to be mobile, cut it off”

Tony heard this unwelcome advice from a doctor, so at age 40 he made the difficult decision to have his left leg amputated below the knee in the hopes of increasing his mobility.

For a while the amputation helped alleviate Tony’s pain. And with physical therapy, he learned how to get around on one leg, even mastering skiing. But 5 years later, he developed severe nerve pain, diagnosed as complex regional pain syndrome (CRPS). That’s when his pain specialist told him about DRG therapy.

Finding a life-changing therapy

Tony initially did a trial period with DRG therapy to see if it could provide some relief. The first day of his trial period, he felt so good that he walked 5 miles around New York City.

“It felt great,” he said. “Up to that point, I had not walked that far in about 5 or 6 years.” Tony then had a permanent DRG system implanted. And he said he’s never felt better. The majority of his nerve pain is relieved, so he’s able to hike again—and even able to go back to skiing. He’s now a ski instructor for disabled people.

“For me, it’s been a life-changing device,” Tony said of DRG therapy. I don’t give up.”

Tony hopes his story can help other people also suffering from CRPS I or Causalgia (CRPS II). “What people need to know is that if you have nerve pain, [DRG therapy] has a huge potential to change the quality of your life,” he said. “For me, it has completely changed the quality of my life.”

What is Proclaim™ DRG Therapy?

Proclaim DRG Therapy is a novel neurostimulation technology that relieves pain at the source by interrupting pain signals at the dorsal root ganglion (DRG) before they reach the spinal cord. The DRG is a cluster of sensory nerve cells that sit along the levels of the spine that researchers have shown to help modulate pain signals from areas of the body where people experience pain. 1 Differing from traditional tonic spinal cord stimulation that has been used for decades, DRG stimulation may be a better choice for those with CRPS I or causalgia of the lower extremities. 2

By focusing electrical stimulation specifically on the DRG pain signals can be interrupted so you don’t feel pain in the same way. Proclaim DRG therapy has been clinically proven to provide significant pain relief, improve physical function, and enhance quality of life. 2*

Eligible patients can trial the therapy to see if it provides meaningful pain relief before committing to a permanently implanted system. 3 To learn more about DRG therapy watch Dr. Kiran Patel’s webinar that covers the nature of pain, common pain conditions, and therapeutic options for pain relief.

ISI

This testimonial relays an account of an individual’s response to the treatment. This patient’s account is genuine, typical, and documented. However, it does not provide any indication, guide, warranty or guarantee as to the response other persons may have to the treatment. Responses to the treatment discussed can and do vary and are specific to the individual patient.

These materials are not intended to replace your doctor’s advice or information. For any questions or concerns you may have regarding the medical procedures, devices and/or your personal health, please discuss these with your physician.

*Quality of life observed in other endpoints in the ACCURATE study

1. Esposito, M., Malayil, R., Hanes, M., & Deer , T. (2019, June). Unique Characteristics of the Dorsal Root Ganglion as a Target for Neuromodulation. U.S. National Library of Medicine. https://pmc.ncbi.nlm.nih.gov/

2. Deer TR, Levy RM, Kramer J, et al. Dorsal root ganglion stimulation yielded higher treatment success rate for complex regional pain syndrome and causalgia at 3 and 12 months: a randomized comparative trial. Pain. 2017;158(4):669-681. doi:10.1097/j.pain.0000000000000814

3. Proclaim™ DRG Neurostimulation System Clinician’s Manual. Plano, TX. 2025.

Risk Information: The placement of a neurostimulation system requires surgery, which exposes patients to certain risks. Complications such as infection, swelling, bruising, and possibly the loss of strength or use in an affected limb or muscle group (e.g., paralysis) are possible. Additional risks such as undesirable changes in stimulation may occur over time. Be sure to talk to your doctor about the possible risks associated with neurostimulation.

Rx Only

Brief Summary: Prior to using Abbott devices, please review the User’s Manual for a complete listing of indications, contraindications, warnings, precautions, potential adverse events, and directions for use. The system is intended to be used with leads and associated extensions that are compatible with the system.

Indications for Use: Spinal column stimulation via epidural and intra-spinal lead access to the dorsal root ganglion as an aid in the management of moderate to severe chronic intractable* pain of the lower limbs in adult patients with Complex Regional Pain Syndrome (CRPS) types I and II.**

*Study subjects from the ACCURATE clinical study had failed to achieve adequate pain relief from at least two prior pharmacologic treatments from at least two different drug classes and continued their pharma- cologic therapy during the clinical study.

**Please note that in 1994, a consensus group of pain medicine experts gathered by the International Association for the Study of Pain (IASP) reviewed diagnostic criteria and agreed to rename reflex sympathetic dystrophy (RSD) and causalgia, as complex regional pain syndrome (CRPS) types I and II, respectively. CRPS II (causalgia) is defined as a painful condition arising from damage to a nerve. Nerve damage may result from traumatic or surgical nerve injury. Changes secondary to neuropathic pain seen in CRPS I (RSD) may be present, but are not a diagnostic requirement for CRPS II (causalgia).

Contraindications: Patients who are unable to operate the system, who are poor surgical risks. Patients who have failed to receive effective pain relief during trial stimulation.

Warnings/Precautions: Diathermy therapy, implanted cardiac systems or other active implantable devices, magnetic resonance imaging (MRI), computed tomography(CT), electrosurgery devices, ultrasonic scanning equipment, therapeutic radiation, explosive and flammable gases, theft detectors and metal screening devices, lead movement, operation of machinery, equipment and vehicles, pediatric use, pregnancy, and case damage.

Adverse Effects: Unpleasant sensations, changes in stimulation, stimulation in unwanted places, lead or implant migration, epidural hemorrhage, hematoma, infection, spinal cord compression, or paralysis from placement of a lead in the epidural space, cerebrospinal fluid leakage, tissue damage or nerve damage, paralysis, weakness, clumsiness, numbness, sensory loss, or pain below the level of the implant, pain where needle was inserted or at the electrode site or at IPG site, seroma at implant site, headache, allergic or rejection response, battery failure and/or leakage. User’s Guide must be reviewed for detailed disclosure.

I Never Gave Up

Written by Krystal Jones for the RSDSA blog.

My name is Krystal Jones and this is my story about how my journey started.

Around the age of 15, my left knee started hurting seemingly out of nowhere. It started out with a little pain and then it got progressively worse over the years.

I was diagnosed with CRPS/RSD back in 2014 by pain management doctors, but the cause of my pain was unknown at the time. Therefore, some doctors told me that I didn’t have CRPS because I was “too young” to be going through that much pain. They thought I was crazy and that I was imagining this pain. They said there was nothing else they could do for me. However, I never gave up.

I consulted with various specialists, including pain management doctors, orthopedic surgeons, sports medicine experts, my primary care physician, physical therapists, rheumatologists, neurologists, and a few behavioral therapists to see if I had CRPS. I tried so many treatments including medications and supplements (with a lot of allergic reactions), different types of topicals, ointments, several injections, multiple surgeries and procedures.

After all of the consultations, I suspected that my first knee surgery, an arthroscopic knee procedure on November 2, 2006 to repair a cartilage tear in my left knee, might have triggered my symptoms of CRPS/RSD as the pain in my knee began to get worse after that. I do not know how the tear came about because I do not remember falling and I did not play sports.

Throughout the years, I have faced numerous challenges, yet I have always overcome obstacles. In May 2020, a former primary care doctor diagnosed me with CRPS Type 1 after I experienced severe, disproportionate pain and underwent various tests, including X-rays, CT scans, nerve test (EEG and EMG), physical therapy, extensive family medical history evaluations and blood work.

Daily life is hard because my symptoms vary and affect both of my knees and feet. CRPS has changed my life. Sometimes I feel ok, but then I have tremors in my right arm and leg that come and go. I start stuttering and I have panic attacks. I sometimes feel confused and it’s hard to hold a conversation. I have brain fog and sometimes it’s hard to decide which leg I want to move first. I have throbbing, sharp, and shooting pain in my knees in addition to muscle spasms in my back that come and go. I have burning pains at the top of my feet and in between a few of my toes. I am on disability. I worked for 14 years as a cashier at a supermarket while dealing with chronic pain.

I wish people who don’t have CRPS/RSD could understand that we are asking for support, comfort and compassion as this is what we go through every day. It is not easy and we try our best to push through. This burning, fire, intense pain along with other symptoms is a constant battle. This pain is REAL!

Things that help me get through my journey include praying daily, meditating, reading books, writing in my journal, relaxing, listening to music, adult coloring books and spending time with my family. I also have a permanent Dorsal Root Ganglion (DRG) stimulator implant in my back.

I have been married to my amazing husband for five years now. I do not have any kids of my own, but I do have one bonus son. I have one sister and one brother and through them I have two beautiful nieces and two handsome nephews.

Krystal recently self-published her first book titled Overcoming Obstacles- This Is My Testimony. Feel free to connect with her on Facebook, Instagram, and via email.

Guest Blog: After 20 Years of CRPS/RSD Pain, Relief Has Finally Arrived With Journavx!

Written by Chris Connelly, D.O., CAQOM, MRO (ret) for the RSDSA blog.

Hello. My name is Chris. Actually, I’m Dr. Chris. I have practiced medicine for 32 years.

Guess what else I am? I am an RSD/CRPS sufferer, probably pretty much like you, if you’re reading this blog.

I was fairly certain of what I had, so I went to the doctor to have my diagnosis confirmed. She confirmed it alright. That was 20 years ago. I learned about RSD as a junior in medical school. I knew even way back then RSD was an ugly painful disease. What I didn’t know was how terribly painful RSD can be. I also didn’t know how limited and difficult treatment could be.

RSD and its treatment had exceeded my worst fears. Even a good graphic description of RSD in a book doesn’t do justice to the depth and breath of the terrible pain and life changing consequences that RSD will produce. Only living through the ups and downs of the excruciating pain and disability can a person truly learn the catastrophic effects that RSD will have on them. As bad as I had it, I’ve read about those who have had it much worse, endured more procedures, and had poorer outcomes than I.

I believe a new hope and relief of RSD/CRPS pain has finally arrived. There is a new medicine on the market and it is now available for use. The medicine is called Journavx (suzetrigine) made by the pharmaceutical company Vertex. It is an entirely new type of painkiller not related to any others. Journavx is non-narcotic, non-opioid and not addictive. It has no psychogenic effects whatsoever. It works by the unique mechanism of plugging the hole in the genetically defective sodium ion channels. It is the passage of sodium ions through the sodium channels that accumulate on the inside of the cell membrane that causes pain impulses. When the sodium channels have a genetic defect, they remain totally open letting sodium ions pass freely without restriction or control.

Simply put, Journavx plugs the hole: no sodium ion accumulation, no pain impulse generation, thus no pain.

The technical research that discovered these molecular structures and their functions is truly amazing. The cleverness and hard work of the research scientists is incredible to the point of almost seeming like magic or Star Wars. Neither magic nor space stories, these painkilling discoveries came about through imaginative brilliant scientific minds and relentless hard work. The result of which is a new medicine targeted at CRPS-type pain with very few side effects of its own.

Does it really work? Yes, Journavx really works for me.

How well does Journavx work? Read on and I will tell you.

I am fairly well versed in the technical aspects of the mechanism of action of Journavx including the molecular neurobiochemistry of the structures and their functions. This is all most impressive, but it is meaningless unless the medication actually relieves pain. I can speak for no one but myself. I can honestly state that Journavx has relieved 90+% of my RSD pain from the first day of taking the medicine.

As of this writing, I am on day 20 of Journavx and have little to no RSD-type pain. In my personal opinion, Journavx works very well for RSD-type pain. It works well for RSD-type pain because I must have the genetically defective sodium channels. Journavx plugs the hole.

Don’t expect Journavx to work wonderfully on every and any old pain. It wasn’t designed for that. It was designed for neuropathic pain of the RSD-type and at this, Journavx excels!

For me, well, I’m starting a new life or at least a new chapter in life. No opioids, no fogged brain or constipation, no needles, no blocks, no surgeries and no electrodes running down my spine, I can pretty much do what this septuagenarian body will permit me to do. Of course I have limitations. RSD has ravaged my left leg and body for two decades. I don’t get those years or my youth back. I do get to go on with my life relatively pain free because of Journavx. To me, after 20 years of excruciating agonizing pain, that seems miraculous, but it is actually cutting-edge brilliant science.

It is my fervent hope that all CRPS/RSD sufferers will at least know about Journavx and maybe give it a try. Because it is a very safe medication with few serious side effects, CRPS/RSD sufferers have little to lose but their pain. I personally recommend they try the new medication Journavx, and certainly before they undergo more invasive procedures.

Thank you for reading my blog. I know I didn’t get terribly personal with all the tears, failures and heartbreak. I’ve had them all. Others have described these events and emotions better than I could; please read their blogs. My purpose is to bring the great news of a scientific triumph that may benefit many or all CRPS/RSD victims.

Dr. Chris… C’est La Bella Vie, Mon Amie!

At the time of publication, Vertex and Journavx are not sponsors of RSDSA.

My Path To Surviving CRPS Torture

Written by Jennifer Ferreyra for the RSDSA blog.

Helping others find their path is transforming to your own life, and one of the greatest blessings in mine. It’s about someone who’s already walked in your shoes reaching back and pulling you up out of the rabbit hole. It’s about love, hope, compassion and reducing pain in the worst of circumstances. Why do I care? I’ve been through my own living hell, not just CRPS, and I can’t leave someone in a similar condition if I can help. If anything that follows helps you I’m blessed. If not, please, keep searching for your formula, advocate for yourself and don’t give up.

My CRPS Pain

My CRPS, started in late December of 2016 at age 53 with a severe, raw, lighting bolt-like onset after I thought I paid my dues to cancer 26 years earlier. I absolutely refuse to lose to this disease which produces the most excruciating pain known to man even at the slightest movement or touch.

I share your pain, your tears, screaming, years of personal research, uneducated doctors, unnecessary medications, EMG tests, blurred vision, photophobia, MRIs, CT scans and years of no meaningful resolution. And please, allow me to point out that the smiley face pain level chart in the doctor’s offices is almost offensive to a CRPS patient.

Each of our CRPS pain and torture is different. Maybe I’m lucky that my pain is dedicated only to my left arm. We have little idea as to why it started except to say it was at a very stressful time in my life.

I have less of what is traditionally explained as gasoline burning, but rather a huge lighting bolt of severe nerve pain racing down my arm top to bottom, holding in the wrist, every two minutes. This includes lots of atrophy, skin scraping off like oatmeal, and brachial plexitis. Sleep? The longest I’ve gone without a stitch of sleep was five days at the Mayo Clinic hotel in Florida where absolutely no resolve was found, along with all the other hospitals I consulted with.

My first onset looked like my arm was a dead white corpse. I couldn’t take a step or move a muscle without triggering severe pain. This lasted almost three years and included the use of do nothing IV treatments, epidurals, anti-seizure medications, opioids, prednisone, and withdrawal, after which the pain was resolved for three years post acupuncture then came back. After a year, a new onset of the same pain returned. I submitted to an unsuccessful stellate ganglion block, and thirty days of implants that attempted to address the symptoms not the cause. By now I was a frequent flyer to the MRI and found it easier to keep my own hospital gown at home for dressing.

How RSDS.org Saved Me

I asked multiple doctors about a support group and to be directed to the authority on CRPS. The response was always “I don’t know.” It was then, still totally consumed by CRPS, that I started to advocate for myself and found RSDSA (founded over 40 years ago!) After seven years in pain, I spent hours reading every article, and watching every video trying to find out what causes CRPS and what pain management is working for patients that made the most sense to me. I learned that CRPS is a disease of the brain, not the limb, and that my doctors were indeed treating the symptom of pain not the cause. This made so much sense because I felt as if I had inflammation in my head for years. 

As a result of seeing all the videos, I chose to march into my pain doctor’s office to request a drug referenced by some doctors and patients as successful – called Low Dose Naltrexone (LDN). He said, “oh, we can try that,” as if he already knew about it.

LDN apparently works with the Glia cells in the brain which is currently thought to be an important area of focus for CRPS. The Glia cells and nerves, relative to CRPS, are described in further detail by Dr. Pradeep Chopra in a Court TV trial presentation for the Maya Kawalski case on September 28, 2023 . You can also find information on Glia cells on rsds.org.

For me, 4.5 mg of LDN (less than $50 per month) showed immediate signs of success and took my pain from 12 to zero in a few months. I am now 16 months pain free. To start I had vivid dreams and mild headaches, which are expected. These subsided after a few months. My understanding is that Naltrexone does not work for everyone, but if it does or if you want to learn more, visit ldnresearchtrust.org, which I also found on my own. I have even emailed questions to the Trust and had return responses. 

Rhetorically, why was I prescribed years of opioids that didn’t work and never told of LDN by any of over ten doctors anytime over seven years? Why did it take my own initiative in excruciating pain to find my own way? Why don’t doctors know about RSDS.org?

I strongly suggest reading and viewing everything on the RSDSA site. Advocate for yourself. Spend the time, in addition to your doctor consults. Take notes. See what resonates with you. It’s empowering.  

Also keep an eye on the RSDSA YouTube Channel! https://www.youtube.com/@RSDSA

How I “Survived” Many Years of CRPS Torture 

CRPS is a courageous fight of physical and emotional suffering. It’s like bleeding from a wound you can’t tell anyone about because they don’t understand. What follows is what aided me in surviving years of CRPS torture. I’ve broken this up so that you can eat the meat and spit out the bones as they say. None of this will fully resolve CRPS, but it was my path out.

Mindset

You must grab on to and not let go of even the smallest thing that takes your mind away from CRPS or any other problem you may have. This is one of the ways out.

Mindset is powerful. CRPS is a brain disease so this makes sense. And this is supported by multiple doctors. For years I found myself latching onto anything that would take my brain’s thoughts away from CRPS pain. Strangely enough, and even to this day out of pain, my cell phone is always with me set to something which will distract my brain from CRPS and other health issues. Music, TV, podcasts, even if I’m not cognitively listening to it. One of my consistent choices is The Today Show every weekday morning before work. This feels to me like I had friends with me every second and the anchors were uplifting. Even NFL and MLB games work.

I recently ran across a clip on Facebook where Jim Carrey describes being buried alive over the eight hours it takes to apply the Grinch make-up, which he did 100 times. The story goes on to say that he put his foot through his trailer wall on day one and quit because he couldn’t take it. A CIA operative with expertise on how to survive torture was hired to help. While I don’t prescribe to the methods mentioned, Jim did say that somehow every song the Bee Gees ever made got him through the eight hour make-up applications. I laughed out loud because those songs did the same thing for me with CRPS pain. It was something about the Bee Gees. Of course there were other songs, but whatever works for you on any given day.

Somehow music speaks to the spirit like words can’t. I heard someone recently say that “music gives organization to our emotions.” In our family, Spotify is the best $12 we spend every month. Almost any imaginable song that might work in a day is there and more. At night I leave the rain and ocean music on to help get me to sleep. 

Mindset is often framed by time with friends, laughter, a photo in a magazine… find a way out and keep it going. Ups and downs are to be expected, but reward or praise yourself for even the smallest victories.

Look up Dr Philip Getson’s “The Optimist Creed”. This was recently shared on a slide in his March 6, 2025 Live Stream with RSDSA on YouTube.

Hope, Expectation, Perseverance

Do not be a bystander in your own life.

Hope is mandatory. 

It’s painful to wait in the hope line, but you must hold onto even the smallest glimmer of hope in your brain. Even if it’s a piece of sand. Find it! You must work at this every day. Focus on it. There will be good days and bad days but you must continue to pull out of the defeatist attitude by latching onto any glimmer of hope, any positive path that your brain provides.

If you can only move one finger or toe, do it, and praise yourself so that your mind understands this is victory. Then add another victory, praise it and so on.  

With perseverance and strength your minds perspective should change for the good and you’ll be encouraged to continue. Do not give up.

Food

Eat an anti-inflammatory diet, stay hydrated.

I’ve found that soy, alcohol, coffee, non-organic, and processed foods increase inflammation in my diet.

I’m lactose intolerant and removed soy from my diet with immediate positive inflammation changes. I now only drink organic almond milk, and organic products where possible. I completely stopped drinking coffee and alcohol which cause almost immediate inflammation in my head. I stay away from products where the first ingredient is generally entitled “enriched”which appears to be a proprietary cocktail of god knows what.

Heat/Cold  – My Heated Vest, Lawn Lounge Chair Pad, Steam Shower and Hot Towel

There is so much to CRPS that we had to learn on our own. Not a single doctor told me that CRPS may be impacted by weather, barometric pressure, and that nerves don’t like cold until years into CRPS after I figured out how to cope for myself. 

In spring, summer and fall, my outdoor lounge chair pad becomes hot in the sun and has been a wonderful aid to relax my muscles.

I can’t do without my heated fleece vests. I use Ororo brand but there are others. I wear the vest around the house and under layers when I go out in winter. 

When pain starts I force my self into a warm shower which includes a steam shower. Heat warms my muscles, increases circulation and seems to put me on a better path. Do not sit and do nothing, you’re patterning your brain to accept the pain path.

In desperate times of pain I wet a hand towel, roll it, put it in the microwave and then throw it over my arm for moist heat. If it’s too hot, add a dry towel over it. Remove it before it becomes cold and start again.

Please note, CRPS also doesn’t like to be too hot, so it’s a balancing act. I’m constantly adding and removing layers on and off throughout a day.

Cut the Stress

When stress enters my life I immediately get non-painful shocks to my bottom lip and my entire nervous system starts shaking beneath my skin. I’m told this is also from the brain and likely from years of CRPS pain without resolve. I’ve had to choose between my health and unhealthy relationships. Be your own advocate and chose that your health comes first. For me this meant stepping back in full or part from certain relationships and events.

Call Me Crazy – Just For Fun 

I DON’T RECOMMEND THE FOLLOWING, except for riding in the golf cart and staying active, but perhaps the following shows my level of commitment, or maybe just my stupidity. (Now I know you must be gentle with CRPS and full on golf may not be the way to do it.)

CRPS Onset #1 – Parenting: I’m a single parent and things had to get done. I would drive my car locally for two minutes, pull over and scream at the top of my lungs in pain, then drive for another two minutes and repeat. I conducted every aspect of my CRPS life with one arm for years. Made beds, did laundry, cooked food, shopped for food, worked a full time desk job, typed, even if it meant triggering level 12 pain.

CRPS Onset #2 – Golf: To pattern my brain for the better, I rode in a golf cart and didn’t play. As part of this plan, I didn’t anticipate actually playing, but that turned out differently. I went so far as to “play” golf in 10 of 10 pain for about three months until Naltrexone worked. I skipped any golf hole where someone other than my three golf friends were present. The pain would trigger when I hit the ball and I would yell a few choice four letter words and try to compose myself.

Going in and out of the golf course was okay. As long as I didn’t press on the left arm I could conduct conversations and nobody would know. If I felt pain coming, I would promptly excuse myself and try to get away fast.

Just sick. But as I said, I refuse to lose to this disease. And I refuse to let it take golf away from me.

Today

I’m 61 years old and 16 months out of pain on LDN which I expect to take for my lifetime. Over exertion causes severe exhaustion and shaking of my entire central nervous system. As I write, I have a persistent pinch in my back where my brain is recalling a years old mildly painful acupuncture needle. I’m addressing this by sitting on my yard lounge chair with a pad that is hot from the sun. 

Being out of severe pain is a blessing, but I work hard every day toward ensuring my brain doesn’t recall the pain of what I hope is in the past.