About complex regional pain syndrome (CRPS)
CRPS usually develops after an injury, fracture, surgery, or period of immobilization, and the pain spreads beyond the injured area and lasts longer than expected. The nervous system becomes overly sensitive, and the nerves that control blood flow and sweating in the limb can stop working normally.
People with CRPS often guard the painful limb and stop using it, which is understandable but can make the condition worse. Early recognition and a steady return to movement are among the most important parts of care, supported by treatments that make movement tolerable.
Common symptoms
- Burning or deep aching pain out of proportion to the injury
- Extreme sensitivity to touch, cold, or light pressure
- Swelling and changes in skin color or temperature
- Changes in sweating, hair growth, or nail growth in the limb
- Stiffness, weakness, or trouble moving the affected limb
Common causes and risk factors
- Fractures, especially of the wrist or ankle
- Sprains, crush injuries, or other soft tissue trauma
- Surgery or long periods in a cast or splint
- Sometimes a minor injury, or no clear trigger
How we diagnose it
CRPS is a clinical diagnosis, meaning it is based on a careful history and exam that looks for a specific combination of pain, sensitivity, swelling, color, temperature, and movement changes. Dr. Chen also looks for other problems that can mimic CRPS, such as a nerve injury, infection, blood clot, or poorly healed fracture, and may use ultrasound, nerve testing, or imaging to rule them out.
How Propel treats complex regional pain syndrome (CRPS)
Active rehab is the core of treatment. A therapist guides graded movement, desensitization, and strength work, often including techniques that retrain how the brain processes signals from the limb. Medications may be used to calm nerve pain and improve sleep, and we pay attention to stress and mood, which can amplify CRPS symptoms.
Sympathetic nerve blocks, which calm the group of nerves involved in blood flow and pain in the limb, may reduce pain enough to allow better participation in therapy. For CRPS that persists despite these steps, spinal cord or dorsal root ganglion stimulation may be considered. This is performed as an outpatient procedure, starting with a temporary trial before any permanent device is placed.
What to expect at your visit
- 1.
We listen first
Your visit opens with a real conversation: how the problem started, what you have already tried, and the activity you want back.
- 2.
Exam and in-office ultrasound
A hands-on exam, then ultrasound at the exam table, often while you move, so your physician can see the tendon, joint, or nerve involved.
- 3.
A clear diagnosis and plan
You leave knowing what is wrong and what your options are, from strength-based rehab to procedures, and why we recommend each one.
- 4.
Treatment and follow-through
Most procedures happen here in the office. We coordinate with your physical therapist and check progress against the goals you set.
Questions about complex regional pain syndrome (CRPS)
- Can CRPS go away?
- Many people improve, especially when CRPS is recognized early and treated with active rehab. Some have symptoms that persist or come and go, and the goal then is to reduce pain and keep the limb working as well as possible.
- Is it better to rest a limb affected by CRPS?
- Gentle, regular use is usually better than rest. Avoiding movement can lead to stiffness and worsen sensitivity. Your therapist will help you find a level of activity you can build on steadily.
- What does a sympathetic nerve block involve?
- Numbing medication is placed near a group of nerves in the neck or lower back that serve the affected limb, using imaging for guidance. If the block helps, the relief can create a window for more productive therapy, and the block may be repeated.