Complex Regional Pain Syndrome (CRPS) Treatment

Medically reviewed by Joshua L. Hare, DO, Founder & Medical Director

Complex regional pain syndrome (CRPS) after an injury or surgery

Complex Regional Pain Syndrome is a chronic pain condition that typically develops after an injury, surgery, or trauma to an extremity. It is characterized by pain that is disproportionate to the initial injury,[1] along with changes in skin color and temperature, swelling, abnormal sweating, and extreme sensitivity to touch (allodynia). CRPS involves dysfunction of the sympathetic nervous system and central nervous system sensitization, making it one of the most challenging pain conditions to treat. At IPC, our specialists have extensive experience managing CRPS with a multimodal approach that may include sympathetic nerve blocks (stellate ganglion or lumbar sympathetic blocks), spinal cord stimulation, dorsal root ganglion (DRG) stimulation, and carefully coordinated medication management.

Symptoms of CRPS

CRPS is distinguished by pain that is clearly out of proportion to the injury that started it — and sometimes by the absence of any injury anyone can identify. It most often affects an arm or a leg and typically involves changes the patient can see, not only pain they feel.

• Continuous burning, throbbing or aching pain, usually in a limb, disproportionate to the original event
• Extreme sensitivity, so that light touch, clothing, bedsheets or a breeze cause real pain, and mild pressure causes severe pain
• Visible changes in the affected limb: altered color (red, blue, blotchy or pale), a temperature difference compared with the other side, and swelling
• Changes in sweating, and over time changes in skin texture, nail growth and hair growth
• Stiffness, weakness, tremor, or difficulty starting movement in the limb

The combination of severe pain plus visible color, temperature or swelling changes is what most distinguishes CRPS from a straightforward nerve injury.

When to see a pain specialist about CRPS

Sooner is materially better with CRPS, and this is the main practical point on this page. Where most pain conditions can reasonably be given weeks of conservative management, suspected CRPS should be evaluated promptly, because outcomes are generally better when treatment starts early in the course rather than after the limb has become stiff and deconditioned.

Ask for an evaluation if pain after an injury, fracture, sprain or surgery is far more severe than expected, is spreading beyond the original area, or is accompanied by the color, temperature, swelling or sweating changes described above — particularly if you have started protecting the limb and using it less.

Treatment usually combines sympathetic nerve blocks, medication aimed specifically at nerve pain, and — importantly — physical therapy that the blocks are intended to make tolerable. Restoring movement is part of the treatment, not something that waits until the pain is gone.

Treatment options for complex regional pain syndrome (CRPS)

CRPS is usually approached in steps. Sympathetic blocks come first, both to treat the pain and to confirm the diagnosis, with neuromodulation considered when the response is real but short-lived. The options below follow that order.

References

Clinical sources for this page.

1. Complex Regional Pain Syndrome. StatPearls [Internet], National Library of Medicine; updated May 4, 2025. Back to first citation ↑