Complex Regional Pain Syndrome Care in Singapore

Complex Regional Pain Syndrome Treatment

There is always a chance that a patient may recover on its own without any treatment. But considering the debilitating nature of the disease, it’s important to start the treatment as soon as possible. The sooner you start the treatment, the better your chances of recovery. It not only improves symptoms but also restores the functionality of the affected limb and prevents disability.

Here are the treatment options for complex regional pain syndrome:

Medications

No drugs are specifically approved for the treatment of CRPS. Your healthcare professional might prescribe these medications to manage your symptoms.

●  Non-Steroidal Anti-inflammatory Drugs 

Drugs, such as Naproxen,  Ibuprofen and Tylenol, may help manage pain and inflammation associated with the condition.

●  Opioids

Over-the-counter drugs won’t work for severe pain. In this case, your healthcare professional might prescribe stronger painkillers that belong to the class of drugs called opioids. Examples include fentanyl, oxycodone and morphine.

●  Corticosteroids

 Corticosteroids, such as prednisolone, might help manage inflammation and improve the range of motion of affected limbs.

●  Anticonvulsants

These groups of medications are usually used to treat epilepsy. However, they can also help manage nerve pain. Gabapentin and pregabalin are the most widely used anticonvulsants for complex regional pain syndrome.

●  Tricyclic Antidepressants

Medicines, such as amitriptyline and nortriptyline, also help manage neuropathic pain.

●  Calcium Channel Blockers

These drugs are used for the management of vasomotor symptoms due to their ability to modulate neural signaling and vascular tone.

Physical Therapy

Physical therapy is a significant part of the treatment of complex regional pain syndrome. It may help increase blood flow to the affected limb, thus improving flexibility and function. It also prevents or reverses complications, such as muscle atrophy or joint stiffness.

It improves your overall health and the ability to perform daily tasks. Your physical therapist might use the following techniques:

●  Desensitization

It is done to reduce hypersensitivity to pain and to improve your tolerance to various sensations.

●  Graded Motor Imagery

This therapy helps retrain your brain and reduce pain and disability.

●  Functional Training

It helps you learn safe, controlled movements that remove the stress from the affected limb and improve your ability to perform daily tasks.

●  Manual Therapy

It helps reduce pain and improve the function of the affected limb by addressing muscle spasms and disuse atrophy.

●  Mirror Therapy

It uses a mirror to trick the brain into perceiving movement in the impaired limb, when, in fact, movement is occurring in the healthy limb. This technique helps rewire the brain and correct the neural abnormality associated with CRPS.

Psychological Support

Living with complex regional pain syndrome is quite challenging and patients may experience certain psychological problems, such as anxiety and depression. It can interfere with your recovery and might deteriorate your health further, so it’s important to look after your mental well-being.

Seeking psychological support can help you recover and improve your symptoms. Research suggests that cognitive behavioral therapy is effective in managing chronic pain conditions. It has been shown to alleviate pain, improve mood and boost overall function in patients with CRPS.

The goal of cognitive behavioral therapy is to make you understand how your thoughts, behavior and feelings affect each other. By understanding your condition and how you feel about it, CBT can help you manage your symptoms better. CBT is particularly beneficial when used as a part of a physical rehabilitation programme.

Interventional Therapies

These are minimally invasive procedures that target the source of your pain to provide relief and improve your quality of life. These procedures include:

●  Sympathetic Nerve Blocks

These are considered the first-line treatment options for the management of complex regional pain syndrome. Your healthcare provider will inject anesthetic drugs to block the pain fibers in the affected nerve, thus providing temporary relief. Your doctor will inject anesthesia on the side of your neck (stellate ganglion block) or in your lower back (lumbar sympathetic block).

●  Dorsal Root Ganglion Stimulation

It targets the dorsal root ganglion, which acts as a relay center and sends pain signals from the affected limb to the brain. The procedure involves sending electrical impulses to the dorsal root ganglion, thus modulating the pain signals before they reach the brain.

●  Spinal Cord Stimulation

In this procedure, your healthcare provider will implant a small device under the skin near the spine. This device will generate electrical impulses and send them to nerves in the spinal cord. This, in turn, reduces pain signals from reaching the brain.

●  Intrathecal Delivery

In this procedure, your doctor will implant a small pump under the skin that delivers medication directly to the spinal cord. This technique allows for a smaller dose of medication to be used as it delivers the drug directly to the source of pain.