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What Is Complex Regional Pain Syndrome (CRPS)? Symptoms, Causes, Diagnosis, Treatment & Outlook

Oct 15
20 min read

Updated: 3 days ago

Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026

Quick Answer

Complex regional pain syndrome (CRPS) is a condition in which damaged nerve fibers in a limb, most often after a fracture, sprain, surgery or burn, trigger an inflammatory reaction the nervous system cannot shut down. It affects roughly 200,000 people in the U.S. each year [2]. Treatment combines physical therapy, psychotherapy, pain medications and, for severe cases, nerve blocks [2].

Key takeaways

  • What it is: A neurological condition causing pain and skin changes in one body part, usually an extremity [1].

  • Most common site: The hand.

  • How common: Relatively rare — about 200,000 people per year in the U.S. [2]

  • Typical onset: Usually 4–6 weeks after an injury, fracture or surgery [2]; peak onset around age 40.

  • Who it affects: Women more than men; mostly adults [1] [2]; about 66–80% of cases in people of European ancestry [2].

  • Two types: Type I (no direct nerve damage) and Type II (known nerve damage) [1] [2] [3].

  • Main symptom: Burning, stinging or tearing pain that is constant or intermittent [1] [2].

  • Other signs: Swelling, skin color/temperature/texture changes, stiffness, hair and nail growth changes [1] [2].

  • Diagnosis: No specific test — medical history, physical exam, symptom review [1] [2]; imaging and EMG to rule out other causes.

  • Best treatment window: Early [1] [3] — before the limb stiffens and pain worsens.

  • Outcome: Usually improves over time and enters remission in most people; recurs in 10–30%.

  • Prevention: Not conclusively preventable; vitamin C before surgery may help.

What the research says

  • Physiotherapy is widely recommended, but the evidence behind it is thin. A Cochrane review of 34 randomized trials (1,339 participants) found that most trials were small and at high risk of bias, and the certainty of the evidence was very low for every comparison, so the effects on pain and disability remain very uncertain. One trial of 135 participants found that multimodal physiotherapy gave a small improvement in disability at 12 months compared with an attention control (mean difference −3.7 points on a 5–50 scale) (Smart et al., Cochrane Database Syst Rev, 2022) [6].

  • Mirror therapy and graded motor imagery show promise. In a systematic review and meta-analysis of 33 randomized trials, low-quality evidence suggested that mirror therapy (added to stroke rehabilitation) and a graded motor imagery program may greatly improve pain and disability for up to 6 months in people with CRPS type 1 after a stroke. Pain exposure therapy and aerobic exercise added to physical therapy may also improve pain, while the evidence for most other treatments was very uncertain (Shafiee et al., Clin J Pain, 2023) [7].

  • Bisphosphonates may ease pain for a while, but they come with side effects. In a meta-analysis of 11 placebo-controlled trials (754 participants, 97% CRPS type I), bisphosphonates may reduce pain by 10.0 points on a 0–100 scale in the short term (more than 4 weeks to 3 months; 95% CI 1.1 to 18.9), with little to no difference at 4 weeks or less and at 3 to 6 months. They probably increase the risk of adverse events (risk ratio 1.1) (Ferraro et al., Ann Intern Med, 2026) [8].

What Is Complex Regional Pain Syndrome (CRPS)?

What is complex regional pain syndrome? A hand with blotchy red and pale patches inside radiating contour lines, a thermometer icon beside it, and dotted pain-signal lines running from the wrist to a brain at the upper right. – rinnit.com
CRPS causes pain and skin changes in one limb, driven by pain signals that the nervous system cannot switch off.

Complex regional pain syndrome (CRPS) is a condition that causes pain, changes in skin color and other symptoms in a certain part of your body — usually in your extremities, which include your arm, leg, hand or foot [1]. It most commonly affects the hand.

The symptoms of CRPS can greatly impact the function of your affected limb, your sleep, your daily activities and your mental health [1].

Experts believe that CRPS occurs as a result of dysfunction in your central or peripheral nervous systems. Your central nervous system consists of your brain and spinal cord. Your peripheral nervous system relays information from your brain and spinal cord to your organs, arms, legs, fingers and toes. In CRPS, that abnormal functioning results in an overreaction to pain signals that your nervous system can't shut off.

CRPS affects roughly 200,000 people in the United States every year [2], making it relatively rare.

The two types of CRPS

Type

Former name

What triggers it

Type I

Reflex sympathetic dystrophy

Occurs without nerve damage — after an illness or injury that didn't directly damage a nerve [1] [3]

Type II

Causalgia

Occurs after known nerve damage [1] [3]

Is CRPS acute or chronic? CRPS can be either acute (short-term) or chronic (lasting longer than six months). It is usually treatable.

Who does CRPS affect?

CRPS more commonly affects adults than children [1] [2], with a peak onset around 40 years of age. It affects women more often than men [1] [2] [3]. About 66% to 80% of cases occur in people of European ancestry [2].

CRPS Symptoms

How severe and how long symptoms of CRPS last varies from person to person. Symptoms typically start within four to six weeks after an injury, fracture or surgery [2] — but they can also develop without a known cause [3].

The most common and prominent symptom of CRPS is pain. The pain is constant or intermittent [1] and feels like a burning, stinging or tearing sensation [2]. It is often deep inside your affected limb [2].

Sensory changes are also common in the affected area:

  • Increased sensitivity to painful stimuli — a pinch may feel more painful than usual [2].

  • Feeling pain from stimuli that are usually not painful, such as just touching your skin [1] [2].

  • Numbness [2].

CRPS symptoms at a glance: a nine-tile chart showing a hand with burning pain, a droplet and finger for heightened sensitivity, a feather touching skin for pain from light touch, a swollen hand, a stiff hand with arrows, a thermometer for temperature changes, a blotchy hand for skin color changes, a droplet with squiggles for sweaty skin, and a nail with hairs for nail and hair growth changes. – rinnit.com
Common symptoms of CRPS at a glance: burning pain, heightened sensitivity, pain from light touch, swelling, stiffness, temperature and color changes, sweating, and nail and hair growth changes.

Other symptoms of CRPS in the affected area include:

Symptom

How it appears

Skin swelling

May come and go or remain constant

Decreased limb function

Reduced ability to move the limb, increased stiffness, difficulty placing pressure on the limb or joint

Skin temperature changes

The skin may feel warmer or cooler compared to the opposite limb [1] [2]

Skin color changes

Skin may appear blotchy, pale, purple/bruised or red [1]

Skin texture changes

Skin may become shiny and thin, or excessively sweaty [1]

Nail and hair growth changes

Rapid hair or nail growth, or no growth at all [1]

Because symptoms of CRPS usually improve over time, the condition is easiest for healthcare providers to diagnose in its early stages. It's important to see a provider soon after you experience CRPS symptoms.

What Causes CRPS?

Researchers aren't sure why some people develop CRPS while others with similar injuries don't. They think it's due to an inflammatory or immune reaction in both your peripheral and central nervous systems.

In more than 90% of cases, CRPS results from nerve trauma or injury to the affected limb that damages the thinnest sensory and autonomic nerve fibers. These small fibers transmit pain, itch and temperature sensations. They also control the small blood vessels and the overall health of surrounding cells.

Injury type

How it can trigger CRPS

Bone fracture

The most common trigger, especially a wrist fracture; a displaced or splintered bone or pressure from a tight cast can damage nerves [1] [3]

Surgery

An incision, stitches or scarring can cause nerve injury [1]

Sprains or strains

Damaged connective tissues allow excessive joint movement, which over-stretches nearby nerves

Burns, bruises or cuts

Noticeable injuries that may also have damaged underlying nerves [1]

No obvious injury

CRPS can develop without an identifiable trigger or due to prolonged immobilization [1] [3]

Risk factors

Several factors may increase your risk of developing CRPS:

  • Poor nerve health. Conditions such as diabetes can leave your nerves less resilient and less able to repair themselves. People with peripheral neuropathy may struggle to regrow nerve cells from an injury that wouldn't otherwise cause problems. Smoking and previous chemotherapy can also make it difficult for your nerves to regenerate.

  • Immune system issues. Your immune system plays a large role in inflammation. Some people with CRPS have elevated levels of inflammatory chemicals called cytokines that contribute to certain symptoms [2]. CRPS is also more common in people with other inflammatory and autoimmune diseases, such as asthma [1] [3].

  • Genetics. Your genes can affect your ability to recover from an injury. Researchers have discovered family clusters of CRPS — although rare, this suggests a possible genetic link [1].

How Is CRPS Diagnosed?

Because CRPS is rare and not fully understood, it is often misdiagnosed. There is no specific test for CRPS [1] [2] [3]. Healthcare providers mainly diagnose it through a careful medical history, physical examination and review of your symptoms [1] [2], and they will ask whether you've had a recent injury or surgery.

During the exam, providers look for a change in the appearance, temperature and texture of your skin in the affected area, a higher-than-expected amount of pain from an injury, and any other diseases or conditions that could explain your symptoms.

Test

Purpose

Medical history and symptom review

Establishes the injury timeline and symptom pattern

Physical examination

Checks skin appearance, temperature, texture and pain response in the affected area

Ultrasound or MRI

Looks for underlying nerve damage — though it isn't always possible to find

Electromyography (EMG)

Rules out other causes of neuropathy that produce similar pain

CRPS Treatment Options

The goal of treatment is to decrease your pain and other symptoms, restore function to the affected limb [1] and maintain your quality of life.

Starting treatment early matters [1] [3]. CRPS can cause the affected limb to stiffen over time, and the pain usually worsens without treatment as movement becomes more and more difficult. It's best to see healthcare providers who have experience treating CRPS, if possible. Treatment requires a combination of carefully managed approaches:

CRPS management strip: a person stretching beside a mirror with upward arrows for physical and mirror therapy, a crossed-out cigarette with a pill bottle and a walking figure for lifestyle changes, a pill beside a heart speech bubble for medication and psychotherapy, and a spine with an implanted stimulator for advanced nerve stimulation. – rinnit.com
Treatment options for CRPS: physical and mirror therapy, lifestyle changes, medications and psychotherapy, and advanced nerve-stimulation options.

Approach

What it involves

Physical therapy and occupational therapy

Improves blood flow, flexibility, strength, muscle tone and function; teaches new ways to do everyday tasks [1]

Lifestyle changes

Quitting smoking, managing diabetes and other conditions, elevating the limb, daily exercise, compression stockings or sleeves

Psychosocial and behavioral therapy

Psychotherapy to cope with factors that contribute to pain [1] [2]; ideally with a pain management clinical psychologist trained in CRPS

Medications

Pain-reducing drugs from several classes (no medication is specifically approved for CRPS in the U.S.) [1]

Alternative therapies

Biofeedback, acupuncture, hypnosis, Reiki, chiropractic

For young children with CRPS, psychosocial and rehabilitation therapies are the mainstay of treatment [1]. Providers typically reserve pain-reducing medical procedures for older adolescents whose symptoms don't respond to other therapies.

Physical therapy techniques

A physical therapist helps improve blood flow to your affected limb and increases flexibility, strength, muscle tone and function with specific exercises. An occupational therapist teaches you new ways to accomplish everyday tasks [1]. Three notable techniques include:

  • Graded motor imagery. A set of treatments that reduce pain and improve movement of the affected body part. Your brain holds a memory or "map" of different body parts and how they feel and function. When a limb goes unused, that map starts to change and can disappear. Graded motor imagery re-establishes the map.

  • Mirror therapy. One of the exercises within graded motor imagery [1]. You look at the reversed image of your non-painful limb in a mirror, so the reflection appears to be the affected limb. This can "trick" your brain into feeling that the painful limb now feels and moves normally.

  • Desensitization. Touching the affected area with materials of different textures and weights, and placing the limb in water of warmer and cooler temperatures. By exposing the area to different sensations slowly over time, your brain adjusts and pain begins to lessen.

Lifestyle changes that support nerve healing

Removing barriers that prevent your nerves from healing can increase both the chance and the speed of recovery:

  • Quitting smoking, which greatly interferes with nerve regeneration.

  • Managing existing health conditions — poorly managed diabetes and other conditions that affect circulation and nerves make healing harder.

Simple at-home steps include keeping your affected limb elevated when resting or sleeping [1] (so excess fluid returns to your heart), exercising every day to improve circulation to the damaged nerves, and wearing compression stockings or sleeves to limit swelling [1], particularly when standing. Discuss an exercise plan with your provider or physical therapist.

Medications

No medications are specifically approved for CRPS in the U.S. [1], but providers commonly recommend drugs with pain-reducing effects:

Drug class

Examples

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Acetaminophen, ibuprofen, naproxen

Topical analgesic creams and patches

Lidocaine [2]

Certain antidepressants

Amitriptyline, duloxetine

Anti-seizure drugs

Gabapentin, pregabalin, topiramate

Bisphosphonates

Alendronate [2]

Botulinum toxin (Botox) injections [1]

—

Your provider's choice depends on your age, other health conditions, current medications and the potential for side effects or drug interactions.

More invasive treatments for severe or ongoing CRPS

If your CRPS hasn't responded well to the therapies above, or you have severe or ongoing pain, providers may recommend:

Treatment

How it works

Trigger point / tender point injections

Local anesthetic (with or without glucocorticoids) injected into trigger points in the shoulder girdle muscles — helpful for early-stage CRPS limited to the upper limb

Sympathetic nerve blocks

Anesthetic injected next to the spine in the lower back (lumbar sympathetic block for lower limbs) or on the side of the neck (stellate ganglion block for upper limbs) [3]; blocks the sympathetic chain that transmits pain signals

Spinal cord stimulation

A pulse generator similar to a pacemaker is implanted under the skin of the abdomen or buttock, with electrode wires near the spinal cord; low-level electrical currents interfere with and reduce pain signals reaching the brain [1]

Dorsal root ganglia stimulation

Smaller wires are implanted directly on the dorsal root ganglion — a cluster of sensory neurons at the junction where each segmental nerve exits the spinal cord, acting as a relay station for pain signals; a more targeted and efficient therapy requiring less stimulation

Peripheral nerve stimulation

A stimulating wire is placed near a major nerve in the limb covering the painful area, interfering with the pain signal through the targeted nerve

IV ketamine infusion

A low dose of ketamine given intravenously over 3 to 5 days; blocks the NMDA receptor in your nervous system that can wind up and worsen pain

Intrathecal drug pumps

An implanted catheter delivers pain-relieving drugs, such as ziconotide, directly into your spinal fluid [1]

Outlook and Prognosis

Each person's experience with CRPS is different. CRPS usually improves over time and eventually goes away — enters remission — in most people.

Severe or prolonged cases, which are rare, can greatly affect your life. In some people, CRPS gets worse and even spreads to other areas of the body [1]. Experiencing increased psychological distress during the injury that led to CRPS may affect its severity and prognosis.

Does CRPS come back? CRPS recurs in about 10% to 30% of people. Most recurrences happen for unknown reasons.

The most important goals are to relieve pain and restore movement and strength in the affected limb. Achieving pain relief increases the odds of improving function and quality of life, and carefully selected treatment plans allow some people with CRPS to manage their pain successfully and lead active lives.

Can CRPS be prevented? Because researchers don't know the exact cause, there's no conclusive way to prevent CRPS. Some studies have found that taking vitamin C before a future surgery might prevent it.

Living With CRPS

When should you see a healthcare provider?

Because the condition is complex and often misdiagnosed, seek out a pain management specialist or a specialty pain center with knowledge of CRPS if you think you have symptoms, if your symptoms are getting worse, or if your condition hasn't responded to other treatment methods.

Common questions about CRPS

Question

Answer

Is CRPS considered a disability?

In the U.S., the Social Security Administration recognizes CRPS as a potential cause of disability depending on its severity and impact on your life

Is CRPS a mental illness?

No — it's a neurological condition, though it can cause or worsen anxiety, depression and stress, and sometimes leads to PTSD

Many treatment options exist, and providers can try many combinations. The earlier you receive a CRPS diagnosis and start treatment, the better the chance that your symptoms will respond [1] [3].

Conclusion

Complex regional pain syndrome is one of the most frustrating conditions in pain medicine: a neurological misfire that turns a routine wrist fracture, sprain or surgery into months of burning, stinging pain and visible changes in the affected limb. The common thread is an inflammatory reaction in the peripheral and central nervous systems — pain signals the body cannot switch off.

The encouraging news is that CRPS usually improves over time and enters remission in most people. The critical factor is timing. Because the affected limb can stiffen and the pain tends to worsen without care, the earliest weeks after symptoms appear are the most valuable window for diagnosis and treatment. A coordinated approach — physical and occupational therapy (including mirror therapy and desensitization), lifestyle changes like quitting smoking and daily exercise, psychotherapy, and a tailored medication plan — covers most cases. For severe or stubborn CRPS, an expanding toolkit of nerve blocks, spinal cord stimulation, ketamine infusion and intrathecal pumps offers meaningful relief.

If you notice persistent burning pain, swelling, skin color or temperature changes, or stiffness after an injury — especially in your hand — don't wait for it to resolve on its own. Seek out a pain management specialist or specialty pain center with CRPS experience early. The sooner treatment starts, the better the odds of restoring movement, strength and quality of life.

If you find visual explanations helpful for understanding or teaching others about complex health topics, explore Rinnit's infographic templates — designed to turn dense medical information into clear, shareable visuals.

Frequently Asked Questions

What is complex regional pain syndrome?

CRPS is a neurological condition that causes pain, skin color changes and other symptoms in a specific part of your body — usually an arm, leg, hand or foot, most commonly the hand.

Is CRPS a neurological condition or a mental illness?

It is a neurological condition, not a mental illness. However, it can cause or worsen anxiety, depression and stress, and may sometimes lead to PTSD.

Is CRPS a disability?

In the United States, the Social Security Administration recognizes CRPS as a potential cause of disability, depending on its severity and impact on your life.

How common is CRPS?

It is relatively rare, affecting about 200,000 people every year in the United States.

What are the two types of CRPS?

Type I occurs without direct nerve damage (formerly called reflex sympathetic dystrophy), and Type II occurs after known nerve damage (formerly called causalgia).

What was reflex sympathetic dystrophy renamed to?

Reflex sympathetic dystrophy is now called CRPS Type I.

What is causalgia?

Causalgia is the former name for CRPS Type II, which occurs after known nerve damage.

What does CRPS feel like?

The hallmark is constant or intermittent pain with a burning, stinging or tearing sensation, often deep inside the affected limb.

Where does CRPS usually start?

In one extremity — most commonly the hand, but also the wrist, arm, foot, ankle or leg.

How long after an injury does CRPS start?

Symptoms typically begin within four to six weeks after an injury, fracture or surgery, though they can develop without a known cause.

Can CRPS develop without an injury?

Yes — it can develop without an obvious injury or due to periods of prolonged immobilization.

What is the most common trigger for CRPS?

A bone fracture, especially a wrist fracture. A displaced or splintered bone or pressure from a tight cast can damage nerves.

Can surgery cause CRPS?

Yes. A surgical incision, stitches or scarring can cause nerve injury that leads to CRPS.

Can a sprain or strain cause CRPS?

Yes. Damaged connective tissues can allow excessive joint movement, which over-stretches nearby nerves.

Can a tight cast cause CRPS?

Yes — pressure from a tight cast can damage nerves in a way that triggers CRPS.

Why does CRPS happen?

Experts believe it results from dysfunction in the central or peripheral nervous system — an overreaction to pain signals that the nervous system can't shut off, likely driven by an inflammatory or immune reaction.

What nerves are damaged in CRPS?

In more than 90% of cases, the thinnest sensory and autonomic nerve fibers are damaged. These small fibers transmit pain, itch and temperature sensations and control small blood vessels.

What are sensory and autonomic nerve fibers?

They are the thinnest nerve fibers that carry pain, itch and temperature sensations and regulate small blood vessels and the health of surrounding cells.

What causes the overreaction in CRPS?

Researchers believe it is an inflammatory or immune reaction in both the peripheral and central nervous systems, though they aren't sure why some people develop CRPS while others with similar injuries don't.

Do cytokines play a role in CRPS?

Some people with CRPS have elevated levels of inflammatory chemicals called cytokines that contribute to certain symptoms.

Is CRPS genetic?

Researchers have discovered rare family clusters of CRPS, suggesting there may be a genetic link — your genes can affect your ability to recover from an injury.

Who is most likely to get CRPS?

Adults more than children, with peak onset around age 40. Women are affected more often than men, and about 66% to 80% of cases occur in people of European ancestry.

What increases the risk of CRPS?

Poor nerve health (diabetes, peripheral neuropathy, smoking, previous chemotherapy), immune system issues (elevated cytokines, autoimmune and inflammatory diseases like asthma), and genetics.

Does diabetes raise CRPS risk?

Yes — diabetes leaves nerves less resilient and less able to repair themselves, making recovery from an injury harder.

Does smoking raise CRPS risk?

Yes — smoking greatly interferes with nerve regeneration and can make recovery more difficult.

What are the symptoms of CRPS?

Burning or stinging pain, increased pain sensitivity, pain from light touch, numbness, swelling, decreased limb function, stiffness, skin temperature and color changes, shiny or sweaty skin, and changes in hair and nail growth.

Can CRPS cause skin color changes?

Yes — the skin may appear blotchy, pale, purple/bruised or red.

Can CRPS change skin temperature?

Yes — the skin on the affected extremity may feel warmer or cooler compared to the opposite limb.

Can CRPS make your skin shiny?

Yes — skin may become shiny and thin or excessively sweaty.

Does CRPS affect hair and nails?

Yes — you may experience rapid hair or nail growth, or no growth at all.

Can CRPS cause swelling?

Yes — swelling may come and go or remain constant.

Does CRPS cause stiffness?

Yes — you may have reduced ability to move the affected limb, increased stiffness, and difficulty placing pressure on the limb or joint.

Can CRPS cause numbness?

Yes — numbness is one of the common sensory changes in the affected area.

Can CRPS spread to other limbs?

In some people, severe or prolonged CRPS gets worse and even spreads to other areas of the body.

How is CRPS diagnosed?

There is no specific test. Providers diagnose it through a careful medical history, physical examination and symptom review, using imaging and EMG to rule out other conditions.

Is there a CRPS blood test?

No — CRPS is diagnosed clinically, through history and exam rather than any specific laboratory test.

Can an MRI diagnose CRPS?

An ultrasound or MRI may be ordered to look for underlying nerve damage, but it isn't always possible to find the damage. Imaging mainly helps rule out other causes.

What is an EMG and why is it used in CRPS?

Electromyography tests nerve and muscle electrical activity and may reveal other causes of neuropathy that produce similar pain scenarios.

Why is CRPS often misdiagnosed?

Because CRPS is rare and not fully understood, its symptoms can mimic many other conditions.

Is CRPS curable?

CRPS usually improves over time and goes into remission in most people. There is no single cure, but many treatment options exist.

How long does CRPS last?

It varies person to person. CRPS can be acute (short-term) or chronic (lasting longer than six months), and it usually improves over time.

Does CRPS go away on its own?

In most people it eventually enters remission, but symptoms usually worsen without treatment, and the limb can stiffen — so early treatment is strongly recommended.

Does CRPS come back?

CRPS recurs in about 10% to 30% of people, and most recurrences happen for unknown reasons.

What is the best treatment for CRPS?

A combination of physical therapy and occupational therapy, lifestyle changes, psychosocial and behavioral therapy, medications, and alternative pain management approaches — tailored to the individual and started early.

What is mirror therapy for CRPS?

A technique where you look at the reversed image of your non-painful limb in a mirror, so the reflection appears to be the affected limb. It "tricks" your brain into feeling that the painful limb moves and feels normally.

What is graded motor imagery?

A set of treatments that reduce pain and improve movement by rebuilding the brain's memory "map" of the affected body part, which can fade when the limb goes unused.

What is desensitization therapy?

Slowly exposing the affected area to materials of different textures and weights and water of warmer and cooler temperatures, so the brain adjusts and pain lessens.

What medications treat CRPS?

No medication is specifically approved for CRPS in the U.S., but providers may recommend NSAIDs (acetaminophen, ibuprofen, naproxen), topical lidocaine, antidepressants (amitriptyline, duloxetine), anti-seizure drugs (gabapentin, pregabalin, topiramate), bisphosphonates (alendronate), or Botox injections.

Does gabapentin help CRPS?

It may — gabapentin is an anti-seizure drug providers sometimes use for pain-reducing effects in CRPS.

Can Botox treat CRPS?

Yes — botulinum toxin (Botox) injections are among the medications providers may recommend.

What is a sympathetic nerve block?

An injection of anesthetic that blocks the sympathetic chain transmitting pain signals. A lumbar sympathetic block treats lower-limb CRPS; a stellate ganglion block treats upper-limb CRPS.

What is stellate ganglion block?

An anesthetic injection on the side of the neck used for upper limb CRPS pain.

What is spinal cord stimulation?

A pacemaker-like device implanted under the skin of the abdomen or buttock with electrodes near the spinal cord. It sends low-level electrical currents that interfere with and reduce pain signals sent to the brain.

What is dorsal root ganglia stimulation?

A more targeted form of stimulation in which smaller wires are implanted directly on the dorsal root ganglion — a cluster of sensory neurons where each segmental nerve exits the spinal cord and relays pain signals from the limbs to the spinal cord and brain. It concentrates on these small relay stations and can be more efficient.

What is peripheral nerve stimulation?

A stimulating wire placed near a major nerve in the limb covering the painful area. It interferes with the pain signal conducted through the targeted nerve.

What is a ketamine infusion for CRPS?

An intravenous infusion of low-dose ketamine given over 3 to 5 days. Ketamine blocks the NMDA receptor in the nervous system that can wind up and worsen pain.

What are intrathecal drug pumps?

Implanted catheters that send pain-relieving drugs, such as ziconotide, directly into your spinal fluid.

What lifestyle changes help CRPS?

Quitting smoking, managing diabetes and other conditions, elevating the affected limb when resting or sleeping, daily exercise to improve circulation, and wearing compression stockings or sleeves to limit swelling.

Does quitting smoking help CRPS recovery?

Yes — smoking greatly interferes with nerve regeneration, so quitting increases both the chance and speed of recovery.

Should you elevate the limb with CRPS?

Yes — keeping the affected limb elevated when resting or sleeping helps excess fluid return to your heart.

Do compression stockings help CRPS?

They may — compression stockings or sleeves can help limit swelling, particularly when standing. Ask your provider if this is an option for you.

How does CRPS affect mental health?

CRPS is associated with worsening anxiety, depression and stress, which can increase pain. Psychotherapy (talk therapy) with a pain management clinical psychologist trained in treating CRPS can help.

Does psychotherapy help CRPS pain?

It can — talk therapy helps you identify and change unhealthy emotions, thoughts and behaviors that contribute to your pain, and can improve coping.

Is CRPS treated differently in children?

For young children, psychosocial and rehabilitation therapies are the mainstay. Providers typically only suggest pain-reducing medical procedures for older adolescents whose symptoms don't respond to other therapies.

Can CRPS be prevented?

There is no conclusive way to prevent CRPS since its exact cause is unknown. Some studies have found that taking vitamin C before a future surgery might prevent it.

Does vitamin C prevent CRPS?

Some studies have revealed that taking vitamin C before a future surgery might prevent CRPS, though prevention is not conclusive.

When should I see a doctor about CRPS?

See a pain management specialist or specialty pain center with CRPS knowledge if you think you have symptoms, if symptoms are getting worse, or if your condition hasn't responded to other treatment methods.

Why does early treatment of CRPS matter?

CRPS can cause the affected limb to stiffen over time, and pain usually worsens without treatment as movement becomes more difficult. Early treatment gives symptoms the best chance of responding.

Can you live an active life with CRPS?

Yes — with carefully selected treatment plans, some people with CRPS successfully manage their pain and lead active lives.

What is the overall outlook for CRPS?

Each person's experience differs, but CRPS usually improves over time and enters remission in most people. Severe or prolonged cases are rare but can greatly affect life.

Related Reading

Pain Management: Types, Treatments and What to Expect explains the treatment options for acute and chronic pain.

QSART Test: How Sweat Testing Checks Your Autonomic Nerves explains the sweat test that checks the small nerves of the autonomic system.

References

  1. National Institute of Neurological Disorders and Stroke. Complex regional pain syndrome. NINDS. Last reviewed May 28, 2026. https://www.ninds.nih.gov/health-information/disorders/complex-regional-pain-syndrome

  2. National Organization for Rare Disorders. Complex regional pain syndrome. NORD Rare Disease Database. Last updated February 8, 2023. https://rarediseases.org/rare-diseases/reflex-sympathetic-dystrophy-syndrome/

  3. Guthmiller KB, Dua A, Dey S, et al. Complex Regional Pain Syndrome. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Updated May 4, 2025. PMID 28613470. https://www.ncbi.nlm.nih.gov/books/NBK430719/

  4. Harden RN, Bruehl S, Perez RSGM, et al. Validation of proposed diagnostic criteria (the "Budapest Criteria") for Complex Regional Pain Syndrome. Pain. 2010;150(2):268-274. PMID: 20493633. https://doi.org/10.1016/j.pain.2010.04.030

  5. Complex Regional Pain Syndrome Association (CRPSA, formerly RSDSA). Home page. CRPSA. Accessed October 30, 2026. https://crps.org/

  6. Smart KM, Ferraro MC, Wand BM, O'Connell NE. Physiotherapy for pain and disability in adults with complex regional pain syndrome (CRPS) types I and II. Cochrane Database Syst Rev. 2022;5(5):CD010853. PMID: 35579382. https://doi.org/10.1002/14651858.CD010853.pub3

  7. Shafiee E, MacDermid J, Packham T, et al. The effectiveness of rehabilitation interventions on pain and disability for complex regional pain syndrome: a systematic review and meta-analysis. Clin J Pain. 2023;39(2):91-105. PMID: 36650605. https://doi.org/10.1097/AJP.0000000000001089

  8. Ferraro MC, O'Connell NE, Goebel A, et al. Efficacy and safety of bisphosphonates for complex regional pain syndrome: a systematic review and meta-analysis. Ann Intern Med. 2026;179(2):256-269. PMID: 41397259. https://doi.org/10.7326/ANNALS-25-03693

Medical disclaimer

This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions about a medical condition or before making decisions about treatment. Never disregard professional medical advice or delay seeking it because of something you have read here.

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