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Pain Management

Complex Regional Pain Syndrome Treatment

03/04/2008

Question:

I had a leg injury from car accident. Back of leg under the calf was cut open and had 3 layers deep of stitches back in 06. I still get pain and stinging there. Doctors have done test, but are not sure what it could be. Ultra sounds they have done have came out fine. Does anyone know what may be causing this? It seems to be worst sometimes when I have been on my legs more. Doctor put me on neorontin. It helps, but it still happens just not as much. Is there a test that can be done to see if it is muscle or nerve damage?

Answer:

You may have a condition known as Complex Regional Pain Syndrome or CRPS for short. It is the newer name that replaced many older name for the condition, the most common being Reflex Sympathetic Dystrophy (RSD). It is a painful condition with so far unknown causative factor(s) though it usually follows trauma, injury and surgery. There are a lot of myths surrounding the condition if you research it on the internet. One of the better sites is that of the RSD association. There are other potential conditions that would be responsible for your pain but this is the most likely given your limited description of the signs and symptoms.

The main treatment for this condition is functional rehabilitation. However, pain often hinders progress with therapy. It is important, then, that you see a Pain Medicine specialist who has a thorough understanding of this condition and its management. A multidisciplinary approach—seeing more than one specialist that manages this condition at the same time-- such as the one offered at University Hospitals of Cleveland would be optimal.

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Response by:

Salim M Hayek, MD, PhD Salim M Hayek, MD, PhD
Associate Professor of Anesthesiology & Perioperative Medicine
School of Medicine
Case Western Reserve University