From the Research
Complex regional pain syndrome (CRPS) resulting from a near amputation due to a motor vehicle accident may require long-term treatment, but not necessarily lifetime treatment in all cases. The prognosis and treatment duration vary significantly based on individual factors including severity, early intervention, treatment response, and psychological factors, as noted in a comprehensive review of CRPS management 1. Early diagnosis and aggressive multimodal treatment typically yield better outcomes, with treatment often including medications such as gabapentin, pregabalin, tricyclic antidepressants, or SNRIs, as well as physical therapy and interventional procedures like sympathetic nerve blocks or spinal cord stimulation, as discussed in a review of interventional modalities for CRPS 2. Some key points to consider in managing CRPS include:
- Early diagnosis using the Budapest criteria, which can be complicated in cases of amputation but are still applicable 3
- Multimodal treatment approaches that may include pharmacological, interventional, and behavioral therapies, with the goal of improving function and reducing pain 1
- The potential for dorsal root ganglion stimulation as an effective treatment option, especially in cases where conventional spinal cord stimulation has failed 4
- The importance of psychological support through cognitive behavioral therapy to manage pain-related anxiety and depression, as the presence of litigation can sometimes complicate recovery due to stress and delayed treatment engagement. Given the complexity and variability of CRPS, a coordinated multidisciplinary approach offers the best chance for functional improvement and pain reduction, regardless of legal proceedings, and this approach should be guided by the most recent and highest quality evidence available, such as the review of interventional treatments for CRPS published in 2021 2.