Not all pain problems can be diagnosed easily. Sometimes, despite the fact that the patient has been complaining of severe pain interfering with their quality of life, the diagnosis cannot be made right away even after seeking multiple doctor consultations and undergoing many diagnostic tests. When this is the case, it may be time to speak with a pain management specialist.
One of these rare chronic pain problems is known as Reflex Sympathetic Dystrophy (RSD) or Complex Regional Pain Syndrome (CRPS).
Although this is a rare pain problem, it can be chronic and debilitating for some patients.
RSD/CRPS is a chronic pain syndrome that mostly develops after limb injuries. This may be small trauma such as needle stick injury, or a ligament sprain. Sometimes it’s a bigger trauma such as fracture or a surgery. As the name implies, this pain syndrome may have a very complex presentation. These patients present with severe and diffuse pain, sensitivity to touch, shiny skin, loss of hair in the painful area, skin color and temperature changes, blood vessel changes, swollen extremities, range of motion problem of joints, and sometimes contractures and loss of muscle bulk of limb. Burning pain and increased sensitivity to touch are the most common early symptom of CRPS.
These patients complain of severe pain more so than expected with similar incidents, and also the duration of pain may be longer than a typical recovery period.
It is a sad fact that the typical RSD/CRPS patient sees an average of seven physicians before they are even diagnosed, let alone treated. If the patients have been complaining of unresolved pain issues and skin color/temperature or other structural changes in the affected limb after a trauma or surgery, they may want to consult a pain management specialist. As the field of medicine learns more about the complexities of pain, it has become more important to have physicians with specialized knowledge and skills to treat these conditions. A pain management specialist is a physician with special training in the evaluation, diagnosis, and treatment of all different types of pain.
RSD/CRPS has strict diagnostic criteria and can be treated by a pain management specialist who has experience in treating patients with similar conditions.
The success of therapy is mostly dependent on the early diagnosis and early treatment, as it gets more difficult to treat this syndrome in later stages.
Treatment of this condition requires a comprehensive treatment plan including: physical therapy, occupational therapy, medication therapy, nerve blocks, other advanced interventional pain therapies such as spinal cord stimulators, and psychological therapy. This multidisciplinary treatment plan can reverse this painful condition back to normal. Pain medicine specialists play an important role in planning and coordinating entire comprehensive multidisciplinary care in this chronic, debilitating and painful disease.
Dr. Semih Gungor is board-certified in anesthesiology and pain medicine. He has specialized in pain management since 2001 and believes that each patient’s condition is unique and requires comprehensive assessment with the highest quality of pain-focused medical care. By providing timely, efficient and thorough care, Dr. Gungor’s goal is to alleviate pain, increase quality of life and achieve the most optimal level of functionality for all patients.
