Interventional Modalities to Treat Complex Regional Pain Syndrome

Curr Pain Headache Rep. 2021 Feb 3;25(2):10. doi: 10.1007/s11916-020-00904-5.

Abstract

Purpose of review: Complex regional pain syndrome (CRPS) is a debilitating pain condition that often requires a multidisciplinary approach including medication, physical therapy, occupational therapy, psychological therapy, and interventional procedures to restore the patient's quality of life. This article reviews the interventional treatments for pain resulting from CRPS.

Recent findings: Sympathetic nerve blocks (stellate ganglion and lumbar sympathetic) are the first-line interventional treatment options for patients with CRPS of the upper and lower extremities, respectively. Fluoroscopic techniques for lumbar sympathetic blocks have not significantly changed throughout the years. However, both novel fluoroscopic and ultrasound approaches to stellate ganglion blockade have arisen. In addition, novel neuromodulation therapies to treat CRPS have been developed to include new waveforms with dorsal column stimulation and entirely new nerve targets such as dorsal root ganglion stimulation. This paper will review the latest interventional treatment options available for the treatment of CRPS.

Keywords: CRPS; Complex regional pain syndrome; Dorsal root ganglion stimulation; Lumbar sympathetic block; Spinal cord stimulation; Stellate ganglion block.

Publication types

  • Review

MeSH terms

  • Analgesia, Epidural / methods*
  • Autonomic Nerve Block / methods*
  • Combined Modality Therapy / methods
  • Complex Regional Pain Syndromes / diagnostic imaging*
  • Complex Regional Pain Syndromes / therapy*
  • Humans
  • Pain Management / methods*
  • Randomized Controlled Trials as Topic / methods
  • Transcutaneous Electric Nerve Stimulation / methods*