Can Spinal Cord Stimulation Relieve My Complex Regional Pain Syndrome?

Maybe you sprained your ankle, broke your wrist, or had neck, back, or foot surgery. Maybe you had knee arthroplasty, a severe cut, or a heart attack. Any of these events have the potential to cause complex regional pain syndrome (CRPS), a debilitating condition characterized by unrelenting pain associated with hypersensitivity, burning, numbness, pins/needles, swelling and redness. 

CRPS is a complex diagnosis and is an area of ongoing research, which means that many doctors may miss it or misdiagnose it, and also fail to provide adequate pain relieving options. But Dr. Jay Shah at SamWell Institute for Pain Management is a CRPS expert and helps his patients throughout Colonia and Livingston, New Jersey find real relief from their pain. 

An overview of complex regional pain syndrome

Most often, CRPS occurs after some type of trauma or soft tissue injury. It could be a fracture, a sprain, or similar injury.  Sometimes this occurs as a result of foot/ankle surgery or after hand wrist surgery, and can also occur after neck or back surgery as well. The symptoms vary widely in kind, severity, and frequency, but one thing is consistent — the pain can be debilitating and it can occur to things like light touch, any movement, or activity that may normally cause pain. 

Researchers believe that CRPS is the result of several factors, including general inflammation, specific inflammation in the nerves, dysfunctional messaging between the nerves and the brain, and/or an abnormal autoimmune response. There are two main types of CRPS.

1. CRPS I

Also known as reflex sympathetic dystrophy (RSD), CRPS I shows no evidence of nerve injury. It’s believed that CRPS I results from incidents such as soft tissue injuries, immobilizations, casts that are too tight, frozen shoulder, and even a heart attack or stroke. CRPS I pain is not nerve-specific and can radiate throughout the body and is considered a central pain causing phenomenon.

2. CRPS II

Also known as causalgia, CRPS II shows clear signs of peripheral nerve damage. This type of CRPS generally occurs when there’s been a trauma that damages a specific peripheral nerve, such as a crushing injury, soft tissue trauma, amputation, or surgery. Nerve damage is also a risk in any type of surgery, but particularly in neck, back, and knee surgery. The pain is usually localized to the site of the injured nerve. 

Both types of CRPS have similar symptoms, including:

• Excruciating pain
• Joint stiffness and swelling
• Redness and burning
• Hypersensitivity to light touch (even clothing or bed sheets)
• Skin changes (hot, cold, pale, red, unexplained sweating)
• Hair and nail changes
• Decreased mobility

Dr. Shah uses the most advanced technology to rule out other possible causes first, but if he diagnoses you with CRPS, you’re in the best hands, because he specializes in pain management related to this challenging condition. 

Hope for CRPS relief

Although there’s no known cure for CRPS, there are many treatment options that can alleviate your symptoms and improve your quality of life. Dr. Shah offers:

• Physical therapy
• Medication
• Nerve block injections
• Platelet-rich plasma (PRP) therapy
• Stem cell therapy
• Neuromodulation (spinal cord stimulation or dorsal root ganglion stimulation)

Depending on the cause and severity of your CRPS, Dr. Shah finds the right combination of treatments that’s best suited to your unique symptoms. Often, the most effective treatment is targetted nerve stimulation that involves treatment without medication and is called spinal cord stimulation (SCS) or dorsal root ganglion stimulation (DRGS).

How SCS and DRGS are similar

Spinal cord stimulation and dorsal root ganglion stimulation both involve a small generator with wire leads that send low-voltage electrical currents to your nerves. The electrical current alters the way your brain perceives pain. In both treatments, Dr. Shah starts with a week-long trial period to make sure you get real relief (50% or more is considered successful), before he implants the small generator through a minimally invasive technique in your low back/flank area. 

How SCS and DRGS are different

With spinal cord stimulation, Dr. Shah places the electrodes in the epidural space of your spinal cord. This offers general relief from nerve pain and is especially effective if you have pain that radiates from one point to another — from your neck to your arm, for instance. The stimulation is “silent” in that you will not feel any tingling or “parasthesia,” and the pain will simply shut off. 

Dorsal root ganglion stimulation targets more specific nerves. Your dorsal root ganglion is a structure within your spine that contains a bundle of nerves. Dr. Shah is able to pinpoint the exact nerve that’s causing your symptoms and place the electrode so precisely that it literally turns off the pain in that nerve. You won’t even experience paresthesia (or tingling sensation from the stimulation) 

If you’ve been suffering from symptoms of complex regional pain syndrome and can’t find a doctor to diagnose it or a treatment that relieves it, contact us at SamWell Institute for Pain Management. Dr. Jay Shah specializes in the unique challenges related to CRPS and can help you understand your condition and live a full and active lifestyle.