PARAMUS, NJ. -- Not all pain problems can be diagnosed easily. Sometimes, despite the fact that the patient has been complaining of severe pain disrupting their quality of life, the diagnosis is elusive even after multiple physician consultations and diagnostic tests. When this happens, it may be time to speak with a pain management specialist. One rare chronic pain problem is Reflex Sympathetic Dystrophy (RSD), also known as Complex Regional Pain Syndrome (CRPS).
RSD/CRPS is a chronic pain syndrome that mostly develops after limb injuries. This may be small trauma such as a needle stick injury or a ligament sprain. Sometimes it’s a bigger trauma such as fracture or a surgery. Patients may have 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 symptoms of CRPS.
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 patients have been complaining of unresolved pain issues and skin color or temperature 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 different types of pain.
The success of therapy is largely dependent on early diagnosis and treatment, as it gets more difficult to treat this syndrome in later stages. 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 eliminate this painful condition and return patients 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 an anesthesiologist and Director of Pain Medicine Research at HSS and specializes in comprehensive, pain-focused medical care. He splits his time between the HSS Pain Management Center in N.Y. and the HSS Outpatient Center in Paramus.