Complex Regional Pain Syndrome (CRPS): Clinical Patient Journey

Reviewed by: Name, MD – Board-Certified Pain Medicine Physician
Affiliation: The Medical Group of New Jersey

Complex Regional Pain Syndrome (CRPS) is an uncommon chronic pain condition that typically develops after an injury, surgery, or fracture affecting an arm or leg. The nervous system responds abnormally to the injury, causing persistent pain that is often more severe or lasts much longer than expected. Symptoms may also include swelling, skin color or temperature changes, sensitivity to touch, stiffness, weakness, and reduced movement.

At The Medical Group of New Jersey, our Pain Medicine specialists work closely with Neurology, PM&R, Orthopedic Medicine, Rheumatology, and Physical Therapy to develop personalized treatment plans focused on relieving pain, restoring function, and improving mobility through comprehensive, multidisciplinary care.

Symptom Onset & Initial Evaluation

CRPS most commonly develops within weeks or months after an injury or surgical procedure, although the original injury may appear relatively minor. Symptoms often affect one arm, hand, leg, or foot but can occasionally spread beyond the initial area.

Common symptoms include:

Severe, persistent burning or aching pain
Pain that seems disproportionate to the original injury
Extreme sensitivity to touch or temperature
Swelling of the affected limb
Changes in skin temperature (warmer or cooler than the opposite limb)
Changes in skin color, including redness, bluish discoloration, or mottling
Increased or decreased sweating
Joint stiffness
Muscle weakness
Reduced range of motion

As the condition progresses, some patients may develop muscle wasting, tremors, involuntary muscle contractions, or difficulty using the affected limb.

During your initial consultation, your physician will review:

When symptoms began
Any recent injury, fracture, or surgery
The progression of symptoms
Previous treatments
Current medications
Medical history
How symptoms affect daily activities, work, and sleep

Because no single test confirms CRPS, early evaluation by an experienced physician is essential.

2: Diagnosis

CRPS is diagnosed primarily through a detailed medical history and physical examination while excluding other conditions that may produce similar symptoms.

Comprehensive Physical Examination

Your physician will evaluate:

Skin color and temperature
Swelling
Sensitivity to touch
Joint mobility
Muscle strength
Reflexes
Circulation
Range of motion
Functional limitations

The examination compares the affected limb with the unaffected side to identify characteristic changes.

Diagnostic Testing

Although no test alone confirms CRPS, additional studies may help support the diagnosis or rule out other conditions.

These may include:

X-rays
MRI
Bone scans
Ultrasound
Electromyography (EMG)
Nerve conduction studies

Laboratory testing may also be performed when inflammatory, autoimmune, infectious, or vascular disorders are being considered.

Diagnosis is often based on internationally accepted clinical criteria, sometimes referred to as the Budapest Criteria, which evaluate pain along with changes in sensation, circulation, sweating, swelling, and movement.1

3: Treatment

Early, comprehensive treatment offers the best opportunity to improve function and reduce long-term disability.

Most patients benefit from a multidisciplinary treatment plan that combines rehabilitation, medications, and selected interventional procedures.

Physical Therapy & Occupational Therapy

Movement is one of the most important components of treatment. Therapy focuses on:

Restoring range of motion
Improving strength
Reducing stiffness
Desensitization exercises
Functional rehabilitation
Improving use of the affected limb

Occupational therapy may help patients regain independence with daily activities.

Medications

Depending on individual symptoms, medications may include:

Anti-inflammatory medications
Neuropathic pain medications
Selected antidepressant medications that also treat nerve pain
Topical pain medications
Bone-protective medications in selected patients

Medication recommendations are individualized based on symptoms and overall health.

Sympathetic Nerve Blocks

Because CRPS may involve abnormal activity of the sympathetic nervous system, sympathetic nerve blocks may provide pain relief for selected patients.

These image-guided procedures deliver medication near sympathetic nerves to reduce pain and improve participation in rehabilitation.

Additional Interventional Procedures

Depending on symptom severity and response to treatment, additional therapies may include:

Peripheral nerve blocks
Trigger point injections
Spinal cord stimulation evaluation for carefully selected patients with persistent symptoms
Other advanced pain management techniques

Your physician will determine which interventions are appropriate based on your individual condition.

Behavioral Health Support

Living with chronic pain can affect emotional well-being.

Treatment may include education, stress management techniques, behavioral therapy, or counseling to help patients develop healthy coping strategies while improving overall quality of life.

4: Ongoing Management & Prevention

Recovery from CRPS varies from person to person. Some individuals improve substantially with early treatment, while others require ongoing management to control symptoms and preserve function.

Long-term care may include:

Continuing physical therapy exercises
Home stretching programs
Pain management follow-up
Medication adjustments
Functional rehabilitation
Stress management
Activity modification when appropriate

Regular follow-up allows treatment plans to evolve as symptoms change while helping patients maintain mobility and independence.

Although CRPS can be challenging to treat, early diagnosis, coordinated care, and consistent rehabilitation often lead to meaningful improvements in pain, function, and quality of life.

Alt Text Suggestions

Pain medicine physician evaluating a patient with Complex Regional Pain Syndrome
Physician examining swelling and skin changes in a patient with CRPS
Image-guided sympathetic nerve block performed for Complex Regional Pain Syndrome
Patient participating in rehabilitation exercises to improve function after CRPS

Related Specialties

Pain Medicine in New Jersey