What is CRPS?
Complex Regional Pain Syndrome (CRPS) is a chronic pain condition that typically affects limbs after an injury or surgery, caused by abnormal nerve responses. It leads to severe pain, swelling, temperature changes, and mobility issues.
CRPS is classified into:

• Type I (Reflex Sympathetic Dystrophy): Occurs without nerve injury.
• Type II (Causalgia): Develops after a nerve injury.

Symptoms

• Severe Pain: Persistent, burning, or stabbing pain.
• Swelling & Skin Changes: Redness, shininess, temperature differences.
• Limited Mobility: Joint stiffness and muscle weakness.
• Sensory Abnormalities: Hypersensitivity or tingling.

Causes and Risk Factors

• Injury or Surgery: Fractures, sprains, or nerve trauma.
• Prolonged Immobilization: Long-term limb immobilization increases risk.
• Genetic or Immune Factors: Genetic predisposition or immune issues.

Diagnosis
Diagnosis is clinical, supported by:

• Bone Scans and MRI: Detect changes in bone or tissue.
• Thermography: Measures temperature differences.
• Nerve Studies: Electromyography (EMG) or nerve conduction studies.

Treatment: Sympathetic Blocks
Sympathetic blocks involve injecting anesthetics near sympathetic nerves to disrupt pain signals.

• Stellate Ganglion Block: For upper limb CRPS.
• Lumbar Sympathetic Block: For lower limb CRPS.

Procedure

1. Preparation: Skin cleaned, anesthesia applied.
2. Needle Placement: Guided by fluoroscopy or ultrasound.
3. Injection: Anesthetic and sometimes corticosteroids are injected.
4. Monitoring: Changes in pain, temperature, and swelling observed.

Benefits

• Pain Relief: Rapid reduction in pain.
• Improved Mobility: Enables physical therapy and daily activities.
• Diagnostic Value: Confirms nerve involvement.
• Adjunctive Therapy: Works with medications and physical therapy.

Risks and Considerations

• Temporary Pain: Mild discomfort at the injection site.
• Infection & Bleeding: Rare, minimized by sterile technique.
• Nerve Injury: Very rare.
• Allergic Reactions: Uncommon.

Effectiveness
Sympathetic blocks offer immediate pain relief and, when combined with physical therapy, provide long-term improvements in function and quality of life.

Conclusion
CRPS is a debilitating condition, and sympathetic blocks are a valuable treatment option for pain relief and improved mobility. Early intervention can significantly improve outcomes for CRPS patients.