Chronic pain conditions such as CRPS have been a significant burden to those with the condition. With approximately 200,000 such cases reported every year in the United States, the quality of life for any particular patient is greatly influenced by the existence of CRPS. Fortunately, there are several available treatment options among the most hopeful is spinal cord stimulation. This procedure has worked for the patients on whom other treatments failed to exert desired results. In the following words, we discuss the details of CRPS and how spinal cord stimulation helps reduce it to a considerable extent.
CRPS in detail
CRPS stands for Complicated Regional Pain Syndrome. It is a rare dysfunction of extremity characterized by extended and severe pain usually in one of the limbs. Although what exactly causes CRPS is unknown, most believe it to be an abnormal response of the nervous system. This syndrome occurs more often in women, being 3-4 times more likelihood of it happening to women than in men. Besides, it occurs more extremely in women, more commonly in people of European descent.
CRPS affects adults more than other age groups, but it mostly occurs in the age range of 37 to 70 years. Not many cases have taken place in children or young adults. In most cases, the development of the syndrome is associated with some initial injury or a trauma. This could be a fracture, sprain, or surgery, for example. However, in other cases, the condition develops quite spontaneously without any such cause.
The major types in which CRPS arises commonly include Type I and Type II.
CRPS Type I
Also known as RSD (Reflex Sympathetic Dystrophy) is the most common type of syndrome. This one involves no obvious damage to the nerve. The current theory for how the pain of CRPS Type I works is that it happens because of dysfunction in the pain pathway of the nervous system
CRPS Type II
CRPS Type II This was formerly known as Causalgia, and is evident with a history of an obvious nerve injury. Majority of patients with the history of a specific nerve injury that subsequently causes the high-intensity and discomforting pain and other symptoms associated with this condition.
The symptoms were found to have a huge variation from individual to individual but they are usually the localization of one limb with severe pain. The level of pain is usually more than the pain resulting from the initial injury or causative factor. Some of the patients feel that their pain even transfers to other limbs, though this is much less common. Hypersensitivity to light touch or mild stimuli is characteristic of CRPS, and at times, an individual may even lose sensation.
The temperature in the affected limb is also known to change. Initially, the limb may look inflamed and warm, but, with the passage of time, it may become cold and pale. Many patients also experience changes in skin color and texture, along with muscle weakness and muscle spasms, which can occur in a group or individually and are known as dystonia. In many patients, these symptoms result in reduced functioning and movement in affected limbs.
Typical Treatments for CRPS
Treatment for CRPS most often begins with physiotherapy to maintain and enhance the mobility and function of the patient. The other type of treatment includes the utilization of such mechanisms as corticosteroids that reduce inflammation, medications for pain as well as narcotics, to control pain, antidepressants and anticonvulsants, used when required to treat pain and enhance mood. Nerve blocks or topical treatments also can be used to target pain and symptoms.
What Causes CRPS?
The exact explanation for the occurrence of CRPS is not clear. However, it's believed that a trauma, including injury, can interfere with the nervous system's activity and thereby establish the conditions responsible for the syndrome. High inflammation and cytokines in the body during the early stage of CRPS causes the high sensation of pain.
What Is Spinal Cord Stimulation?
Spinal cord stimulation is an advanced way of managing pain and assists in the relief of chronic pain by changing how the nervous system processes pain signals. Normally, it involves the implantation of a small device in the spinal column and some thin leads that find their way to some specific locations along the spinal cord. The leads are used to deliver electrical impulses, which then impede the transmission of pain signals from a certain limb to the brain.
Spinal cord stimulation works by blocking the conduction of painful stimuli to the area of the central nervous system. The site of the leads will depend on the type of discomfort experienced. A spinal cord stimulator for foot pain, for example, is going to be implanted in a much different way than a device used for arm pain. Many patients have expressed the feeling of a tingling sensation and no pain at all, and with the majority of patients having significant improvement in effective pain relief and quality of life in general.
How Spinal Cord Stimulation Can Help People with CRPS
Historically, then, spinal cord stimulation was indicated only as a therapy of last resort for CRPS, usually engaged or sought after failure of other treatments. Since the procedure is certainly invasive, most practitioners would still prefer to run the spectrum of other therapies first. Most recent practices now allow considering spinal cord stimulation as early as three months after the onset of CRPS if other treatments are not effective.
Research points to spinal cord stimulation as carrying great effect over the painful, vascular, and motor symptoms of CRPS. A 2010 study determined that spinal cord stimulators are capable of important improvement in these three symptoms, although the mechanisms by which they achieve this are still unknown.
Spinal Cord Stimulator Trial
A test of a temporary device will generally be used with patients before the actual screening process of a permanent spinal cord stimulator, to see if enough pain relief using this therapy will be felt by the patient. Patients who find a decrease in their pain level of greater than 50% during the trial can look to permanent implantation, then.
Post-operatively, the spinal cord stimulator must be given adequate time to heal or to be placed correctly. The patient is given a handheld controller with which to manage the impulses and, hence pain. He can control pain on a personal basis and can increase or decrease the impulses to achieve the best effect.
Outcome of Spinal Cord Stimulation
While spinal cord stimulation for CRPS will not take the pain away altogether, it typically provides maximum value. Maximum value for the patient is more likely to be a decrease in radiating pain which they often describe as more of a light tingling, not the severe pain they once experienced. This will provide a quality life difference and also could help reduce medication uses for this condition.
CRPS is a very rough life circumstance to try and live with it; however, with interventional treatment options like spinal cord stimulation, it is easier to manage the pain and improve the quality of life. The team is made up of doctors and nurse practitioners skilled in treating such conditions as CRPS. If CRPS has been a long-standing problem, this team at Pain & Spine Specialists will do its best to help explore alternatives for treatment, including spinal cord stimulation, to find an answer best for you.
