Complex Regional Pain Syndrome (CRPS)

Conditions

Understanding Complex Regional Pain Syndrome (CRPS)

Complex Regional Pain Syndrome (CRPS) is a chronic and often severe pain condition that usually develops after an injury, surgery, or fracture. In CRPS, the nervous system becomes overactive, sending persistent pain signals long after the original injury has healed. It can affect any limb, though the arms, hands, legs, and feet are most commonly involved.

CRPS involves dysfunction of both the peripheral and central nervous systems, along with changes in circulation, inflammation, and tissue sensitivity. The pain is typically disproportionate to the initial injury and may spread beyond the original site.

Typical symptoms include:

  • Continuous burning, stabbing, or throbbing pain
  • Swelling, stiffness, or joint immobility
  • Skin colour changes (red, purple, pale) or temperature differences between limbs
  • Abnormal sweating, shiny or thin skin, or changes in hair/nail growth
  • Hypersensitivity to touch, cold, or movement
  • Muscle weakness or wasting due to disuse and pain avoidance

CRPS can be devastating, but early, coordinated treatment can significantly improve function and reduce symptoms.

Wessex Pain Clinic

How We Diagnose

At Wessex Pain Clinic, diagnosis begins with a detailed history and physical examination to assess pain characteristics, skin changes, swelling, and movement limitation.

We use internationally recognised diagnostic criteria (the Budapest Criteria) and may perform additional investigations to rule out other causes of pain, such as infection, vascular disease, or nerve compression.

Our consultants work closely with orthopaedic, neurological, and rehabilitation specialists to ensure comprehensive evaluation and care.

wpc scan mod min
Lifestyle and Complementary Therapies

Our physiotherapy and rehabilitation partners are central to recovery from CRPS. Early, gentle, and consistent movement is essential. Treatment includes:

  • Desensitisation therapy to reduce touch and temperature sensitivity
  • Graded motor imagery and mirror therapy to retrain the brain’s pain perception
  • Hydrotherapy for supported, low-impact movement
  • Functional rehabilitation programmes to rebuild strength, confidence, and coordination

Our pain psychology partners provide expert support using CBT, ACT, and mindfulness to help patients manage anxiety, fear of movement, and the emotional toll of chronic pain.

This multidisciplinary approach — combining medical, physical, and psychological care — gives the best chance of meaningful recovery and return to normal activity. At Wessex Pain Clinic, we work as a team and meet regularly to discuss complex, treatment resistant or unusual cases. As such you will often receive the expertise of several pain consultants. We believe that we are one of very few pain clinics to offer this.

Medications

We may prescribe:

  • Neuropathic pain medications such as amitriptyline, duloxetine, pregabalin, or gabapentin to calm overactive pain signals
  • Anti-inflammatory medicines (NSAIDs) or short courses of corticosteroids to reduce inflammation and swelling
  • Bisphosphonates or calcitonin in selected cases for bone-related pain
  • Topical treatments such as lidocaine or capsaicin creams for localised sensitivity
  • Vitamin C supplementation (supported by research for early CRPS prevention and symptom reduction)
Interventional Procedures

Our consultants specialise in image-guided interventions designed to target pain pathways directly, including:

  • Magnesium infusions: Under sedation we isolate the affected limb with a surgical tourniquet. An Intravenous cannula is placed in this limb and magnesium, local anaesthetic and steroid is injected. This baths just the affected limb in high strength localised pain relief. This aims to break the pain cycle and enable greater rehabilitation and physiotherapy.
  • Peripheral nerve blocks to calm localised pain and support rehabilitation
  • Lidocaine infusions to decrease central sensitisation and nerve hyperexcitability
  • Spinal Cord Stimulation (SCS) — in severe or treatment-resistant CRPS, this advanced therapy can help control pain by altering how pain signals are processed by the spinal cord
Our management of CRPS is multidisciplinary and consultant-led, combining medical, interventional, physical, and psychological therapies to restore movement, reduce pain, and prevent long-term disability.

Treatment at Wessex Pain Clinic

Treatments