Interventional Treatment of Complex Regional Pain Syndrome

Abstract

Interventional therapies are critical and integral parts of a multipronged strategy for pain relief and rehabilitation in patients with complex regional pain syndrome (CRPS). These therapies include intravenous drug infusion to a specific limb or as a systemic drug delivery route, sympathetic blocks, and neuromodulation modalities, such as peripheral nerve stimulation, dorsal root ganglion stimulation, spinal cord stimulation, and intrathecal drug delivery. This chapter focuses on the clinical evidence of efficacy of the interventional therapies for CRPS, as well as the essential skills in clinical practice of these interventions. There is level I evidence to support neuromodulation via dorsal root ganglion and spinal cord stimulation; level II evidence to support intrathecal drug therapy and sympathetic blocks; and substantial yet variable evidence to support peripheral nerve stimulation and intravenous therapies. It is imperative that interventional treatment is individualized, with an emphasis placed on improving quality of life and function.