Complex regional pain syndrome: manifestations and the role of neurostimulation in its management.

The hallmark of complex regional pain syndrome (CRPS) is excruciating pain (aching, burning, pricking, or shooting). Diagnosis should be established as soon as possible, as response to treatment is adversely affected by any delay. Treatment of CRPS is aimed at improving function, using an interdisciplinary, time-dependent, patient-dependent approach that encompasses rehabilitation, psychological therapy, and pain management. If no response to conventional treatment (e.g., pharmacotherapy) is noted within 12-16 weeks, a more interventional technique such as spinal cord stimulation (SCS) should be used. SCS has been shown to be highly effective in the treatment of CRPS type I, resulting in a significant, long-term reduction in pain and improvement in quality of life. SCS is particularly effective at helping to restore function in affected extremities, especially if applied early in the course of the disease. SCS is also cost effective and improves health-related quality of life.