Nerve Blocks Crps

An option in pain management that could be useful for CRPS

When it comes to pain management, there are many options out there that might represent a resolutive path for patients affected by different conditions. Pain Management in Complex Regional Pain Syndrome, however, can be very challenging for patients as well as for doctors. This is because CRPS is a debilitating condition of which pain is merely a symptom. We all know that, although there is a valid treatment path, there is no actual cure for this condition and that simple pain management might work for a while, yes, but, on the long run, it can be less and less efficient, when it isn’t worsening the situation.

However, pain management options can help a patient in passing through the acute phase of CRPS, before undergoing the correct treatment. In this small article, we would like to briefly analyze one option adopted by many as a first choice to treat the pain of CRPS.

Nerve Blocks consist of the injection of a specific numbing medication into a specific area of the body. This technique can also be used to help with the diagnosis since, because of the reaction of the nervous system, it gives an idea of the source of the pain. As far as CRPS and its pain management, unfortunately, the option still is to “try” different options until one works. Nerve blocks have proven to be successful in more than 50% of cases, showing an acceptable level of pain relief for 3 to 6 months after the treatment. However, there are very few studies conducted strictly on patients affected by CRPS: usually, the trials are conducted on various types of conditions causing neuropathic pain. For example, one of the most recent studies conducted (published in October 2019) was on the use of nerve blocks to assess the correct positioning of a Spinal Cord Stimulator (inconclusive in that sense) and found that it may help patients with Complex Regional Pain Syndrome.

There has been a promising study with Nerve Blocks involving only children (9 to 16 yrs old) which showed how this therapy could help with pain management and give the patient the strength of undergoing physical rehabilitation. There have not been many studies involving adult patients: one was promising in 1989 but had no follow-up. It has shown that a nerve block conducted after an early diagnosis could help with the pain management enough to bear the real treatment, but it can not be considered a resolutive option.

Another promising case was recorded in ’91 and, more recently, a study conducted in 2018 on 3 patients has shown promising results within 6 months from the diagnosis. The study concluded that the blocks would need further investigation to demonstrate the clinical efficacy of the option.

If nothing else helps, from minor pain management drugs to anti-inflammatory therapies, this could be a good and less invasive option to manage the pain and, after that, undergo the correct treatment path. A multidisciplinary approach remains the best way to treat Complex Regional Pain Syndrome and hope for a total remission.

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