Chronic Pain members - Welcome, please introduce yourself

I hadn’t thought if acupuncture could worsen CRPS but that’s a good point to bring up. I was supposed to get acupuncture (for the 1st time) but Covid hit so acupuncture was postponed. Now I’ll question my doctors before trying it in the future.

@jerid I have tried PT acupuncture antidepressants antipsychotics dry needling myofascial therapy and about 50 supplements and topical creams. I believe I have exhausted all avenues but am open to suggestions. Thanks for asking.

I didn't realize having a TKR would result in so much after pain. Did they severe a nerve or something. What went wrong? This just isn't right and is no doctor who did the surgery showing any responsibility for anything? I am not a person to sue, but man this is just so wrong for you to suffer so much and have no answer. If I were you I would at least try the red light laser. Like I said there is a 90 money back guarantee. I know it's a lot of money, but in the big picture of things is it really if it helps. I was told there was nothing to help my constant agony also, but I got lucky and found the laser.

Okay, I just remembered there is a liquid nerve pain reliever that I got at Walmart that worked wonders at first. It is cheap and just might work for you. My husband and I were really shocked as to how good it was, but I needed something that lasted longer. If you have to apply it several times a day... so what if it helps you. Let me know if you get it and how it works for you. Best of luck. Jeri

Another cream that might work is Bioron Arni Cream listed on the same site above. I hurt the arch to my left foot one time and was left with a weird nerve pain and my naturopathic physician suggested it and dang if it didn't work great. I no longer have to use it. I guess the nerve healed. If neither of these work you might really consider having the nerve ablation.

Would they do nerve ablation on feet? How exactly does nerve ablation work? Please chime in anyone. My sciatica goes from my butt through the bottoms of my feet including my outside shins, hamstrings, etc

On me, they did the main nerve just above my left eyebrow that fed the left side of my head, forehead and some of the eye. I have a feeling on you they would target the exact sciatica nerve through the spinal nerves that feed to your particular nerve. Just before I went in , for my treatment, the lady before me that had come out had an ablation to her spine for her arthritis. He told me because the arthritis never goes away and the nerve grows back this particular lady has it done every 6 months to help with her arthritis, where ever it was they were targeting. I am no physician, but if yours is in your feet maybe they could target one specific nerve in that foot or your sciatic nerve leading to that foot. I am presuming it is a foot and not both feet. It is worth a consultation with a Chronic Pain Specialist in your area with a good reputation. I had no choice, but one 60 miles from our home town. After meeting with him and reading his info on the internet I felt comfortable. The first treatment they tested a numbing medication and the ablation medication into the nerve. I had to wait 1 month for a revisit to give the medication time to do its job. It lasted 3 days and then it was over. The second treatment they used the numbing medication only and it did nothing. A month later they did a much stronger ablation procedure and it lasted 2 weeks. The procedure is relatively easy and mine didn't take very long. 30 minutes at the most. These are the procedures that my insurance regulated. It is painful, but nothing compared to the daily pain I was living with. I presume it would be the same for you as far as the pain goes. We were both disappointed it only lasted 2 weeks. I have be known to be sort of a stubborn person though. Ha Ha! Believe me I was not trying to be stubborn towards this treatment. I so wanted it to work for the rest of my life. If you can get this done and it gives you 6 months or more relief it will be worth the small pain of the moment. I just didn't go back after the 6 months since my results were only 2 weeks long. The red light laser has been my blessing. Like I said it could be yours as well, maybe. Check out a Chronic Pain Specialist. Mayo clinic might be a good place to go for this treatment as well. We just didn't have one close to us. I guess I am trying to say you will never know until you search for the answer. Keep an open positive mind. God will lead you to the right answer. I don't believe it is drugs. To me they only mess you up otherwise with other side effects. Jeri

I just looked up CRPS and here is what I found. There are interesting treatments. I marked one that said acupuncture. Hope this help, even if in a small way.

How is CRPS treated?

Most early or mild cases recover on their own. Treatment is most effective when started early.

Primary therapies that are widely used include:

Rehabilitation and physical therapy. This is the single most important treatment for CRPS. Keeping the painful limb or body part moving improves blood flow and lessens circulatory symptoms, as well as maintains flexibility, strength, and function. Rehabilitating the affected limb helps prevent or reverse secondary spinal cord and brain changes associated with disuse and chronic pain. Occupational therapy can help people learn new ways to become active and return to work and daily tasks.

Psychotherapy. People with severe CRPS often develop secondary psychological problems including depression, situational anxiety, and sometimes post-traumatic stress disorder. These heighten pain perception, further reduce activity and brain function, and make it hard for patients to seek medical care and engage in rehabilitation and recovery. Psychological treatment helps people with CRPS to feel better and better recover from CRPS.

Graded motor imagery. Individuals are taught mental exercises including how to identify left and right painful body parts while looking into a mirror and visualizing moving those painful body parts without actually moving them. This is thought to provide non-painful sensory signals to the brain that helps reverse brain changes that are prolonging CRPS.

Medications. Several classes of medication have been reported as effective for CRPS, particularly when given early in the disease. However, none are approved by the U.S. Food and Drug Administration (FDA) to be marketed specifically for CRPS, and no single drug or combination is guaranteed to be effective in everyone. Drugs often used to treat CRPS include:

Acetaminophen to reduce pain associated with inflammation and bone and joint involvement.
Non-steroidal anti-inflammatory drugs (NSAIDS) to treat moderate pain and inflammation, including over-the-counter aspirin, ibuprofen, and naproxen in sufficient doses.
Drugs proven effective for other neuropathic pain conditions, such as nortriptyline, gabapentin, pregabalin, and duloxetine. Amitriptyline, an older treatment, is effective but causes more side effects than nortriptyline, which is very similar chemically.
Topical local anesthetic ointments, sprays, or creams such as lidocaine and patches such as fentanyl. These can reduce allodynia, and skin coverage by patches can provide additional protection.
Bisphosphonates, such as high dose alendronate or intravenous pamidronate, that reduce bone changes.
Corticosteroids that treat inflammation/swelling and edema, such as prednisolone and methylprednisolone.
Botulinum toxin injections can help in severe cases, particularly for relaxing contracted muscles and restoring normal hand or foot positions.
Opioids such as oxycodone, morphine, hydrocodone, and fentanyl may be required for individuals with the most severe pain. However, opioids can convey heightened pain sensitivity and run the risk of dependence.
N-methyl-D-aspartate (NMDA) receptor antagonists such as dextromethorphan and ketamine are controversial unproven treatments.

*Spinal cord stimulation. Stimulating electrodes are threaded through a needle into the spine outside the spinal cord. They create tingling sensations in the painful area that helps block pain sensations and normalize signaling into the spinal cord and brain. Electrodes can be placed temporarily for a few days to assess if stimulation is likely to be helpful. Minor surgery is required to implant the stimulator, battery, and electrodes under the skin on the torso. Once implanted, stimulators can be turned on and off and adjusted with an external controller.

Other types of neural stimulation. Implanted neurostimulation can be delivered at other locations including near injured nerves (peripheral nerve stimulators), under the skull (motor cortex stimulation with electrodes), and within brain pain centers (deep brain stimulation). Recent noninvasive commercially available treatments include nerve stimulation at the peroneal nerve at the knee. Another is repetitive Transcranial Magnetic Stimulation or rTMS, a noninvasive form of brain stimulation that uses a magnetic field to change electrical signaling in the brain. Similar at-home use of small transcranial direct electrical stimulators is also being investigated. These stimulation methods have the advantage of being non-invasive; however, repeated treatment sessions are needed to maintain benefit, so they require time.

*Spinal-fluid drug pumps. These implanted devices deliver pain-relieving medications directly into the fluid that bathes the nerve roots and spinal cord. Typically, these are mixtures of opioids, local anesthetic agents, clonidine, and baclofen. The advantage is that very low doses can be used that do not spread beyond the spinal canal to affect other body system. This decreases side effects and increases drug effectiveness.

*****Alternative and holistic therapies. Based on studies from other painful conditions, some individuals are investigating accessible treatments such as medical marijuana, behavior modification, acupuncture, relaxation techniques (such as biofeedback, progressive muscle relaxation, and guided motion therapy), and chiropractic treatment. These do not benefit the primary cause of CRPS, but some people find them useful. They are generally accessible and not dangerous to try.*******************************************************************************************************************************************

Limited use therapy for the most severe or non-resolving pain that has not responded to conventional treatment, such as ketamine. Some investigators report benefit from low doses of ketamine—a strong anesthetic—given intravenously for several days. In certain clinical settings, ketamine has been shown to be useful in treating pain that does not respond well to other treatments. However, it can cause delusions and other symptoms of psychosis with long-lasting impact.

Rarely used former treatments include:

*Sympathetic nerve block. Previously, sympathetic blocks—in which an anesthetic is injected next to the spine to directly block the activity of sympathetic nerves and improve blood flow—were used. More recent studies demonstrate no long-lasting benefit after the injected anesthetic wears off and there is the risk of injury from needle injections, so this approach has fallen from favor.

Surgical sympathectomy. This destroys some of the nerves that carry pain signals. Use is controversial; some experts think it is unwarranted and makes CRPS worse, while others report occasional favorable outcome. Sympathectomy should be used only in individuals whose pain is temporarily dramatically relieved by sympathetic nerve blocks.

Cutting injured nerves or nerve roots. People with CRPS often ask if cutting the damaged nerve above the site of injury would end the pain. In fact, this causes a larger nerve lesion that will affect a larger area of the limb. Also, the spinal cord and brain react badly to being deprived of stimulation which can result in central pain syndromes. Other than in exceptional circumstances such as palliative care, this should not be performed.

Amputating the painful lower limb. This is an even more drastic and disabling form of nerve cutting, and the consequences are irreversible, whereas CRPS almost always improves over time, albeit sometimes slowly. Amputation is thus not appropriate for pain control alone, but it is rarely required to manage bone infection or to permit use of a prosthesis for long-affected non-recovering individuals. This last resort should not be performed without input from several specialists along with psychological counseling.

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Thank you so much for this thorough information about CRPS. It’s helpful.

You are welcome.

Please be careful with any treatment regarding CRPS. Much of it is outdated. The most up to date therapies and treatments regarding both types of CRPS and all presenting forms, progressive, regressing, peripheral presentation in hand or foot, neck, shoulder, back, or origination of injury is not found within the United States but Europe.
The only tap to that source I have found is The Reflex Sympathetic Dystrophy Syndrome Association’s Website http://www.rsds.org. Others attempt to stay up to date with Europe’s strides with CRPS and RSD but they are woefully behind the eight ball INCLUDING our CDC, FDA, DEA, NIH, and the WHO.