Treatment of complex regional pain syndrome (CRPS) is most effective when it is started early in the course of the syndrome. This can lead to dramatic improvement of symptoms or remission of the disease. On the other hand, failure to treat CRPS early can result in significant spread of the pain that may be increasingly difficult to treat.

Treatment methods will vary depending on the type of CRPS, the individual needs of the patient and the physician’s recommendations. Treatment options may include:

• Medications. Several types of drugs are used to treat symptoms of CRPS. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce pain and inflammation. Some prescription medications, including antidepressants, anticonvulsants and opioids, are sometimes used to treat pain stemming from a damaged nerve (neuropathic pain), and corticosteroids may be prescribed to ease inflammation. Local application of a lidocaine patch or a cream from peppers has some success in relieving symptoms. Certain medications used to treat bone loss, such as bisphosphonates, may also be helpful.

Some patients may respond to alpha blockers, a class of medication that is also used to treat high blood pressure and benign prostatic hyperplasia. Possible complications of alpha blockers include an eye condition called intraoperative floppy iris syndrome, which even years later may affect cataract surgery, one of the most commonly performed operations.

A physician may recommend injection therapy, such as sympathetic nerve-blocking medication. Injection of an anesthetic can relieve pain by blocking pain fibers in affected nerves. Examples include lumbar sympathetic nerve blocks, stellate ganglion nerve blocks and Bier blocks. In severe cases, leaving a continuous catheter in the epidural space or around ganglion to deliver medicine has been recommended.

• Physical therapy. Directed exercise of affected limbs can boost range of motion and strength, particularly when started early in the progression of CRPS. The therapist may also offer modalities such as electrical therapy.
  
  
• Transcutaneous electrical nerve stimulation (TENS). Procedure that applies electrical impulses to nerve endings, thereby easing chronic pain.
  
  
• Spinal cord stimulationSpinal cord stimulation. Technique in which tiny electrodes are inserted along the spinal cord before a small electrical current is delivered to these areas. This form of electrical therapy sometimes results in pain relief. Placing the same stimulator device around the affected peripheral nerve may also relieve symptoms.
  
  
• Biofeedback. Technique that helps patients to become more aware of their bodies so they can relax and blunt pain symptoms.
  
  
• Acupuncture. Procedure in which needles are inserted at particular points of the body to relieve pain. Acupuncture may be helpful for short-term pain relief in some patients.
  
  
• Psychological therapy. Patients with CRPS may experience emotional trauma. Cognitive behavioral therapy or other therapy can help patients deal with the stress and depression that sometimes stem from this disorder.
  
  
• Occupational therapy. Patients who have difficulty performing daily activities may benefit from instruction in ways to adapt.  
  
  
• Sympathectomy. Surgical procedure to sever the sympathetic nerves leading to the affected area. This may be used when other forms of treatment fail.

In addition, researchers have recently found that performing bilateral activities (involving the affected and unaffected limbs) in front of a mirror sometimes helps. They theorize that this treatment may work because CRPS could impair the brain’s image of the body and cause a split between sensory and motor systems.