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Case Study: Complex Regional Pain Syndrome

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Complex regional pain syndrome (CRPS) is a chronic pain condition most often affecting one of the limbs (arms, legs, hands, or feet), usually after an injury or trauma to that limb. CRPS is believed to be caused by damage to, or malfunction of, the peripheral and central nervous systems. The central nervous system is composed of the brain and spinal cord, and the peripheral nervous system involves nerve signaling from the brain and spinal cord to the rest of the body. CRPS is characterized by prolonged or excessive pain and mild or dramatic changes in skin color, temperature, and/or swelling in the affected area.

hands-crpsCRPS can be a controversial topic due to disagreements between medical professionals. Doctors aren’t sure what causes some individuals to develop CRPS while others with similar trauma do not. In more than 90% of cases, the condition is triggered by a clear history of trauma or injury. The most common triggers are fractures, sprains/strains, soft tissue injury (such as burns, cuts, or bruises), limb immobilization (such as being in a cast), or surgical or medical procedures (such as needlestick). CRPS represents an abnormal response that magnifies the effects of the injury.

Our office recently helped a worker afflicted with CRPS when the insurance company’s physician disputed the diagnosis. We arranged for another medical opinion with a well-respected physiatry (rehabilitation) physician who testified that the worker indeed suffered from CRPS.

Diagnosis is based on the affected individual’s medical history and signs and symptoms that match the definition. But because several other conditions can cause similar symptoms, careful examination is important. Since most people improve gradually over time, diagnosis may be more difficult later in the course of the disorder.

With a dispute between physicians, our office successfully persuaded the Judge to order an independent medical exam with a physician selected by the Judge. That third physician agreed with the CRPS diagnosis and our client received specialized treatment including a series of Ketamine infusions. Ultimately, our client improved dramatically and has returned to work.

Are you or someone you know suffering from Complex Regional Pain Syndrome? Call our office at 317.569.9644 or email rklezmer@klezmermaudlin.com to talk to one of our experienced attorneys to see how we can help.

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