Surgery

Spinal Cord Stimulation (SCS)

SCS is one of the more promising techniques available for treating CRPS. It is usually considered only after medicine, nerve blocks and other less invasive treatments fail to control your pain. During surgery, the surgeon will put a small wire under your skin near your spinal cord. The wire will be connected to a device called a spinal cord stimulator. An SCS device sends tiny, safe amounts of electrical current through the wire to the nerves that are causing CRPS pain and other symptoms. The electric current blocks pain messages in the nerve pathways going to the brain. You may feel tingling instead of pain.

Outcomes vary with the skill and experience of the health care team. Great care should be taken in choosing a health care provider who offers this therapy. SCS is generally first offered on a temporary basis. If successful, it is then used on a more long-term basis through surgery. Risks include equipment failure, infection, and injury to the spinal cord. The long-term outcomes of SCS await further study, but there are some promising reports.

Peripheral nerve stimulation (PNS)

Peripheral nerve stimulators are similar in action to spinal cord stimulators. They are placed near the spinal cord or further away in the limbs, usually when severe pain is present in the territory (or “distribution”) of a somatosensory nerve. PNS is a highly specialized area that is available in few parts of the country. There is limited information about its usefulness.

Surgical Nerve Decompression

This surgery may be done to relieve pain in people with nerve injury (CRPS-II). During this procedure, surgeons move nerves away from surrounding tissue to relieve pain and other CRPS symptoms. A common example is carpal tunnel release, where surgery is done to relieve pressure on the median nerve in the wrist. Most experts believe that any surgery done to a CRPS-involved area requires use of a regional nerve block. This may help to prevent the CRPS from getting worse.