Ways to Manage Complex Regional Pain Syndrome (CPRS) in the Knee

by / Saturday, 11 May 2019 / Published in Blog, Knee Pain

Chronic knee pain can increase after an injury, even more so with the development of complex regional pain syndrome. This type of chronic pain is persistent and can make daily life hard to manage. There are ways to control this chronic pain in your knee. Some treatments known to help this condition are physical therapy, ultrasound-guided injections, and electrical nerve stimulation. You can find relief from your complex regional pain syndrome, getting your normal life back.


What is Complex Regional Pain Syndrome (CPRS)?


Complex regional pain syndrome (CRPS) is a chronic pain condition that mostly affects one limb (arm, leg, hand, or foot), usually after an injury. Complex regional pain syndrome is thought to be caused by damage to the peripheral and central nervous systems. The central nervous system is composed of the brain and spinal cord, while the peripheral nervous system involves all of the nerve signaling from the brain and spinal cord to the rest of the body. CRPS is characterized by longer than normal or excessive pain, changes in skin color, temperature, and/or swelling in the injured area. There are two kinds of complex regional pain syndrome: CRPS-I and CRPS-II. Patients who have not been diagnosed with an injury to their nerves fall into the CRPS-I category.

Ultrasound guided injections of medication into the knee can greatly reduce chronic pain from CPRS

When a patient has a diagnosed nerve injury they fall into the CRPS-II category. The treatment is generally the same for both forms of complex regional pain syndrome. CRPS symptoms can vary, and some cases are mild enough they go away on their own.  In the most severe cases, patients may never recover and have a long-term disability. In almost 90% of CPRS cases, the cause is from a previous injury. Complex regional pain syndrome is an abnormal body response to an injury and can magnify the pain. CPRS can affect the immune system of patients with this disorder, increasing the amount of inflammatory properties in the blood and injured area. Some studies suggest this disorder is influenced by genetics. In very rare cases, CPRS can develop in patients without an injury.


How Can I Manage the Pain In My Knee From CPRS?


Physical Therapy


Exercising your knee can increase blood flow, and move inflammatory fluid out of the joint. These exercises also help to strengthen the knee joint, leading to better use of the joint and less pain. Physical therapy has also been shown to reverse the brain and nerve changes from chronic pain.


Ultrasound-guided injections


Ultrasound-guided injections of medication into the knee can greatly reduce chronic pain from CPRS. A variety of medications can be used to treat nerve pain, such as nerve blocks, prolotherapy, PRP injections, and stem cells. All of these medications have different purposes, but the ultrasound guide ensures correct placement of the treatment into the knee.


Electrical Nerve Stimulation


Stimulating electrodes can be surgically placed in the spine through a needle near the spinal cord that provides a tingling sensation in the painful area. Neurostimulation can also be delivered in other locations, not just the spinal cord.  These include injured nerves outside the brain and within the center of the brain that control pain. A recent, non-invasive option uses magnetic currents applied to the outside of the brain. However, repeated treatments are needed.