Unfortunately, there is no medical cure for CRPS.
The best that can be done is to try and ease the symptoms and to help the patient to rebuild their life with the help of pain management and rehabilitation.
Prompt diagnosis and the earliest possible treatment are vital to try and prevent things from getting worse. This is the recognised “best practice”. Delays can cause additional physical problems and a possible spreading of the condition to other parts of the body. In addition, the longer the patient is left to suffer in silence, the more likely they are to have significant and entrenched psychological symptoms brought about by having to live with such a painful and debilitating condition.
Delays can often occur because the medical practitioners are not very familiar with CRPS. The unusual range of symptoms can lead to an innocent misdiagnosis with resultant delays in getting the right treatment regime in place.
A co-ordinated multidisciplinary approach is needed. This should involve a referral to specialists in pain management and rehabilitation.
UK guidelines have been developed for the diagnosis and management of CRPS. Unfortunately, patient access to specialist pain management and rehabilitation services is rather patchy across the country.
The Royal College of Physicians has produced UK Guidelines for the diagnosis and management of CRPS. They apply at both GP and Specialist level.
The Guidelines have been put together by a panel of experts taken from a large number of medical disciplines such as the British Pain Society; the Royal College of Medical Practitioners; the British Society for Rehabilitation Medicine; the Physiotherapy Pain Association; the Society of British Neurological Surgeons; the Pain Relief Foundation; the British Psychological Society; and many others.
The UK Guidelines are intended to provide clinicians at all levels (GP; Consultant; Therapist; etc) with a clear and co-ordinated approach to the care of CRPS sufferers. The Guidelines spell out just how unpleasant CRPS can be. Very significantly, the Guidelines also recognise that some patients still report a lack of understanding and support from some health professionals. This is very disappointing and quite disturbing. A CRPS victim needs full support and not a half-hearted treatment plan.
The aim of the treatment program is to reduce pain; try and improve the patients range of movement (or at the very least stop it from getting worse); and to help the sufferer to start to take some control of their condition with a view to improving their overall quality of life. Unfortunately, there is no such thing as a quick fix.
The UK guidelines talk about 4 “pillars” of care. They are:
- Pain relief through appropriate medication and procedures
- Physical and vocational rehabilitation
- Psychological interventions
- Patient information and education to support self-management
All 4 “pillars” have equal standing and importance. Good practice dictates that the best support can be given to patients by giving clear information about CRPS; giving good advice about what to expect; the treatment options available; setting realistic goals; and involving partners and other family members where appropriate.