Complex Regional Pain Syndrome

Complex Regional Pain Syndrome (“CRPS”), formerly known as Reflex Sympathetic Dystrophy (“RSD”), is a chronic, painful, and disabling progressive disorder of the sympathetic nervous system. It affects one or more extremities and most often occurs following trauma, such as a fracture or nerve damage to the affected extremity. [1] CRPS is characterized by excruciating pain that is disproportionate to the original injury, which continues long after the original injury has healed. See id. Additionally, CRPS causes vasomotor (relating to the constriction and dilation of blood vessels), sudomotor (stimulation of sweat glands), inflammation, motor impairment, hyperesthesia, trophic changes (changes brought about in tissues from interruption or destruction of nerve, blood supply, or both), and allodynia (a painful response to a normally innocuous stimulus such as a touch, sound, temperature, or vibration) in the affected extremity. See id. 

Pain is a subjective experience. This recognition led to the development of the McGill Pain Scale, which is widely used around the world to help health care professionals gauge their patients’ level of pain. See id. “A CRPS pain flare is the most intense pain known to man and ranked the highest on the McGill pain scale, scoring higher than amputation and childbirth.” Id. Many who are diagnosed with CRPS commit suicide due to an inability to tolerate the excruciating pain and an inability to cope with the severe functional limitations.  The Reflex Sympathetic Dystrophy Syndrome Association (“RSDSA”), a non-profit organization dedicated to providing support and education while driving research to find effective treatments and a cure for CRPS, compared living with CRPS to “living with chronic pain more severe than a constant jellyfish sting” and constant electrocution from “sitting in an electric chair with bolts of electricity running through the [affected extremity].” [2]

There is no cure [3] but various medical procedures can be used to reduce pain, such as stellate ganglion blocks. Many suffering from CRPS will experience “unremitting pain and crippling, irreversible changes in spite of treatment.” Id.  No single drug or combination has produced consistent long-lasting improvement in symptoms. See id. CRPS pain “is severe and unresponsive to almost all analgesics.” [4] “Opioids will not control the pain of a flare-up unless given in a quantity that would make the patient somnolent.” [5] Therefore, “[o]pioids are not considered as first-line treatments for patients suffering from CRPS.” Id. “Because there is no cure for CRPS, treatment [such as physical therapy] is aimed at relieving painful symptoms.” [6]

Treatment Options for CRPS

A plan for individualized CRPS treatment usually includes a team of healthcare providers, possibly including a combination of physical therapists, orthopaedic specialists, and/or neurologists. Since there is no cure for the syndrome, the medications prescribed are often the ones also used to treat other chronic pain conditions. The primary goal of treating CRPS is to restore functionality in the affected body area and relieve pain. This care normally includes physical and/or occupational therapy. Early treatment of Complex Regional Pain Syndrome is crucial in the battle against minimizing symptoms and seeking remission. Medical intervention may involve invasive and noninvasive treatments, such as:

  • Ketamine, an anesthetic
  • Steroids
  • Nerve block injections (also known as Stellate Ganglion Block)
  • Spinal cord stimulator implants
  • Aquatic therapy

Organizations, such as the RSDSA, offer information on current and emerging medical care. Clinical studies are being conducted for CRPS treatment that may provide even more tools to fight CRPS.

Receiving Treatment for Complex Regional Pain Syndrome

It is important to choose qualified medical professionals when seeking treatment for Complex Regional Pain Syndrome.  You will also want to consult with a CRPS law firm that is knowledgeable about the syndrome and the medical providers in the area. At Tien Law Firm, we offer free consultations for those being treated for Complex Regional Pain Syndrome or for those who have been recently diagnosed. Contact Tien Law Firm for a free consultation today.

Do you have Reflex Sympathetic Dystrophy (RSD), also known as Complex Regional Pain Syndrome (CRPS)? After the body suffers an injury or trauma, this neurological condition can develop and drastically change one’s life by limiting one’s ability to use the affected limb and limiting one’s ability to perform basic tasks. The ability to complete routing activities of daily living may be lost or much more difficult. As a hallmark characteristic of RSD, we usually see a great loss of strength in the affected limb, discoloration of the affected limb, swelling, extreme sensitivity, and excruciating pain that our clients say feels like their limb is on fire or being electrocuted.

If you or someone you know is living with this serious and painful condition, an experienced RSD/CRPS attorney may be able to help. At Tien Law Firm, we have recovered financial compensation for clients who suffer from the chronic pain of RSD due to others’ negligent actions.

As a dedicated advocate and attorney for my clients with CRPS, we have made it our mission to understand the complexity of CRPS and fight for our clients who have had to receive that diagnosis on account of the negligence of someone else.

RSD/CRPS lawsuits may be filed when the condition is caused by an:  

    • Injury, such as in a car accident,
    • Unnecessary surgery,
    • Injection given in the wrong place,
    • IV infiltration that went unnoticed.

More Information About CRPS/RSD

We have helped clients suffering from CRPS with knowledge and in-depth understanding of the complex diagnosis. Our RSD lawyer understands that this chronic condition is painful, permanent, and expensive. An RSD lawsuit addresses the potential for a lifetime of medical bills. Some of our clients have ended up on disability. They are financially devastated and dealing with the negative effects of the syndrome on their social and personal relationships.

There are definite benefits to choosing an attorney who is experienced in RSD/CRPS cases:

    • We know how to discuss the chronic pain of this often misunderstood condition with insurance adjusters, defense lawyers and juries;
    • We have heard and already addressed many defense arguments against RSD claimants;
    • Medical professionals we have worked with may be able to offer resources and powerful testimony;
    • We handle these cases on a contingency basis, meaning we only get paid if you do.

RSD/CRPS Lawsuit Information

The value of an North Carolina RSD/CRPS case depends on a number of factors, including the:

    • Severity of the RSD, as medically diagnosed;
    • Amount and type of treatment required;
    • Whether permanency is medically documented;
    • Amount of claimant’s lost wages, which can be large in RSD cases; and
    • Amount of the victim’s economic damages.

Length and Cost of an RSD Case

Each case is different, but it is more common for these cases to take about two years versus just a few months. As a Complex Regional Pain Syndrome lawyer, we understand that most sufferers do not have the money to take legal action. This is why we generally take care of the case costs. Remember, as your RSD law firm, we never get paid unless you get paid!

Symptoms of RSD

Not all patients have all the signs or symptoms of RSD. The first sign is pain that is more severe than expected after bodily trauma, such as a broken bone or motor vehicle accident injury.

Patients describe:

    • Burning pain and/or swelling in the affected area;
    • Changes in skin’s temperature, sensitivity, color and characteristics; and
    • Symptoms that progressively worsen.

It is very important that RSD victims be diagnosed promptly by a qualified physician, preferably with a specialist that has treated this condition before, since early treatment can lead to better outcomes. If you’ve been diagnosed with this condition as the result of an injury or medical negligence, we invite you to contact our RSD/CRPS lawyer now to ask any questions that you have and see if we can help.

Complex Regional Pain Syndrome, or Reflex Sympathetic Dystrophy, is a progressive pain syndrome characterized by severe pain that can be burning, electrical-like, or shooting. Pain is centered around the site of injury. Other symptoms patients with CRPS/RSD experience can include muscle spasms or atrophy, stiff joints, and a decrease in mobility of the affected region. There can be skin changes like color changes, increased sweating, temperature changes (the area feels hot or cold), or swelling. Hair and nail changes like increased or decreased growth; nails may become brittle and develop grooves. Patients may experience osteoporosis. The most dramatic symptom is pain. Sensitivity to even the lightest touch can have dramatic pain symptoms. Air blowing over the skin can even trigger this pain. Another component of CRPS/RSD is an immune system response creating inflammation in the surrounding injured tissues, which results in pain.

Some days are better than others for RSD patients. The pain triggers and intensity are so severe that the pain has even been referred to as severe as childbirth. Some patients even desire to amputate their affected limb to make the RSD pain go away, but a respected orthopaedic specialist we recently deposed said that amputating the affected limb would not help.

Types of CRPS/RSD

    • Type I: CRPS/RSD, reflex neurovascular dystrophy without any evidence of nerve cell damage
    • Type II: Causalgia with evidence of nerve damage

Causes of CRPS/RSD

CRPS/RSD appearing within days or weeks after a collision has a high likelihood of relatedness due to damage to the nerves in the injured area, which results in the hyper-excitement of the nervous system and excruciating pain. Recently, a local orthopaedic specailist we deposed in one of our CRPS cases opined on the record that, in his professional medical opinion, our client’s injuries were inflicted by the motor vehicle collision at issue. Early identification and treatment of CRPS/RSD is crucial in preventing further disability, debility, and progression of symptoms, and may facilitate remission.

If you have CRPS/RSD, we may be able to recover money for you.

We are a personal injury law firm in North Carolina that has successfully recovered money for clients suffering from CRPS. If you’re suffering from CRPS/RSD after a motor vehicle collision, you need a CRPS lawyer who understands just how serious, permanent, expensive, and mentally traumatic CRPS is. Contact us today for a free consultation.

Frequently Asked Questions

How much is my CRPS case worth?

Valuing a CRPS case is difficult and depends on many factors, including the severity of the CRPS, the amount and type of treatment required, a claimant’s wages, and how significant the economic damages are. Also, it is important to evaluate how likely it is that our client will win the case and what the client’s doctor will say when asked if the injury is permanent, painful, and disabling.

How long will the CRPS case take?

Each case is different, but in our experience, it is more common for a CRPS case to take about two years on average to resolve versus just a few months, and that is because of the length and amount of treatment CRPS requires. Honestly, claimants that settle CRPS cases too early risk not knowing the full extent of their injuries and not being fully compensated for the severity of their injury.

How much money will it take to pursue my CRPS case and who pays for those costs?

In almost all our cases, Tien Law Firm agrees to advance all the necessary case costs. CRPS injury cases can be very expensive and can cost tens of thousands of dollars due to expert costs that most likely are required for a CRPS case. Medical experts are paid a flat fee of a few thousand dollars usually and/or a high hourly rate to read medical records, research issues, and consult with the CRPS lawyer. Besides expert consultants, money is generally spent purchasing medical records, paying filing fees, and buying deposition transcripts of the witnesses who are interviewed under oath during the lawsuit. As CRPS lawyers, we understand that most individuals with RSD do not have the monetary resources to invest in a lawsuit, which is why we almost always take care of the costs.

Then how do the CRPS lawyers get paid?

Our CRPS lawyer works on a contingent-fee basis, taking a percentage of the amount recovered at the end to pay our fee, meaning all the case work is done upfront. Remember, we never get paid unless you get paid, and we truly want to see our clients succeed. We are proud to fight the good fight against large insurance companies every day for our injured clients throughout North Carolina.

Additional CRPS Resources

[1] See Colleen M. Johnston, Florin I. Oprescu & Marion Gray, Building the Evidence for CRPS Research from a Lived Experience Perspective, 9 Scandinavian Journal of Pain 30, 31 (2015).

[2] See RSDA Information Package, The Reflex Sympathetic Dystrophy Syndrome Association, (May 18, 2016), http://rsds.org/wp-content/uploads/2016/03/RSDSA-Information-Package-3-31-16.pdf; see also Audrey Johns, The Taste & CRPS: The Story of a Brave Pain Warrior, 1 The Reflex Sympathetic Dystrophy Syndrome Association Newsletter, 2 (2014), http://rsds.wpengine.com/wp-content/uploads/2015/02/RSDSA_NEWSLETTER_ISSUE_2_R9.pdf.

[3] See Complex Regional Pain Syndrome Information Sheet, National Institute of Neurological Disorders and Stroke, (Nov. 3, 2015), http:// www.ninds.nih.gov/disorders/reflex_sympathetic_dystrophy/reflex_sympathetic_dystrophy.htm.

[4] See RSDA Information Package, The Reflex Sympathetic Dystrophy Syndrome Association, (May 18, 2016), http://rsds.org/wp-content/uploads/2016/03/RSDSA-Information-Package-3-31-16.pdf. 

[5] See Im Ducharme, M.D., C.M., F.R.C.P., Tips for Managing Complex Regional Pain Syndrome, Reflex Sympathetic Dystrophy Syndrome Association, (Sept. 11, 2015), http://rsds.org/wp-content/uploads/2016/03/RSDSA-Pediatric-Information-Package-03-30-16.pdf.

[6] See Complex Regional Pain Syndrome Information Sheet, National Institute of Neurological Disorders and Stroke, http:// www.ninds.nih.gov/disorders/reflex_sympathetic_dystrophy/reflex_sympathetic_dystrophy.htm.