Sympathetically Maintained Pain is a subset of CRPS in which there is analgesia to SNBs. CRPS patients may also display sympathetically-independent pain.
If a SNB provides good analgesia to a specific patient, then a short series of empiric blocks in conjunction with active reactivation-focused therapy is advocated based on consensus recommendations.
Complications for interventions must be weighed versus the putative benefits. Complications include bleeding, infection, intravascular injection, intrathecal injection, epidural abscess, pneumothorax, and others.
Interventional treatments are used for CRPS patients who are having difficulty starting and/or progressing in a functional restoration/interdisciplinary program. The treatment schedule begins with less invasive blocks, then infusions, and if necessary, more experimental neurostimulation techniques.
In summary, symptoms of CRPS encompass all the biopsychosocial complexities of chronic pain; therefore, helping patients to adopt a systematic, stable, empathetic, and above all, interdisciplinary/functional restoration approach should be the central intervention and outcome standard in CRPS.
Harden, R.N. & Bruehl, S.P. (n.d.) Complex Regional Pain Syndrome. pp. 314-326.
Core Curriculum for Professional Education in Pain, edited by J. Edmond Charlton, IASP Press, Seattle, © 2005