If you’ve lived with CRPS for years, you’ve probably tried more than one of these already. You may have been given a prescription by one doctor, a procedure by a specialist, and a different plan by the next, and each plan made sense on its own. Together they can leave you comparing options by yourself.
You are not crazy. These symptoms are real, and they make sense when we look at the nervous system. Cleveland Clinic describes CRPS as a neurological condition that causes pain and other symptoms in a certain part of your body. We often explain the nervous system as software coordinating a computer: when the coordination slips, parts that look fine can still misbehave. That’s the lens we bring, and it’s why we say treat the nervous system, not just the symptom.
Below is how the common options compare, ours included. We can’t promise you an outcome from any of them, and neither can anyone else. Hope is still within your reach, and it’s a fair place to start. For the wider picture of the condition, see Everything to Know About Complex Regional Pain Syndrome (CRPS).
What treatments do people with CRPS compare?
Most patients compare five groups of options: medication, physical and occupational therapy, brain-based retraining such as graded motor imagery, ketamine and other nerve procedures, and intensive nervous system rehabilitation. They aren’t rivals. AAPM&R says the best evidence supports a multidisciplinary approach.
| Option | What it is | What the published sources say | Worth asking |
|---|---|---|---|
| Medication | Medicines chosen and monitored by your prescriber | AAPM&R says there are no well-accepted treatment guidelines for pharmacotherapy | Which symptom is this aimed at, and what happens if it doesn’t help? |
| Physical and occupational therapy | Graded movement, desensitization, swelling control | AAPM&R says outcomes can improve when started early | Does the therapist have CRPS experience? |
| Graded motor imagery and mirror therapy | Training the brain to reconnect with the painful limb | AAPM&R reports improvement at 6 months in trials of CRPS I | Who will guide the steps? |
| IV ketamine, nerve blocks, implanted stimulators | Infusion over several days, or procedures aimed at the nerves | Cleveland Clinic describes the ketamine infusion | What does the treatment measure, and what is the plan if it doesn’t hold? |
| Intensive nervous system rehabilitation | Many therapies delivered together, in person, over an extended stay | Published evidence for our specific program is not yet something we can cite | Can you be away from home that long, and can you afford it? |
Read the table as a map of questions, not a ranking. The right row for you depends on your history, and your own prescriber or specialist should stay part of the decision.
Does one approach work best for CRPS?
No single approach has won, and the sources are candid about it. AAPM&R’s treatment overview states that there are no well-accepted treatment guidelines for pharmacotherapy. It also says the best evidence supports a multidisciplinary approach.
That’s worth knowing when you’re tired of hearing that one thing is the answer. If a clinic tells you its method is the only route, treat that as a reason to ask more questions. We say the opposite about ourselves: we believe in our program, and we don’t think it’s your only hope.
What can medication do for CRPS?
Medication is where many people start. The NHS says there’s no known cure for CRPS, but a combination of physical treatments, medicine and psychological support can help manage the symptoms. AAPM&R adds that there are no well-accepted treatment guidelines for pharmacotherapy.
Because these drugs are chosen one symptom at a time, a long list of them can leave you feeling that no one is holding the whole picture. If that’s you, a medication review with your prescriber is worth having, and we’d never suggest stopping anything on your own. We’ve also written about newer options in New Treatments for CRPS.
Do physical therapy and graded motor imagery help?
For many people they do, and timing matters. AAPM&R says physical and occupational therapy can improve outcomes in CRPS when started early, meaning symptoms for less than one year. The same source reports that trials of graded motor imagery have shown improvement in pain and functional disability at 6 months in patients with CRPS I.
If you’re well past a year, that doesn’t close the door. It does mean you should ask any therapist how they adapt the approach for long-standing CRPS. The NHS warns that too much or too vigorous exercise can aggravate the condition, so your therapy should be supported by a therapist with experience of CRPS.
What about ketamine and nerve procedures?
These sit at the more invasive end of the options, and many patients research them after other care hasn’t been enough. Cleveland Clinic describes IV ketamine as a low-dose infusion given over 3 to 5 days. Ask any provider what the treatment measures, how long relief is expected to last, and what the next step is if it doesn’t hold.
If you’re weighing them, it’s fair to also look at care that works on the nervous system without infusions, and to decide which fits your life. We don’t have a source we can cite on how nerve blocks or implanted stimulators perform for CRPS, so we’re leaving that comparison to your pain physician rather than guessing.
Where does an intensive nervous system program fit?
It fits people who want care aimed at the nervous system itself rather than one symptom at a time, and who can commit to being in person. The Spero Clinic is an intensive, in-person neurologic rehabilitation program in Fayetteville, Arkansas, founded by Dr. Katinka van der Merwe. Our focus is restoring balance and function across the central and autonomic nervous system.
In practice that means several therapies delivered together under one roof. We combine them on purpose, because we believe each one works better alongside the others.
Dr. Katinka’s belief is that the body is intelligent and capable of change when the nervous system receives the right support and enough time. That is a belief, not a forecast. No responsible clinician can promise relief or remission, and we won’t. To see how the approach works in detail, read How The Spero Clinic Treats CRPS or What to Expect At Our Clinic.
Who may not be a fit for an intensive program?
Several kinds of people may not be, and we’d rather say so now than on a call. If you’re mainly looking for infusions or a drug-based plan, a clinic that offers those is the better match. If you can’t spend an extended stretch away from home, work or family, the program may simply not be possible.
Cost is the other honest barrier. Our program is private-pay and usually not covered by insurance, and we don’t publish a price on this page. We’d tell you about the cost, the time away and the travel on the discovery call, so you can decide with the full picture.
It’s also not a replacement for medical evaluation. If you have new symptoms or an emergency, that belongs with your medical team, not with us.
What does progress look like, and will CRPS go away?
For many people symptoms ease over time, though nobody can predict whose will. The NHS estimates that around 85% of people with CRPS slowly experience a reduction in their pain and some of their symptoms in the first 2 years. The same page says there’s currently no way to predict who will improve and when.
A slow start doesn’t mean nothing will change, and a good stretch doesn’t guarantee it stays. Cleveland Clinic reports that CRPS recurs in about 10% to 30% of people. We go deeper on this in What Does CRPS Remission Look Like?.
What mistakes do people make when comparing CRPS treatments?
The most common one is choosing on desperation. After years of pain, a confident promise sounds like relief, and that’s exactly when to slow down and ask for specifics. A good provider will tell you what they can’t promise as readily as what they can.
Another is treating each option as a verdict on the last. If a drug or a procedure didn’t help, you didn’t fail it. That tool didn’t fit your case.
People also compare price and ignore the rest of the cost. Time away from work, travel, housing and the people who’d have to cover for you all count. Add them up before you decide, not after.
Finally, many people go it alone. Caregivers and family often carry the research and the logistics, so bring them into the comparison early.
FAQ
What is the most common cause of CRPS?
Cleveland Clinic reports that in more than 90% of cases, CRPS results from nerve trauma or injury to the affected limb. Dr. Katinka’s view is that injury is the trigger, not the whole story: the nervous system is why one person develops CRPS while others with the same injury recover. Your clinician can work out your own history.
What are some tips for coping with CRPS?
Pace your activity and work with a therapist who knows CRPS. The NHS notes that too much or too vigorous exercise can aggravate the condition. Gentle, graded movement supported by an experienced therapist is the usual aim. Tell the people around you what a flare looks like.
What are the signs of early-stage foot CRPS?
The sources we can cite don’t describe early foot signs specifically. Cleveland Clinic says CRPS usually affects an arm, leg, hand or foot. The NHS says movement or stimulation of the limb increases pain, swelling, colour changes and sweating. A clinician can evaluate a painful foot. Our guide on how CRPS is diagnosed explains more.
Will CRPS ever go away?
For many people symptoms ease, but nobody can say for whom. The NHS estimates around 85% of people slowly see a reduction in pain and some symptoms in the first 2 years. Some people have continuous pain despite treatment, and CRPS can recur.
Your next step
If you’d like to talk through where an intensive program fits and where it doesn’t, we’d like to hear your story.
