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Complex Regional Pain Syndrome (CRPS)
What Are the Symptoms of CRPS?
Complex Regional Pain Syndrome (CRPS) is an extremely painful and potentially long-lasting consequence of a work injury. It can affect the arms and legs. The causes are varied and the injury itself may range from moderate to severe, but there are a few tell-tale signs of CRPS that you can look out for.
The primary symptoms experienced in the affected areas are:
- Burning pain
- Hypersensitivity and pain to touch
- Flare-ups of pain
- Warm or cold temperatures of the skin
- Sweating of the skin
- Nail changes
- Skin color changes
CRPS can spread to other areas of the body, so it’s best to get treatment for this condition as soon as possible.
Why Do Insurers Deny Workers’ Compensation Claims for CRPS?
Injured workers and their health providers—as well as their employers and insurers—expect a “normal” recovery time from an injury. In the case of an ordinary sprain or a simple fracture injury, for example, there is a predictable length of disability and a predictable time for healing and resolution and return to work. Insurers tend to use selected data to “predict” how long an injury “should” last. Insurers set their expectations about your case according to the type of injury that first occurred.
An injured worker developing CRPS will not improve his or her pain without correct diagnosis and proper treatment. In fact, the patient who is misdiagnosed can get much worse in terms of sensitivity and pain to touch of the skin, and the injured worker can experience increasingly higher levels of sustained burning and deep pain and also significant flare-ups of pain. The effects of CRPS don’t match that of the original injury.
Complex Regional Pain Syndrome (CRPS) is often not noticed by health providers in a timely manner. Initially, even the injured worker may doubt himself/herself. He/she may begin to think that the pain must be “all in my head.” That’s because there’s nothing from the injured worker’s past experience of injury that resembles what is happening now. Often that’s when problems begin with the workers’ compensation insurer.
Insurer Strategies to Deny CRPS
When the injured worker’s pain worsens instead of improves, the insurers become suspicious. Insurers may argue that the injured worker is “exaggerating” his or her pain. Insurers may allege that the injured worker is intentionally trying to stay out of work and collect benefits. Insurers may allege that the injured worker is not interested or motivated to return to work. None of that is true, because the injured worker has CRPS.
The truth is Complex Regional Pain Syndrome (CRPS) is a real, neurogenic pain condition that produces pain levels that are out of proportion compared to what one might expect from the original injury. It can arise out of an ordinary sprain or a simple fracture or crush injury, and sometimes it can arise from a successful surgery. Even if a sprain or fracture is minor, if CRPS develops the pain and length of disability worsens. The injured limb sometimes perspires and feels clammy and sweaty. At physical therapy sessions, the experience is extremely painful, almost like torture. The therapist touches the skin and moves a limb according to their professional training, but the injury is not getting better—it’s getting worse. This bizarre reality is what often leads insurers to resist and deny that there is actually a problem. They may allege that you don’t have CRPS. The treatment and the cost of a CRPS work injury can be very expensive to the insurer.
How Long Does CRPS Last?
Complex Regional Pain Syndrome (CRPS) can involve long-term, intractable pain. Some injured workers suffer disability from it for many, many years. It can even become totally disabling, putting a person out of work due to permanent total disability.
Complex Regional Pain Syndrome (CRPS) is all too often poorly understood by many physicians and insurers at its early stages, which is why the syndrome is often misdiagnosed until an enlightened physician considers CRPS and begins to treat it properly with a dedicated treatment plan. Often many months go by before the correct diagnosis and the correct treatment plan is put in place.
Complex Regional Pain Syndrome Treatment
Treatment plans can vary in stages. Treatment generally begins with physical therapy and prescription medicines. Prescription medicines can include Gabapentin, Lyrica, Tramadol, Amitriptyline, low dose Naltrexone, Ketamine Troches, and compounded creams.
Other treatment offerings include:
- Stellate ganglion nerve blocks
- Spinal cord stimulator device with implant battery
- Scrambler Therapy
- Mirror Imaging Therapy
- IV Ketamine and IV Lidocaine injections
One of the best actions that injured workers can take on their behalf is to be very thorough communicators of their symptom experience. The sooner a treatment provider understands the injured worker’s symptoms, the better the opportunity for the provider to correctly diagnose and begin to properly treat the condition. Thorough reporting of symptoms is also important for a Vermont workers’ compensation case because an undiagnosed condition leads to problems with the workers’ compensation claim and with the insurer.
If you have been diagnosed with or suspect you have CRPS, contact the Law Office of Charles L. Powell right away at (802) 731-0154 or write to us online.
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