Safe and Effective Treatment for Complex Regional Pain Syndrome

"Although CRPS is often a challenging condition to treat, I have seen full recovery with CRPS of the knee, arm, hand, and neck. Historically, the individuals who experienced complete relief in my care had not responded to other therapies for between 8 and 16 months.

Treatment of the foot and ankle has been less responsive for reasons which are not yet clear, but I'm hopeful that treatment strategy for those patients can be continually improved."

Dr. Eric Windsor, D.Ac.

Complications

We have not seen any side-effects from our treatment. However, we have observed increased difficulty in treating CRPS in several scenarios related to other medical conditions and treatments. We evaluate the presence of these situations during the pre-qualification phase which is typically conducted by phone. We do this in order to ensure the highest likelihood of patient satisfaction.

How Does Acupuncture Work?

Modern research has shown that acupuncture can help the body to release its own naturally occurring pain-relief chemicals, called endogenous endorphins or endogenous opioids. Acupuncture also helps the body to reduce certain chemicals involved in inflammation. According to traditional acupuncture theories, pain can be caused by a blockage in the body's vital energy. Acupuncture provides relief from pain by clearing blockages and promoting the smooth flow of this energy.

The effects of acupuncture on endorphins and anti-inflammatory chemicals help to explain the immediate pain-relief that people experience. However, these effects are not enough to fully explain the long-term benefits that patients often receive from acupuncture treatment. Many scientific questions still remain about the way acupuncture works.

Some of our patients with CRPS have experienced long-term and apparently permanent relief. Of course, each individual's case is different, and some cases require more frequent sessions over a longer period of time. Within 3 or 4 sessions, it is typically very clear to the patient whether the treatment is beginning to help. You are more likely to get the best results from acupuncture by visiting a practitioner who has some years of experience treating your condition successfully with acupuncture.

Most of our patients with CRPS have received this diagnosis from another medical provider. Early treatment tends to produce a better outcome for the patient.

How Does Acupuncture Compare with Alternative Medical Treatments?

Alternatives to acupuncture include a range of medications which may be prescribed for pain and inflammation. Strangely, Wikipedia even lists amputation as a possible treatment for CRPS, although they acknowledged that even this drastic approach is only effective in reducing pain around 50% of the time. Therefore we highly recommend our own treatment before going down that approach. At our clinic we use extremely safe methods to reduce pain and promote healing, and many of our patients with this condition have experienced significant improvements in function and reduction of pain.

Medications used to treat CRPS may include drugs called NSAIDs, NMDA receptor antagonists, corticosteroids, opioids, and neuroleptics. Each of these are described below along with some of their known side effects.

If you are taking prescription medications, be sure to talk to your doctor before making any changes. Some medications need to be reduced slowly.

Non-steroidal anti-inflammatory drugs (NSAIDs) are over-the-counter medications such as aspirin, ibuprofen and naproxen. In many cases of CRPS, NSAIDs cannot fully control the pain level. Most people can take NSAIDs without side-effects for under a week, but significant side-effects are increasingly likely when they are taken for more than a week at a time.

Side effects of NSAIDs can include stomach bleeding, allergic reactions, kidney problems, high blood pressure, strokes, and heart problems. Among people taking NSAIDS for more than 2 months, 1 person in 1200 has a side-effect from NSAIDs causing death. Every year over 100,000 people are hospitalized in the United States due to the side effects of NSAIDs, and 16,500 deaths are caused by NSAIDs in the United States.

Gabapentin (neurontin), pregabilin, nortriptyline, duloxetine, and amitryptaline are called neuroleptics, and these may also be prescribed for CRPS. Many people take these medications for years without serious side effects. Common side-effects include dizziness, and dry mouth. Rare and serious side-effects of these medications include intestinal bleeding, liver damage, and increased risk of suicide.

Neurontin and amitryptaline can also cause a life-threatening reaction in approximately 0.2-0.5 % of patients (between 2 and 5 out of every 1000 patients) called neuroleptic malignant syndrome. This syndrome begins with symptoms of fever, muscle stiffness, severe confusion, sweating, and fast/irregular heartbeat, and is fatal in around 10% of cases. If the reaction is not fatal, it can cause temporary or permanent memory damage. Males under age 40 are at the highest risk of developing this condition in response to neurontin and amitryptaline.

Another class of drugs used for CRPS is opioid drugs. For patients with CRPS, in our observation, the use of opioids may lead to addiction rather than to pain relief. This class of drugs includes oxycontin, morphine, hydrocodone, fentanyl, and vicodin. Common side-effects include sedation, dizziness, nausea, vomiting, constipation, physical dependence (addiction), tolerance, and respiratory depression. Opioid medications caused 475,000 emergency room visits in 2009, and caused at least 16,000 deaths in 2012 (more deaths than heroin and cocaine combined). Nearly three out of four prescription drug overdoses are caused by these opioid pain relievers. In the United States, there has been a 300% increase in opioid prescriptions since 1999. These U.S. death statistics due to opioid pain relievers are mentioned at the CDC website.

Drugs known as NMDA receptor antagonists may also be used to treat CRPS. These include dextromethorphan and ketamine. Ketamine is a dissociative anesthetic and barbiturate similar in action to the illegal drug PCP. Side-effects of ketamine include dream-like feeling, double vision, jerky muscle movements, dizziness, drowsiness, nausea, vomiting, loss of appetite, and sleep problems (insomnia).

Especially in the early stages of CRPS, your doctor may recommend corticosteroids such as prednisone and methylprednisone. These can help decrease the swelling and allow the tissue to heal. Frequent use of corticosteroids can cause significant short-term and long-term side effects, such as bone loss, skin atrophy, tendon rupture, weight gain, acne, elevated blood pressure, elevated blood sugar in diabetics, and reduced ability to fight infections. Frequent use of cortisone can cause cataracts and in some cases, even the death of bone tissue in the large joints (avascular necrosis). Dr. Windsor treats some of the side-effects of prednisone, including avascular necrosis, tendon issues, and blood sugar issues.

Maryland Holistics provides specialized acupuncture therapies which can often reduce CRPS symptoms significantly within 8-12 sessions.

In the hands of an experienced practitioner, acupuncture may be able provide excellent relief for CRPS within around 8-12 sessions, and without any of the side-effects which are mentioned above. We also offer an optional, accelerated treatment schedule, which may be of interest to patients outside of the Baltimore-Washington area.

Acupuncture helps the body's natural healing response to become activated, and patients often feel more well-rested and relaxed after sessions. Acupuncture has also been shown to help regulate the immune system, improve blood sugar control, and reduce blood pressure in people with hypertension. In the Maryland area, most health insurance companies recognize the value of acupuncture for pain-relief and may cover acupuncture for this purpose.

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About Maryland Holistics

Maryland Holistics LLC is the private practice of Dr. Eric Windsor, D.Ac., L.Ac. Our serene, professional office is located in Ellicott City, MD. Maryland Holistics has provided care to thousands of satisfied customers since opening in 2009. Dr. Windsor is a preferred provider in the CareFirst, Blue Cross Blue Shield, GEHA, and United Healthcare networks.

3525 Ellicott Mills Dr., Ste E
Ellicott City, MD 21043
Phone: 301-588-5858
Fax: 443-308-5690