A Comprehensive Guide to Symptoms, Causes & Advanced Treatment in NYC

If you’re experiencing persistent burning pain, swelling, sensitivity, or
color changes in an arm or leg after an injury, surgery, or for no clear
reason, you may be dealing with Complex Regional Pain Syndrome (CRPS) — a
condition that is real, painful, and highly treatable.

At UES Interventional Pain, board certified pain specialist Dr. Matthew
Spiegel helps patients across the New York metropolitan region receive
accurate diagnoses and modern, minimally invasive treatment options —
including advanced nerve blocks, sympathetic blocks, neuromodulation and
personalized rehabilitation strategies.

Whether your symptoms started recently or have been present for months or
years, the right treatment can still make a profound difference.

What Is CRPS?

Complex Regional Pain Syndrome is a chronic pain condition that most often
affects an arm, hand, leg, or foot. It usually develops after an injury,
fracture, sprain, surgery, or period of immobilization — but sometimes appears
without a clear trigger.

CRPS involves abnormal inflammation, nerve dysfunction, and changes in blood
flow, leading to pain that is out of proportion to the original injury.

CRPS Type I vs. CRPS Type II

• CRPS Type I (formerly Reflex Sympathetic Dystrophy, or RSD):
  Occurs without a confirmed nerve injury.

• CRPS Type II (formerly causalgia):
  Occurs after a known nerve injury.

Both types share similar symptoms and both are treatable.

Other terms patients often search for

To help patients find accurate information, we include alternate names
commonly used online:

• CRPS 1 / CRPS I
• CRPS 2 / CRPS II
• Reflex Sympathetic Dystrophy (RSD)
• Causalgia
• Post-surgical nerve pain

Is It Too Late to Treat CRPS?

No — CRPS can improve at any stage.

While early diagnosis often leads to the quickest recovery, even patients with
long-standing CRPS (months or years) can still make meaningful progress.

Pain pathways remain modifiable. Treatments like sympathetic nerve blocks,
neuropathic medications, neuromodulation and targeted physical rehabilitation
can reduce symptoms and restore function even after the early “window” has
passed.

Don’t give up hope — improvement is still possible.

Common Causes & Triggers

CRPS may develop after:

• Fractures (wrist, ankle, foot, hand)
• Sprains, strains, and soft-tissue injuries
• Surgery (orthopedic, plastic, or general)
• Immobilization or casting
• Nerve injuries (compression, laceration, trauma)
• Infection or inflammatory conditions
• No identifiable cause (idiopathic)

CRPS vs. Diabetic Neuropathy

While
diabetic peripheral neuropathy
is a separate condition, its symptoms may overlap with CRPS: burning,
tingling, temperature sensitivity, and color changes.
When diabetic neuropathy behaves like CRPS, the patient may benefit from
similar nerve-targeted interventions.

Symptoms of CRPS

Symptoms may vary but often include:

• Severe burning or “electric” pain
• Swelling or puffiness
• Sensitivity to touch (allodynia) — even clothing can hurt
• Temperature changes (hot/cold compared to the other limb)
• Skin color changes (red, purple, pale, mottled)
• Changes in sweating
• Stiffness or decreased mobility
• Hair or nail growth changes
• Shiny or thin skin
• Muscle spasms or weakness

You do not need all symptoms to have CRPS.
If you suspect it, an evaluation is important.

How CRPS Is Diagnosed

A correct diagnosis often requires a specialist experienced in pain
medicine.
Dr. Spiegel uses a comprehensive approach that may include:

• Detailed physical exam
• Review of symptoms and medical history
• Ruling out other causes (neuropathy, radiculopathy, arthritis, vascular
  issues)
• Imaging when appropriate:

• Bone scan
• Ultrasound for nerve compression
• Thermography or temperature comparison
• Nerve conduction testing (in select cases)

Early diagnosis may simplify treatment, but late diagnosis is still treatable.

Advanced CRPS Treatment Options at UES Interventional Pain

At UES Interventional Pain, treatment is carefully individualized. The goal is
to calm the sympathetic nervous system, reduce inflammation, restore nerve
function, and help you return to normal activity.

1.
Sympathetic Nerve Blocks

These are among the most effective interventional treatments for CRPS,
especially in the arms, hands, legs, and feet.

• Stellate ganglion block (for upper extremity CRPS)
• Lumbar sympathetic block (for lower extremity CRPS)

These procedures reset overactive nerve pathways and often provide noticeable
relief within minutes.

2.
Peripheral Nerve Blocks
& Nerve Hydrodissection

For patients with nerve entrapments or CRPS Type II, targeted nerve procedures
can reduce pain at its source.

3. Minimally Invasive Spine & Joint Procedures

• Epidural steroid injections

• Selective nerve root injections

• Joint injections

• Neuromodulation:

  • spinal cord stimulation

  • peripheral nerve stimulation

  • dorsal root ganglion stimulation

4. Medication Management

Focused on non-opioid approaches whenever possible:

• Neuropathic medications
• Anti-inflammatories
• Medications to support circulation and bone health
• Topical therapies

5. Rehabilitation & Desensitization

CRPS recovery is significantly improved with:

• Gentle physical therapy
• Desensitization exercises
• Mirror therapy
• Movement restoration programs

Dr. Spiegel coordinates care with experienced NYC physical therapists familiar
with CRPS recovery.

CRPS Prognosis: What to Expect

Many patients experience significant improvement with the right combination of
treatments — even if symptoms have persisted for years.

Your outcome depends on:

• How long symptoms have been present
• Location and severity of CRPS
• Individual response to nerve blocks and treatments
• Engagement in physical therapy
• Presence of nerve injury

But importantly:

CRPS is not often “permanent.”

Improvement is possible at every stage.

CRPS vs. Other Sources of Burning or Neuropathic Pain

Patients often wonder if their symptoms are caused by:

• Carpal tunnel syndrome
• Pinched nerve in the neck/back
• Diabetic neuropathy
• Sciatica
• Post-surgical nerve pain
• Vascular issues
• Arthritis flare

During your evaluation, Dr. Spiegel will rule out these possibilities to
ensure the most accurate diagnosis.

Why Choose UES Interventional Pain for CRPS Care?

• Fellowship-trained board-certified interventional pain specialist
• Extensive experience diagnosing & treating CRPS
• Expertise in sympathetic nerve blocks
• Minimally invasive approach — avoiding unnecessary surgery
• Personalized treatment plans
• Convenient Manhattan location
• Compassionate, patient-centered care

Take the Next Step — Don’t Wait.

If you think you may have CRPS, getting the right diagnosis and treatment is
essential — but it is never too late to get help.