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Complex Regional Pain Syndrome: The Story You’re Not Hearing

Complex Regional Pain Syndrome CRPS

Complex regional pain syndrome (CRPS) is a form of chronic pain that could affect the parts of the body, mostly the arm, leg, hand or foot. It is not fully understood what causes complex regional pain syndrome. By reading this blog you should be better informed if you have this condition as early treatment can be very important. Another term that is often used is called reflex sympathetic dystrophy which has similar symptoms but tends to be a more severe state of complex regional pain syndrome.

The signs and symptoms of Complex Regional Pain include the following

  • Changes in skin temperature – the affected area may be warmer or cooler.
  • Changes in skin color – the skin may be whiter or have a purplish or bluish discoloration.
  • Muscle spasms and weakness in severe cases.
  • Burning and/or throbbing pain.
  • Sensitivity to touch or cold temperatures.
  • Decreased ability to move the affected limb.

It is important to note that occasionally CRPS can spread elsewhere in the body including the opposite limb. The symptoms of CRPS may go away on their own but for many the symptoms may persist for months or years and early treatment is most effective to reverse the symptoms.

Causes of Complex Regional Pain Syndrome

Conventional Medicine categorizes CRPS into two types:

  • Type 1 – this is often referred to as reflex sympathetic dystrophy and may occur after an injury or an illness but there may not be any direct damage to the nerves of the affected area. Most people are thought to be type 1.
  • Type 2 – this is often referred to as causalgia. The symptoms of this type are similar to type 1; however, type 2 occurs after a specific nerve injury.

The following are examples of what may cause the symptoms of CRPS. They include a crushing injury, fracture, ankle sprain, heart attack, strokes, and for others, it may be a result of surgery on the hands, feet, or legs. With more chronic CRPS, treatments may be more challenging as it may start to affect the central nervous system also. Whereas in the beginning, it was a localized issue in the lower extremity. The full mechanism between the central and peripheral nervous systems is not well understood as it relates to CRPS.

How do doctors diagnose CRPS?

  • Patient’s History – The patient will report an illness, injury, or surgery where symptoms started for many people.
  • Specific tests to diagnose CRPS include Ultrasound or Magnetic Resonance Imaging (MRI) which may be used to identify underlying nerve damage.
  • EMG may also be used for testing nerve function.

Conventional Treatment Options

For many, the treatment of CRPS involves seeing a doctor who specializes in pain management, and the pain management doctors may use the following treatments.

  • Physical Therapy/Occupational Therapy
  • Psychological and Behavioral Therapy
  • Medications – this can include nonsteroidal anti-inflammatory drugs, anti-depressant drugs that may be used, and also anti-seizure drugs such as gabapentin and pregabalin. These medications are usually prescribed to treat CRPS.
  • Narcotics – If other medications fail, narcotics may be used and carefully monitored by the prescribing doctor.
  • Topicals – topical analgesic creams can be used such as lidocaine.
  • For severe symptoms, the use of spinal cord stimulation.
  • Sympathetic nerve blocks – these blocks involve injections to the lumbar area of the back which can offer pain relief but is usually temporary.
  • IV ketamine infusions – this is another treatment option.

Things that you can do at Home

  • Exercising on a daily basis is important to move the affected body part and it may help repair the damaged nerves.
  • If there is swelling present, compression stockings may also help.
  • If there is a swelling in the limb, elevation while resting may also be helpful.

The game-changing approach that peripheral nerve surgeons are using to discover the root cause and reverse CRPS.

The Non-conventional Treatment Options

Demystifying the cause of Complex Regional Pain Syndrome: Why you should consider consulting with a peripheral nerve surgeon

With the advancement of the knowledge of the peripheral nerve system in the lower extremities, a subspeciality of doctors has been created that specializes in the evaluation and treatment of peripheral nerve disorders including neuropathy, restless legs, and chronic pain. From our knowledge and experience, we are now able to reverse the symptoms of CRPS by evaluating and treating the injured nerve. This has helped many patients avoid the need for spinal cord stimulators and has allowed others to get off narcotics.

What are the options a peripheral nerve surgeon would offer?

  1. Injections – Injections may be used in the early stages to reverse the symptoms of the damaged nerve but are also helpful in identifying which nerve branches are damaged.
  2. Laser Treatments and Electrical Stimulation Treatments – These treatment modalities can be used if in mild cases.
  3. Surgery– Surgery may involve the removal of the damaged nerve branch and also burying the nerve in the muscle to prevent regrowth.

The goal of a peripheral nerve surgeon is to discover the specific nerve that has been damaged and address treatment locally in the foot or leg. Thus, eliminating the need for medication or spinal cord stimulators for many. If you would like to learn more about these options, please consider visiting https://www.aens.us/aens/default.asp

Call us today at our Fort Collins location (970) 484-4620, Broomfield location (720) 259-5053 or use our online scheduling system to book your appointment.

How Laser Treatment Improves Your Ability to Get Rid of Foot and Ankle Pain!

laser treatment for foot pain MLS

At Anderson Podiatry Center, we like to bring you cutting edge technology. We feel it will allow us to deliver the best results for your foot and ankle care – and laser treatment is one of these technologies. We use the MLS laser system which brings the latest advancements in laser technology for your treatments. Laser is a treatment that is offered if conventional treatments are not working. This blog will introduce you to the laser treatment for foot pain option for foot and ankle issues.

How Does Laser Treatment for Foot Pain Work?

Our MLS laser therapy uses deeply penetrating light to help repair your body’s tissues. It is a “multi wave lock system”. MLS, that uses specific wavelengths of light. One wavelength penetrates closer to the surface and is continuous. Its primary function is to reduce swelling and inflammation. The second wavelength is pulsed and reaches deeper into the tissues and nerves for pain relief. Compared to earlier generation lasers, these lasers penetrate well below the skin layer (2-3 cm) allowing for more successful results. The laser works by stimulating your body’s own reparative processes. It very specifically helps the mitochondria in each of your body’s cells to do a better job. The mitochondria is an area of each cell that creates energy for the cell, repairs the cell, and eliminates waste from the cell. In this process three things occur:

  • Reduced Inflammation: The laser treatment can reduce inflammation and help speed up the reparative processes. This anti-inflammatory effect results with pain relief. This process also reduces swelling.
  • Positive effect on Pain Receptors: It also helps to reduce pain because of its effect on pain receptors. While your body’s healing processes are accelerated, the laser also helps to reduce pain.
  • More Blood Flow: The laser increases the blood to the targeted area. This aids in the healing processes which accelerates healing.

What is Treatment Like?

During this process, the laser light will be applied to the area being treated. There are a few things you’ll notice throughout the process:

  • You may feel a warming sensation, but the treatment is painless and there are no side effects.
  • The treatments can last for 15 to 30 minutes depending on how many areas are treated.
  • Generally, 6-12 treatments are recommended and are done 2-3 times per week.
  • You may begin to feel improvement after the first one or two treatments.

What Conditions Can Lasers Be Used For?

There are various reasons why we use laser for foot pain. Most commonly, we use laser in conjunction with surgery to accelerate healing and reduce swelling. Lasers can reduce scar tissue after surgery on joints to reduce stiffness. It can also accelerate the repair of nerves when we do nerve decompression surgeries to reverse the symptoms of neuropathy and restless legs. It is also used in conjunction with other treatment modalities for common foot and ankle conditions such as:

  • Heel Pain (plantar fasciitis): This is one of the most common foot complaints.
  • Neuroma Pain: This pain is in the ball of the foot which causes compression of a nerve branch in the ball of the foot.
  • Achilles tendonitis and other types of tendonitis.
  • Joint Pain: Laser has also been used to reduce the symptoms of arthritis in foot and ankle joints.
  • Neuropathy: This is a condition that causes burning, tingling and numbness in the foot and ankle.
  • Foot and Ankle Ulcers: This can speed up the repair of ulcer common in the diabetic foot.
  • Restless Legs: We have also used laser in conjunction with ESTIM electrical stimulation to reverse the symptoms of restless legs.
  • Foot and Ankle Injuries: It can speed up recovery from soft tissue injuries such as foot and ankle sprains. It can speed up the repair of damaged tissue.

In general, laser technology has allowed us to offer more options and to optimize the results we can offer our patients. If you’re frustrated with your foot and ankle issues, it’s something you may want to consider laser as a treatment option.

Testimonial from our patient who received laser treatment for foot pain!

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Cutting Edge MLS Laser – Doctor/Patient Feedback

MLS doctor testimonials laser treatment ankle pain

Get Back to Your Active Life, Fast

Active Life

Get Back to Your Active Life

The more time I spend with patients, the more I see that no matter what their symptoms are, their primary desire is essentially the same. They want to get back to their previous activity level, and they want to do it fast. Whether they are a runner, busy parent, or professional who works on their feet, it’s important to get back to their normal, active life.

In the field of podiatry, many treatments we have utilized in the past have been successful at curing the patient’s complaint, but it often take months to complete. Traditional treatments like orthotics, walking boots, cortisone injections and physical therapy have their place in our specialty, but can take months to relieve foot or ankle symptoms.

The exciting thing is we now have innovative treatment options that allow us to get patients back to those activities significantly faster. We have modalities that allow us to heal the tissue that produces the inflammation, rather than doing the old standby treatments of cortisone, anti-inflammatories and ice. These treatments reduce the inflammation, but do not heal the injured tissue itself.

There are two innovative treatment options that we have today that not only address the inflammation, but can help to heal the injured tissue. These modalities, AmnioFix therapy, and laser therapy, work at a cellular level by creating a response to the inner tissue that helps it to heal more rapidly than we have ever seen before.

AmnioFix Therapy is a simple, in-office injection that enhances healing, reduces scar tissue formation, and reduces inflammation. MLS Laser therapy is an FDA-approved therapy that accelerates cellular reproduction and growth, and therefore helps damaged cells to repair faster.

The third treatment is the use of custom orthotics. Though this has been around for many years, we have found that when we use regenerative therapies like the laser and AmnioFix, combined with orthotics, patients are able to get back to their activities faster than ever before. Additionally, we are seeing less patients going on to surgery because of the success of these new treatments.

If you have been struggling with conditions like heel pain, arthritis, tendonitis, ligament sprains or tears, tendon tears, or plantar fasciitis, and haven’t been able to be as active as you once were, come see us. You don’t have to endure daily pain and there are options that can help. We will work with you based on your lifestyle and goals to get you back to where you want to be.

Fact vs. Fiction: Neuropathy

Neuropathy is a frustrating, debilitating, painful, and, most discouragingly, a confusing disease. If you or someone you know has neuropathy, chances are they have really struggled with finding accurate knowledge on the subject, and with all the information out there it can be overwhelming deciphering what’s true from what isn’t.

Though neuropathy is a fairly common disease, it is not widely known about. One of the first struggles with neuropathy is getting it properly diagnosed. Also, there are so many thoughts and opinions on neuropathy that you may hear conflicting or even false information. As doctors who specialize in neuropathy and treatments for it, we have compiled a helpful list of fact versus fiction to finally help you better understand your neuropathy.

Neuropathy Facts:

  1. There are a wide variety of symptoms, and not everyone experiences them all.
    • The most common symptoms include: muscle weakness, twitching, tingling, loss of balance, numbness, burning, prickling sensations, and/or nerve pain in your legs or feet, and symptoms can vary from one foot to the other.
  1. Neuropathy is progressive.
    • This is one of the most important facts to know! Neuropathy will get worse over time, so if you have symptoms do not delay treatment. Some patients wait until their symptoms are more severe before seeking treatment, which can reduce the chance to reverse or alleviate them.
  1. Neuropathy is a fancy word for nerve damage.
    • Though it may sound simple, this is exactly what neuropathy is. It’s the disease or dysfunction of one or more peripheral nerves.
  1. There are treatments that can reverse neuropathy symptoms.
    • Though many don’t realize this, there are treatment options that have had huge success in reversing, or at the very least improving some people’s neuropathy. These treatments include:
      • MLS Laser Therapy– helps to reduce pain and inflammation and improve nerve function.
      • Electrical Nerve Stimulation (ESTIM)– helps to decrease chronic nerve pain, often done in conjunction with nerve blocks.
      • Nutritional counseling– when done in tangent with MLS and/or ESTIM can help reverse symptoms.
      • Nerve decompressing surgery– opens up the tight nerve tunnel to allow the nerve to function properly, is a viable option for the majority of patients, and offers the very real hope of reversing neuropathy’s effects, allowing you to move with little to no pain or instability.

Neuropathy Fiction:

  1. Neuropathy only affects diabetics.
    • Although neuropathy is common in people with diabetes, it is a misconception that it only affects those with it. It can have many other causes including injury, infections, alcoholism, and even certain cancers. There are also unknown (idiopathic) causes
  1. If the pain subsides or goes away, you are getting better.
    • False! This is a very dangerous fallacy. When symptoms seem to be getting better they are often actually getting worse, because the later stages of neuropathy can cause numbness making you not feel the pain that is actually there.
  1. I will always have to be on medication.
    • Though medications are commonly the first step in treating neuropathy, they typically come with unwanted side effects or are ineffective. What people don’t understand is that by seeking other treatments options like the ones listed above, you can reduce or even get off your medication.
  1. Any doctor can help treat neuropathy.
    • Although most doctors know what neuropathy is, they are not all equal in understanding or treating it. Our doctors at Anderson Podiatry Center are members of the Association of Extremity Nerve Surgeons. These national and international physician and PHD members receive specialty training and have a minimum two years’ experience in diagnosing and treating neuropathy. AENS members are committed to disseminating current effective treatment knowledge, and to ongoing research that supports the treatment of extremity nerve disease.

These are just some of the basic misunderstandings on neuropathy. If you suffer from neuropathy come see us today so you can finally get the help you deserve!

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Ankle Problems: Why It’s Important You Don’t Ignore Them

With all the wear and tear we put our bodies through it’s no wonder we go to bed sore at night. We often get so accustomed to these persistent aches and pains that we just live with them. It’s normal to have foot pain and ankle pain after a long day of work, right? Sometimes, yes.

Minor aches and pains at the end of the day, especially if you live an active lifestyle, are typically nothing more than a tired body that needs rest, but don’t let these minor aches and pains you are used to feeling make you ignore more serious issues that require treatment.

Some of the most common foot problems that are ignored are in the ankle. People frequently excuse genuine ankle issues to simple daily wear and tear, so they don’t seek treatments that can help. Three common problems that shouldn’t be ignored include:

  1. Ankle Instability– If you sprain your ankle regularly, have stiff or swollen ankles, or have trouble walking across uneven ground, (especially in high heels) then you may actual suffer from ankle instability.
  2. Ankle Pain– If your ankle seems to always be in pain, tender to touch, swollen, or unstable, this could be a signal to a larger problem, such as arthritis, a fracture, or an inflamed tendon.
  3. Ankle Sprain– Spraining an ankle is a very common injury that often heals on its own with proper rest and care, but when it won’t heal is when there is concern. If your ankle sprain is not healing, is swollen, bruised, painful, and difficult to walk on, then you need to get it looked at. Serious ankle sprains when untreated can develop into long-term problems.

Ankle instability, pain, and sprains can put a huge damper on your active lifestyle. If you experience any or all of the above, the below treatment options may be what you need:

  • AmnioFix Therapy this new, regenerative medical product enhances healing, reduces scar tissue formation, reduces inflammation, and may be just what your ankle needs to heal.
  • Custom orthotics doctor-fitted orthotics made from the mold of your actual foot offer huge benefits to your feet and ankles.
  • Casting– casting a mold of your foot is typically done when making custom orthotics, and allows a podiatrist to see the exact condition of your ankle, so they can treat it correctly.
  • Physical therapy- some ankle injuries require physical therapy, especially if they go ignored and cause more permanent damage.
  • Braces or supports– these may not sound ideal, but if they ease your pain, prevent further injury, or fix current problems they are worth it.
  • Arthroscopic surgery– this minimally invasive joint surgery can help fix many common ankle injuries.
  • MLS Laser Therapy this laser therapy is an exciting new treatment for a wide range of injuries and conditions that cause pain, including ankle problems.

If you have chronic ankle problems don’t ignore them! We are here to help you keep active! Call us today!

Don't Ignore Ankle Problems