Differences Between Peripheral Neuropathy and Complex Regional Pain Syndrome


What is the Difference between Peripheral Neuropathy and Complex Regional Pain Syndrome?Elliot T. Udell, DPM

In podiatry, when we talk about peripheral neuropathy we generally are referring to conditions that affect the local nerves in the lower extremity. This is distinct from conditions that affect the brain and/or spinal cord Diabetes is one of the leading causes of peripheral neuropathy. Research shows that diabetes affects the tiny nerves and small arteries in the area where the patient is experiencing pain. The pain is generally described as “severe burning” or “pins and needles” and is generally worse at night. Months or years later, this pain may lead to numbness indicating the presence of far greater nerve damage, and in such cases we have to be concerned with the development of ulcerations.

Complex regional pain syndrome (CRPS), also known as reflex sympathetic dystrophy syndrome (RSD), presents quite differently. Because my practice is focused on patients with severe foot and ankle pain syndromes, I treat people with both peripheral neuropathy and CRPS/RSD. Hence, I am well aware of the overt as well as subtle differences between these conditions.

People with CRPS/RSD generally present with a history of an inciting injury, which may be a sprain, fracture or even surgery (many elective surgical procedures can lead to CRPS/RSD). They also present with severe pain, which is far more intense than that experienced by people with peripheral neuropathy. The pain is so severe at times that even air blowing on the area can cause a person to wince in distress. People who have CRPS/RSD can also present with other symptoms generally not associated with peripheral neuropathy, such as sleep disturbances and clinical depression. The depression results from the physiology and anatomy of the sympathetic nervous system synapses rather than purely from an emotional reaction to the pain. Moreover, we commonly see skin problems associated with CRPS/RSD, such as edema and small shiny plaques that are exquisitely painful.

Another significant difference is the tendency of non-treated CRPS/RSD to progress to the opposite extremity and to the upper limbs. A glance at the anatomy of the sympathetic nervous system, which runs parallel up and down both sides of the spinal cord with perpendicular crosses from right to left, may explain why this illness can easily progress to other parts of the body. Also, CRPS/RSD patients often have both spasms of the muscle and progressive muscle weakness. Untreated, this muscle weakness can lead to atrophy and loss of use of the extremity. Such extensive and debilitating muscle weakness, as well as atrophy, is not common in peripheral neuropathy.

Because the anatomy and physiology of the symptoms are different, so are the treatments of these conditions. The treatment of CRPS/RSD is complex; we use intense physical medical modalities and many different types of oral pain medications and antidepressants. Each condition is different, challenging, and time consuming, but the rewards of seeing patients leave their wheel chairs and crutches and return to work and school makes any effort we put into working with these people emotionally rewarding.

Dr. Elliot Udell specializes in pain management of the foot and ankle. He is in practice in Hicksville, New York. He is currently president of the American Society of Podiatric Medicine and is on the board of the American Society of Podiatric Dermatology. He is board certified in Podiatric Primary Care as well as Pain Management. He lectures at medical seminars throughout the US as well as in Europe.
He can be reached at Suite 206, 120 Bethpage Road, Hicksville, New York 11801
Tel: (516) 935-1113, e-mail Elliotu@aol.com
Updated10/07/2005

44 thoughts on “Differences Between Peripheral Neuropathy and Complex Regional Pain Syndrome”

  3. Could you assist with a possible CRPS? 55 Femal, RA on DMARD, Motor Vehicle accident with several contrusions, x-ray Unremarkable. Post trauma approx. 4weeks she complains of severe pain in right foot, NSAID unresponsive, swelling, pain with movement, change in temp and color;

    Is CRPS present? It does occur greater in women too – correct?

    Thanks and great site mate.

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  4. Thank you very much for a nicely written and very informative article. I have been searching all over the internet about neuropathy because my Dad has one and we don’t know how to help Dad. I read from Neuropaty in Feet that we shouldn’t worry much because as you have written here, there is a cure for the pain. Thank you very much! More power to your site!

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  5. Having had spinal surgery 6 yrs ago I have not been able to be out of pain. I’m presently researching a intrathecal pump implant, as the SCS test did nothing for me. Can you perhaps advise me or direct me to a forum to find some answers. Thank you very much, Harold Gordon

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  6. I had a Cervical surgery (C5-C6)in ’06 and ever since have been in agony. It started in my right arm with burning in the muscle and the NS that did my surgery even said it was my C5. So, I wonder why now after having 3 ESI’s(Epidural Steroid Inj.)my symptoms increased ten fold. I am in so much agony and misery that I don’t know what to do anymore. I am lucky that I have a PC that knows that I am suffering and prescribes meds, but get this the strong med. that he has me on is only taking half or less away and something is seriously wrong. I just want to be fixed not take meds all my life. At least not what I am taking(Fentany 75mcg,Norco10/325,Neurontin 300mg 4xday,Xanax 1mg.)and still pain.HELP!

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  7. Thanks for the info! I’ve had RSD for 7 yrs, my girlfriend has diabetes and severe neuropathy I thought she had RSD, now I know it’s not the same. Thanks for the info, as for meds I’ve had so many I can’t remember half of them nerve blocks, implant stimulator nothing has worked for me, I live in the U.P. and fall and winter just about kill me plus I have SAD. Good luck to you all, we need it!

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    • You are most welcome Nancy.

      Like you I’ve had over a dozen Lumbar Sympathetic Nerve Blocks. I’ve had an SCS since 2006, a revision to add an additional lead in 2009. I attended a 6 week long, 7 hours a day, 5 days a week Functional Restoration Program. Phew that was hard. I participated in a 6 month Neurpathic Pain Study which ended recently. I’m currently in a LLLT (Low Light Laser Treatment) Clinical Study Trial.

      So many different medications over the years I’ve lost count. I’m currently on 4 plus Lidoderme Patches, and using Pennsaid drops for Osteo.

      This is a tough ride to endure for sure.

      Wishing you most well,
      ~Twinkle

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  8. Not a comment, more like a question: I had a graft of the saphenous(sural) nerve done to repair an amputated thumb in 1985. Eversince the pain has been getting worst on my lower extremety near graft.(ankle,knee right leg) Been diagnosed with saphenous neuritis by V.A. doctors, but my symtoms seem to be closer to that of Complex Regional Pain Syndrome. My question is — Could the nerve graft have been the cause of my illness and if it is will it be consider as a CRPS type 2?

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    • Hello

      Yes the nerve graft could be a cause of CRPS. You are also correct in that it would be CRPS Type 2. Type 2 is with known nerve damage. (also known as Causalgia)

      I’m not a doctor, so I cannot diagnose you. I know you are not asking me to, you’re just asking a question, but I needed to disclose that for other readers who may not realize.

      RSD and CRPS can evolve from even a minor injury or nerve damage. Please discuss this with your doctors.

      If you do have CRPS, you will need to be treated for it as soon as possible.

      I wish you pain eased days and nights,
      ~Twinkle

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  10. Hi I enjoyed your article, I have been dealing with CRPS I for almost 4 years now. It started in my right hand after a crush injury and has gone up my arm into my neck and face, to my left arm down through my left hand. My doctor is cautiously considering there may be some further spread to my legs as well. It has been a challenging 4 years, I have had several medication infusions, Electric stimulation therapies, more medications than I care count, nerve blocks, and tomorrow I am having SCS trial unit procedure. I have the added problem of having Celiac disease, so medications become an issue. Most of those that use grain fillers are a huge problem for me(I won’t go into the gory details) Narcotic pain meds are a problem for me as well, I have had one severe reaction or another to almost all of them, The meds I am prescribe manage to control the pain so that I can function. However, function now means get out of bed, make myself meals, take care of my dog (feed, Walk, etc.) maybe do some light housework on a good day. This is not anywhere near the quality of life I had before this disease. I raised two Children on my own, coached softball teams, worked as Correction Officer in a Maxium Security Prison, danced, was going to college full time. I stumbled on your article in trying to find a connection between the two conditions for my disability retirements with my employer, and Social Security. The sad thing is it isn’t listed as a qualifying condition specifically, but neuropathy is. Thank you so much for your insightful article, I am going to forward a copy to my attorney it may help him in his work fighting for me.

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  11. Thank you for the information. I have had RSD/CRPS for a long time, it began in my right hand for no apparent cause. In the beginning I was misdiagnosed and it just by accident that an Emergency room MD made the connection and I was sent to a specialist who agreed that I did have RSD. With some testing, sympathetic nerve blocks, among other things, rounds of medications as well as extensive physical therapy, none of which helped, RSD/CRPS has continued to invade my life. With the support of a truly great physician and a wonderful family
    I have fought to stay active, as wife to a cattle rancher, mother to three and grandmother to six, as a writer, cowboy/western poet, songwriter, vocalist and performer. It is a struggle with a disease that has hit me in every way to destroy me by stealing my mobility inside and out. I now have swelling in my right leg, ankle and foot of course with severe pain, and discoloration and what I assume is pitting of the skin. It has also moved into the left leg, but not as bad. I am having difficulty walking, cannot stand having anything touch me and I have these beautiful children who want to hug me and I want to hug in return and somehow I do and then work to not make a sound or cry. Even vibrations from other people walking across the floor sends me into tears (I am not a crier, but this has drawn it out of me! ) Needless to say I am worried that I will be on crutches or worse in a walker and while I can be grateful that is available I will fight to walk tall as long as I can! .
    I was told it could not possibly be RSD/CRPS that I have and that RSD/CRPS doesn’t move into other parts of the body and it is self limiting and I am too old to still be having symptoms… tell that to my pain please maybe it will go away. Again Thank You for an article that tells it like it is, one that I can use to help educate others to our needs. Like others I want to be free of this disease and not have to take medication just to get through the days and nights of unforgiving pain and while my medication does not take away the pain, it does help enough that I am productive and the rest of the world doesn’t see what I don’t want them to see most of the time.

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    • Dear Donna

      Thank you and thank you also for sharing your story with me. You’ve been through so much and I admire what you have accomplished in your life as well.

      It has been said that CRPS is regional (The Regional part of Complex “Regional” Pain Syndrome”. That is stays in the area it developed. This is not entirely true.

      It can move and spread to other areas of the body and include internal organs and while this is not likely and only includes a small percentage of patients it can happen.

      The symptoms you describe are indeed apart of CRPS.

      I admire you also for trying to walk as long as you can. We do have to keep as active as possible but please don’t ever over do it. That means if your body can only walk 10 minutes, 30 minutes etc, try not to push beyond that or you will end up in a flare up. Pain is already going to exist. Always try to pace your activities.

      I have a wheel chair, a walker with a seat and hand breaks on it and several walking canes as well as a large and tall walking stick.

      I only use my wheel chair when I am not able to continue, I use it more as a walker, its always in the van, and I use my cane as needed. For short trips I use neither.

      I like the independence of not having to use them.

      But also know that these are tools to help us. Please use them as you need them. I had a problem for a long time with the stigma of others wondering “why” I needed these tools to assist me. I felt embarrassed. Most of us do not look sick or disabled.

      I finally realized with my husbands help that my quality of life depended on these items at times.

      If you are on Facebook feel welcome to join my CRPS support group at:

      https://www.facebook.com/groups/RSDCRPSAdvisory.InfoSupport

      You will remain in my thoughts and prayers
      I am sending a hug your way…

      Sincerely,
      ~Twinkle V.

      .

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  12. Hi Twinkle, Thank You for your comments. I needed to feel that I am not unique to the strangeness of this disease. There are days when I want to give in , I am so tired and with the spread of the symptoms I am at times emotionally overwhelmed.
    Education is so important in the fight we face daily with CRPS and the more we can educate our selves, our family and healthcare providers the better off we are. I still run into the attitude that because you don’t look sick then you cannot possibly be sick and RSD “burns its self out in three months” so therefore what you are going through is not
    RSD/CRPS and most likely all in your head!
    I don’t want you to think that I am not using any aides available. I realize that by being too “proud” to use help I could end up with broken bones and more trouble than I have now. Still it is hard to give up the freedom to walk and in my case perform on stage without a walker or crutches. Reading your letter I decided not to feel guilty for wanting to continue to perform so I have figured out ways to adjust for the help and thus far have managed to keep my audiences comfortable by making it feel and look natural when I use a walking stick or other prop. I don’t make an issue of what is wrong with me, but I usually get to share what it is in interviews. Thanks for reminding me to pace myself…it is so hard to do. I also take care of my three year old granddaughter whose parents work and I believe this has been an integral part of staying alive. Gods gift of love
    Twinkle, just writing this down and sharing it with another who knows what CRPS does to us has helped. I honestly could not believe that I had started another chapter. I was told that this was not possible at my age … ha Fortunately my wonderful MD has given me the greatest gift , she supports me and if I didn’t have something to help with the pain I would not be here to share…..I am on Facebook will look forward to staying in touch. God bless and again I thank you for your thoughts and suggestions. I will try to keep things shorter, I am a wee bit too chatty. I send a hug and prayers your way,
    Grandma Rhymer

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  13. You are so very welcome.

    I pray you can continue to remain before your audiences for years to come. Using props is an excellent idea.

    A thought has just come to me that I have used during holidays and maybe you can incorporate it or something similar into your shows.

    I decorate my walking canes like candy canes at Christmas time. I use white and red ribbon and then hang little ornaments off the handle so they jingle with Christmas cheer. Its uplifting.

    I change it to different holidays if I think about it.

    Back when my own pride was still keeping from using my tool decorating the cane was what brought it out of me. Helped me. And people loved it.

    Please never feel like you are too chatty, so many of us keep so much inside. I loved listening to you and getting to know you more.

    We have a 7 year old grandson. I smiled when I learned you have a 3 year old grand daughter. But winced when I read you take care of her. That must be hard. I recall the times I had our grand son when he was younger, Phew! Of course we want them around us, we love them, but boy is it hard. Now that he is older, we have him back over more often again.

    I admire you, I just keep thinking how much you much keep inside in order to continue to go on.

    My heart, thoughts and prayers are with you. I am happy to know you or be getting to know you.

    I wish you pain eased days and nights,
    Always be as well as you can be,
    ~Twinkle V.

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  14. Howdy again! I enjoy talking with you too. My husband and I were with all of the clan yesterday and had a great time … pretty tiring and have played catch up on sleep off and on today. We are fortunate to have family close, we ranch and the boys are partners with us. The family have ranched in Colorado for over 60 years.
    Evie the youngest of the Grand children comes over early during the school year for us to get ready for day care. Three days a week she is in day care all day and two days a week we keep her all day and when mom (who is a 6th grade teacher, coaches middle school basketball and track ) has practice during the week after school and away meets we keep her after school as well) her Daddy works at a gold mine and gets home late so we help out until one of the parents gets home. Our daughter and her husband live three minutes away. Our son-in-law was married before and has two children from those previous marriages, he has custody of his son. So we have a step grandson and when there are away games and he cannot stay at school with our daughter we also keep him. Our sons who work the ranches with us have families too and we are all very close, and while it does get hectic at times we are blessed and love is abundant. Your grandson would fit in with ours age wise the boys are 9,5 and 4 with two at 9 and the girls are 12, 5 and 3.
    I feel like we would get along well as friends and looks like we have some things in common. Sharing about our lives already has opened the door to becoming friends please tell me more about you. Living with CRPS is a challenge to the whole family and our net work of friends at home have to deal with the losses they see in our day to day lives, it helps to be able to talk with others we have just met and to find out that we are not so different. Friends at home are well meaning and yet make it harder in some ways to deal with the changes we have to over come. They want us the way we were and I understand that, but I am in denial
    too,
    Thank You for the suggestions on decorating they are great. I have some walking sticks I have decorated for the western themes and when we have a large show I decorate the set so that I can sit when I need to.
    I am trying to find out how others have dealt with other medical needs. I need dental work done and I am a difficult patient at the best of times but I am really in a mess right now.
    Got to go, but thanks again for writing back and to all of you reading this I am praying for you too.
    Donna (Granma Rhymer)

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    • I have had some days that defy description, I thought I had suffered every type of pain and that it could not possibly get worse … how ignorant and unprepared …
      All my plans are laying in shreds and I don’t have the strength to gather them up.
      When I wrote previously I was still telling myself that I could pick myself up and keep on going. I have been so good at hiding the truth and being so strong so noble and courageous, how nauseous ! In these days since I first wrote I have gone from walking upright to being bend like a twig, swollen and discolored and utterly humbled
      The information I have read will be put to good use. My Doctor has been very supportive in documenting my condition, but the pages that profile so many others in language far more eloquently than mine tell a chilling story of what RSD/CRPS does and how far reaching it is are here on this article and in the lives of the many others I have read about as I went about trying to find out if I was just going crazy.
      Thanks for your letters and articles, I have sent the address of this Blog to my MD.so she can read them for herself and with hopes that we will find some way to get help for me and others in our area.
      I have experienced throughout this journey in pain so many misconceptions and it still seems that anything to do with chronic pain and the use of pain meds is still met with suspicion. So the fight goes on just to be heard and treated with respect..My best to you all and God Bless You, Donna

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  15. Hello again Donna

    I’m sorry it has taken me a bit to write back. I went to the RSDSA Integrated Solutions to CRPS Conference in San Francisco on Friday May 10th which was wonderful to learn from and meet so many CRPS patients, but boy was the pain high the next days after. 2 days after my return I fell backwards in the middle of the night on my way to the restroom and scraped my inner right wrist and hit my butt cheek where my internal battery to my Spinal Cord Stimulator is implanted inside me. The mattress of this spare bed I’m staying on must have pushed closer to the wall and I hit the bed frame instead of the mattress. I bruised myself up pretty good back there. My unit still works thank goodness. My legs just gave out. Not the first time that has happened but my husband usually has my hand when it has to help break any fall.

    On Tuesday I have 2 procedures under full anesthesia. It’s a long story but I will try to tell you in a short way. 14 months ago my Gall Bladder was removed. I had a small bleed internally and was sent home with a JP drain (Jackson Pratt). I had a tube inside me and I had to drain the blood from inside me, measure, record it on paper for the doctor and discard it into the toilet for approx 8 days before the drain could be removed. I was also told a small percentage of gall bladder couldn’t be removed but no one went into much detail. I asked if it would cause me future trouble and was told no. All year I was still having pain in my belly, up beneath my chest on the right side, right breast area but no one believed it could be the gall bladder. I had my gall bladder removed on an emergency basis through a different ER hospital than my primary hospital. Finally late February I ended up back in the ER with severe pain and was told it was probably constipation but to follow up with my primary, I did. He ordered an ultrasound right away and it was found I still had stones inside me and must have had them all along. It was also found that that piece of gall bladder was causing inflammation on my posterior liver wall. It is literally adhered to my liver. Now I have to have an ERCP where more than likely my bile duct will be cut, stones removed, cleaned out, a stent or tube left behind, photos taken of the liver and then I have to have surgery to cut part of the liver away to get that piece off. If all goes well on Tuesday I will be home the same day if my Pancreas ends up being effected then I will be admitted for a few days the doctor said. From there the liver surgery will be scheduled.

    Seems like it’s all taking forever. And of course this is all on top of my CRPS.

    You are so very right in how so many treat us and assume we want medication or that we just want to complain, or even that our illness doesn’t exist even though it’s existed since the Civil War.

    I’m so sorry about the swelling and discoloration, sadly those are the symptoms of this. I just wish you didn’t have to endure it. It is painful. And not a lot helps except waiting it out.

    Please always feel welcome to write, I look forward to hearing from you. From time to time it may take me a bit to reply though.

    The first Friday after the procedure I have to be back at Mercy Hospital for a Pulmonary Function Test, but should only be away from home a couple of hours.

    And yes please feel most welcome to share this blog.

    You will remain in my heart and thoughts,
    Godspeed,
    ~Twinkle.

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    • Twinkle You are in my prayers and on my prayer partners as well. I understand fully why you are not on line 24/7, infact I AM AMAZED that you are wrting at all right now, except unless like me it is a release of sorts.
      I started a school for therapeutic horseback riding many years ago never knowing that one day I would be the one having the therapy. Unfortunately while doctoring my horse (three years ago ) waiting for the Vet to come, but. some thing spooked her causing her to rear up she came down ion me twice … 1200 pounds I could not get up and we ended up sliding across the barn floor of concrete landing against the far wall, she was trying to get up and I was trying to get out from under her she clipped me in the head and then when I pulled myself up she again lunged kicking me in the stomach, wow, I thought, that hurt! I was still not out and the horse was also still trying to get up. I figured I was dead already, but I was down between her rear and I managed to grab the panels of the corrals and pulled myself out, the owner of the barn said it looking like I was being birthed like a foal! The horse kicked again heaving to her feet, but this last kick caught me in the back . Because I was still moving around I figured there were no broken bones and originally refused to go to the hospital, but to make this story shorter, I nearly ruptured my stomach and was bleeding into my abdominal cavity was later transported to the hospital by ambulance. I did not break any bones and the damage to my stomach didn’t show up on x rays and even though my blood pressure was bottoming out and I looked 8 months pregnant from the swelling and could not walk or stand up straight I was sent home!!! As an CRPS/RSD patient I have found few ER personel who know anything about the disease, but what they do know is to show their contempt and because I have pain 24/7 you can guess what I have endured. Over the weeks and months after the accident I developed gastro-paresis, simply a paralzied stomach. Recently I stepped down off our back step, fell and scraped my leg and twisted my ankle since then I have started this latest battle. Anyway Twinkle, I understand completely what you are going through and I honestly admire you for all that you are doing for others. You are an incredible lady and I appreciate the time you have taken to read my story and to address my situation.
      I guess you have figured out I hate going to the hospital and I have had RSD/CRPS for a very long time. I was misdiagnosed and I was told I was crazy, had empty nest syndrome, treated for tendonitis told to use ice packs and had my arm packed in ice which had me screaming in agony and caused swelling so severe that my skin split open, but I caused that because I wanted pain meds. I think I wrote that it was an ER Doctor who finally made the diagnosis for me, he told us remembered treating a soldier in Viet Nam for RSD after orthopedic surgery. Still if you don’t look sick dying of cancer and yet have pain that no one can figure out then you must be seeking drugs and attention or whatever else they want to label you with. I get plenty of attention as a performer, the good kind of attention from doing what I love for people that I love. I resent having a disease that is taking my ability to function away from me, but I will not give up or give in to it, what I want is the respect all of us deserve to be believed when I say I have pain so bad it feels like it is a living breathing animal digging it’s way out through my bones! Well, I have written an epistle on this subject of pain …this is enough for tonight, but I do a lot of my writing late when I can’t sleep.
      Please let me know how you are doing you will continue to be in my prayers…you do a great service for all of us, but you need to take care of yourself just the way you tell others to do as well..God Bless, Donna

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      • Twinkle, I should have taken more time to read my latest offering cause.I sure needed to correct my spelling, among other things! I just wanted to Thank You again for giving all of us a place to open our hearts freely to tell what we are feeling without fear of recrimination. As you go into this next round of surgeries I want you to know the hope and release you have given me to follow through with treatment that I need. You are very brave. I will watch for the message that tells us how you are in the mean time my family and I will keep you and yours in our prayers. Gratefully, Donna Hatton

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  16. Good morning Donna!

    Please never worry about spelling. My goodness for the last few years now I switch words around in my sentences and sometimes even type out a word how it sounds when I know exactly how it’s spelled. Obviously my brain is malfunctioning. This can happen to us also.

    I’m so sorry it has taken me so long to write back. I feel like I’m always playing catch up with myself. I’ve felt so ill lately and I admit a bit depressed as this surgery and my situation is taking so long to resolve. I finally see the surgeon again on the 19th.

    How are you doing my friend? Thank you so very much for the prayers, you remain in my thoughts and my prayers also.

    I hope to write to you more soon! We have our grandson with us now. He came over yesterday to spend the day but then when his mom came to get him he wanted to stay over so he spent the night with us. We’ll have him until later this afternoon.

    In the meantime, I’m sending a hug your way…
    And wishing you pain eased days and nights.

    Your friend,
    ~Twinkle

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  17. Had right ankle fusion and subsequent CRPS for 2 years. On Lyrica (300mgs. per day), (50mgs. of Nortriptyline) and Norco, when needed. Have considered a SCS to eliminate drugs, but only take narcotics once a week and understand that CRPS changes from sympathetically maintained pain to independently maintained pain within a year. Knowing this, why would anyone have a SCS IMPLANTED.

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  18. Good afternoon, Chuck!
    From my understanding not everyone moves from SMP to IMP that quickly. This is not to say that some do not. You do bring up a great point regarding SCS’s though. It is so very important that if someone is considering one and decide on the trial that they are honest with themselves and their doctor on how much relief they really get from it. Usually they (Docs and SCS Reps) require between a 50-70 percent decrease in pain levels for a patient to even be able to go forward with the permanent implant. Many patients are so desperate some will think they got the relief or hope the permanent will work better, have the surgery only to end up suffering more with a unit that doesn’t work for them. My SCS is my lifeline. I’ve had to learn tricks to it over the years so that it can continue to assist me.

    My best advice is if the trial doesn’t work, people should never go on to get the permanent implant.

    Spinal Cord Stimulator’s have greatly improved many lives. They have also failed many.

    I wish you pain eased days and nights,

    Happy New Year!

    ~Twinkle

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  19. I devour anything to do with RSD(you can tell I’ve had it for awhile by my use of the term, RSD). I have felt very fortunate, 8 1/2 years ago to have found a Dr. well versed, as was possible in those days, in RSD. I had been put through the mill by various Dr.’s prior to my current Dr., insisting I needed to work through the pain. Much physical therapy where I would return home and crawl into bed. PT did help make the edema dramatic, very dramatic. I’m a women, I wore pants and loved my shoes. I woke one day after a long PT session to find my legs were purple in color, edema that looked like elephantitis. No more pants, no more shoes, I wore men’s stretchy slipper throughout that winter and slept with my blankets hovering above me, by using a contraption my husband built. Speaking of which, he always believed I had something different and PT was not the route for me. I had 4 major surgeries, one went poorly, I have a titanium 8 hole cage S1L5, in a matter of 18 months. There was so little information, except what I read in civil war records, about RSD I thought I would never get help. I did eventually, and only a couple of miles away! We tried many things, I had much success with a vest that had electrodes that stimulated certain areas of the body, it contained a computer chip, which was read by the Dr( how much use and at what level ) on a monthly bases. Surprise! The insurance company refused to pay for this experimental, yet successful therapy, and I was put on oxycontin, which I tolerated quite well. Was able to have a life larger than my bedroom. The swelling went down by gentle exercises in the pool and 4 years ago I had a red letter day, finally able to wear pants. Unfortunately all that is gone, I live in about the third hole over of the Bible Belt and they have declared war on oxycontin. It is similar to fishing for marlin in the ocean and running a big net that picks up all matter of fish and that is just the price that must be paid to make oxycontin go away. They have declared war. My own Dr is now only allowed to write a minut amount. I am forced by law to wean myself at breakneck speeds and am beginning to return to my bed and take Lyrica, which is a drug I hate. I feel like I have taken a drug when taking Lyrica and have fallen asleep in dinner plates in the past. Oxycontin from the beginning never made me feel drugged but worked
    well on the pain and gave me my life back. Off of my soapbox, I am truly so grateful for the information that you are providing! I did, unfortunately, in the time it took to finally find a knowledgeable Dr., end up with “drop foot” with much atrophy in my right leg. My hospital bedside tray has been brought back up to my room and my world is turning small again. But articles like yours give me tremendous hope. Should you every need a lab rat for testing feel free to contact me. I will do anything to help those that come after me to not feel hopeless, afraid, and doubt their sanity! Just a note,over here in east TN, in our town we are finding there has been a big resurgence of herion. I never thought I would hear that word and soccer mom in the same sentence. Keep up your most excellent work!

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  20. I have a quick question for anyone that is familiar with idiopathic Small Fiber Neuropathy-in diabetics, the large fibers are affected first. I have been diagnosed with RSD/CRPS and the idopathic small fiber. Can someone answer, what are differences bw large and small..?

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  21. Pingback: Peripheral Neuropathy Chest X-ray | Neuropathy - InstaHealth

  22. Pingback: Differences Between Peripheral Neuropathy and Complex Regional Pain Syndrome | RSD Advisory- Where Chronic Pain & Depression Collide | Salon n Stuff

  24. This reply a bit later than your update (now 2016). Pain in right leg ever since surgery years ago debride right ankle joint and remove anterior spur. Mayo diagnosed pain as rsd/crps. Dr’s currently say I have peripheral neuropathy. Is there a noninvasive treatment available? I’ve read advertisements for laser treatment in this regard. I am confused about what disease I have. Live in Maryland. Thanks for any help.

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    • Dear Marie

      I’ve done Low Light Laser Treatments dozens of times since 2011. Low Level Light Therapy (LLLT). It is non-invasive and has been helpful in edema and related symptoms.

      2011 episode of Living with HOPE with Guest Speaker Twinkle Van Fleet with featured Host Trudy Thomas
      http://www.blogtalkradio.com/thebodymindandspiritnetwork/2011/03/18/living-with-hope

      I hope this helps some. I wrote an article too, will try to locate it. My last treatment was about 4 weeks ago and has assisted enough to continue them.

      CRPS/RSD is a neuropathic pain syndrome/disease and while peripheral neuropathy is a bit different, they can still co-exist, even when it doesn’t seem likely.

      My heart is with you.

      ~Twinkle

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  25. Hello…My precious dad has neuropathy. .it’s not the diabetic type..he has no diabetes…he has to use a walker now and this is not my dad..I pray for him every day that he will be healed..I pray for God’s miracle…when I was young he took care of our family, now my mom takes care of him…I live in a different state and I visit on a regular basis…this was not suppose to be..he was a hard worker and a great dad…I just pray that there is something out there that will at least take the pain away and he could walk without his walker…he takes infusions for a week once a month…thank goodness for that…….this was suppose to be their time….not like this….I continue to pray!

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    • Dear Jessica,

      Neuropathy can exist without having diabetes and many of the symptoms are similar or same. My heart is with you for your dad… and you. I know how hard it is for a man, the provider, to hurt, and no longer be able to physically care for his family the way he previously did. This doesn’t mean he’s any less of a man that he was before Neuropathy. Be sure to tell him often how much you know he’s done as a father, so that his will to survive is stronger. I provided a link above to LLLT. There may not ever be anything to cure or take his pain away entirely, but he may get some relief of symptoms. Everyone is different. I’ve also had a Spinal Cord Stimulator since 2006 which has kept me from regular or permanent use of a wheelchair.

      Godspeed!

      ~Twinkle

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    • Hi Jessica My mum has neuropathy from diabetes and was told by her Dr there was nothing hw could do for her. My sister did aome research and found the product Nerve Renew and ordered it for her from the USA. Mum lives in NZ. and since taking these tablets she has been so much better. She is now 97 yrs old and deserves a quality of life.

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  27. Thank you for taking the time and sharing this information. After reading the information you provided, it gives me new questions to ask my PCP and Specialists. For based on your information, and my 30 years as a diabetic, it would appear that since I have all symptoms of both problems listed, my issues need to be looked at, and treated differently.

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  28. I have CRPS for about two and a half years now everything they tried failed, all I want is for it to go away, right now I just want them to kill the nerve to the foot or cut it off. I hope the neurosurgeon I just seen will help, she said she will get with the other doctors to see if they can kill the nerve, I really need it done because I’m at my wits end, you name it they tried it! This is my only help, and I pray to god they come through for me!

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  29. (MUST READ: HOW I GOT CURED FROM COPD)
    My name is Amir I thought i should share this here as someone may need this information; I was diagnosed of COPD in February 2015, my doctor told me it has no permanent cure, i was given inhaler to help relax my airway and other medications to ease the situation, this continued till a friend of mine Anna Burke told me about Dr Grosh from United State who cured her father of COPD and Glaucoma. I contacted this herbal doctor via his email and bought the herbal medicine from him, i received it within 6 days and applied it as prescribed and was totally cured within 19 days of usage. my life is back again! Contact this doctor via his email drgroshdiabetesservice@hotmail.com

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  30. I am diagnosed with PN. The differences you are sighing in this article is just not true !!!
    You certainly DO have sleep disturbance and insomnia.
    You Do experience extremely severe pain with PN.
    You have significant muscle weakness and atrophy that is very debilitating!!! and it DOES move to both sides of the body and other places in the body hence polyneuropathy! We have spasms and loss of use also. Everything you just stated does not happen in PN DOES HAPPEN AND IS VERY COMMON IN PN. I could not believe what I was reading !!!
    Please do not take this article fir truth. Did a Dr really write this ??? Really ???

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  31. Thank you for your information on this very debating desise. I have suffered from this around 14 years now. I have to take meds every day to be able too function. It’s very hard for my grown up children to realize what I suffer. I think there is not enough awareness about this.

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