Our Approach

The Neuropathic Pain Center at Vincera brings together internationally-recognized neuropathic pain specialists who are dedicated to the diagnosis, treatment, and prevention of neuropathic pain disorders. Among them are the center’s chief medical advisor, Robert Schwartzman, MD, who is one of the highly published pioneers in the diagnosis and treatment of complex regional pain syndrome (CRPS), also known as reflex sympathetic dystrophy (RSD). Our experts also include orthopedic and general surgeons, acupuncturists, physiatrists, pain management physicians, physical therapists, yoga instructors, nutritional specialists, and massage therapists.

If you are experiencing pain, it is important to see a trained health professional.

At Vincera’s Neuropathic Pain Center, your treatment plan is tailored to your specific clinical needs. This ensures that you receive the individualized care that is essential to optimal outcomes.

Complex Regional Pain Syndrome

Complex regional pain syndrome (CRPS), also known as reflex sympathetic dystrophy (RSD), is a chronic pain condition that most often affects one of the limbs—arms, legs, hands, or feet—usually after an injury or trauma to that limb—including fractures, sprains, or strains; soft-tissue injuries such as burns, cuts or bruises; or medical procedures. However, in some cases, no specific cause can be identified.

CRPS is believed to be a “neuro-inflammatory” disorder meaning there is a malfunction of both the nervous system and the immune system in response to a painful or traumatic event. The condition can strike at almost any age and is seen in both males and females, although it is more common in females.

Symptoms may include:

  • dramatic changes in skin temperature, color, or texture—especially compared to the opposite, unaffected limb.
  • intense, burning pain
  • extreme skin sensitivity
  • swelling and stiffness in affected joints
  • decreased ability to move the affected body part
  • motor function disturbances, including muscle spasm/jerks and cramps

For research studies on CRPS and related conditions, please see Dr. Robert Schwartman's publications.

Other Conditions

The specialists at Vincera treat numerous other neuropathic pain conditions including:

Small Fiber Neuropathy
Fibromyalgia
Diabetic Peripheral Neuropathy
Postherpetic Neuralgia
Radiculopathy
Central Post-Stroke Pain Syndrome
Pain related to Multiple Sclerosis
Failed Back Surgery Syndrome
Intractable migraine and cervico-genic pain

Diagnosis

Early diagnosis is crucial in preventing the progression of symptoms and achieving better outcomes. Since the disorder is often misunderstood, many patients see multiple physicians and search for years for a conclusive diagnosis. The Neurological Pain Center at Vincera is staffed with experienced clinicians that understand the disorder and the many challenges facing CRPS patients.

Our experts at the Vincera will personally guide you through diagnostic tests that may include:

Treatment & Procedures

The medical team at the Vincera's Neuropathic Pain Center have developed an innovative and unique approach to the treatment of chronic neuropathic pain conditions. This approach is personalized and multidisciplinary as there is no single treatment that completely addresses the various symptoms of these complex disorders. Through strategies designed to modify the neurological system, the neuro-immune system, the neuro-endocrine system and the neuro-gastrointestinal system we are able to exert an effective and long-lasting reduction in chronic pain according to each patient’s pain profile and characteristics.

The Neuropathic Pain Center offers patients a variety of treatment options for CRPS, including a number of emerging, promising therapies. Treatment options include:

Therapeutic Injections & Nerve Blocks

Therapeutic injections and nerve blocks are often helpful in treating the pain generators that aggravate neuropathic pain disorders. Some of these procedures can be performed in the physician’s office using local anesthesia (numbing medication). Others are administered with mild sedation and are guided by imaging for the highest possible patient comfort, safety and accurate needle placement.

Infusions: Ketamine & Lidocaine

Many patients with severe, generalized CRPS have not responded to a wide variety of conventional therapies. Intravenous administration of either Ketamine or Lidocaine has been demonstrated to be effective in both animal models of neuropathic pain and in several human studies, as well. Both of these medications have been approved for use as anesthetic agents and have been safely used in clinical practice for many years. These infusion therapies typically result in a significant decrease in symptoms of CRPS for many patients.

IVIG & Plasmapheresis

Research suggests that maladaptive immune and inflammatory pathways play a role in sustaining pain associated with CRPS. Low doses of intravenous immunoglobulin (IVIG) can reduce pain intensity in CRPS patients who have not responded well to other treatments. Plasmapheresis, or plasma exchange therapy, is another option. After a careful evaluation of your history and symptoms, your Vincera physician will work with you to design a plan of care that meets your individual needs.

Physical Therapy & Other Services

Your physical therapy and other treatment plans will begin as soon as your physician clears you. Your comprehensive plan may include:

To set up your appointment at The Neuropathic Pain Center at Vincera, contact us at: 267.592.3177 or email us.