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Pain Management
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Pain management clinic at VIncera Institute

The pain management clinic at the Vincera Institute is led by Dr. Enrique Aradillas, a board-certified neurologist. It is staffed with experienced clinicians that understand the disorder known as complex regional pain syndrome and the many challenges facing patients.

Our experts at the Vincera will personally guide you through diagnostic tests to determine the best course of treatment to manage your pain.

What is 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 — the arms, legs, hands, or feet.

It usually occurs after an injury or trauma to that limb, including fractures, sprains or strains, or 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. That means 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 of CRPS

People who feel they are suffering from CRPS may notice some of these symptoms:

  • Dramatic changes in skin temperature, color or texture, especially when compared with 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
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Other pain conditions Vincera treats

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

  • Small fiber neuropathy
  • Chronic back pain
  • Chronic neuropathic pain conditions

Treatment for CRPS and other pain

Ketamine and lidocaine infusions

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.

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

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.

Medical marijuana

Medical marijuana can be used for patients of CRPS and other significant ailments to relieve the pain, reduce muscle tension and help alleviate the stress and depression associated chronic pain. Pennsylvania legalized medical marijuana in 2016, and it became available in 2018. Patients must register with the state's registry and have a physician certify they suffer from a qualifying medical condition.

Other options

Additional treatments at Vincera Institute for managing pain include:

  • Oral medication
  • Back injections (epidurals, facet joint and SI joint injections)
  • Nerve pain procedures such as stellate Ganglion blocks, US guided injections of nerves, lumbar sympathetic blocks, greater and lesser occipital nerve blocks and cervical plexus blocks
  • Greater trochanteric injections
  • Botox for Migraines
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