Getting a Correct Diagnosis for Pain: Sooner Is Better


By Staff Reports

(DGIwire) – Imagine someone has sustained a fracture, sprain/strain or tissue injury such as to the arm, leg, hand or foot. Perhaps one of their limbs has recently been immobilized in a cast, or they recently underwent a surgical or medical procedure. In any case, instead of starting to feel better, they are now feeling worse—way worse—with extreme pain in that limb. It’s an intense burning sensation, and maybe they also notice a dramatic change in their skin’s temperature, color or texture.

The nightmare continues when the patient complains about the pain to their doctor. Instead of a quick diagnosis, they find themselves seeing a variety of healthcare practitioners: family physician, orthopedist, physical therapist, pain specialist or neurologist, and then back to their primary care physician. Finally—after a long period of time and only after several visits with different doctors—is a diagnosis confirmed: complex regional pain syndrome (CRPS).

Unfortunately, this scenario is common, due to the fact that CRPS is rare and not well understood. However, the sooner CRPS is recognized, the sooner a patient can start a treatment regimen. According to the National Institute for Neurological Disorders and Stroke (NINDS), the most common triggers for CRPS are those listed above: fractures, sprains/strains, tissue injury), limb immobilization (such as being in a cast), or surgical or medical procedures. CRPS represents an abnormal response that magnifies the effects of the injury, NINDS also reports.

CRPS can strike anyone but affects women more commonly than men, reports NINDS. The average age of affected individuals is about 40. According to the McGill Pain Index—a pain-ranking system developed at McGill University in 1971—the pain of CRPS is greater than childbirth without anesthesia, cancer pain and amputation of a digit. Signs and symptoms can include continuous burning or throbbing pain, usually in an arm, leg, hand or foot; sensitivity (in the place of the originating injury/trauma) to touch or cold; swelling of the painful area; changes in skin temperature, color or texture; and stiffness and spasms, according to NINDS.

Although there is currently no medication approved for the treatment of CRPS in the United States or the European Union, it is vital that patients with the condition receive an accurate diagnosis as soon as possible so that various approaches to treatment can be initiated. Approaches that have been tried include pain relievers, antidepressants and anticonvulsants, corticosteroids and bone-loss medications, as well as heat/cold therapy, topical analgesics, physical therapy and transcutaneous electrical nerve stimulation. However, new innovative approaches specifically targeting CRPS are now being developed.

“We are currently enrolling patients at sites across the U.S., Canada, the U.K. and Australia in a clinical study, called CREATE-1, to evaluate our experimental medication AXS-02 for the treatment of chronic pain caused by CRPS,” says Randall Kaye, M.D., Chief Medical Officer of Axsome Therapeutics, Inc., a clinical-stage biopharmaceutical company developing novel therapies for the management of central nervous system disorders. “This medication is not yet approved. AXS-02 has been granted Fast Track and Orphan Drug Designation by the U.S. Food and Drug Administration and Orphan Medicinal Product Designation.”

Anyone who suspects they have CRPS or has been diagnosed with CRPS within the past six months, and is interested in learning if they qualify for the study, should visit

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