Management of CRPS type II unresponsive to sympathetic nerve block with trigger points injection

Abstract Objective: Complex regional pain syndromes (CRPS) type II (causalgia) is one of the causes of neuropathic pain. For the management of CRPS type II, various kinds of medications, nerve block, intravenous lidocaine and neurostimulation are used. We report good results by injection of trigger points around the left calf and lateral dorsum of the foot after unsuccessful different treatments in a patient with CRPS type II. Case Report: The authors describe a twenty-three year old female patient with CRPS type II after damage to the left sciatic and tibial nerves. The continuous epidural administration of opioids and local anesthetics, and oral medication with phenoxybenzamine did not sufficiently control the pain. Pain control was satisfactory with injections into the trigger points in the involved limb muscles. After six years, the patient complains of only slight tingling sensations around the left little toe.