What other modalities can be used to treat CRPS?

What other modalities can be used to treat CRPS?

Intravenous regional bretylium Bier blocks can be per-formed along with or in lieu of sympathetic nerve blocks. Bretylium is a sympatholytic agent that decreases cate- cholamine release from nerve endings. Mixed somatic/ sympathetic blocks such as epidurals or spinals can be used but will lack diagnostic specificity. Oral sympatholytics such as β-blockers will decrease sympathetic discharge but can cause systemic side-effects especially related to the car- diovascular system. Anticonvulsant agents, tricyclic anti depressants, oral steroids, and antiarrhythmic agents have also been described as therapies for CRPS. Spinal cord stimulation has recently shown very encouraging results for the treatment of refractory CRPS. Physical therapy to prevent the trophic changes associ- ated with CRPS is of the utmost importance in conjunc- tion with other treatment modalities. The key to successful therapy seems pre-eminently dependent on treating the syndrome as early as possible. Psychotherapy is sometimes a productive adjunct.