A Closer Look at CRPS: When You Have a Case, Here's What Happens Next

 For patients, it's often the emotional and mental anguish suffered that they cannot deal with, leading to high rates of suicide. © BigStockPhoto

For patients, it's often the emotional and mental anguish suffered that they cannot deal with, leading to high rates of suicide. ©BigStockPhoto

A CRPS (Complex Regional Pain Syndrome) diagnosis can be a relief to many people. Knowing that their pain is real, valid, and lending a name to everything they've felt possibly for years is a relief. Despite the relief a CRPS diagnosis may bring emotionally, the mental toll chronic pain takes on the psyche of a patient is immeasurable. Living with a disease dubbed "the suicide disease" due to its lack of symptom relief is an endless nightmare of doctors, treatments, procedures, and tests that all lead down the same road: one of pain and suffering that seems endless.

For patients, it's often the emotional and mental anguish suffered that they cannot deal with, leading to high rates of suicide. Knowing they're going to be in pain–possibly forever–is as debilitating as the physical pain itself. Whether a CRPS diagnosis is due to medical malpractice or an accident (these are what's known as causalgia), retaining legal counsel to obtain compensation can ease the financial burden those afflicted with "the suicide disease" face; sometimes for the rest of their lives when left nearly bed bound and unable to support their family.

The million dollar question

 Rushing clients out the door with a minimal amount of compensation just to be able to say the case was won is not the kind of attorney with empathy or who upholds a high moral standing.© BigStockPhoto

Rushing clients out the door with a minimal amount of compensation just to be able to say the case was won is not the kind of attorney with empathy or who upholds a high moral standing.©BigStockPhoto

It’s easy to pose the question why do I need an attorney to represent me after being diagnosed with Complex Regional Pain Syndrome? and we've answered this question before, here on the Shaked Law Blog. However, the answer to that line of questioning bears repeating in a more in-depth manner: an aside from the fact that of course, an experienced attorney has your best interest at heart and has the knowledge of prior Complex Regional Pain Syndrome cases under their belt, the answer to that question lies in whether a person's CRPS diagnosis was caused by surgical error, medical malpractice, or an accident. CRPS II as it's known, has a definitive cause for the pain (although regardless of Type, there is very little in the way of what can be done to relieve the pain).

When it comes to retaining counsel after medical malpractice, remember: Rushing clients out the door with a minimal amount of compensation just to be able to say the case was won is not the kind of attorney with empathy or who upholds a high moral standing. A board certified civil trial attorney will never treat their clients as a number, nor are board certified attorneys "paper pushers" or "adjusters" who have thousands of cases won simply because they obtained some amount of compensation, even if it wasn't the highest amount deserved by the victim!

A board certified civil trial attorney will truly understand the situation and have compassion for the circumstances, all the while maintaining a level head navigating the complexities of a Complex Regional Pain Syndrome case. Being board certified holds an attorney to the highest standard in their chosen specialty–board certification doesn't come standard with the law degree.

Pills, patches, physical therapy, oh my!

As we discussed in our first CRPS series of articles, there are standard forms of medication that are prescribed to CRPS patients as first-line methods of pain control.

  • NSAIDs: Nonsteroidal anti-inflammatory drugs are known to treat moderate amounts of pain. Most NSAIDs (without codeine) are available over the counter and should be taken according to the instructions printed on the bottle. Some name brand NSAIDs are Excedrin, Motrin, and Advil. Prescription only NSAIDs such as Celebrex, Voltaren-XR, and Ketorolac are much stronger and should be used with caution due to their GI-related side effects. As with all NSAID usage, a doctor should closely monitor liver function for those treating CRPS pain longterm with these medications.
  • Anti-seizure medications: While these drugs were once strictly for the treatment of epilepsy, research is now showing doctors that they can effectively provide some relief-of-pain for those diagnosed with CRPS. Lyrica, Elavil, Pamelor, and Cymbalta are in the group of the anti-seizure medications that are recommended by neurologists in cases of CRPS. Each case varies and not every case may see relief with anti-seizure medications.
  • Opioids: Morphine, Hydrocodone, and Fentanyl are common prescription opioids for severe pain. These are drugs that are highly habit-forming (addictive). A patient and their physician enter into a "Pain Contract" where the patient agrees to remain monitored by the physician for the duration of their opioid use. Most states now require these "Pain Contracts" or the medication cannot be dispensed. Physicians must monitor any patient prescribed opioid drugs as they can pose severe, longterm side effects that could be fatal if ignored.
  • Other RX treatments include: lidocaine patches, creams, and Voltaren––which is alternatively dispensed for topical application (a cream or lotion).

Treatments for Complex Regional Pain Syndrome is rarely covered by insurance because of its chronic nature, and if it is covered, there are only certain treatments that the insurance company will pay for–and only for a short length of time. Experimental treatments and newer therapies, as well as pain management (a newer form of medicine that has risen to prominence for chronic pain patients over the last couple of decades) are often out of pocket for the financially burdened victim. Because of this, they continue to suffer for years without the correct medication and therapies that could afford them a better quality of life.

 Experimental treatments and newer therapies, as well as pain management are often out of pocket for the financially burdened victim. © BigStockPhoto

Experimental treatments and newer therapies, as well as pain management are often out of pocket for the financially burdened victim. ©BigStockPhoto

Opening doors for chronic pain sufferers

So, now that we've taken a second look at CRPS, let's look at the legal side. An attorney agrees to take on a client's CRPS-related case, as the CRPS diagnosis is found to be wholly caused by medical malpractice and therefore the surgeon and the hospital are able to be have litigation brought against them for their negligence toward the patient. What happens now? Now that a victim has secured an attorney-client relationship with their chosen counsel, the next steps following the hefty stack of paperwork and "discovery" (which we intend to discuss in-depth in an upcoming blog), there's the Letter of Protection.

For those uninitiated to the Shaked Law Blog, let's define this common Personal Injury practice:

A letter of protection within the scope of personal injury law is defined as a letter sent to a medical professional (physician, surgeon) by a board certified personal injury attorney on behalf of their injured client. This letter will guarantee payment for all medical treatment from future compensation obtained in a settlement.

A "complex" legal system

With a Letter of Protection in place for the client, their suffering may be eased by doors for treatment options being opened to them outside of prescription drugs. Physical therapy, massage therapy, occupational therapy, and mental health counseling all become available when a client retains experienced legal counsel that knows how to secure the proper treatment on the legal side for their client. Doctors work well with board certified attorneys because a board certified attorney knows how to get things done quickly, concisely, and with little unnecessary back and forth that can drag out the proceedings longer than the legal system often does all on its own.

Unfortunately, there are victims who suffer the relentless chronic pain caused by CRPS for the rest of their lives after medical malpractice. In these cases, the victim trusted their surgeon to care for them and treat their illness or injury, only to learn they would be in pain for the rest of their lives due to the carelessness of that trusted medical professional. It’s important for the victim to seek board certified counsel in the event that their Complex Regional Pain Syndrome was caused by medical malpractice. Personal Injury attorneys–the experienced ones–know that behind the most complex cases are the victims who need justice the most.

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