CRPS Message Being Heard in Emergency Rooms

CRPS Message Being Heard in Emergency Rooms

November is CRPS Awareness Month. It may be that awareness is already building in the hospital emergency rooms in the U.S.

Two men, committed to promoting the CRPS awareness and treatment, spent last week at the American College of Emergency Physicians meeting in Boston and came away believing their work is paying off.

There were two messages they wanted to deliver

  1. Understand that CRPS is Real
  2. Ketamine injections may help in treating CRPS

“It was 1000% better than we expected,” said Jim Broatch, who runs RSDSA which is the nation’s leading CRPS non-profit. “We were meeting emergency room doctors and were pleased to see that the awareness is dramatically improving.”

The “we” that Broatch refers to includes Louisiana physician Dr. Billy Alexander, a former ER doctor who has become a leading voice in CRPS awareness since his college age daughter, an athlete, was injured and developed CRPS.

Alexander said that there is more talk about using ketamine in the emergency room for CRPS patients and other chronic pain patients who are experiencing acute flares.

This is the second year that Broatch and Dr. Alexander have attended this meeting. Progress is being made.

“They’ve been reading articles and other information that we have provided,” said Broatch. “They are trying to get away from prescribing opioids in the ER, and ketamine is an alternative that makes sense to them since they use it in other settings, particularly involving injuries to children.”

For Dr. Alexander, the progress in awareness is positive. Some of the ER physicians shared that they are actually gathering data to document the use of ketamine in treating CRPS and other chronic pain issues.

The two shared Dr. Jim Ducharme’s article on managing CRPS (link here) and RSDSA’s own education about recognizing the disease in the ER Setting (link here).

Some of the awareness work must still be done by the patient, particularly in emergency rooms where there most likely is no prior relationship with the physician.

Chronic pain advocate Gracie Gean Bagosy has advice for CRPS sufferers.

“I recommend everyone with CRPS keep copies of the RSDSA CRPS ER Protocol and Hospital Protocol with them at all times. I keep copies in my purse,” she said. “These documents contain an easy to understand explanation of what CRPS is along with instructions on how you should be cared for. Be sure that your loved ones know where these documents are in the event of an emergency as well.”

For Dr. Alexander, who believes ketamine should be used more broadly to help the CRPS patient, he says the patient has a job after leaving the ER.

“If they do get the treatment and it helps, by all means write the hospital and let them know,” Dr. Alexander urged. “That can help accelerate adoption.”

Speaking of awareness, the RSDSA is doing quite a bit this month. One is the virtual walk it is promoting for CRPS sufferers, their friends and families. For more on that click here.






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Authored by: Ed Coghlan

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I’ve seen the use of Ketamine for years and it’s mixed results in patients. I have RSD/Crps in my entire body due to other disease prosses that required very invasive surgeries from spine to my face. Unfortunately, the only Ketamine infusion therapy I have access to is at research center that only accepts cash for treatment. Tell me how a person suffering with, and living on disability is supposed to swing that? There’s at treatment out there that might work! I here to tell all doctors and treatment are not a like.

I’m sorry but I do not see this as a victory or a positive move in the treatment for severe chronic pain. Ketamine would be of no help in my situation and I’m sure most others feel the same way.

Doctors know what drugs work and if all they chose to do is use a drug like ketamine then why not just administer a large dose of; here see if this helps. Lets not settle for minimal treatment when what’s needed is effective treatment.

Thank you,

John S

Thanx chelsea I appreciate your response.

Ina_cox: I saw your comment and thought to reply to your call out for help. I’m a nurse and work primarily with chronic pain sufferers- of all types. I administer lidocaine to people, intravenously and I’ve seen tremendous results with a patients preceived pain level. Lidocaine essentially calms or quiets the nerves that are sending pain signals.

I start everyone at 200mg (10ml) lidocaine which is mixed in 100ml 5%dextrose solution, infused at 110ml/hr and 130ml volume to be infused. Depending on the patients reaction, the next time I see them (every two weeks) I will increase the dose by 40mg (20ml); working up to 400mg (20ml). However, more is NOT necessarily better as that can actually cause more pain. Once a dose is found to reduce pain, the dose is tripled and administered at 2ml/hr, subcutaneously. If that doesn’t give the patient the same amount of pain reduction than we will try that same tripled dose intravenously.

I hope this helps you- hopefully you can locate a doctor who will work with you to investigate every option. I understand how debilitating pain is as I’m a pain sufferer myself. Good luck on your journey and stay positive!!

I’ve been diagnosed with crps April 2015 no meds have worked our therapy since work comp case they have stopped all treatment I’m miserable any suggestions appreciated

My went to the er recently. Another bad experience and my CRPS ,just brushed aside. Extreme right sided cheekbone pain into the ear and radiating up to the temple…Went to a dentist, he did panoramic xray, nothing up top. He said may be bottom back molar, so he pulled it. That was on a sunday. He sent me home with an antibiotic that I had a know allergy too, so I went back in before I drove away. He gave me an antibiotic,and hydocodone for pain. BY Wednesday, my pain had not subsided at all, actually it was more intense, since now I had that tooth pulled too! I went back to the dentist, he did xray and said no dry socket and didn’t understand why I was in so much pain..and so , they gave me lidocaine and my whole body shook so badly before I had the tooth pulled..I didn’t know with crps you shouldn’t have epinephrine. ..So that visit he switched me to percocet.It helped much better as the hydocodone just made me sick to my stomach . So, Sunday 1 week from having the tooth extracted, I’m still in so much pain ,I just want to put my head through the wall….So, I went to the local Er , no xray, told me I had a sinus infection, switched my antibiotic, gave me a script for hydocodone.I told her No hydocodone because it made me sick…so the tech comes over to discharge me hands me a script for norco. I said isn’t this hydocodone, she said no….So I pulled out the bottle from my purse and showed her it’s generic for hydro, and asked her to tell the doc I wanted percocets…they at least took the edge off the pain.. but anyway ,I took lyrica, valium, percocets, and motrin..I did NOT have any sinus issues….It was all a flare up…Last visit to that er was the previous year, flare in my feet ,swollen,blistering ,itchy, they were aweful…they diagnosed me with scabies, the first doc I saw before going to the er was a local podiatrist , he dxed me with shingles ( it was both feet) lol…after that , I went to MUSC, er and told her of my crps…she knew right away it was a flare and was great…I wasn’t able to go there for my facial flare due to flooding in charleston that day ..but this is typical of what we as patients go through…

I have to say I extremely disappointed in this article, for not everyone’s body is the same but yet you are suggesting this is the treatment all chronic pain patients should be given.

I have to strongly disagree with your statements that opioids do not work in patients with CRPS & their flareups! As a CRPS II patient for almost 20 years taking morphine has been the only thing that has worked on me. I was able to function living life as best as anyone with this can, which also kept me out of the ER. Before finding something that worked I’ve tried just about every type of medication including “Ketamine” but cannot tolerate them or they just didn’t work. Believe me my life would be much simpler if it worked on me! So thousands + chronic pain patients like me are now having to deal with not being prescribed ANY opioids or way under medicated. We are NOT drug seekers, we ARE pain relief seekers! We are NOT thrill seekers, we ARE living life seekers!

So what are those of us that are unable to take Ketamine to do now? Have to wonder if this is another ploy from pharmaceutical companies like so many before. Or how long it will takes before this too is abused by non-patients.
I hope at your next conference you do mention a few times some patients are not a candidate for this treatment using Ketamine.

Its so great to see ketamine starting to get the attention it deserves. Thank you RSDSA for all the important work you do everyday. At Ketamine Clinics of Los Angeles, Steven L. Mandel MD, board-certified anesthesiologist and masters in psychology, has provided over 1000 IV Ketamine Infusions to treat depression and other mood disorders and CRPS and other pain conditions. We have seen suicidality reversed in as fast as 1 hour. We’ve seen the worst CRPS go into complete remission. The average time it takes before a significant improvement is seen for all of our patients is just 2-3 days, with patients often noting complete relief of their symptoms. There are no long term side effects either, making ketamine one of the safest, fastest acting antidepressants and pain relievers available today. For more information on our clinic and IV Ketamine Infusion Therapy, please see

This is good news for most with CRPS/RSD, but the Veterans Administration as a whole throughout the USE needs to understand this! Dr Gallagher has made information but it not believed by the various VA-PCPs, VA-Pain Drs and by far VA-Urgent Care/ERs on this matter. Rural ERs also seem not to be getting the word 🙁 keep going to these Annual Meetings RSDSA n Dr but go even wider as well! 90% of ER VAs and Rural America ERs even if bring this information ,”Ketamine won’t do anything for CRPS!” and will not talk about while at the ER be it VA or in most of Rural America ERs. Keep pounding the message one day a Big City ER Dr will want to go back “home to a Rural area n work in their ER” who can teach that area little by little it is a start!

I have rad crps and Social Security Says it’s not a problem and I can still work for 4 days now I’ve been down the pain is that bad seems like I’m of on state don’t care about it help .my family see it everyday why can’t the state.

I wanted to share with the readers and this seems like a good post to do it. although i don’t have CRPS i do suffer with debilitating fibro. i’m currently having issues with kidney stones and kidney infections. it is beyond belief to me that i get much better care from the emergency room than i do from my urologist. the er stops my pain and gives me a script for a few pain meds. my urologist acts like i can’t possible be in pain and need pain meds. in fact the last time i saw him he told me there is no reason for him to see me again until Jan. i never thought there would be a day when er doctors were more compassionate than someone i’m supposed to be building a relationship with. does this mean that maybe views on chronic pain are changing or am i just getting lucky with the er doctors i’m getting. either way the er is a blessing right now and i really can’t believe it.