Complex Regional Pain Syndrome

Conditions We Treat

CRPS produces pain that is severe, persistent, and disproportionate to the original injury. Early, coordinated, multidisciplinary care offers the strongest evidence for meaningful improvement.

Off-Label

rTMS for CRPS is an off-label application in Australia, offered under psychiatrist oversight with full informed consent. Medicare rebates under MBS 14216 and MBS 14217 apply for treatment-resistant depression only and do not cover rTMS for CRPS. All care is AHPRA-compliant. For referring clinicians: detailed scientific literature available on request at info@brainaidclinics.com.

Understanding the condition

What is CRPS?

Complex Regional Pain Syndrome is a chronic condition producing intense, disproportionate pain — typically in an arm, leg, hand, or foot — usually following an injury or surgery. The defining feature is that the pain is more severe than the original event would predict, and it persists and often evolves beyond the expected healing period.

CRPS involves changes across multiple levels of the nervous system. Peripheral sensitisation, autonomic dysregulation, and central sensitisation all contribute — producing a presentation that includes not only pain but skin changes, swelling, temperature asymmetry, and movement difficulties. The condition is classified using the Budapest Criteria, which requires characteristic signs across at least three of four clinical categories.

Early diagnosis and multidisciplinary intervention produce the best outcomes. CRPS that has been present for years is more complex to manage, but meaningful improvement remains possible with coordinated, appropriately targeted care.

Characteristic features

Severe, disproportionate pain — burning, stinging, or throbbing, sometimes spreading beyond the original injury site

Skin changes — colour, temperature, or texture differences in the affected area

Allodynia and hyperalgesia — pain from light touch or mild stimuli; exaggerated response to painful stimuli

Swelling and movement difficulties — weakness, tremor, reduced coordination or range of motion

Autonomic changes — abnormal sweating, changes in hair or nail growth

Mechanisms and diagnosis

What causes CRPS and how is it diagnosed?

Causes

CRPS most commonly follows injury or surgery to a limb, even where the initial trauma appears minor. Several mechanisms contribute:

Nerve dysfunction and neuroinflammation

Post-trauma changes in peripheral and central nervous system function — including altered neurotransmitter activity and neuroinflammation — perpetuate pain signals beyond normal healing.

Autonomic dysregulation

Abnormal sympathetic nervous system activity contributes to vasomotor and sudomotor disturbances — the skin colour, temperature, and sweating changes characteristic of CRPS.

Central sensitisation

Ongoing pain input alters brain networks involved in pain processing — leading to persistent pain, allodynia, and hyperalgesia that outlast any peripheral tissue damage.

Diagnosis — the Budapest Criteria

There is no single definitive test. Diagnosis is made clinically by an experienced clinician using the Budapest Criteria, requiring:

1. Persistent, disproportionate pain in the affected limb, greater than expected from the inciting event

2. Signs and symptoms in at least three of four categories: sensory (allodynia/hyperalgesia), vasomotor (skin colour/temperature changes), sudomotor/oedema, motor/trophic

3. No other diagnosis better accounts for the signs and symptoms

A referral from your GP or specialist (neurologist, pain physician, rheumatologist) documenting your diagnosis or clinical suspicion of CRPS is required for assessment at Brain Aid Clinics.

Our approach

How Brain Aid Clinics supports CRPS

A multidisciplinary, individualised approach produces the best outcomes for CRPS. Brain Aid Clinics contributes neuromodulation and the TMF Programme within that framework — coordinating with your existing treating team rather than working in isolation.

01 rTMS — targeting central sensitisation

Motor cortex and prefrontal rTMS can modulate the central pain-processing circuits that sustain CRPS symptoms. MRI-guided neuronavigation at Brain Aid Clinics ensures stimulation reaches the intended cortical target — verified against your individual brain anatomy each session. Offered off-label under psychiatrist oversight with full informed consent.

02 The TMF Programme

Thought, Movement, and Food. Cognitive strategies (CBT, ACT, graded motor imagery) address fear-avoidance and catastrophising. Structured physical activity — carefully graded for CRPS — supports desensitisation and neuroplasticity. Nutritional guidance targets neuroinflammation. Integrated into every course of treatment.

03 Collaboration with your treating team

We work alongside GPs, neurologists, pain physicians, physiotherapists, occupational therapists, and psychologists. Reports are provided to your referring clinician at agreed intervals. CRPS is rarely resolved by a single intervention — effective management requires coordinated care across disciplines.

04 Telehealth for initial assessment

Initial assessments are available via telehealth for patients anywhere in Australia. For those with severe CRPS who find travel difficult, this removes a practical barrier to accessing a specialist clinical conversation. rTMS treatment sessions require in-person attendance at our Gold Coast or Melbourne clinic.

Common Questions

What patients ask us

Is CRPS treatable or curable?

CRPS can be complex to manage, particularly where it has been present for some time. Early intervention — ideally within the first few months — combined with multidisciplinary support produces the best outcomes, with some patients achieving substantial improvement or remission. In more chronic presentations, complete resolution is not always achievable, but a personalised combination of therapies can meaningfully reduce pain intensity and restore daily function for many people. Outcomes vary between individuals; we work closely with each patient to support the best possible quality of life for their specific presentation.

Do I need a referral to access CRPS services at Brain Aid Clinics?

Yes. A referral from your GP or specialist (neurologist, pain physician, or rheumatologist) is required, documenting your diagnosis or clinical suspicion of CRPS — ideally referencing the Budapest Criteria. Recent clinical notes and relevant investigations (imaging, nerve conduction studies) help our team develop an appropriately tailored plan.

Is rTMS for CRPS covered by Medicare or private health insurance?

Medicare rebates for rTMS are currently limited to treatment-resistant depression (MBS 14216, 14217). rTMS for CRPS is not Medicare-funded as a standalone indication — treatment sessions are self-funded. Standard consultations are generally claimable. Private health insurance may cover some allied health services and consultations under extras cover; investigational rTMS is typically not covered, though some funds may have provisions for exceptional circumstances. WorkCover, TAC, and CTP funding pathways may be available in some cases — our team can assist with documentation.

Do you work with other healthcare providers?

Yes — collaborative care is central to our approach for CRPS. We work regularly with GPs and specialists (neurologists, pain physicians, orthopaedic surgeons, rheumatologists) for ongoing medication management and procedures such as nerve blocks; physiotherapists and occupational therapists for movement, desensitisation, and rehabilitation; psychologists and psychiatrists for psychological therapy and mental health support; and dietitians and exercise physiologists as part of the TMF Programme.

Do you offer telehealth for CRPS assessment?

Yes. Initial assessments and follow-up appointments are available via telehealth for patients anywhere in Australia. We aim to offer initial telehealth assessments within 2–4 weeks of receiving complete referral information. For more urgent situations — significant flares or rapid changes in function — please ask your referring clinician to note urgency so we can prioritise where possible. rTMS treatment sessions require in-person attendance at our Gold Coast (Southport) or Melbourne (Epping) clinic.

How do I book an assessment for CRPS?

Obtain a referral letter from your GP or specialist, then contact us at info@brainaidclinics.com or call 0466 352 811. Our team will arrange an initial telehealth consultation (or in-person if you are near the Gold Coast or Melbourne) to review your history and plan next steps. Following this, we will schedule an in-person assessment where appropriate.

Clinical and regulatory note: rTMS for CRPS is an off-label application in Australia, offered under psychiatrist oversight with full informed consent. Medicare rebates (MBS 14216, MBS 14217) apply for treatment-resistant depression only and do not cover rTMS for CRPS. All information is for general informational purposes and does not constitute medical advice. Please consult a qualified health professional. For referring clinicians seeking scientific literature on rTMS for CRPS, contact info@brainaidclinics.com. Brain Aid Clinics operates within AHPRA-compliant boundaries. ABN 76 664 676 420.

0466 352 811

Conditions We Treat