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CRPS and Bicycle Accident Lawsuits

CRPS, or complex regional pain syndrome, is a relatively rare but serious syndrome that can result from injuries caused in a bicycle crash, such as broken arms or legs. Because this syndrome is often not properly diagnosed, it is especially important to educate yourself about it if you think you may have it.

What is CRPS?

The consensus definition of CRPS is:

“CRPS describes an array of painful conditions that are characterized by a continuing (spontaneous and/or evoked) regional pain that is seemingly disproportionate in time or degree to the usual course of any known trauma or other lesion. The pain is regional (not in a specific nerve territory or dermatome) and usually has a distal predominance of abnormal sensory, motor, sudomotor, vasomotor, and/or trophic findings. The syndrome shows variable progression over time.”

In a nutshell, CRPS is pain in a limb that is ongoing and without a clear cause, along with at least one symptom in 3 out of the 4 following categories: sensory (such as extreme sensitivity to touch); vasomotor (such as skin color changes, or temperature changes); sudomotor (changes to sweat); and motor/trophic (such as change in range of motion or strength). The pain is often described as being a burning sensation, and it is felt constantly.

Usually, although not always, CRPS is triggered by an injury or surgery. But instead of healing normally, the pain – as well as other symptoms such as those listed above – persist. The pain can be very intense – so much so that patients have been known to ask if the affected limb can be amputated so they can be free from the pain.

CRPS is much more common in women than in men, and is especially common in middle-aged women.

There are many great resources online to learn more about complex regional pain syndrome generally, like this article in the American Academy of Neurology’s magazine.

Why is CRPS under-diagnosed?

Although CRPS is becoming increasingly recognized in the medical community, there is still a lot that we don’t know about CRPS – and still a lot of doctors who are inexperienced with the syndrome.

There isn’t an easy or sure way to diagnose CRPS. Instead, diagnosis generally involves ruling out other causes for the pain and other symptoms, such as infection or arthritis. In some cases, indication of CRPS can be seen in triple phase bone scans or even simple x-rays. But CRPS can not be reliably ruled out with these diagnostics because many people with CRPS will have unremarkable bone scans or x-rays.

Treating CRPS

Unfortunately, there isn’t a simple way to treat CRPS. For some people, the symptoms will resolve on their own – while for others, CRPS leads to long-term, debilitating chronic pain. Treatment usually involves a multidisciplinary approach to decrease the severity of pain and other symptoms. A combination of patient education, physical therapy, psychotherapy, and pain medication is often used.

Research continues to be done on new treatment methods for CRPS. For instance, at the University of California San Francisco, there is an ongoing clinical trial assessing dorsal root ganglion (DRG) stimulation for managing CRPS pain. Some new methods show promise for long term pain management.

CRPS and Your Personal Injury Case

A good bicycle accident lawyer will be on the lookout for CRPS symptoms following a bike crash. Unexplained pain beyond the time expected for normal healing should always be investigated before settling a case. That way, you know exactly why the pain is happening, and how to treat it.

Because CRPS can be chronic and require ongoing treatment, it can be very expensive. It may also interfere with one’s ability to work or accomplish chores around the house – resulting in additional economic costs to those suffering with CRPS. Therefore, knowing whether you have CRPS before a case settles will help you make sure you are compensated appropriately for all the economic and noneconomic ways your life has been affected.

Because many of the symptoms of CRPS are invisible, and because there isn’t a simple, straightforward way to diagnose it, expect a big fight from the insurance company. Remember – insurance companies exist like any other business to make money, not to provide fair compensation to people who have been injured.

In a lawsuit involving a plaintiff with CRPS, the insurance company will almost always hire a defense doctor to dispute the plaintiff’s diagnosis. Common tactics used by these defense doctors include: claiming that CRPS doesn’t exist; claiming that the plaintiff does not have CRPS and is exaggerating their symptoms or causing the symptoms (such as atrophy) by voluntarily not using the affected limb; and claiming that even if the plaintiff has CRPS, it was not caused by the accident at issue in the lawsuit.

Contact an Experienced Bicycle Lawyer

A bike crash can be scary, and the aftermath – between getting the care you need and keeping up with your bills – can be very overwhelming. A good bike injury attorney will help you navigate the process and bring you peace of mind. Having an experienced personal injury attorney on your side will also help you make sure you get to the bottom of any ongoing health concerns before the case settles – to give you the best shot at getting back to the way life was before your crash.

At Bay Area Bicycle Law, we advocate for cyclists in the San Francisco Bay Area — from San Jose to Marin and beyond — every day. If you’re looking for a San Francisco bike lawyer, give our law firm a call for a free consultation.