Treating CRPS and FNSD in an Adolescent: A Case Study

Complex Regional Pain Syndrome (CRPS) is a significantly impairing pain condition that can co-occur with other disorders, including Functional Neurological Symptom Disorder (FNSD). Interdisciplinary interventions augmented with peripheral nerve catheters (PNCs) are gaining attention as effective treatments for CRPS, but their utility in treating comorbid conditions like FNSD remains unclear. This case study presents a 15-year-old female who completed a PNC-augmented interdisciplinary pain program followed by outpatient psychotherapy, providing the first description of this approach for a patient with comorbid CRPS and FNSD and examining its short- and long-term impact. The PNC-augmented CRPS program resulted in resolution of CRPS symptoms and initial improvement in FNSD symptoms. However, functional symptoms returned post-discharge with a different presentation. A subsequent course of psychotherapy was associated with reduced FNSD episode frequency and improved overall functioning. Brief interdisciplinary treatment augmented by PNCs may be beneficial for CRPS; however, it does not appear effective for the long-term treatment of FNSD, which may require psychotherapy and intervention. For patients with comorbid CRPS and FNSD, longer-term interdisciplinary or psychological treatment appears essential to support sustained recovery and functional restoration.