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CRPS and Chronic Nerve Pain After an Accident: What I Learned Watching Insurers Attack These Claims

CRPS and Chronic Nerve Pain After an Accident: What I Learned Watching Insurers Attack These Claims

by | Aug 18, 2026 | Car Accident Attorney, Car Accident Lawyer, Lancaster Injury Lawyer, Los Angeles Accident, Personal Injury Attorney, Personal Injury Lawyer, Santa Clarita Attorney, Santa Clarita Lawyer, SCV Attorney, SCV Lawyer |

Authored by Mason Rashtian | Personal Injury Lawyer, The Mason Law Firm

Dedicated Personal Injury Lawyer in Santa Clarita, Valencia, Canyon Country, Newhall, Stevenson Ranch, Castaic, Val Verde, Palmdale, Lancaster, the San Fernando Valley, and the Greater Los Angeles Area

There’s a specific moment I used to see on the defense side, and I still see it now from the other side of the table.

A client comes in with what looked, on paper, like a minor injury. Perhaps, a sprained wrist, or a twisted ankle from a fall in Valencia Town Center or the Vons in Stevenson Ranch.  Nothing that should, on paper, still hurt six weeks later.

Except it does. In fact, it hurts more. Now, the skin has changed color, the client can’t tolerate a bedsheet touching the injured area, and here is how the insurance company’s file note will read, “no objective findings, pain complaints out of proportion to injury.”

This combination of real, worsening pain and a total absence of a single test that proves it is the exact setup for what we call Complex Regional Pain Syndrome, or CRPS. It’s one of the most painful conditions in medicine, and it is also one of the conditions insurance adjusters are trained to fight hardest, precisely because there’s no X-ray that shows it.

I want to walk through what CRPS actually is, why it shows up after accidents that seemed minor at first, and why the insurance company’s playbook here is different from almost any other injury claim.

Call The Mason Law Firm today at 661-506-2992 for a FREE consultation. We serve clients throughout Santa Clarita, Valencia, Newhall, Saugus, Canyon Country, Stevenson Ranch, Castaic, Val Verde and all of Los Angeles County

What Is CRPS?

CRPS develops when the nervous system doesn’t properly shut off its pain response after an injury heals. Instead of the burning, throbbing signal fading as tissue repairs itself, the nerves stay locked in an overactive state.

The result is pain that is genuinely out of proportion to whatever caused it.  So, a fractured wrist from a fall on an uneven sidewalk in Canyon Country, or a relatively routine rear-end collision on the I-5 freeway near McBean Parkway can, in a small percentage of cases, trigger it.

CRPS is categorized in two types.

CRPS Type 1 

CRPS Type 1 is what used to be called Reflex Sympathetic Dystrophy, or RSD.  This condition develops without a confirmed injury to a specific major nerve, and can occur after a fracture or forceful trauma to an arm or leg.

Type 1 comprises  the large majority of cases I’ve seen.

CRPS Type 2

CRPS Type 2 follows a documented injury to a specific nerve, like the sciatic or median nerve.

Both types can be devastating. Both can also look, to an untrained eye or a cost-conscious adjuster, like a client who is exaggerating.

Why This Diagnosis Terrifies Insurance Companies, and Why That Cuts Both Ways

When I worked defense, chronic pain claims without a clean diagnostic test were treated differently than a broken bone or a torn ligament.

A fracture shows up on an X-ray. In contrast, a CRPS diagnosis is built on a clinical picture, i.e. symptoms across multiple categories, evaluated against something called the Budapest Criteria, developed by pain specialists specifically because there is no single blood test or scan that confirms it on its own.

I want to be direct about what that means for your claim. It cuts both ways.

On one hand, the absence of a single definitive test is exactly what an adjuster will lean on to argue the pain is psychological, pre-existing, or exaggerated. I watched that argument get made regularly. It is a strategy, not a medical opinion, and it works often enough that carriers keep using it.

On the other hand, the Budapest Criteria exist precisely because the medical community recognized this gap and built a structured, defensible way to diagnose the condition anyway. 

Research conducted by the National Library of Medical shows that the following criteria need to be present:

1.   Continued pain that is disproportion to any inciting event

2.   Must report at least one of the following:

  • Sensory symptoms,
  • Visible skin color changes, and temperature changes,
  • Swelling and sweating abnormalities, and
  • Motor and trophic changes, such as decreased range of motion, weakness, tremor, and/or trophic changes in hair, nail or skin

3.   Must display at least one sign at time of evaluation in two or more of the following:

  • Sensory: evidence of hyperalgesia, i.e. an increased or exaggerated sensitivity to pain
  • Vasomotor: evidence of temperature and/or skin color changes
  • Sudomotor/oedema: evidence of swelling and/or sweating changes
  • Motor/trophic:  evidence of decreased range of motion, weakness, tremor and/or trophic changes hair, nail, skin

4.   There is no other diagnosis that can better explains the signs and symptoms.

When a treating physician documents findings across these categories properly, and it’s paired with objective supporting tests, the “there’s no proof” argument gets a lot harder for a defense attorney to make in front of a jury.

That’s the whole ballgame with a CRPS claim: whether the medical record was built well enough, early enough, to survive the attack that is coming.

What Are The Warning Signs Worth Knowing?

CRPS symptoms typically show up within days to a few weeks of the original injury, and they tend to hit several systems at once rather than staying isolated to “it still hurts”:

  • Burning pain that feels disproportionate to the original injury
  • Pain triggered by things that shouldn’t hurt at all, such as a sleeve brushing the skin, or a light breeze
  • Visible changes in skin color or temperature in the affected limb
  • Swelling paired with unusual sweating patterns
  • Changes in nail or hair growth in the area
  • Stiffness, weakness, or tremors

If you’re dealing with an injury from an accident anywhere in Santa Clarita, Valencia, Newhall, Saugus, Stevenson Ranch,  Castaic, or Val Verde, and the pain is getting worse instead of better weeks after the incident, that’s not something to dismiss.

That trajectory is the opposite of how normal soft-tissue recovery looks, and it’s worth a conversation with a specialist quickly.

Why Timing Matters More With CRPS Than With Almost Any Other Injury?

There’s a treatment window, generally considered the first three to six months after the triggering injury, where the odds of meaningful remission are highest. Getting to a pain management specialist inside that window matters for the client’s actual health, not just the case.

It also matters for the case itself. CRPS diagnoses take time to firm up, which means the evidence that supports them, compromising of a clean, consistent treatment timeline, early objective testing, and a doctor who documented findings across the right categories from the start, has to be built while it’s still available.

A gap in treatment, or a slow start to specialized care, becomes exactly the kind of ammunition an adjuster uses to argue the condition isn’t real or isn’t related to the accident.

I’ve also seen the deadline conversation get overlooked in these cases specifically because the diagnosis takes a while to solidify. California generally gives you two years from the date of injury to file a standard personal injury claim.

If a government entity is involved, resulting in injury from a poorly maintained public roadway, a Metrolink or transit-related incident, a city or county bus or vehicle, that window shrinks to six months. A slow-developing CRPS diagnosis does not extend that clock. If anything, it makes early legal evaluation more important, not less.

How CRPS Is Treated

Treatment for CRPS typically works on two fronts at once.

Interventional treatments aim to interrupt the pain signal itself.  These include sympathetic nerve blocks, spinal cord stimulation using surgically implanted electrodes, or in some cases ketamine infusion therapy to help reset an overactive nervous system.

Rehabilitative treatments work in parallel, retraining the nervous system’s response through approaches like desensitization therapy and graded motor imagery, which use gradual sensory exposure to reduce hypersensitivity over time.

What matters most from a claims standpoint is that treatment usually isn’t a single fix,  it’s an ongoing, multi-specialist effort involving pain management physicians, neurologists, and physical therapists, often over months or years. That’s part of why a CRPS claim has to account for future care, not just the bills that have already come in.

A client who stops treatment early, or bounces between providers without a consistent plan, hands the insurance company an easy argument that the condition wasn’t as serious as claimed, even when it was.

What Does a CRPS Claim Account For?

Because CRPS is frequently progressive and can become permanent, a properly built claim looks very different from a standard soft-tissue case. It generally needs to account for:

1.   Ongoing and future medical treatment, including nerve blocks, potential spinal cord stimulator hardware, specialized medication management

2.   Lost earning capacity, when the condition prevents someone from continuing in their prior line of work

3.   Pain and suffering that reflects the reality of a chronic, often lifelong condition, not a temporary injury

4.   A life care plan projecting future medical and therapeutic needs

This is not a case to settle early, and it’s not a case an adjuster is going to value fairly without a fight. I’ve sat on both sides of that fight, and I know which arguments get made and in what order.

What Should You Do If You Think You’re Dealing With CRPS?

Remember that documentation and consistency is the key.

1.   See a specialist fast

Don’t downplay what you’re feeling.  If you continue to experience pain, swelling, skin discoloration and persistent temperature changes, ask your doctor to refer you to a pain management specialist who has experience with CRPS.

2.   Document your symptoms by keeping a daily journal

Keep a record of your symptoms as they develop, including pain levels, visible changes, what you can no longer do.

3.   Document your symptoms visually

In addition to keeping a daily journal, document your symptoms visually by taking photographs of skin discoloration and swelling.  Make sure you document the date each photo is taken.

4.   Stick with your treatment plan

This is crucial.  Follow your health care provider’s advice and recommendation.  Keep your appointments, attend your treatments, and be consistent.  Do not stop or skip treatment for any extended period of time because gaps in care are exactly what gets flagged by adjusters.

5.   Consult with an attorney

Finally, talk to an attorney before you’re deep into a claim, not after an adjuster has already built a file arguing your pain isn’t real.  However, make sure you speak with the right attorney, one who is familiar with the Budapest Criteria, the relevant expert witnesses, and how California courts and insurers actually evaluate these cases. 

Avoid any attorney who handles multiple types of legal matters, such as an attorney who handle criminal defense, personal injury, business litigation and estate planning. Remember “a jack of all trades is a master of none”! 

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If you or someone you know is dealing with pain that isn’t following the normal healing timeline after an accident in the Santa Clarita, Valencia, Saugus, Newhall, Stevenson Ranch, Canyon Country, Castaic, Val Verde, Palmdale, Lancaster, or anywhere in Los Angeles County, Ventura County and Kern County, I’m happy to talk through what you’re seeing and what your options look like.

📞 Call 661-506-2992 for a free consultation.

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The information in this blog post is for general informational purposes only and does not constitute legal advice. Reading this post does not create an attorney-client relationship. If you have been injured, please contact an attorney to discuss the specific facts of your situation.

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