With his uncontrolled pain a diagnosis of chronic regional pain syndrome (CRPS) would be the possibility. Following should be integrated in the management;
1) Physical therapy and occupational therapy, plays an important role in functional restoration.
2) Recreational therapy; take part in pleasurable activities that help to decrease pain.
3) Vocational therapy; provide work capacities and targeted work hardening, and one may return to gainful employment.
4) Sympathetic blocks
5) Bier block (intravenous regional block)
6) Continuous epidural infusion
7) Spinal cord stimulator
8) Baclofen pump; Intrathecal infusion (Intrathecal bupivacaine infusion or Morphine pump are the other alternatives)
9) Sympathectomy; Surgical sympathectomy or Chemical sympathectomy or Radio frequency or cryoprobe lesioning should be considered.
11) Relaxation techniques; associated with the above treatment.
12) Biofeedback training
He needs to consult following specialists;
a) Pain management physician
b) MD in physical medicine and rehabilitation
These are likely to prevent amputation.
Please feel free for your follow up questions.
I would be happy to assist you further, if you need any more information.
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