Complex Regional Pain Syndrome (CRPS) of the foot is one of the most devastating pain conditions a patient can face. What often begins as a simple injury—an ankle sprain, a foot surgery, even a minor fracture—can spiral into relentless, burning pain, extreme sensitivity to touch, swelling, color and temperature changes, and loss of function. Shoes become unbearable. Walking becomes impossible. Sleep disappears.
For many patients, the most heartbreaking part of CRPS is not just the pain—it’s the exhausting cycle of treatments that simply don’t work.
CRPS is notoriously resistant to standard therapies. Decades of research show that while physical therapy, medications, nerve blocks, and ketamine infusions may provide modest or temporary relief, long‑term control is uncommon, especially once the disease becomes chronic.
Some sobering realities backed by the literature:
No medications are FDA‑approved specifically for CRPS, and drug responses are inconsistent.
Steroids and ketamine may help early on, but benefits are often short‑lived.
Sympathetic nerve blocks frequently fail to provide durable benefit in established CRPS.
Traditional spinal cord stimulation (SCS) often struggles to adequately cover the foot, with pain relief weakening over time.
CRPS of the foot is particularly difficult to treat because the pain is highly localized and exquisitely sensitive. Broad neuromodulation approaches often miss the mark.
That is where Dorsal Root Ganglion (DRG) stimulation fundamentally changes the game.
The dorsal root ganglion is a cluster of sensory nerve cell bodies that acts as the “gatekeeper” for pain signals traveling from a specific area—like the foot—to the brain. DRG stimulation allows physicians to target exactly the nerve responsible for the painful area, rather than blanketing the spinal cord with generalized stimulation.
Level 1 evidence
The landmark ACCURATE Trial, the largest randomized controlled study ever conducted in CRPS patients, demonstrated results that reshaped pain medicine:
81.2% of DRG patients achieved ≥50% pain relief at 3 months.
Only 55.7% of traditional spinal cord stimulation patients reached the same outcome.
Results for DRG stimulation remained stable at 12 months, while spinal cord stimulation showed significant loss of effectiveness (therapy habituation).
In real terms, this means DRG stimulation delivers:
Superior pain relief
Better coverage of the foot and ankle
Less unwanted stimulation in non‑painful areas
Improved function and quality of life
No other therapy for chronic foot CRPS comes close to these outcomes in controlled trials.
Despite its effectiveness, DRG stimulation is technically demanding. Lead placement is precise, patient selection is critical, and subtle errors can determine success or failure. Multiple studies emphasize that outcomes are strongly linked to physician expertise and volume.
This brings us to one of the most important decisions a CRPS patient can make: who performs the procedure.
In the Houston medical community, Dr. Ioannis Skaribas, MD, DABA, FASA is widely recognized for his advanced expertise in neuromodulation and complex pain syndromes, particularly CRPS of the lower extremity.
Dr. Skaribas has been at the forefront of DRG stimulation since its early adoption following FDA approval in 2016, focusing specifically on patients who have failed conventional therapies.He is a key opinion leader in the field nationally and internationally recognized for his experties and skills.Dr.Skaribas has 25 years of experience with more than 2 thousand neuromodulation trials or implants performed to date.He is double board certified in Anesthesiology and Pain Medicine, a fellow of the american society of Anesthesiologists, with a fellowship in interventional pain management.
What sets Dr. Skaribas apart:
For patients who have been told “nothing else can be done,” his practice frequently represents the turning point.
DRG stimulation is not a first‑line treatment—but for patients who meet the criteria, it is often life‑changing.
You may be a candidate if:
Clinical trials and long‑term follow‑up show that the earlier appropriate DRG therapy is offered, the better the outcomes.
CRPS of the foot is not “just chronic pain.” It is a neurological disease that requires precision treatment. For too long, patients have been cycled through therapies with low success rates and dwindling hope.
DRG stimulation has changed that reality.
Backed by the strongest clinical evidence in CRPS care and delivered by experienced hands, this therapy offers something that many patients haven’t felt in years: real, lasting relief.
For patients in Houston searching for answers after everything else has failed, Dr. Ioannis Skaribas stands at the forefront of this transformation.
