My name is Richmond Stace and I am a physiotherapist with a background in pain neuroscience. I specialise in the treatment of chronic pain and injury taking a very modern approach to provide treatment, education, practical strategies and programmes of care that embrace the latest understanding of pain. One condition that I see commonly is Complex Regional Pain Syndrome (CRPS), a prime reason as to why this blog now exists. I wanted to create an opportunity for those who have CRPS to be able to access the latest research findings, treatments and thinking in the field of pain that is dedicated to CRPS, and here it is.

Specialist Pain Physio Clinics, London

My clinics, The Specialist Pain Physio Clinics, are based in London in Harley Street, Chelsea and Temple (click here for details) and in New Malden, Surrey (click here). This is where I do my clinical work with patients from in and around London but also further afield. I see a range of persisting complaints and conditions including CRPS, back pain, sciatica, neck pain, fibromyalgia, recurring sports injuries, repetitive strain injury (RSI), tendinopathy, tennis elbow, arthritis, whiplash, chronic widespread pain and other complex pain cases. The model of care is patient focused, meaning that the individual is as important as the condition, and biopsychosocial in the way that the biology, psychology and social impact of the problem are all considered and addressed. The treatment programmes tackle the peripheral and central components of pain using the latest neuroscience based strategies and techniques.

There is a great deal of change in our understanding of pain and this continues to evolve. One of my missions is to maintain an up-to-date view on these changes so that patients are in receipt of the most contemporary approaches to pain and their specific condition.


16 thoughts on “About

  1. It is so beneficial to finally find a site like this for those of us who suffer with CRPS. The one thing that is difficult to research is information regarding having the condition and undergoing further surgery in the affected limb (in my case it’s my left foot). I want to be fully up-to-speed when I see my surgeon in a weeks time, knowing the right questions to ask, what type of nerve block specifically he spoke of last time, the type of post-op care, and so the list goes on. Just very hard finding this information on the internet. Please keep this informative site going, we are the unknown sufferers because we suffer in silence due to there not being a great understanding of this condition.
    Regards, Pippa Smith

  2. Thank you for replying so quickly. Are you able to give me any advice on the types of things I need to ask my surgeon when I see him? I’m very concerned about having more surgery on the same operation site where I have now got CRPS following the last operation I had. Any advice would be very welcome

    Many thanks

  3. The top unit for CRPS in this country is at Bath. When they were asked a similar question last year their reply was that any operation is virtually certain to cause spreads or an outbreak at the incision site.
    They ae wrong in the US they have known since 2000 that the use of Pre-emptive analgesics can prevent spreads.
    You need to research this and show your surgeon the papers

  4. Hi Kevin
    Thank you for your response. I was initially being sent to the Unit in Bath but circumstances would not allow me to give up two weeks to be a residential patient there. The consensus that I am now coming to is that the UK follows a very different procedure for patients who are going under the knife in an area that they already have CRPS in to that of the USA. Does make you wonder who to listen to! I have found a 80 page document that is very easy to read and informative that is written by The Royal College of Physicians that is endorsed by many medical associations and societies. I am printing this off and highlighting the necessary and applicable info in preparation for my consultation with my surgeon.

  5. I have had 3 ops on my crps leg and thanks to a fantastic anesthetist and surgeon providing adequate nerve blocks and pain relief have had no spread at all. I did have some aggravation to the symptoms of CRPS but that was temporary and much easier to cope with than the pain from the arthritis the ops were treating. its a case of weighing up the pros and cons and deciding whether the results are worth the risk. Bizarrely Ive just had the other foot done and am worried that CRPS has set up home there too as a result. that would be fairly typical of me and my broken body. CRPS, fibromyalgia, arthritis and CTS make life a tad difficult at the best of times.

  6. Either your anesthetist knows the procudure the Americans are using or you were extremely lucky. My first spread was caused by the use of a sensitivity pin 4ins outside the affected area, caused the RSD to spread from below the wrist right upto the elbow.

    • Kevin, it certainly sounds as though you have had and are having a hard and difficult time with RSD. It makes life very difficult but I do find some reassurance that I am not alone with this condition. It’s the lack of knowledge from my work colleagues and others around me that I have found very hard, they do not appreciate the pain nor the type and intensity of pain that CRPS causes. Nor do they know what to do, in my case when I have a flare up and also when I have a reaction to my meds, no two days are ever the same are they!

  7. Hi Helen. It sounds like my surgeon is planning on a very similar procedure to the one you underwent involving a nerve block. Apparently there are only 3 anaesthetists in my county that do the required block (in my case into the back of the knee) and it will be dependent upon them as to whether they go ahead and do my operation that way. I see my surgeon next week for the results of the CT scan (checking bone density to make sure crps is in remission prior to operating) so I will have more information about the procedure he intends to undertake then. It has helped me though to read you have had a very similar procedure, thank you for sharing that. Pip

  8. Hi Richmond and other Guys, I am very interested in your comments. I work with many RSD, CRPS patients in a military setting and we see a number of patients coming through our doors on a monthly basis. The one thing I have learnt is that nothing is certain, no single treatment works for everybody and you have to go with what works for you. We work with frontline consultants who use a similar array of analgaesics to our US counterparts, unfortunatly there is no single analgaesic or cocktail which works better, be it beres block, sympathectomy, pre-gabelin or in extreme cases elective surgery. There are some good recgonised guidelines from the Budapest Protocol, however these again only reiterate the difficulty in treating and diagnosing CRPS. Will continue to monitor with great interest

  9. Hi everyone. I’m seeing my surgeon tomorrow so it will be very interesting (and informative) to hear exactly what he has to say re the plan and procedure he plans to follow for my impending operation. All comments on here have been good to read and have gone some way in helping me to prepare for my consultation. I will update once I know what the plan is.

    • Luke, thanks for your comment. The work that you do and others in the pain science field is utterly invaluable. I seek to keep the communication channels open between the researchers & scientists and myself as a clinician focusing upon the more complex and chronic pain cases including complex regional pain syndrome. Richmond

  10. we got lost getting to parliment took an extra hour getting there agony couldn’t even walk to the entrance security got a wheelchair and pushed me round to the cafe while June parked. It was only right before the start that Iain told me he was going to use my name, I asked him not to but he said he couldn’t change his speech now. He was amazing much better than I expected, couldn’t control it and I broke down in tears a couple of times. When the Minister spoke I realised that if he is being given false information by the professionals then it’s not his fault. managed to thank the other 2 MP’s and the minister stopped and spoke to me afterwards and said to send everything to Iain and he will discuss it with him.
    if you want to see it it’s here, starting 02.19.55 going to be in real agony for at least a week but it was worth it.

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