My limbs used to be cold all the time but now that only happens during flare ups where the area flaring gets ice cold...though according to dr measurements there is always a slight difference where the rsd limbs are colder. Since my pain was so much lower I didn't notice the cold at all except on the one day I flared. I'm surprised the rep didn't come out to change your settings or have you come in. Mine called every day to check in and I went in 3 days after the trial started for a check in but since I was getting good relief they didn't need to make any adjustments. I have heard some stories where people just had ok relief but after getting it adjusted it was amazing. But like everything else I suppose with CRPS no treatment is going to work the dame for everyone. I hope you get some answers from the rep and dr.