Complex Regional Pain Syndrome: What is it & what treatment is available?

Complex Regional Pain Syndrome (CRPS) as the name suggests is a complex condition involving multiple categories of diagnosis resulting in a hypersensitivity to movement and touch with severe pain that does not correlate to any other acute injury. CRPS can develop up to a year following the original inciting event and includes the following signs and symptoms:  edematous (full of fluid), severe allodynia (pain induced with a non-painful stimulus), sweating asymmetry, temperature asymmetry, changes in colour, trophic changes (skin, hair and nail), decreased range of motion or motor dysfunction (weakness, tremor, and dystonia), and there is no other possible diagnosis. CRPS normally effects the upper and lower limbs in particular hands and feet, having a profound impact on activities of daily living.

CRPS is traditionally treated using a multifaceted approach including pharmacological intervention, Physiotherapy, Occupational Therapy and Motor Imagery. Research into such interventions suggests that some treatments have a negative impact on the condition heightening pain responses including: electromyography (ultrasound and pulsed electromagnetic therapy), and massage, although suggested to increase edematous drainage, is not an effective treatment (Smart et al., 2016). Suggested effective treatments include: Graded Motor Imagery or Mirror Therapy, which can provide pain relief and increase mobility through amending maladaptive somatosensory issues and motor cortex reorganisation (Moseley 2005).

What does all of this mean in the treatment of CPRS? Hands on therapy is contraindicated, whilst specific targeted exercise therapy can reduce symptoms and improve activities of daily living. Exercise therapy includes the use of mirrors to copy the unaffected limb whilst visually blocking the effected limb. The mirror is used to retrain the brain as to how the effected limb should move by encouraging it to copy the unaffected limb (Cacchio et al., 2009). This technique has been shown to be highly effective in increasing range of movement. Through consistent movement and graded increases in movement complexity towards load bearing activity, CPRS clients can see improvements in function and reduced reliance on pharmacological interventions.

If you, or someone you know are suffering from a condition such as this, contact us and book in a consultation with an Absolute Balance Exercise Physiologist. You can contact us at info@absolutebalance.com.au or visit our website www.absolutebalance.com.au for more information.

ingrid

Ingrid Hand (BSc – ExHealthSc, GraddipSc – ExRehab, MSc – HumMvt)
Exercise Rehabilitation Manager – Accredited Exercise Physiologist (AEP) (ESSAM)

P 9244 5580 – M  0455 458 885  – F 9244 5582

 

 

References:

Cacchio, A., De Blass, E., De Blasis, V., Santilli, V., & Spacca, G. (2009). Mirror therapy in complex regional pain syndrome type I of the upper limb in stroke patients. Neurorehabilitation and Neural Repair, XX(X), 1-8.

Moseley, LG. (2005). Distorted body image in complex regional pain syndrome. Neurology, 65(1), 773-778.

Smart, KM., Wand, BM., & O’Connell,  NE. (2016). Physiotherapy for pain and disability in adults with complex regional pain syndrome (CRPS) types I and II. Cochrane Database of Systematic Reviews, 2(CD010853), 1-103.