Symptom reduction and improved function in chronic CRPS type 1 after 12-week integrated, interdisciplinary therapy
Minna Elomaa1, Jaakko Hotta2,3, Amanda C de C Williams4
1Pain Clinic, Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Scandinavian Journal of Pain
|February 22, 2019
Summary
This study found that a 12-week intensive rehabilitation program for Complex Regional Pain Syndrome (CRPS) reduced some symptoms and improved function. However, it did not significantly alter rest pain, distress, or quality of life in chronic CRPS patients.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Pain Management
Background:
- Chronic Complex Regional Pain Syndrome (CRPS) presents limited treatment options when spontaneous recovery fails.
- Existing therapies like medication, physiotherapy, and psychological interventions show restricted effectiveness in chronic cases.
Purpose of the Study:
- To evaluate the impact of a 12-week intensive outpatient rehabilitation program on pain and function in chronic upper limb CRPS patients.
- To assess changes in CRPS symptom count, motor performance, psychological factors, pain intensity, and quality of life.
Main Methods:
- A 12-week multimodal intervention combining pharmacological (morphine, memantine), psychological (CBT, ACT), and physiotherapy (graded motor imagery) approaches.
- Assessment of 10 chronic upper limb CRPS I patients using standardized questionnaires, clinical evaluation of hand function, and a hand action observation video experiment.
Main Results:
- Significant reduction in CRPS symptom count, particularly motor/trophic (19%) and sensory (18%) symptoms.
- Improvements observed in movement pain, motor symptoms, and altered perceptions during hand action observation.
- No patient dropouts, indicating good tolerability of the intensive program.
Conclusions:
- The intensive 12-week multimodal intervention effectively reduced certain CRPS symptoms and improved function.
- The program was insufficient to improve rest pain, distress, or quality of life, possibly due to program duration or patient-specific factors.
- Results support the efficacy of interdisciplinary rehabilitation for chronic CRPS pain and function, though further research on distress and quality of life is warranted.
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