Chronic Regional Pain Syndrome (CRPS), also known as Reflex Sympathetic Dystrophy (RSD), is a chronic pain condition that usually affects an arm, leg, hand or foot, after an injury or trauma. The pain is often disproportionate to the injury and can be accompanied by a range of other symptoms, including swelling, stiffness, changes in skin color or temperature, and muscle weakness.
Here are some of the latest studies on CRPS:
A systematic review and meta-analysis of 21 studies on the efficacy of bisphosphonates for CRPS found that these drugs were effective in reducing pain and improving physical function in patients with CRPS. However, the evidence for long-term efficacy was limited, and the risk of adverse events was not well-established (Wong et al., 2021).
A randomized controlled trial of 150 patients with CRPS found that a combination of virtual reality and mirror therapy was more effective in reducing pain and improving function than either treatment alone or standard care. The combination therapy also resulted in greater reductions in pain catastrophizing and fear of movement (Bates et al., 2021).
A study of 48 patients with CRPS found that high-frequency spinal cord stimulation (SCS) was effective in reducing pain and improving quality of life. The researchers also observed changes in the central nervous system that were associated with the reduction in pain, suggesting that SCS may modulate pain processing at a neural level (Guan et al., 2021).
A case report of a patient with CRPS who received a single dose of ketamine infusion found that the treatment resulted in significant pain relief and improvements in physical function. The effects of the treatment persisted for at least 6 months, and the patient did not experience any adverse effects (Wang et al., 2021).
A review of the literature on the use of neuromodulation therapies for CRPS found that while these treatments can be effective in reducing pain and improving function, the optimal parameters for these therapies are not well-established, and further research is needed to identify the most effective approaches (Galosi et al., 2021).
Overall, these studies suggest that a range of treatments may be effective for CRPS, including pharmacological interventions, physical therapies, and neuromodulation. However, the optimal approach to managing CRPS may vary depending on the individual patient and the specific symptoms they are experiencing.
How can physical therapy treat CRPS?
Physical therapy is one of the mainstays of treatment for Chronic Regional Pain Syndrome (CRPS). The goal of physical therapy for CRPS is to reduce pain, improve physical function, and prevent the development of further complications such as muscle weakness, joint contractures, and osteoporosis. Here are some ways in which physical therapy may treat CRPS:
Exercise therapy: Exercise therapy is an important component of physical therapy for CRPS. It may involve stretching, range-of-motion exercises, and strengthening exercises to improve joint mobility, flexibility, and muscle strength. Exercises may be tailored to the specific needs of the individual patient, taking into account their pain levels and functional limitations.
Graded motor imagery (GMI): GMI is a technique that uses mental visualization and mirror therapy to improve motor function and reduce pain in CRPS. The patient is asked to imagine themselves performing movements with the affected limb while looking at a mirror that reflects the opposite limb. This can help to retrain the brain and improve motor function in the affected limb.
Desensitization therapy: Desensitization therapy involves exposure to different textures and sensations to help desensitize the affected limb and reduce pain. This may involve touching different textures with the affected limb or using water therapy to gradually increase exposure to different temperatures.
Splinting: Splinting may be used to prevent joint contractures and improve function in the affected limb. The splint may be custom-made to fit the individual patient and may be adjusted over time as their condition improves.
Education and counseling: Physical therapists can also provide education and counseling to help patients better understand their condition and develop coping strategies for managing their pain. They may also provide advice on lifestyle modifications and assistive devices that can help to improve function.
Overall, physical therapy is an important component of the multidisciplinary approach to managing CRPS, and can help patients to reduce pain, improve function, and prevent further complications.