Luke Parkitny talks CRPS at BiM

Luke is a PhD student at Neuroscience Research Australia researching some of the factors that play a role in the development of complex regional pain syndrome (CRPS). Luke joins the Body in Mind team with a background of clinical practice and research in Western Australia. He has rapidly cultivated an interest in all things pain and has very successfully exploited every opportunity to share this knowledge with other health professionals and lay-persons. Link to Luke’s published research here.

Here is Luke talking more about what he does at BiM.


  1. Luke Parkitny says:

    Dear all:

    Firstly, thank you for the encouraging comments.

    People formed hypotheses around the involvement of inflammation in CRPS for as long as we have recognised a CRPS-like disorder (I am mainly referring to the early suggestions of Paul Sudeck that it plays a role in the condition). Until now, research has focused on identifying inflammatory markers in people with CRPS and on appropriate, albeit speculative, treatment strategies.

    For us, the real interest lies at describing the early formative stages of CRPS. This is a period of time that is simply not understood (in fact we really don’t know enough about how any persistent pain develops). So, why is it that most people recover but some do not? Is there something different about how their bodies (I use the term as one that encompasses everything that we normally consider to be part of ‘us’) respond to a traumatic event (regardless of the severity of that event)?

    But, to return to the topic at hand, clearly inflammation is crucial to our survival. Without it, we would not heal, we could not fight bacterial invasions, etc. We also know that its activity causes pain, causes us to feel tired, unmotivated, etc (the sickness response). So, perhaps an inflammatory response that is greater than that required leads to an excessive response and longer suffering.

    So, for now, step 1 is to find out if there is something different in the recovery of some people.

    Is there something different about those people and the way they respond to trauma? Is there something about the trauma and its context?

    If there is, can we change it? After all, the inflammatory mechanisms should not be shut down completely. Can we reliably prevent the ‘ideal CRPS environment’ from forming if, indeed, there is such a thing? At this stage we do not know enough about how CRPS develops to definitively make any recommendations.

    The IVIG (and similar) approach is also difficult – we do not really know exactly how large a role inflammation actually plays in developed CRPS. Other pain conditions also exhibit increased inflammatory markers – perhaps its more of a generic response to a certain “state of being”. The brain and the inflammatory factors interact in many complex ways and we know that inflammation, mood, exercise, pain, etc etc all influence each other immensely! Perhaps when an approach like IVIG works, it may reflect that inflammatory factors/the immune system DO play a great role in that person. Perhaps in others, however, they may not play as great a role in maintaining CRPS.

    All very interesting and stimulating questions. We’ll keep at it…

    Laura Reply:

    Hi again Luke – thanks so much for the reply here. You mention your interest in why most CRPS patients recover and some don’t – out of interest, have you any statistics on that? As patients, most of us are told at some time that ‘most people recover’ that ‘it will burn out’ and phrases to that effect, but as someone using internet forums to connect with other patients, we see very few stories of improvement.

    You also mentioned that your primary interest is in the formative stages of CRPS and in the inflammatory factors involved (am I reading you correctly here?). This is purely observation, but it always seems to me that we as patients have a much more difficult time with pain management – never mind remission, once any major inflammatory signs/symptoms start to subside and that real central sensitisation (if that’s truly what it is) process begins to take over. I apologise for starting to draw you off track here, but I’d be interested to hear your thoughts.

  2. This is fascinating research so far, and something I will certainly be following. I have had CRPS for almost 13 years – now with ‘full body’ involvement subsequent to a knee injury aged 14. Mine has proven refractory to all standard treatments – perhaps owing in part to a six year delay in diagnosis – and I was keen to try IVIG based on the research of Andreas Goebel in the UK. Unfortunately we were knocked back here in Australia as there is no established clinical basis for its use.

    Any research giving us a clue as to the origins of this would be more than welcome – keep it up guys!

  3. Fascinating research!
    I have had CRPS in my left leg for nearly 5 years now, with no known cause for the sudden on-set; although I had a previous wrist fracture 4 years prior to developing this condition. My wrist never healed to 100% (but was never looked into…). I am really interested in knowing the results for this study. Wondering whether there is a correlation between the inflammatory process after a fracture and the timing of the on-set of CRPS.

  4. Once you’ve established whether there is a difference will you consider going on to ask why? In my case we just moved to a new house a few days earlier and three days before I fell into a stairwell, down 13 stairs and sustained a tripple compound colles wrist fracture I begain a new job (three stressors there). At the time of the accident I was heading to the kitchen, in the dark in a house to get asprin for a migraine (thought to be another risk factor). There needs to be a catalyst that triggers CRPS to develop at one time and not another. My accident was in 1998, two ears before Paul Zollinger’s research. What concerns me now is that his simple suggestion for possible prevention isn’t widely known or used.

  5. I would love to read your results. We have just started IVIG therapy here, first go resulted in an allergic reaction. Next two were okay (different product) but it is too soon to say if there will be any pain reduction. If there is, as good as that will be, it will mean being tied to one place, no extensive travel etc allowed, having to go into the local hospital every three and a half weeks for treatment, and then about two days for recovery time. CRPS – what a life. We need a real cure!