When can you say you are well again? How do people with Complex Regional Pain Syndrome define recovery?

Complex Regional Pain Syndrome (CRPS) is diagnosed according to a clear and distinct description of the signs and symptoms of the condition [1]. Clinician observations and patient reports are used and reaching a threshold “score” determines a positive diagnosis. This all seems simple enough, and, for the majority of patients, the signs and symptoms … [Read more...]

Are we overly negative when interpreting the results of clinical brain imaging studies?

Two recent studies suggest that brain changes in chronic pain are not all pathological Chronic pain, and the biological mechanisms contributing to pain, are as multifarious and complex as the people who experience them. Because a better understanding of individual differences offers opportunities to design better targeted treatments, … [Read more...]

What does current Complex Regional Pain Syndrome (CRPS) rehabilitation look like?

As a practicing clinician I recognise that CRPS is notoriously difficult to treat. International clinical guidelines recommend rehabilitation therapies as a core treatment for CRPS (1,2,3). They suggest a very broad range of possible treatments with some variation across the guidelines. Despite these recommendations, a recent Cochrane review (4) of … [Read more...]

Attention bias in complex regional pain syndrome: it’s not just about the body

Some of the difficulties that people with Complex Regional Pain Syndrome (CRPS) report in feeling and moving their affected limb appear to be similar to a condition called hemispatial neglect [1,2]. Patients with ‘neglect’ have difficulty attending to one side of the environment following brain injury, and the similarities between the two … [Read more...]

Data comparison made easy! A Core Outcome Measurement set for complex regional PAin syndrome Clinical sTudies (COMPACT)

This work was driven by a mutual desire to advance the understanding of the mechanisms and management of Complex Regional Pain Syndrome (CRPS). For many years, some of us working in the field of CRPS have been frustrated by the challenges of synthesising research evidence. Specifically, the absence of an international, standardised set of … [Read more...]

Oldies but Goodies – What is Complex Regional Pain Syndrome – in plain English

Over this holiday season we are posting the most read articles from the last five years.  Here is the first. What is Complex Regional Pain Syndrome – in plain English What is Complex Regional Pain Syndrome? Well, complex regional pain syndrome (CRPS) is exactly that Complex: Many, many different problems have been identified in people with … [Read more...]

The healthy hand in the CRPS brain –  digging deeper

‘Cortical reorganisation’ is a commonly used term in pain. In CRPS there has long been evidence of cortical changes; specifically that representation of the CRPS-affected hand in the primary somatosensory cortex (S1) is smaller than that of the S1 representation of the other, healthy, hand [1-5]. In 2015 we performed our own functional MRI … [Read more...]

Does mirror box therapy reduce sensitivity to touch?

Mirror box therapy is best known for its use in treating phantom limb pain, Complex Regional Pain Syndrome (CRPS), and paralysis after stroke. It only appears to help a small proportion of patients [1] and understanding the sensory processes that occur during the therapy may help us to discover why this is the case and how it could be adapted to … [Read more...]

Anaesthetizing forearm decreases sensorimotor impairment and cortical excitability in CRPS

When reading this title some people who work in the pain field might think: why anaesthetize the forearm when the hand is in pain? Actually, this “first step approach” was not intended to interrupt pain chronicity but to increase knowledge in basic pain physiology. Sometimes, the overall aim to alleviate pain can put us under pressure and can … [Read more...]

Movement representation techniques: it’s a fuzzy name, but it might just work!

A systematic review and meta-analysis has just come out in The Journal of Pain looking at the efficacy of “movement representation techniques” for people with limb pain. Now, you might ask “what is a movement representation technique”? Well, according to the authors of this review, a movement representation technique can encompass any therapy that … [Read more...]