Complex Regional Pain Syndrome
Complex Regional Pain Syndrome (CRPS), formerly known as Reflex Sympathetic Dystrophy (RSD), is a chronic pain condition that typically affects an arm or a leg. It can develop after an injury, surgery, stroke, or heart attack, although the exact cause is not fully understood. CRPS involves persistent, disproportionate pain, swelling, changes in skin colour and temperature, and sometimes changes in hair and nail growth.
Physiotherapy is an integral part of the comprehensive management of CRPS. The goals of physiotherapy in CRPS are to reduce pain, improve function, and enhance overall quality of life. Here are some common approaches used in physiotherapy for CRPS:
Pain Management Techniques:
Gentle Exercises: Gradual and controlled movements of the affected limb can help prevent stiffness and maintain joint flexibility.
Desensitisation Techniques: Physiotherapists may use tactile desensitisation techniques to help the affected limb become more tolerant to touch and various sensations.
Strengthening and Range of Motion Exercises:
Isometric Exercises: These involve contracting muscles without moving the joint. Isometric exercises can help prevent muscle atrophy and maintain strength without exacerbating pain.
Passive and Active Range of Motion Exercises: Controlled and progressive movement exercises are designed to improve joint mobility without causing additional stress.
Mirror Therapy:
Mirror therapy involves using a mirror to create the illusion that the affected limb is moving without pain. This technique may help retrain the brain's perception of the affected limb and reduce pain.
Graded Motor Imagery (GMI):
GMI is a therapeutic approach that involves mental visualisation and imagery of movements to improve motor control and reduce pain perception.
Aquatic Therapy:
Water-based exercises in a warm pool can provide a low-impact environment, reducing the stress on the affected limb. The buoyancy of water can also make movements more comfortable.
Cognitive-Behavioral Therapy (CBT):
CBT techniques may be integrated into physiotherapy to help individuals manage the psychological aspects of pain, such as fear of movement or pain catastrophising.
Modalities for Pain Relief:
Heat and Cold Therapy: These modalities can be used to manage pain and improve comfort.
Transcutaneous Electrical Nerve Stimulation (TENS): TENS units deliver mild electrical impulses to the affected area, potentially providing pain relief.
Functional Rehabilitation:
Gradual reintroduction of functional activities is an essential component of CRPS physiotherapy. This may involve activities of daily living and work-related tasks.