Physiotherapy management of complex regional pain syndrome

Complex Regional Pain Syndrome is a painful debilitating condition characterised by sensory, vasomotor, sudomotor, and trophic changes. Traditionally, physiotherapy treatments have been directed at peripheral symptoms, often with limited efficacy. In light of the growing scientific evidence promoting the major role of the central nervous system in the pathogenesis of Complex Regional Pain Syndrome, there has been a shift towards interventions considered to modulate central processing. A systematic review performed in 2009 aimed to assess the evidence regarding the physiotherapy management of Complex Regional Pain Syndrome. Techniques showing some promise include mirror therapy, Graded Motor Imagery, tactile discrimination training, and exposure therapy. This paper aims to elaborate on the scientific framework for these techniques and explore the current research regarding treatment efficacy. Hopefully, further wide dissemination of these ideas will spark more interest from clinical practitioners and clinicians alike in the quest to more completely understand and manage this complex condition. Pollard C (2013) Physiotherapy management of complex regional pain syndrome New Zealand Journal of Physiotherapy