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Complex Regional Pain Syndrome — Rehabilitation

Multidisciplinary rehabilitation programme for complex regional pain syndrome combining graded motor imagery, desensitisation and functional restoration.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Fizik Tedavi ve Rehabilitasyon department. Book Appointment →

What is Complex Regional Pain Syndrome — Rehabilitation?

Complex regional pain syndrome (CRPS) is a chronic pain disorder that typically develops after a limb injury or surgery, characterised by disproportionate pain, sensory, motor, vasomotor, sudomotor and trophic changes (Budapest criteria).

Type 1 occurs without identifiable nerve injury, type 2 in the presence of a defined peripheral nerve lesion; pathophysiology involves peripheral and central sensitisation, autonomic dysregulation and maladaptive cortical reorganisation.

Rehabilitation is the cornerstone of management and starts as early as possible. The aim is to restore function and reduce pain through gradual loading and exposure rather than rest.

Core components include graded motor imagery (laterality recognition, imagined movements, mirror therapy), desensitisation, contrast baths, gentle range-of-motion and progressive strengthening exercises, weight-bearing in lower limb CRPS, edema control and pacing strategies.

Pharmacological and procedural therapies (neuropathic analgesics, bisphosphonates, sympathetic blocks, spinal cord stimulation) are integrated with active rehabilitation; psychological support including cognitive behavioural therapy and education is essential.

Symptoms

Continuous burning or aching pain disproportionate to injury
Allodynia and hyperalgesia in the affected limb
Skin temperature and colour changes
Edema and sweating asymmetry
Trophic changes in skin, nails and hair
Decreased range of motion and muscle weakness
Tremor, dystonia or motor neglect of the limb
Disability in activities of daily living

Risk Factors

Distal radius fracture or other limb fracture
Surgery or immobilisation of an extremity
Female sex and middle age
History of migraine, asthma or chronic pain
High pre-operative pain or psychological distress
Smoking and prolonged plaster immobilisation

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent severe pain after a fracture or operation beyond expected period
  • Limb that cannot tolerate normal touch or movement
  • Visible swelling, colour or temperature change of one limb
  • Increasing limb stiffness despite physiotherapy
  • Functional decline and depressive symptoms

Treatment Methods

01
Early multidisciplinary rehabilitation referral
02
Graded motor imagery and mirror therapy
03
Desensitisation and contrast bath therapy
04
Progressive range of motion, strengthening and weight-bearing exercises
05
Edema management and joint protection
06
Cognitive behavioural therapy and pain education
07
Neuropathic analgesics (gabapentinoids, tricyclics, SNRIs)
08
Bisphosphonates in selected early cases
09
Sympathetic blocks or spinal cord stimulation in refractory disease
10
Smoking cessation and management of comorbidities

Which Department to Visit?

You can visit our Fizik Tedavi ve Rehabilitasyon department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Fizik Tedavi ve Rehabilitasyon Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.