Spontaneous recovery of long-term severe complex regional pain syndrome of the upper limb: A case report

Glassey, Nicole; Gunawardane, P.O.; Starley, Ian F

doi:10.1177/1758998313497698

Cited by 2 publications

(6 citation statements)

References 14 publications

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Section: Resultsmentioning

confidence: 99%

“…Interdisciplinary treatment approaches are globally recognised as best practice for CRPS management. 89 However, only five studies in this review assessed the results of such approaches, 41,47,60,61,70 with critical appraisal scores ranging from 43% to 73%, and a median of 65%. All programmes included pharmacological and physiotherapy treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Occupational therapy treatment was provided in three, 47,61,70 and psychology input in four. 41,60,61,70 While no relationship has been identified between psychological factors and CRPS onset, 95 as CRPS pain intensity may be impacted by psychological distress, a vicious cycle can occur where pain, distress, and disability maintain each other. 96 Assessing and treating pain-related beliefs, behaviours, and mood-disorders is therefore a critical aspect of disability-reducing treatment for CRPS; 97 however, only one study of interdisciplinary treatment assessed psychological factors.…”

Section: Discussionmentioning

confidence: 99%

“…Study design, characteristics of participants, interventions, outcome measures, and CCAT quality rating were collated (see Table 1). Six different designs were identified; 14 single case studies, [36][37][38][39][40][41][42][43][44][45][46][47][48][49] eight randomised control trials, [50][51][52][53][54][55][56][57] eight prospective cohort studies, [58][59][60][61][62][63][64][65] four case series, [66][67][68] three retrospective notes reviews, [69][70][71] and one mixed methods study. 72 13 interventions were categorised as sensory retraining, 37,38,40,42,54,55,57,58,63,64,…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…72 13 interventions were categorised as sensory retraining, 37,38,40,42,54,55,57,58,63,64,67,69,71 seven as kine siotherapy, 36,39,45,48,65,66,68 seven as manual therapies, 43,44,46,49,53,56,73 six as physical modalities, [50][51][52]59,62,72 and five as interdisciplinary treatment. 41,47,60,61,70 All studies (n = 38) measured pain intensity, and most (n = 24) measured objective physical parameters such as pinch or grip strength, ROM, oedema, or perceptual abilities (e.g. laterality/pointing accuracy, and tactile detection, discrimination and dexterity) (see Table 1).…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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Person-centred management of upper limb complex regional pain syndrome: an integrative review of non-pharmacological treatment

et al. 2023

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Introduction Complex Regional Pain Syndrome (CRPS) is most common in the upper limb and associated with high disability. The purpose of this review was to critically appraise and synthesise literature exploring non-pharmacological treatment for upper limb CRPS, to guide upper-limb-specific management. Methods Using an integrative review methodology, 13 databases were searched to identify all published studies on non-pharmacological management of upper limb CRPS. The Crowe Critical Appraisal Tool was used to provide quality ratings for included studies, and analysis employed a qualitative descriptive approach. Results From 236 abstracts reviewed, 113 full texts were read, and 38 articles selected for data extraction. Designs included single case ( n = 14), randomised controlled trial ( n = 8), prospective cohort ( n = 8), case series ( n = 4), retrospective ( n = 3), and mixed methods ( n = 1). Interventions were categorised as sensory retraining ( n = 13), kinesiotherapy ( n = 7), manual therapies ( n = 7), physical modalities ( n = 6), and interdisciplinary treatment programmes ( n = 5). All studies measured pain intensity, and most ( n = 24) measured physical parameters such as strength, movement, or perceptual abilities. Few measured patient-rated function ( n = 13) or psychological factors ( n = 4). Quality ratings ranged from 30% to 93%, with a median of 60%. Conclusion Methodological quality of non-pharmacological treatment approaches for upper limb CRPS is overall poor. Movement, desensitisation, and graded functional activity remain the mainstays of intervention. However, despite the impact of CRPS on wellbeing and function, psychological factors and functional outcomes are infrequently addressed. Further robust research is required to determine which aspects of treatment have the greatest influence on which symptoms, and when and how these should be introduced and progressed.

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