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Navigating CRPS: Effective Treatment Strategy and Hope for Pain Relief

May 16, 2024

Illustration of fascial manipulation therapy

Living with CRPS can feel like an uphill battle, with pain as its constant companion. But what exactly is CRPS, and more importantly, how is it treated? This concise guide demystifies CRPS and identifies an effective treatment plan, offering a beacon of hope for pain relief to those suffering from this intense and persistent condition.

Key Takeaways

  • CRPS is a chronic condition identified by continuous, neuropathic pain primarily affecting limbs, with symptoms that include pain, swelling, and changes in skin texture, which can have significant impacts on both physical and mental health.
  • Fascial Manipulation is an effective treatment for CRPS, relieving myofascial restrictions to improve blood flow and nervous system function, with personalized approaches enhancing its efficacy for individual patient needs.
  • Early intervention and specialised physical therapy are crucial for CRPS recovery, with techniques like graded motor imagery and mirror therapy instrumental in retraining the brain to reduce pain sensation and improve limb function.

Understanding Complex Regional Pain Syndrome (CRPS)

Illustration of a human nervous system

CRPS is a condition characterized by continuous, often burning or throbbing neuropathic pain, typically affecting the arm, leg, hand, or foot. Imagine the agony of severe pain persisting long after an injury has healed, or even without any apparent cause. This is the reality for individuals living with Complex Regional Pain Syndrome (CRPS).

The symptoms of CRPS may vary among patients, with some experiencing a resolution of their symptoms, while others may suffer persistent symptoms for extended durations. Initial symptoms can include:

  • Pain
  • Swelling
  • Redness
  • Temperature changes
  • Pronounced hypersensitivity to cold and touch

CRPS may sometimes even spread from its original site to affect other parts of the body, including the opposite limb.

As a chronic pain condition, CRPS not only affects physical health but also exerts a significant impact on mental well-being and can be linked to neurological disorders. The persistent pain can be debilitating, leading to increased psychological distress, which further complicates pain management.

Defining CRPS and Its Symptoms

The primary symptoms of CRPS include severe pain, changes in skin texture, temperature, and color, and impact on affected limbs. When a person experiences developing CRPS, their normal life can be turned upside down as the affected body part can become almost unbearable to touch or move.

Joint stiffness, swelling, and damage are other common symptoms of CRPS, which can lead to a decreased ability to move the affected body part. Imagine the frustration of not being able to perform simple daily tasks due to pain and stiffness.

Changes in skin texture associated with CRPS can include:

  • Tender skin
  • Thin skin
  • Shiny skin
  • Changes in hair growth
  • Changes in nail growth

These visible changes often add another layer of distress to the already taxing experience.

The Role of Fascial Manipulation in Treating CRPS

Illustration of fascial manipulation therapy

In the face of such a challenging condition like reflex sympathetic dystrophy, which affects the spinal cord, Fascial Manipulation emerges as a ray of hope in CRPS treatment options. This treatment addresses the altered somatosensory, autonomic, motor, and inflammatory systems all known to be involved in the pathology of CRPS.

Fascial Manipulation works to relieve hypertonic myofascial restrictions, which can improve blood flow, reduce inflammation, and normalize nervous system function, including spinal cord stimulation. These effects collectively contribute to pain relief in CRPS patients, offering a promising treatment approach for Complex Regional Pain Syndrome (CRPS).

This technique focuses on the role of fascia in pain and dysfunction, which is commonly affected in CRPS. The fascia, a band or sheet of connective tissue beneath the skin, plays a crucial role in mobility and flexibility. When this is disrupted, it can contribute to the chronic pain experienced in CRPS.

Personalised Approach to Fascial Manipulation

Fascial manipulation for CRPS is specifically tailored to address the unique needs of each patient, making the treatment personalized and effective. Personalized fascial manipulation incorporates counterstrain techniques where tender points are identified and treated through tissue positioning, using patient feedback to achieve maximal comfort.

Specialised Care for Foot and Ankle CRPS

Illustration of specialized lower limb physical therapy

Lower limb CRPS is particularly debilitating as it can greatly impact mobility and independence. The clinic’s specialised CRPS treatment of the foot and ankle focuses on:

  • Reducing pain
  • Keeping the limb mobile
  • Preventing stiffness and loss of muscle tone
  • Tailoring exercises to individual pain levels and conditions.

Patients with lower limb CRPS are also assisted in lifestyle adjustments, ensuring they maintain regular activities and rest appropriately, while finding ways to adapt hobbies to manage their condition effectively. The clinic prides itself on offering specialized physical therapy treatment for CRPS affecting the lower extremities, deploying a multidisciplinary approach tailored to the unique needs of each patient. The most common area we see is CRPS in the foot with patients coming from all over the UK to seek treatment.

Support for Heroes: Collaborations and Referrals

Recognising the specific needs of veterans suffering from chronic pain conditions like CRPS, the clinic receives referrals from the medical department of the charity Help for Heroes. With experience in this area, awareness about the specialized needs of veterans is high, leading to effective, tailored care for this unique patient group.
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Advancements in CRPS Treatment Through Research

Illustration of clinical trials for CRPS treatment

Harnessing the power of scientific research, there are continuous efforts to advance CRPS treatment options. The clinic has received research grant funding from the UK government to progress the use of fascial manipulation in the wider clinical context.  The findings from this research were then used to inform how we progressed in the treatment of CRPS using this technique.

These efforts lead to significant improvements in patient care. (removed the word could in the middle of this sentence)

Rehabilitation and Recovery: A Path Forward

The primary goal in treating CRPS is to enhance movement using physical rehabilitation therapies, with early intervention focused on treating pain and symptoms, restoring limb function, and maintaining a patient’s quality of life.

The clinic focuses on being CRPS specialists in the use of fascia manipulation as a treatment method.  However, due to the complex nature of the syndrome some patients (but not all) may dovetail it in with other treatment methods provided by other specialists in their field.  Other methods physical therapists may use alongside our work, as podiatrists, for CRPS may include:

  • Physical therapy to promote blood flow and maintain limb flexibility
  • The use of compression garments to control swelling
  • In some cases, chiropractic manipulation to aid in pain relief and improve function.

Desensitization techniques help normalize the sensation of touch in the affected limb. The progression of these techniques includes:

  • Gentle movements
  • Firmer stroking
  • Tapping
  • Circular movements
  • Using different textures to re-introduce the limb to a variety of sensations

These comprehensive treatment approaches aim to improve the overall wellbeing of CRPS patients, reduce the severity of symptoms, and offer a path towards recovery and a better quality of life.

Importance of Early Intervention

When it comes to treating CRPS, promptness is key. It is important to seek treatment for CRPS early in its course, as this can improve the likelihood of its effectiveness. Starting treatment early may lead to better outcomes in managing CRPS symptoms. Groundbreaking research conducted by NeuRA’s Centre for Pain IMPACT and the University of South Australia suggests early detection and effective treatment can significantly aid recovery from CRPS within 18 months.

Research findings indicate that up to 80% of CRPS patients may recover within the first 18 months after diagnosis if an early and comprehensive treatment strategy is implemented. Thus, initiating treatment promptly after CRPS diagnosis is critical in order to reduce the risk of muscle contractures and maintain limb functionality.

Role of Physical Therapy in Recovery

Physical therapy plays a pivotal role in the recovery from CRPS. Graded motor imagery and mirror therapy are crucial elements of this, tailored to retrain the brain’s perception and control over the body. These techniques work by providing missing or confused information to the brain, which in turn helps improve movement and reduces the sensation of pain.

Physical therapy for CRPS may include:

  • Manual therapy
  • Range-of-motion exercises
  • Strengthening of muscles to correct imbalances
  • Progressive strengthening exercises
  • Functional training
  • Gradual gait training to aid in the responsible use and acclimatization of the affected limbs

A comprehensive recovery-oriented physical therapy program, including physical or occupational therapy, can help in the management and treatment of CRPS.

Summary

This exploration of CRPS and its treatment options underscores the critical role of early detection, comprehensive treatment, and a unique fascial manipulation approach in managing this chronic pain condition. Despite the challenges CRPS presents, there is hope. Ongoing research, advancements in treatment, and personalised care strategies offer the potential for improved quality of life and recovery. Remember, every step taken towards understanding and treating CRPS is a step towards reclaiming control over your life.

Frequently Asked Questions

What is Complex Regional Pain Syndrome (CRPS)?

Complex Regional Pain Syndrome (CRPS) is a chronic pain condition that mainly affects the limbs and is characterized by persistent pain, skin changes, temperature fluctuations, and decreased mobility.

What is Fascial Manipulation?

Fascial Manipulation is a promising treatment approach for CRPS, amongst other conditions, aiming to normalise neuro muscular function. It addresses altered somatosensory, autonomic, motor, and inflammatory systems involved in CRPS.

How is early intervention important in treating CRPS?

Early intervention is crucial in treating CRPS as it enhances the effectiveness of the treatment, with up to 80% of patients possibly recovering within the first 18 months after diagnosis if a comprehensive treatment strategy is implemented promptly.

What advancements have been made in CRPS treatment?

Advancements in CRPS research mean that the understanding of the condition and therefore patient care has improved significantly. These advancements will tailor more effective treatment plans, contributing to enhanced patient care.

If you think you may be experiencing foot or ankle CRPS, click to book in with one of our expert practitioners