The future of CRPS research

Doctors and scientists all over the world continue to research every facet of CRPS in order to better understand the condition, and in turn, find a cure. These are some of the studies that we can expect to learn from in the coming years.

Clinical evaluation of the effects of mirror therapy

Patients with CRPS-I will undergo a study at the Department of Physical Medicine and Rehabilitation, Hand Rehabilitation Unit at the Medical Faculty of Ankara University. The purpose is to research the clinical effects of CRPS alternative treatments, specifically mirror therapy.

Patients will be split into two groups (the mirror group and control group). The mirror group will receive mirror therapy for 30 minutes per day in addition to routine treatment. Mirror therapy will include several different flexing exercises, as well as various object grasping activities according to the status of the patient’s hand functions. Each patient will undergo a total of 20 sessions.

Every patient participating in the study will be assessed before and immediately after the treatment, as well as one month after the trial. Each assessment will include pain severity, grip strength, lateral pinch strength, hand circumference measurements, hand dexterity, hand function in daily living activities, and health-related quality of life.

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Investigations of pathophysiology of dystonia and CRPS

Dystonia is a movement disorder in which a person’s muscles contract uncontrollably. The purpose of this study is to understand why people with CRPS often develop dystonia, and if these reasons are different in people with focal hand dystonia.

This detailed study will require participants to either stay at the clinical center for five or six days or have several different outpatient visits.

During testing, participants in the study will undergo MRI scans and transcranial magnetic stimulation (TMS) sessions. Participants with the ability to determine two separate stimuli as different will be tested by using a weak electrical shock to their fingers. They will also be asked to feel small plastic domes with ridges.

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Low-dose naltrexone treatment for CRPS

Stanford Medicine’s Systems Neuroscience and Pain Lab is conducting a study sponsored by the Reflex Sympathetic Dystrophy Syndrome Association (RSDSA).

They believe there is significant evidence to suggest that the FDA-approved drug naltrexone can effectively treat certain types of pain, fatigue, and sleep disorders (in low doses). This will be the first official study of the effectiveness of LDN as a CRPS treatment medication.

Participation will last 14 to 28 weeks and gives patients an opportunity to receive LDN treatment at no cost. The study will require up to five in-person visits to Stanford, as well as weekly questionnaires and daily pain scores.

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Facts about complex regional pain-syndrome

What is complex regional pain syndrome?

Complex regional pain syndrome (CRPS) is a chronic (lasting greater than six months) pain condition that most often affects one limb (arm, leg, hand, or foot) usually after an injury.  CRPS is believed to be caused by damage to, or malfunction of, the peripheral and central nervous systems.  The central nervous system is composed of the brain and spinal cord; the peripheral nervous system involves nerve signaling from the brain and spinal cord to the rest of the body.  CRPS is characterized by prolonged or excessive pain and changes in skin color, temperature, and/or swelling in the affected area.

CRPS is divided into two types:  CRPS-I and CRPS-II. Individuals without a confirmed nerve injury are classified as having CRPS-I (previously known as reflex sympathetic dystrophy syndrome).  CRPS-II (previously known as causalgia) is when there is an associated, confirmed nerve injury.  As some research has identified evidence of nerve injury in CRPS-I, it is unclear if this disorders will always be divided into two types.  Nonetheless, the treatment is similar.

CRPS symptoms vary in severity and duration, although some cases are mild and eventually go away.  In more severe cases, individuals may not recover and may have long-term disability.

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How is CRPS treated?

The following therapies are often used:

Rehabilitation and physical therapy.  An exercise program to keep the painful limb or body part moving can improve blood flow and lessen the circulatory symptoms.  Additionally, exercise can help improve the affected limb’s flexibility, strength, and function.  Rehabilitating the affected limb also can help to prevent or reverse the secondary brain changes that are associated with chronic pain.  Occupational therapy can help the individual learn new ways to work and perform daily tasks.

Psychotherapy. CRPS and other painful and disabling conditions often are associated with profound psychological symptoms for affected individuals and their families.  People with CRPS may develop depression, anxiety, or post-traumatic stress disorder, all of which heighten the perception of pain and make rehabilitation efforts more difficult.  Treating these secondary conditions is important for helping people cope and recover from CRPS.

Medications. Several different classes of medication have been reported to be effective for CRPS, particularly when used early in the course of the disease.  However, no drug is approved by the U.S. Food and Drug Administration specifically for CRPS, and no single drug or combination of drugs is guaranteed to be effective in every person.

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