Does evidence support physiotherapy management of adult Complex Regional Pain Syndrome Type One? A systematic review

Anne E. Daly and Andrea E. Bialocerkowski

The objective of this review was to source and critically evaluate the evidence on the effectiveness of Physiotherapy to manage adult CRPS-1.  The search strategy identified 1320 potential articles. Of these, 14 articles, representing 11 studies, met inclusion criteria. There were five randomised controlled trials, one comparative study and five case series. Physiotherapy treatments varied between studies and were often provided in combination with medical management. This did not allow for the ‘stand-alone’ value of Physiotherapy to be determined. There was good to very good quality level II evidence that graded motor imagery is effective in reducing pain in adults with CRPS-1, irrespective of the outcome measure used. No evidence was found to support treatments frequently recommended in clinical guidelines, such as stress loading.

Graded motor imagery should be used to reduce pain in adult CRPS-1 patients. Further, the results of this review should be used to update CRPS-1 clinical guidelines.

European Journal of Pain, 2009, 13(4), 339-353

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