Report of a focus group survey of current practice in the therapeutic treatment of Complex Regional Pain Syndrome in the United Kingdom

Abstract

Complex Regional Pain Syndrome (CRPS) typically affects the hand following trauma. It is characterised by pain, altered sensation, motor disturbance, oedema, functional limitation and psychological disturbance. There is no definitive curative treatment for CRPS and controversy exists regarding the most effective combination of interventions for the treatment of this syndrome (Siddiqui et al 2001). A study was commissioned in 2006 to explore the therapeutic interventions being implemented with patients with CRPS in the UK. Sixty therapists at the British Association of Hand Therapists annual conference consented to participate in focus group discussions. Categories were established to identify all therapeutic modalities currently used by participants. Therapists utilised the following therapeutic techniques: functional activity, exercise, education, support, sensory re-education, desensitisation, stress loading, pressure garments, mirror visual feedback, splints and psychological strategies, amongst others. The identified interventions were then reviewed against evidence in the recent literature. There is insufficient evidence to support the use of a single set of multidisciplinary interventions (Stanton-Hicks et al 2002) to address the primary long-term goals of functional restoration and pain relief. This study has, however, highlighted that this is achieved through the treatment of individual symptoms, using multiple therapeutic interventions and algorithms in a multidisciplinary approach.