Complex regional pain syndrome type I

Abstract

Complex regional pain syndrome type I (CRPS) is a chronic pain disorder involving the sensory, motor, and autonomic nervous systems, often leading to severe debilitation. Most commonly, a preceding limb injury catalyzes CRPS, although insidious onset has been known to occur. An estimated 60,000 Americans are affected by CRPS, including individuals between 25 and 55 years of age. CRPS is three times more likely to occur in women, although it can affect anyone [1]. Table 1 contains the CRPS clinical diagnostic criteria suggested by the International Association for the Study of Pain (IASP). Because of the poor understanding of the etiology of CRPS, its medical management is nebulous. Along with pain management, optimal treatment outcomes appear to be achieved when emphasizing functional restoration-a realm largely encompassed by physical therapists (PT). However, a review of the literature found that the term physical therapy is often used vaguely with no corresponding definition or description of procedures employed during treatment [2]. This has left PTs with a lack of guidance in treating patients with CRPS. The purpose of this case report is to describe the physical therapy management of a 38-year-old patient with CRPS developed from a chronic anterior talofibular ligament (ATFL) injury by using Active Release Techniques® (ART®) in combination with joint mobilization, gait training, therapeutic exercise, and education to document the observed clinical and functional improvements.