International Journal of Physical Medicine & Rehabilitation
Open Access

Pain exposure physical therapy (PEPT) may be a safe and effective treatment for longstanding complex regional pain syndrome type 1

3^rd International Conference and Exhibition on Physical Medicine & Rehabilitation

May 18-20, 2015 San Antonio, USA

Jan Willem Ek1, Jan van Egmond2, Chiel Koen1, Robert van Dongen2, Frank Klomp2 and Edwin Draaijer1

Posters-Accepted Abstracts: Int J Phys Med Rehabil

Abstract :

Background & Aims: To investigate a new and promising functionalapproach neglecting the pain (Pain Exposure Physical Therapy) for chronic CRPS type 1. Methods: Patients with longstanding CRPS (meeting the IASP-criteria for CRPS type 1) were included and treated with a functional approach, neglecting the pain. This approach is not in line with the usual approach with radical scavengers and physiotherapy restricted by pain tolerance. The mobility of the affected limb was measured with functional tests (Radboud Skills Test (arm), 7 meters walking, 3 stepsup and down, walking distance (leg)). Pain was measured with an NRS. Results: In 94 out of 102 patients with end stage CRPS type 1, earlier treated with various accepted therapies, the function of the affected extremity improved. Pain, although not directly treated, decreased in 75 patients. In a total of 45 patients function was completely restored. Conclusion: This pilot study provides evidence that this approach is safe and effective. The treatment is short, monodisciplinary, cheap and no side effects were observed. The main issue in the treatment is that pain in CRPS 1 has no physiological aim and should not interfere with functional use by the patient, or with treatment by the therapists. The therapist ignores the pain, verbally and non-verbally. This must also be understood by the patients (and their relatives).

Biography :

Jan Willem Ek studied medicine at the Erasmus University of Rotterdam. In the same place he specialized as general practitioner. He worked several years at the University of Amsterdam and Groningen as coach and teacher. After he was confronted by accident with a treatment that seemed successful for long lasting CRPS type 1, he studied this syndrome and got interested in pain, especially chronic pain, in general. This resulted in a publication and a job at the rehabilitation department of the Bethesda Hospital in Hoogeveen.