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Complex regional pain syndrome type 1 (CRPS1) is characterized by pain, swelling, and sudomotor and motor dysfunction. The affected limb is exquisitely sensitive, and gentle movements can exacerbate symptoms. Local or spinal mechanisms, or both, may mediate symptoms, including pain. Evidence of altered sensorimotor processing suggests that symptoms may also be mediated by cortical mechanisms.1 This clinical note reports on findings from one patient with CRPS1 in whom imagined movement of the affected limb, without local muscle activity or movement, increased pain and swelling.
Case report.
A woman aged 34 years sought treatment for CRPS1 of the left hand 17 months after an uncomplicated wrist fracture. Management involved performance of a motor imagery task in which she was shown 56 pictures of a hand in various postures (28 left hands and 28 right hands) and was required to imagine adopting the hand posture shown without moving her hand. After performing the task, the patient reported increased pain and swelling in the affected limb. …
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