Pain and reduced mobility in complex regional pain syndrome I: outcome of a prospective randomised controlled clinical trial of adjuvant physical therapy versus occupational therapy

There are no adequate comparative studies on physical therapy (PT) versus occupational therapy (OT) in patients with complex regional pain syndrome I (CRPS I). Therefore, we conducted a prospective randomised clinical trial to assess their effectiveness. The outcomes regarding reducing pain and normalising active range of motion (AROM) are discussed. Included in the study were 135 patients who had been suffering from CRPS I of one upper extremity for less than one year. They were randomly assigned to one of three groups: PT, OT, or control (social work, CT). Measurements were taken at base-line (t0), after 6 weeks, and after 3, 6 and 12 months (t1 to t4). Pain was measured on four visual analogue scales (VAS) and the McGill Pain Questionnaire, Dutch Language Version (MPQ-DLV). The AROM was recorded relative to the contralateral side. Explorative statistical evaluations were performed (Wilcoxon; α=0.05). PT and to a lesser extent OT, resulted in more rapid improvement in the VAS scores than CT, especially for the VAS during or after effort ( P