Effectiveness of an algorithm-based rehabilitation program for practical management and therapy of complex regional pain syndrome type 1 of the hand

Background: Complex regional pain syndrome (CRPS) type 1 is a rare but disabling pain condition, usually involving distal extremities such as the wrist, hand, ankle, and foot due to either direct or indirect traumas [1,2]. CRPS type 1 is characterized by a complex set of symptoms where no correlation can be identified between the severity of the initial injury and the ensuing painful syndrome [3]. Over the years, numerous treatment strategies have been proposed for CRPS management, but therapies still remain controversial. Indeed, at present, there is no successful therapeutic intervention exists for this condition. Questions/purposes: The aim of the present study is to propose and to assess the effectiveness of a rehabilitative treatment algorithm for CRPS, which is actually in use at the Center for Rehabilitative Medicine “Sport and Anatomy” of the University of Pisa. Methods: We retrospectively reviewed all the patients that underwent physical rehabilitative treatment algorithm for hand CRPS between 2014 and 2021 at our Institution. Results: All the parameters taken into consideration, namely Purdue Pegboard test (PPT), Disability of the Arm, Shoulder and Hand (DASH), Visual Analog Scale (VAS), as well hand oedema recorded with a hand volumeter, were significantly improved at the end of the rehabilitation protocol. Conclusion: The results obtained in the present study demonstrated that early and skillful rehabilitation intervention is of paramount importance for CPRS type 1 management to achieve a stable and optimal functional recovery while preventing the onset of deformities. In addition, our rehabilitation protocol was able to achieve substantial improvement in pain and quality of life scores.