The saying "more pain, more gain" may be true for those already in terrible pain due to a chronic and debilitating condition, contrary to received wisdom. For those with Type I Complex Regional Pain Syndrome (CRPS), working through the pain of an aggressive physiotherapy program often leads to far better results than a more cautious pain-free approach.
That was the result of a new study in Clinical Rehabilitation, published this week by SAGE. In fact, nearly half those who were given the painful treatment recovered normal physical function, whereas those who avoided painful physiotherapy usually had further loss of physical function.
CRPS is a chronic progressive disease characterized by severe pain, swelling and changes in the skin. The cause of this syndrome is currently unknown. Although CRPS may follow injury and surgery, this is not always the case.
Jan-Willem Ek, Jan C van Gijn and colleagues from the Department of Rehabilitation Medicine at Bethesda Hospital in The Netherlands studied 106 patents suffering severe physical impairments from CRPS Type I, which does not involve nerve lesions (unlike Type II). They found that almost all the patients improved significantly when subjected to a rehabilitation program involving graded pain exposure. In fact, more than half the patients in the study recovered full physical movement, and none of the patients experienced adverse effects from this more aggressive approach. While this "full on" approach doesn't reduce the amount of pain associated with the condition, it does provide sufferers with a significant increase in mobility, function and quality of life. Traditional treatments for this chronic condition typically minimize the pain, which limits physiotherapy significantly and usually leads to greater deterioration of the affected limb.