Treatments for CRPS/RSD there is a great website resource called about my pain which gives chronic pain and CRPS sufferers information about RSD treatment including the dorsal root ganglion (DRG) stimulation treatment for CRPS.Cognitive learning theory in the classroom why not have a look at the website? The treatments for CRPS are split up into groups, as there are different areas that are used to try and restore the function and even the movement of the limb that has been affected, many of which will be mixed together to give you a full pain management regime. They are:

cognitive learning theory in the classroom

The idea of physiotherapy and other methods for treatment of CRPS is to try and relieve at least some of the signs and symptoms that are caused by the condition.Cognitive learning theory in the classroom this involves both physiotherapy and occupational therapy. Physiotherapy in conjunction with occupational therapy (OT), especially in the early stages of the condition, plays an important role in functional restoration of the CRPS limb (singh, M et al. 2015).Cognitive learning theory in the classroom it is also suggested by the professionals that physio is used together with other treatments given to patients with CRPS, such as medication, alternative RSD treatments, implanted devices. ( daly, A.E. & bialocerkowski, A.E. (2008))

cognitive learning theory in the classroom

• MOVEMENT of the limb affected by CRPS can try to be restored by using muscle strengthening exercises, gentle movement and some exercises for the whole of the body – learning to cope with the condition in your life ( see the burning nights blog on COPING STRATEGIES ).Cognitive learning theory in the classroom when you first go to physiotherapy do ask them if they have had any experience of people with CRPS as this will make a difference as to how they approach things with you.Cognitive learning theory in the classroom

• DESENSITISATION TECHNIQUES– most of you with CRPS who have been to physio’s around the country or in fact the world will have been told about desensitisation and how important it is.Cognitive learning theory in the classroom this is done by using different textures to gently rub at the beginning, on your CRPS affected limb. This could be using a tissue, feather, cotton etc.Cognitive learning theory in the classroom then as you gradually are able to tolerate the textures try and rub slightly harder until you can tolerate the different textures and therefore stop causing you to feel any pain.Cognitive learning theory in the classroom

• AQUA (WATER) THERAPY – if you are able to tolerate water then this is a good form of therapy so that you become weightless in the water thereby enabling you to do exercises that would ordinarily be difficult outside of the water.Cognitive learning theory in the classroom there is also the possibility of using a hydrotherapy pool where the water is a lot warmer than a usual pool and can help with the problem of being sensitive to temperature changes.Cognitive learning theory in the classroom

• PAIN EXPOSURE PHYSICAL THERAPY (PEPT) – PEPT is a patient-centred physical therapy, also know as the “ macedonian method”, which was developed by ms.Cognitive learning theory in the classroom shinka in 2003. It is based on the supposition that limited use or non-use of an extremity or limb, whether or not caused by fear of movement or pain, can lead to disease deterioration.Cognitive learning theory in the classroom PEPT is tailored towards improving activities in daily life, using progressive-loading exercises, desensitisation and ‘self-forced’ use, in which patients have to encourage themselves to use their affected extremity, both during RSD treatment exercises and in daily activities, without the use of medication. (raymakers, L. 2015) A recent study undertaken by barnhoorn, K.J.Cognitive learning theory in the classroom et al. (2015)found that the patients having PEPT showed a greater improvement in AROM but more research is needed.

Some physiotherapists in the past have used ice as a therapy for CRPS.Cognitive learning theory in the classroom however, there is very important thing to point out, that doctors, specialists and healthcare professionals recommend that you NEVER PUT ICE nor use any cold or hot/cold contrast therapy on the limb that has been affected by CRPS.Cognitive learning theory in the classroom it can cause symptoms to come on faster and can even cause frostbite if the ice is held on too long – see nishikawa, M. Et al (2008). In the case study by nishikawa, M.Cognitive learning theory in the classroom et al (2008) a patient, despite repeated cautions against cold-induced injury, continued all-day cooling of the CRPS arm. She was later admitted to hospital once again with extensive skin necrosis on the left arm and a contracted left elbow joint.Cognitive learning theory in the classroom the areas of skin necrosis exactly matched the sites where she had applied ice packs.

“application of any type of a cold compress to an area that is affected with CRPS reduces blood flow to the area.Cognitive learning theory in the classroom it also damages the myelin sheath surrounding the nerve tissue and constricts blood vessels. CRPS makes it difficult for the blood vessels and myelin sheath to recover, possibly causing nerve and blood vessel damage and further aggravating the condition.”

cognitive learning theory in the classroom

“…use of cryotherapy can cause permanent somatosensory and thermosensory (sympathetic) nerve damages with contrasting complications of focal somatic myelinated nerve fibers damage and focal pain, versus C-thermoreceptor nerves (CTN) damage causing neuropathic regional pain and inflammation (skin ulcers).Cognitive learning theory in the classroom long-term exposure and extreme hypothermia can cause permanent nerve damages.”

• SPINAL CORD STIMULATOR (SCS) – this is a very expensive treatment for CRPS and many PCT’s / hospitals are reluctant to do this.Cognitive learning theory in the classroom the cost is in the region of £15,000 and so you would have a trial stimulator put in for a few days, weeks or a few months and then if the trial is successful for you in reducing your pain and symptoms then they will implant the full SCS.Cognitive learning theory in the classroom before you are considered for an SCS you have to go through a full psychological assessment. Electrodes are put on the spinal cord and a battery pack is inserted at the front of your body under your skin in the abdomen region.Cognitive learning theory in the classroom you are given a ‘ wand’ to place on the outside where the battery pack is and you can control the on/off and volume of the stimulation up and down.Cognitive learning theory in the classroom there are now however different types of SCS including a 10 khz high frequency SCS – see russo, M & van buyten, J-P. (2015) usually the SCS is seen and implanted as a last resort treatment due to various implications including the cost and invasiveness of the RSD treatment.Cognitive learning theory in the classroom however research studies such as the 2012 poree, L. Et al. Study say that:

• DORSAL ROOT GANGLION STIMULATION (DRG) – dorsal root ganglion is a small bundle of nerves that are involved in sending pain messages to the brain.Cognitive learning theory in the classroom they control when sensations can enter your spinal cord and you will find there is a DRG in every section of bone in your spine. DRG stimulation uses implanted equipment under your skin in your spine to send mild electrical impulses to the area of the DRG in your spine.Cognitive learning theory in the classroom deer, T.R. Et al. (2015), van buyten, J.-P. Et al. (2015) and van bussel, C et al. (2014) and apiliogullari, S et al. (2015) and oxford university hospitals DRG leaflet (2015).Cognitive learning theory in the classroom learn more about the dorsal root ganglion stimulation treatment for CRPS from our DRG stimulation treatment blog. Also check out the about my pain website for DRG stimulation treatment for CRPS.Cognitive learning theory in the classroom

Many chronic pain patients who may have been affected by post stroke pain or may have even had a stroke and are struggling with walking. It can be given along any of your pain pathways which for example include the exterior of the brain membranes (the medical terminology for this is ‘motor cortex stimulation with dural electrodes’), the areas of your brain that control pain (the medical terminology is ‘deep brain stimulation’) and near to nerves that have been injured (the medical terminology is ‘peripheral nerve stimulators’).Cognitive learning theory in the classroom new research has comprised of using magnetic currents that are directed to the exterior part of the brain – the current name for this treatment is ‘ rtms or transcranial magnetic stimulation’.Cognitive learning theory in the classroom

In a 2013 randomized, multicenter, double-blind, crossover, sham-controlled trial done by hosomi, K. Et al (2013) they “aimed to assess the efficacy and safety of 10 daily rtms in neuropathic pain patients.” in this trial they discovered that: ” the real rtms, compared with the sham, showed significant short-term improvements in VAS and SF-MPQ scores without a carry-over effect.Cognitive learning theory in the classroom PGIC scores were significantly better in real rtms compared with sham during the period with daily rtms. There were no significant cumulative improvements in VAS, SF-MPQ, and BDI.Cognitive learning theory in the classroom no serious adverse events were observed. Our findings demonstrate that daily high-frequency rtms of M1 is tolerable and transiently provides modest pain relief in NP patients.” rtms = transcranial magnetic stimulation VAS = visual analogue scale SF-MPQ = S hort form of the mcgill pain questionnaire PGIC = patient global impression of change scale BDI = beck depression inventory NON-INVASIVE CALMARE PAIN THERAPY TREATMENT (R) (also known as SCRAMBLER THERAPY) – calmare therapy is considered a non-invasive and non-pharmaceutical treatment for CRPS and since 2011 used for CRPS/RSD sufferers.Cognitive learning theory in the classroom according to dr. M. Cooney , the clinical director and calmare NJ certified provider he explained that it wasn’t an intentional focus on his part to treat CRPS/RSD sufferers, however he found that calmare is very useful in treating several types of chronic pain including CRPS/RSD.Cognitive learning theory in the classroom one of his 1st CRPS/RSD patient was a lady called amanda davidson from indiana, USA (youtube video) both amanda and her mother were very involved in the CRPS/RSD community and she shared her very positive outcome with the support groups she was involved in.Cognitive learning theory in the classroom patients go and have calmare pain therapy treatment from as far away as australia and south africa.

You may find it hard to relax, unable to cope or find that you don’t get support from family and even friends.Cognitive learning theory in the classroom all of things are perfectly normal to feel if you have been diagnosed with CRPS and also for anyone with chronic pain. In fact in a majority of occasions it will intensify the pain feeling and it tends not to help the sufferer cope with everything associated with CRPS nor does it help people rehabilitate.Cognitive learning theory in the classroom so many treatments for CRPS are often used for the psychological aspect of the condition these include:

They are usually in-house i.E. Short or long stays in the pain clinic part of the hospital however there are now some found at GP’s surgeries.Cognitive learning theory in the classroom the groups that you will become part of don’t tend to be large instead they have around 6-8 people in similar situations like yourself. They teach you ways of coping with your CRPS or chronic pain, try and improve your quality of life and also learn techniques for better sleep.Cognitive learning theory in the classroom various healthcare professionals will usually be involved during your stay including, physiotherapists, psychologists, occupational therapists and obviously doctors / pain specialists.Cognitive learning theory in the classroom there are over 300 pain clinics around the UK but there are not as many PMP centres.

• HYPERBARIC OXYGEN THERAPY (HBOT) – this form of treatment is often used in patients who have MS.Cognitive learning theory in the classroom there are actually very few centres with HBOT in the UK. However there have been several studies done that discuss the use of HBOT with patients who have chronic pain including CRPS patients, but very few in the last few years.Cognitive learning theory in the classroom unfortunately there is simply not enough research into the use of HBOT for CRPS patients and it is still unknown as to whether it would help with pain and oedema / swelling.Cognitive learning theory in the classroom you would lie down in the chamber which has pressurised air. The treatment would in effect give your body more oxygen i.E. In all your tissues and organs.Cognitive learning theory in the classroom you would be breathing 100% oxygen at a higher than normal atmospheric pressure, whereas the usual air we breathe everyday has around 21% oxygen.Cognitive learning theory in the classroom in the study by kiralp, M.Z. Et al. (2004) they found that:

• INTRAVENOUS IMMUNOGLOBULIN (IVIG) – this has recently been studied by the noted consultant and researcher dr andreas goebel along with other professionals.Cognitive learning theory in the classroom his recent study 2014 – ‘immunoglobulin G for the treatment of chronic pain: report of an expert workshop,’ pain medicine. The trial of only 13 patients who had been diagnosed with CRPS and had not responded to other treatment were involved in this study.Cognitive learning theory in the classroom the end result was that those who had been given the IVIG had found that there was a decrease in their pain scores. Also see tamburin, S. Et al. (2014) to find out the results from the much larger low-dose immunoglobulin trial aka LIPS trial visit -> low-dose intravenous immunoglobulin treatment for complex regional pain syndrome (LIPS): study protocol for a randomized controlled trialunfortunately the research study into IVIG for long standing complex regional pain syndrome (CRPS) by goebel, A.Cognitive learning theory in the classroom et al (2017) did fail and patients weren’t able to tell the difference between the placebo and the actual drug itself . See goebel, A. Et al (2017) for further info

cognitive learning theory in the classroom

• BISPHOSPHONATES – bisphosphonates (bps) are potent inhibitors of osteoclastic activity widely used for the management of osteoporosis and other metabolic bone diseases there have been a couple of trials of bps such as the neridronate in 2013 ( gatti, D.Cognitive learning theory in the classroom et al 2013) and also a variety of bps in 2015 ( giusti, A. & bianchi, G. 2015). It was found in a placebo controlled trial by varenna, M.Cognitive learning theory in the classroom et al (2013) that aminobisphosphonate neridronate shows significant benefits in patients with CRPS. In this trial in CRPS, aminobisphosphonates seem to be most effective in high doses and in the trial, 2 100 mg doses of neridronate were given intravenously four times over 10 days, estimated to be equivalent to pamidronate at 90mg given four times over 4–10 days.Cognitive learning theory in the classroom the results were that ≥50% reduction of the pain VAS score was seen in 73% of patients in the neridronate group versus 32% in the placebo group.Cognitive learning theory in the classroom

• KETAMINE (oral or infusion)– in some patients ketamine has been used to treat CRPS pain where other treatments have not be successful. This drug is actually an anaesthetic and there have been studies where patients with CRPS were given ketamine in low doses intravenously for a few days.Cognitive learning theory in the classroom they then find that there is either an elimination of the pain or substantial reduction. However the specialists have not recommended ketamine for many people as the drug can induce what is known as ketamine bladder.Cognitive learning theory in the classroom this is where your bladder is totally affected by the drug and cause serious harm . According to connolly, S. Et al. (2015) it was found that: