CRPS - pain that takes on a life of its own

How physiotherapy and occupational therapy can help with complex regional pain syndrome

CRPS - complex regional pain syndrome - is a rare but extremely distressing pain disorder. After an injury, operation or fracture, disproportionately severe pain develops, often accompanied by swelling, temperature changes, restricted movement and vegetative symptoms. For many sufferers, this marks the beginning of a long ordeal. However, modern physiotherapy and occupational therapy can help - if they start early, individually and holistically.

What is CRPS?

CRPS (formerly known as "Sudeck's disease") is a disease of the peripheral and central nervous system. It often occurs after trauma (e.g. broken bones, surgery) - even if the original injury has long since healed.

Typical symptoms:

• Severe, burning, often deep pain that does not match the original injury

• Swelling, skin changes, temperature differences

• Hypersensitivity to touch, cold or movement (allodynia)

• Restriction of movement, stiffness, muscle atrophy

• Vegetative changes (e.g. sweating, changes in hair growth, discoloration)

• Psychological stress: anxiety, helplessness, depressive moods

There are two forms:

• CRPS type I (without direct nerve lesion)

• CRPS type II (with proven nerve injury)

Why early and targeted therapy is so crucial

CRPS is not a psychosomatic reaction or "imaginary pain" - but a serious neuroinflammatory disorder with central nervous system involvement. The earlier the diagnosis is made and the more coordinated the treatment, the better the chances of recovery.

The aim of treatment is not just to relieve pain - but to restore function, participation and self-efficacy.

Physiotherapy - dosed, sensitive, functional

Traditional exercise therapy is often not easy to implement with CRPS. The sensitivity to pain is too great and the vegetative involvement too complex. This makes an experienced, sensitive physiotherapeutic approach all the more important.

Therapeutic focus:

• Graduated exercise therapy: gradual build-up of exercise without pain provocation

• Desensitization: via tactile stimuli, thermal stimuli, mirror therapy

• Sensorimotor training: to reorganize disturbed body perception

• Breathing, vagus and relaxation techniques for vegetative regulation

• Medical yoga for CRPS: gentle activation, mindfulness, vegetative stabilization

Principles of treatment:

• Never work against the pain - communicate with the nervous system.

• Establish security and control - do not demand performance.

Occupational therapy - enabling participation, regaining everyday life

CRPS affects not only bodily functions - but also everyday life as a whole. Many sufferers withdraw, avoid exercise and lose occupational and social functions. This is where occupational therapy comes in.

Occupational therapy measures:

• Gradually resume everyday activities (e.g. dressing, housework, writing, grasping)

• Desensitization strategies in the domestic context

• Adaptation of aids and workplace advice

• Pacing, energy balance and load dosing

• Body image work, creative techniques and resource activation

Important: Occupational therapy offers not only techniques - but also space for emotional processing, self-awareness and the ability to act.

Biopsychosocial understanding of pain - treating CRPS holistically

At Hockenholz, we work according to a modern understanding of pain that takes biological, psychological and social factors into account. CRPS is a prime example of central sensitization, dysregulation and loss of control - and this is precisely where our therapy comes in:

• Creating understanding: What happens in the nervous system? Why does "touch" hurt?

• Strengthening self-efficacy: making small successes visible

• Regulating the nervous system: via movement, breathing, relationship

• Promote teamwork: Cooperation with pain physicians, psychotherapists, general practitioners

Conclusion: CRPS needs more than standard therapy - it needs expertise, patience and empathy

CRPS is a complex but treatable condition. The earlier and more differentiated the conservative therapy is started, the better the prospects of improvement. Physiotherapy and occupational therapy play a central role in this - as part of an interdisciplinary concept that takes a holistic view of the individual.

Are you a therapistand want to find out more about working with CRPS patients?
You can find our training courses on complex pain syndromes, autonomic regulation and functional movement therapy here:
👉 www.hockenholz.com/weiterbildungen

Are you affected yourself?
We support you - empathetically, evidence-based and individually. In our practice in Berlin or online.