Is pain provocation during physiotherapy of complex regional pain syndrome harmful or safe?
What is it about?
Concerns often arise among both clinicians and patients regarding the potential negative consequences stemming from pain provocation during physiotherapy for Complex Regional Pain Syndrome (CRPS), despite clinical guidelines advocating for a departure from pain-contingent approach. To shed light on this matter, this narrative review critically examines the findings of six selected articles that explore exposure-based therapies. Remarkably, the available data fails to support the notion of significant long-term deterioration in symptoms or function, nor does it uncover any notable harms associated with pain provocation during CRPS physiotherapy. However, it is important to highlight that only one of the included studies placed primary emphasis on evaluating safety, while the reporting of potential harms in the remaining studies was inadequate, leading to a very low level of certainty in the available evidence.
Why is it important?
Acknowledging the low level of certainty surrounding the available evidence, this narrative review offers a degree of support and reassurance regarding safety for clinicians and individuals living with complex regional pain syndrome who are willing to explore exposure-based therapies as one of the potential avenues for reducing disability and improving quality of life.