Complete Guide To Graded Motor Imagery (GMI) for CRPS | Burning Nights CRPS (2022)

Last Updated: 13th May, 2020

Graded Motor Imagery is one of two treatments for Complex Regional Pain Syndrome or CRPS that have shown to be effective and to have good outcomes.

The second treatment considered effective is Mirror Therapy also known as Mirror Visual Feedback(O’Connell, N.E. et al 2016).

Complex Regional Pain Syndrome (CRPS) is a complex and difficult condition not only to diagnose but also to treat, therefore finding a treatment that can help every CRPS patient is extremely difficult as all CRPS patients are individuals where their CRPS signs and symptoms are concerned.

Graded Motor Imagery is just one of a range of CRPS management options that have been included in the Complex Regional Pain Syndrome (CRPS) guidelines from the Royal College of Physicians in the UK.

We’ve previously written an article on How To Use Mirror Therapy as a CRPS treatment however this current article focuses on the Graded Motor Imagery Programme (GMI) for CRPS.

Graded Motor Imagery (GMI) was first developed by Professor Lorimer Moseleyand is an up to date rehabilitation programme that has been based on clinical trials and the latest science. GMI is seen as a cost-effective and noninvasive treatment with limited adverse effects and complications (Limakatso, K. et al 2016).

In a 2016systematic review of interventions (O’Connell, et al 2016) that wasaimed at reducing pain, disability, or both, in patients with complex regional pain syndrome (CRPS), Graded Motor Imagery or GMI was found to may be effective for pain and function when compared with the usual CRPS treatment options.

Johnson, S. 2013 concluded that Graded Motor Imagery is an approach used for the rehabilitation of patients with chronic pain; it aims to activate the cortical networks involved in sensory-motor processing.

The GMI or Graded Motor Imagery Programme for Complex Regional Pain Syndrome (CRPS) is a 3 stage treatment that aims to gradually engage cortical motor networks without triggering the protective response of pain.(Bowering, K. et al 2013)

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What Tools Are Involved In Graded Motor Imagery (GMI) for CRPS?

According to theRanelli, S. (2013)GMI uses 2 main tools including:

  • Flash cards – which are a random collection of pictures of hands and feet in different postures and position and doing different tasks. They are used to help re-train the ability to recognise where the body or body part is in space
  • A computer programme OR App called ‘Recognise’

However you can also include magazines, imagination and creativity to the list of tools that you can use for Graded Motor Imagery (GMI).

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Recognise™ App

The Recognise™ app has been developed and released by the NOI Group™ and is available for both iPhones/iPads and Android.

The app uses the same pictures as in the flash cards and also assesses your accuracy (how many of the positions and postures you recognise correctly as left or right side) and the time it took for you to record your response. This means that you can take a step-by-step approach to improving your recognition ability and this is usually associated with a decrease in pain and an improvement in your function.

It is available for the following areas of the body:

  • Foot
  • Knee
  • Back
  • Hand
  • Neck
  • Shoulder

As we’ve just mentioned, the app accurately measures both the accuracy and speed of recognising an image of the body as either the left or right. This is the first stage of the Graded Motor Imagery Programme and it is otherwise known as Left/Right discrimination. The app provides the option to vary the number of images and the length of time the user has to view each image. As part of the Recognise™ Hands app, to increase complexity, the user can progress through ‘Vanilla Hands’, ‘Context Hands’ and ‘Abstract Hands’.

(Video) Mirror Therapy & Graded Motor Imagery with Candida McCabe, MSc, PHD, RGN - RSDSA

The Recognise ™ app also helps the patient go through the second stage of the Graded Motor Imagery Programme; explicit motor imagery.

The app is considered a simple tool to help a patient go through the Graded Motor Imagery (GMI) Programme. However the NOI Group™ website – Graded Motor Imagery does explain in detail the process of graded motor imagery (GMI), and how to incorporate the use of the Recognise™ app. You can purchase theRecognise™ app via theNOI Group™ website at a cost of £5.99 (AUS$9.99).

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Features of the Recognise™ App

There are a number of features as part of the Recognise™ app and according to the NOI Group™’s app description, these are:

  • ‘Memory’ and ‘Speed Match’ tools to take your training to the next level
  • Graded difficulty levels and personal best challenges
  • Detailed onscreen results and graphs to map your progress
  • Powerful clinical integration tools – export and email your results directly to your clinician or therapist
  • Capture your own images on your phone or table and use them in your training
  • Comprehensive explanation of the science behind left/right discrimination and Graded Motor Imagery

Recognise™ App Features taken from iTunes

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Stages of Graded Motor Imagery (GMI)

The GMI treatment programmeinvolves 3 progressive stages that are designed to exercise the brain in different ways.These techniques or stages are delivered sequentially but this is flexible and can be moved forwards, backwards or sideways by the clinician to completely suit the patient.If symptoms occur in one of the sequential steps, the clinician may go back to the previous step to decrease the unwanted symptoms.Those stages are:

  • Left/Right discrimination – Identify left or right images of their painful limb or body part
  • Explicit motor imagery – Thinking about moving without actually moving
  • Mirror therapy – This is mentioned in a separate article – How To Use Mirror Therapy for CRPS

(Graded Motor Imagery website)


The GMI treatment programmeinvolves 3 progressive stages that are designed to exercise the brain in different ways. These techniques or stages are delivered sequentially but this is flexible and can be moved

Left/Right Discrimination

What Is Left/Right Discrimination or Laterality?

This is the first stage of the GMI programme and this stage is the ability to identify left or right images of the patient’s painful body part(s). This stage isalso called laterality recognition task or simply ‘laterality.’

Research indicates that people with ongoing pain lose the ability to accurately discriminate between left and right body parts, or movements to the left or right as well as decreased speed in discriminating between left and right.

This task stimulates the representation of the body part in the brain, and due to neuroplasticity, causes changes in this representation.

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How Is This Stage Undertaken?

Using flash cards, magazine pictures or the ‘Recognise’ programme (or app), this stage willchallenge patients to quickly identify images as showing left or right body parts or left or right movements. If you don’t have the Recognise app or the flash cards you could also use magazine pictures or photos for this stage.Patients will usually do this stage of the GMI five (5) times per day for 5 minutes, however the health professional will decide on the plan for each patient after establishing a baseline beforehand.

What Is The Goal Of This Stage?

The goal of this stage of GMI is to show improvement in accuracy of identification, as well as speed of identification. Swart et al reported that leftand right identification focuses on the premotor cortex and motor imagery focuses on the primary motor cortex, both of which are integral parts of priming the system. (Swart et al 2009). However it doesn’t activate the primary somatosensory and motor cortices (Cocksworth & Punt, 2013).

Avoidance of early activation of motor cortices was considered important because movement execution commands are known to readily trigger pain responses (Melzack, 1990; Moseley, 2004a) in patients with conditions similar to CRPS (e.g. phantom limb pain). Moreover, laterality recognition tasks may be considered less threatening to patients than imagined movement or mirror therapy (Heeger, G et al. 2017 Commentary)

(Video) Physical Therapy, CRPS, and Chronic Pain with Julie Bergmann, PT, OCS - RSDSA


What Are The Response Times?

As mentioned above, a baseline must first be established before starting the GMI Programme. This baseline is the level of activity (or thinking about an activity) that can be accomplished without pain. Here are the response times that are seen as correct for this stage:

  • 1.6 sec +/- .05 sec (Backs and Necks)
  • 2 sec +/- .05 sec (Hands and Feet)
  • Accuracy of Judgments – 80% or above
  • Side to Side Difference – Response time and accuracy should be equal
  • Results should be stable and consistent for over a week

How Often Should You Do The Discrimination Exercises?

In Professor Moseley’s research into GMI for CRPS 1, they used the first stage left/right discrimination exercises for 2 hours per day for 2 weeks. This was done before moving onto the second and third stages of Explicit Imagery and Mirror Therapy.

However this doesn’t mean you have to do the 2 hours in one single block. This can be split up into manageable times to suit the patient. Some patients may not need the 2 weeks if they have reached the recommended response times (as above).

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Explicit Motor Imagery

The Explicit Motor Imagery is the second stage of Graded Motor Imagery (GMI).

In this second stage of GMI, the patient will imagine the limb in a position and then imagines the limb moving in specific illustrated positions or completing an activity with the limb. It is important that this phase is started by imagining the limb is a stationery position before imagining the limb moving.

Whenever we watch someone else’s movements we activate mirror neurons in the brain. This technique is often used by athletes, when theylearn new skills, and also when they are rehearsing performances. This Motor Imagery phase of GMI is a way to exercise the brain before the rest of the body.

Imagery trains the brain’s representation of the movement. It also builds up confidence levels without creating as much threat as actual movement. In patients with complex chronic conditions like CRPS, even imagining movement can cause an increase in symptoms including anxiety.

Information from several research studies have suggested that mental imagery may be very helpful, but they’ve indicated that more studies are needed.

It has been discussed that explicit motor imagery can help activate neural pathways in preparation for movement (Moseley, 2005). However, the use of explicit imagery without a preliminary laterality task may result in increased pain and swelling in some adult patients with CRPS (Moseley, 2004b).

How Often Should You Do The Explicit Motor Imagery Exercises?

Just as in the first stage left/right discrimination exercises, they used the explicit motor imagery exercises for 2 hours per day for 2 weeks, before moving on to the final mirror therapy stage.

Once again this can be split up into more manageable time slots.

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Mirror Therapy

The mirror therapy phase is the third stage of the GMI programme and it uses a mirror to reflect the movement of a patient’s unaffected body part that will create an illusion that the painful body area is moving freely without any pain and other symptoms. This changes its representation in the brain.

Just as in Stage 2, the Explicit Motor Imagery, this exposure to movement should be done in a graded way so as not to trigger the protection habit of the brain and cause the patient to have a flare up of their CRPS symptoms. This Mirror Therapy Stage of the GMI programme uses the same principles as the stand alone treatment – Mirror Therapy or Mirror Visual Feedback. It is thought that mirror therapy helps to reconcile sensory feedback to motor output.
Here is anvideo by the NOI group and that shows you the Recognise programme in use:

(Video) Talking graded motor imagery for pelvic pain with Katie Thurtell

How Often Should You Do The Mirror Therapy Exercises?

Just as in the previous two stages, they used the mirror therapy exercises 2 hours a day for 2 weeks. Once again this can be split up into more manageable time chunks and not all patients need the 2 weeks.

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How Could Graded Motor Imagery (GMI) Help CRPS?

Davis, M (2015) said that

“GMI offers an alternative approach, where the brain is retrained and ‘exercised’ in conjunction with the physical program.”

We are already aware that the brain in CRPS patients perceive any touch no matter how soft or hard as painful. Theidea behind both mirror therapy and GMI as a for Complex Regional Pain Syndrome (CRPS) treatment is to help ‘retrain the brain’ to not be painfuland in recent studies it has been shown to beeffective in reducing pain levels and also improving function.GMI is focusing on training the brain to re-connect to the body part affected by the Complex Regional Pain Syndrome (CRPS) pain. In other words, GMI aims to activatethe cortical networks involved in sensory-motor processing. (Johnson, S et al 2012)

In the research study byJohnson, R. (2014)he explains more about the pain that is produced by Complex Regional Pain Syndrome:

“When you have CRPS in one part of your body, your brain “disowns” the body part, recognising it as threat, instead of your hand or foot. When your brain recognises a threat to your survival, it produces pain to protect you. It is an alarm system that goes off so you can treat the injured area. However, in cases of CRPS, this alarm system is faulty.”

After the research from McCabe, C. et al. (2003) that found that mirror therapy was ineffective in chronic CRPS, it was then considered that chronic CRPS patients might benefit from a sequence initially involving hand laterality recognition and pure motor imagery before receiving actual mirror therapy. (Maihöfner, C. & Speck, V. 2012)

Moseley proposed (Moseley, GL. 2005) that imagined or mirror movements not preceded by hand laterality recognition have a poor effect on symptoms because these movements activate per se cortical networks involved in pain processing (Decety et al., 1994; Decety, 1996).

Therefore using this knowledge and research, the GMI programme consists of hand laterality recognition training, motor imagery and mirror therapy, and aims at consecutive activation of the cortical premotor and motor networks, which are relevant to the planning, selection and execution of actions (Moseley, 2004b).

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Does Graded Motor Imagery (GMI) For CRPS Work?

Everyone with Complex Regional Pain Syndrome is an individual and everyone will react differently to Graded Motor Imagery (GMI) just as in every other CRPS treatment.

A systematic review of interventions aimed at reducing pain, disability, or both, in patients with Complex Regional Pain Syndrome (CRPS) (O’Connell, 2013) identified that GMI may be effective for pain and function when compared with usual treatments for the condition. The Cochrane Review (Smart, K. M. et al 2016) rated the evidence for GMI as very low quality that GMI plus medical management may be more effective at reducing pain and improving function than conventional physiotherapy plus medical management in the treatment of CRPS I of the upper limb. (Smart, KM et al 2016) However the Cochrane Review did conclude that their findings did suggest that:

“GMI may provide clinically meaningful medium and long-term improvements in both pain and disability in CRPS I, although the results from these trials were not consistent.”

Brain training should stay ‘one step ahead’ of physical challenges. Confidence in movement has to be built up first and take fear and prediction out of the pain cycle before the brain will allow the movement physically. (Davis, M 2015)

Another systematic review of physical therapies for CRPS Type 1 concluded that there is good evidence that GMI is effective in adults with CRPS Type 1 and that GMI should be employed as part of good clinical practice (Daly and Bialocerkowski, 2009). In the research by Moseley, G.L. 2004, it also concluded that there is evidence that a six-week program of Graded Motor Imagery rehabilitation for CRPS patients does result in the improvement of both CRPS symptoms and function.

(Video) Graded Motor Imagery-By Dr. Manisha Uttam Soi PT

However in the multi-Centre prospective audit research by Johnson, S et al (2012), it was concluded that although results of Graded Motor Imagery (GMI) obtained within the context of clinical trials were encouraging, fundamental differences exist in clinical practice. This meant that the ‘real-world’ implementation of GMI failed to identify a reduction in pain intensity after treatment.

For those health professionals who are using Graded Motor Imagery for CRPS it is important to remember and be aware of the fact that GMI may be potentially ineffective or may even lead to an increase in pain in a patient. Therefore it is crucial to carefully consider the individual feedback from the patient.

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Final Words On Graded Motor Imagery

As you can see from our article above on the Complete Guide To Graded Motor Imagery (GMI) for CRPS,more work needs to be done in bringing GMI out of a clinical trial setting and into actual clinical practice.

You can also see that there are a few RCTs for GMI showing a mixture of conclusions including the Cochrane Review (Smart, K 2016) that found there was low evidence for GMI. Unfortunately for Graded Motor Imagery, the evidence is limited and analysis are not independent between the different types of CRPS, as all the evidence available is aimed towards CRPS Type I rather than both types of CRPS.

Graded Motor Imagery (GMI) is a treatment for Complex Regional Pain Syndrome (CRPS) that has to be individually tailored to the patient and cannot exist as a stand-alone treatment without patient education and interdisciplinary care.Patients’ responses and feedback to GMI will thereforebe very individual, and patients should be made aware of this. If a patient finds their pain increases during the GMI programme, they should be ready to move back a step. Pushing through or fighting thepain will always be counter-productive, therefore Pacing is the key. Life stressesand triggers should also be considered when moving through the stages of GMI. Patients and professionals should realise that not every patient will find Graded Motor Imagery (GMI) for their CRPS, an effective treatment.

It is important that practitioners/physiotherapists should build up a patient’s confidence in movement, and to remove fear and prediction out of the pain cycle before the brain will allow the movement physically.

For the mirror therapy section of the Graded Motor Imagery as a stand alone CRPS treatment as discussed in our other article – How to Use Mirror Therapy for CRPS, there are amixture of reviews and thoughts from the available research.

Please feel free toshare our Complete Guide To Graded Motor Imagery (GMI) for CRPS or make comments below. How do youthinkGMIhas worked for you either as a CRPS patient or medical professional? Let us know your thoughts.

P.S. Have you seen our other blogs on 18 Tips Preparing For Your Pain Appointment or our Complete Guide to the Dorsal Root Ganglion Stimulation for Complex Regional Pain Syndrome (CRPS)? Don’t forget to take a look!

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Read some of our other articles on CRPS treatments

Have you had chance to check out our other articles on CRPS treatments? Here’s 5 articles talking about various CRPS treatments that are available or CRPS clinical trials for new CRPS treatments:

  • Pain Diary For Chronic Pain Template
  • Learn How To Use Deep Breathing Exercises For Your CRPS or Persistent Pain
  • Series of Guides To Alternative Therapies For CRPS and Persistent Pain
  • How To Use Distraction Techniques To Help You Cope With Your CRPS or Persistent Pain
  • How To Use Desensitisation Techniques

Cited Resources:

*This blog article on Graded Motor Imagery (GMI) is for information purposes only. Please note Graded Motor Imagery (GMI) is not meant to replace your regular current treatment regime, it is usually explained to you and practiced in a hospital or clinic setting. If in doubt please contact your doctor or pain specialist. Burning Nights CRPS Support cannot be held liable for any injury, loss, accidentaldamage. Please refer to the Disclaimer for full details.

Written: 16/01/2019

Last Updated: 12/05/2020

LET’S SPREAD AWARENESS of CRPS!

Don’t forget to have a read of some our other alternative therapies for CRPS

    FAQs

    Is CRPS brain damage? ›

    The complex regional pain syndrome (CRPS) is a rare but debilitating pain disorder that mostly occurs after injuries to the upper limb. A number of studies indicated altered brain function in CRPS, whereas possible influences on brain structure remain poorly investigated.

    How does mirror therapy work for CRPS? ›

    Mirror box therapy for CRPS is thought to work by providing such a visual feedback: by moving the unaffected limb in front of the mirror there is cortical reorganisation of the sensory homunculus within the parietal cortex. Whether these changes in the cortex are a primary or secondary effect of CRPS is still unknown.

    How can I improve my CRPS? ›

    Therapies
    1. Heat therapy. Applying heat may offer relief of swelling and discomfort on skin that feels cool.
    2. Topical analgesics. ...
    3. Physical or occupational therapy. ...
    4. Mirror therapy. ...
    5. Transcutaneous electrical nerve stimulation (TENS). ...
    6. Biofeedback. ...
    7. Spinal cord stimulation. ...
    8. Intrathecal drug pumps.
    10 May 2022

    What organs does CRPS affect? ›

    Experts believe that CRPS occurs as a result of dysfunction in the central or peripheral nervous systems. Your central nervous system consists of your brain and spinal cord. Your peripheral nervous system relays information from your brain and spinal cord to your organs, arms, legs, fingers, and toes.

    Does CRPS cause memory loss? ›

    Anecdotally, patients with CRPS describe significant problems with attention/ concentration and multitasking (i.e., executive and working memory deficits), word finding problems, and problems in learning and retaining new information (i.e., declarative memory deficits).

    How often should you do mirror therapy? ›

    Do Mirror Therapy three to five times per day. Initially, you may only be able to observe the image of the mirrored hand and perhaps make small movements. With time, try to make larger and smoother movements with both arms.

    How long does it take for CRPS to go away? ›

    There's no known cure for complex regional pain syndrome (CRPS), but a combination of physical treatments, medicine and psychological support can help manage the symptoms. It's estimated around 85% of people with CRPS slowly experience a reduction in their pain and some of their symptoms in the first 2 years.

    How does mirror therapy trick the brain? ›

    Mirror therapy works by essentially “tricking the brain” out of pain. Because pain signals are processed in the brain, we can change the brain “input” and get different “output” in terms of pain. When mirror therapy is practiced, the brain receives information that both limbs are intact and functional.

    Is CRPS worse at night? ›

    The pain will usually spread upward from the injury site. The pain may persist for months or years and usually will be much worse at night.

    How do you calm down CRPS flare up? ›

    Anticonvulsants, such as gabapentin (Neurontin), are often used to treat neuropathic pain. These medications have nerve-calming properties that can alleviate symptoms of CRPS.

    Can you drive with CRPS? ›

    When can I return to driving and work? Usually, most patients with CRPS type 1 (80%) have a complete restoration of symptoms and mobility in 18 months.

    What is graded motor imagery for CRPS? ›

    Graded motor imagery is a set of treatments that are used to help reduce pain and improve the ability to move the hand, wrist, arm or any other part of the body affected by persistent or wide-spread pain.

    Which perspective is best for motor imagery? ›

    During visual motor imagery the subject sees him/her self performing the movement as from a distance (third person perspective). The results of Stinear suggest that kinesthetic motor imagery would be more effective for motor learning than visual motor imagery.

    How do you do mirror box therapy? ›

    Sit comfortably with the injured/painful hand in the box, keeping it hidden from view. Place the other hand in front of the mirror. Leaning forward and comfortably centred, look at the image created in the mirror. Your brain is now 'seeing' the injured/painful hand.

    Can CRPS affect your bowels? ›

    CRPS can spread to ALL aspects of the body, including our internal organs. Bladder dysfunction, bowel dysfunction and abdominal pain can be affected according to the April 2014 online health chat with Dr.

    How does CRPS affect teeth? ›

    As symptoms of the condition, many people suffering CRPS develop swollen gums and brittle teeth. Some reports suggest that 75% of CRPS sufferers have dental issues, often serious. As we all know, whilst it is improving slowly, awareness of CRPS among the medical profession generally is poor.

    Where is CRPS on the pain scale? ›

    CRPS (formerly known as RSD) is classed as the most painful chronic pain condition that is known. It reaches approx 42 out of 50 on the McGill Pain Scale, higher than non-terminal cancer, higher than amputation of a finger without anaesthesia…

    What part of the brain is affected by CRPS? ›

    The patients with newly diagnosed CRPS exhibited reduced perfusion and gray matter volume in brain regions associated with the limbic system, somatosensory cortex, and spatial body perception, indicating brain plasticity during the early stages of the disease.

    Does CRPS cause brain fog? ›

    Commonly referred to as 'brain fog', sufferers say the benign symptom is one of the most debilitating and embarrassing side-effects of the chronic condition. Brain fog is a very common complaint amongst patients with CRPS.

    Is CRPS all in your head? ›

    The cause of CRPS is unknown, but it's thought to be the result of the body reacting abnormally to an injury. It used to be thought that CRPS was a psychosomatic condition, where the symptoms are "all in the mind", but research has disproved this.

    When should you stop using mirror therapy? ›

    When to stop Mirror Therapy? Side effects are not common. However, if you experience any of the following symptoms discontinue the exercises and speak to your therapist: Increase in phantom limb pain, phantom sensations, feelings of grief or confusion, dizziness, sweating, or sensory changes.

    How long does it take for mirror therapy to work? ›

    At the end of treatment, mirror therapy moderately improved movement of the affected upper and lower limb and the ability to carry out daily activities for people within and also beyond six months after the stroke. Mirror therapy reduced pain after stroke, but mainly in people with a complex regional pain syndrome.

    Is mirror therapy easy or difficult? ›

    Mirror therapy is actually quite easy to do at home and many people find it a fun way of having additional therapy for their hand and arm.

    Is CRPS a permanent disability? ›

    The exact cause of complex regional pain syndrome isn't well understood but may involve abnormal inflammation or nerve dysfunction. The pain of this condition is greater than would be expected from the injury that causes it. Typically, CRPS is a permanent disability as there is no cure for it.

    How do I know if my CRPS is spreading? ›

    Signs of the Syndrome Spreading

    If the CRPS spreads, it will usually stay on the same side of your body or spread to the opposite limb. Therefore, it's important to pay attention to neighboring regions of the body. For instance, if your CRPS is in your left leg, monitor both your left arm and also your right leg.

    Does gabapentin help with phantom pain? ›

    This study has shown that after 6 weeks therapy with gabapentin, spontaneous phantom limb pain is reduced compared with placebo in postamputa- tion patients.

    What happens in mirror therapy? ›

    It is thought that the mirror works by 'tricking' the brain to believe that the painful limb is now 'normal', through looking at the reflection of the unaffected limb. This helps, over time, to correct the messages to the brain and reduces pain which in turn may assist exercise.

    What is a mirror stroke? ›

    Mirror therapy uses a mirror to create the illusion that the arm or leg affected by the stroke is moving. After a stroke, mirror therapy can improve movement in affected upper or lower limbs and activities of daily living and appears useful as a supplement to other stroke rehabilitation activities.

    Does CRPS make you tired? ›

    Fatigue, lethargy, tiredness and weakness are frequent complications of complex regional pain syndrome. This is likely due to the body's inflammatory response as the condition progresses.

    What are the 3 stages of CRPS? ›

    The three clinical stages of type 1 complex regional pain syndrome (CRPS 1) are acute, subacute, and chronic. The acute form lasts approximately 3 months.

    Is CRPS a mental illness? ›

    Complex Regional Pain Syndrome (CRPS) is a neuropathic disorder that usually occurs after a trauma, surgery, medical procedure, prolonged immobilization (1).

    What triggers CRPS? ›

    Many cases of CRPS occur after a forceful trauma to an arm or a leg. This can include a crushing injury or a fracture. Other major and minor traumas — such as surgery, heart attacks, infections and even sprained ankles — also can lead to CRPS . It's not well understood why these injuries can trigger CRPS .

    Is heat or ice better for CRPS? ›

    Heat therapy relaxes the muscles and warms the cool skin that often accompanies CRPS. Individuals should be careful not to apply too much heat for too long. Ice or cold therapy should be avoided as it can worsen CRPS symptoms (regardless of any short-term relief).

    Can CBD help with CRPS? ›

    According to the below website, CBD oil is excellent at helping people with CRPS, helping to relieve nerve pain,muscle spasms,inflammation and stiffness.It can also help relive insomnia. Pure CBD oil has no psychoactive effects as the THC is removed ( the stuff that makes you high).

    Does flying make CRPS worse? ›

    Be aware – cabin pressure on an aircraft can exacerbate CRPS. Not everyone is affected and some only mildly, but others experience a significant increase in pain and swelling during a flight.

    Can I claim Pip for CRPS? ›

    CRPS and Personal Independence Payment (PIP)

    As with almost all applicants, a CRPS sufferer claiming PIP will be required to undergo an eligibility assessment. The amount of benefit varies according to the assessed level of disability.

    Can CRPS go into remission? ›

    If CRPS is diagnosed early and treatment begins as soon as possible, however, there is a chance that the disorder may go into remission. With treatment, a sufferer may experience as many as 5 years of remission or more before the effects of CRPS return.

    Is CRPS all in your head? ›

    The cause of CRPS is unknown, but it's thought to be the result of the body reacting abnormally to an injury. It used to be thought that CRPS was a psychosomatic condition, where the symptoms are "all in the mind", but research has disproved this.

    Does CRPS affect life expectancy? ›

    It is possible to live a normal life after being diagnosed with CRPS, but certain things will have to change. The sufferer must understand his or her limits and be attuned to the demands being made of his or her system.

    How do I know if my CRPS is spreading? ›

    Signs of the Syndrome Spreading

    If the CRPS spreads, it will usually stay on the same side of your body or spread to the opposite limb. Therefore, it's important to pay attention to neighboring regions of the body. For instance, if your CRPS is in your left leg, monitor both your left arm and also your right leg.

    Does CRPS qualify you for disability? ›

    Thus, some people wonder if they or a loved one can get disability benefits for complex regional pain syndrome. The short answer is yes, it is possible to receive Social Security disability benefits, but one must be eligible. While there is not a specific listing for CRPS, it is often times a severe impairment.

    Is CRPS worse at night? ›

    The pain will usually spread upward from the injury site. The pain may persist for months or years and usually will be much worse at night.

    Where is CRPS on the pain scale? ›

    CRPS (formerly known as RSD) is classed as the most painful chronic pain condition that is known. It reaches approx 42 out of 50 on the McGill Pain Scale, higher than non-terminal cancer, higher than amputation of a finger without anaesthesia…

    Does CRPS show up on MRI? ›

    Magnetic resonance imaging (MRI) can also be used to determine if tissue changes typical of CRPS and specialized magnetic resonance neurography can be used to evaluate for specific nerve involvement.

    What are the 3 stages of CRPS? ›

    The three clinical stages of type 1 complex regional pain syndrome (CRPS 1) are acute, subacute, and chronic. The acute form lasts approximately 3 months.

    Can CRPS affect eyesight? ›

    People suffering CRPS commonly report blurred vision, double vision, poor focus, light sensitivity and “dry eye”.

    What makes CRPS flare? ›

    In more than 90 percent of cases, CRPS is triggered by nerve trauma or injury to the affected limb that damages the thinnest sensory and autonomic nerve fibers.

    Is CRPS considered a rare disease? ›

    With just 200,000 people in the U.S. diagnosed with CRPS in the U.S., most people have not heard of CRPS, which is classified as a “rare disease” with no cure.

    How do you describe CRPS pain? ›

    Continuous burning or throbbing pain, usually in the arm, leg, hand or foot. Sensitivity to touch or cold. Swelling of the painful area. Changes in skin temperature — alternating between sweaty and cold.

    Can you drive with CRPS? ›

    When can I return to driving and work? Usually, most patients with CRPS type 1 (80%) have a complete restoration of symptoms and mobility in 18 months.

    Can I get long term disability for CRPS? ›

    If you are suffering from a Complex Regional Pain Syndrome (CRPS), you can apply for the long-term disability benefits if eligible. If successful, these will provide you with monthly income payments during long absences from work to ease the financial pressure weighing you down.

    Should you see a neurologist for CRPS? ›

    When a primary care physician gathers evidence suggesting you may eventually be diagnosed with CRPS, he or she should refer you to a neurologist for ongoing diagnostic work and treatment.

    Does CRPS cause fatigue? ›

    Fatigue, lethargy, tiredness and weakness are frequent complications of complex regional pain syndrome. This is likely due to the body's inflammatory response as the condition progresses.

    Videos

    1. Physical Therapy, CRPS, and Chronic Pain with Julie Bergmann, PT, DPT, OCS RSDSA
    (Southern California Aquatic and Physical Therapy)
    2. Ask a Researcher with Katie Kelly - Graded Motor Imagery in Genito-pelvic Pain
    (Vida Health & Wellness)
    3. Facebook Live with Anita Davis, PT, DPT | RSDSA
    (RSDSA)
    4. The Treatment of Persistent Pain
    (The Institute of Clinical Excellence)
    5. Complex Regional Pain Syndrome part 3 by Nityal Kumar
    (JSS physio insights)
    6. Treating the brain in pelvic pain - with Dr Sandy Hilton
    (Jilly Bond)

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