Authors: Kira L, Donnelly, SPT; Lauryn M. Helmers, SPT; Olivia M. Verberne, SPT; Roger J. Allen, PT, PhD
Title: The Effectiveness of Desensitization Therapy for Individuals with Complex Regional Pain Syndrome: A Systematic Review
Purpose: Systematically review evidence supporting the use of desensitization therapy to treat Complex Regional Pain Syndrome (CRPS).
Subjects: This systematic review evaluated 10 studies from peer-reviewed journals fitting research criteria.
Materials/Methods: Databases were searched between Mar and Aug of 2014 with the following search terms: complex regional pain syndrome, CRPS, allodynia, desensitization, neuropathic pain, physical therapy, tactile desensitization, pressure desensitization, hydrotherapy, physiotherapy, capsaicin and somatosensory.
Results: Initial search yielded 42 articles with 10 fitting inclusion/exclusion criteria. Articles were evaluated with the STROBE scale and organized by desensitization type: chemical, tactile, thermal and pressure desensitization. Outcome measures varied, including assessing functional use, pressure tolerance and pain tolerance.
Conclusions: Despite lacking a standard desensitization protocol, research suggests implementing desensitization by selecting the proper somatosensory modality and using a graded protocol in order to reduce allodynia.
Clinical Relevance: Desensitization is often a component of a multifaceted treatment approach for patients with CRPS, which is difficult to isolate within research. To make solid conclusions about desensitization efficacy, studies need to isolate desensitization as a treatment using larger numbers of subjects with CRPS with clear, controlled and replicable protocols. Given current research limitations, existing evidence is promising for continued utilization of graded desensitization therapy for individuals with CRPS.
Keywords: desensitization, complex regional pain syndrome, allodynia, tactile desensitization, pressure desensitization, hydrotherapy, capsaicin, physical therap