We’ve been looking at how movement can reduce your pain for the past few Wednesdays, (1, 2, 3). CRPS (Complex Regional Pain Syndrome) is a severe neurological pain problem, with symptoms including pain, temperature instability, and movement problems like tremors and spasm.
1 type of movement problem is dystonia, a form of significant muscle spasm. This limits functioning, as well as being painful.
A new study by neurologist Esther Gieteling et al. from the Netherlands looked at what fMRI brain scans show in patients with CRPS who had dystonia. What they found included:
- when patients imagined movements of their painful side, their brain blood flow was less in certain brain areas compared to people without CRPS
- when patients actually moved either side, their brain blood flow was the same as controls
- when patients imagined movements of their non-painful side, their brain blood flow was also the same
The authors believe this study shows that brain control of movement is altered in CRPS. This means the problem is not (just) in the muscles themselves, but in the brain. (They’re unsure why actual movement of the affected side looked the same in patients and controls.)
The previous posts (see above 1, 2, 3) show what you can do to help pain by slowly practicing movements. 2 websites which offer very helpful information are:
The original study is in press 6/07 in Pain, and is based on work from the Department of Neurology, University of Groningen.
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4 responses so far ↓
Matthias // Jul 11, 2007 at 8:46 am
CRPS, Dystonia, RSI and all the other diseases are primarily diseases of the brain. The outward symptoms like muscle cramps or sympathetic dysregulation are caused by cortical misrepresentation of the affected limb.
of basing it’s decisions on the cortical representation and not the actual state of the limb itself.
Our brain has the bad habit
In Dystonia the cortical fields become “smudged” - there are no longer clear boundaries between the fingers for example. Re-establishing these separate cortical fields is crucial in the treatment of these disorders.
It can only be hoped that blogs like yours and others will get the message out to more people who suffer from these conditions so that the old treatments stop and new - brain based treatments - become available everywhere.
Keep up the good work!
Matthias
HtCwP // Jul 11, 2007 at 12:23 pm
Thanks for your comment. You’re right… newer understandings of pain really need to be broadcast!
jeisea // Jul 11, 2007 at 11:07 pm
Thank you HTCWP and Matthias. The new approach to pain and pain management has made a huge difference to me. Today I feel great. Having breaks between flare up is new for me and has only been happening since I’ve been using mirror therapy. I think Matthias, the smudging in the brain you speak of, also explains the spread of CRPS. The point of location of pain becomes less defined and the area of pain spreads out as if you rubbed a pencil word with your finger.
When I do mirror therapy for eg my whole left side. I know the location of injury (or initial pain) is my shoulder. When I begin mirror therapy, the pain retreats back both from the top (head) and the bottom (feet/leg) - rubbing out the smudge. After a while of doing mirror therapy, the pain and symptoms are confined to the shoulder area. This eventually also goes.
Guided Imagery, limb laterality programs such as Recognize and mirror visual therapy have provided a fresh, inexpensive and drug free approach to pain management.
jeisea
HtCwP // Jul 12, 2007 at 7:00 am
Be sure to check out Jeisea’s website, which shows how she works with mirrors. She’s been using this technique a while, and knows some good ways to do it.
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