Other publications by CRPS Network members 2019-2020

Many of our Network members are experienced researchers in the field of CRPS and chronic pain. Not all of their publications are directly related to Registry studies, but are still very relevant to our work. A key selection are listed below.

Abstracts (overviews) of all research papers can be accessed using the following links, but please note that some will require an active subscription to the relevant journal in order to access the full publication.

Sensitivity to Ambient Temperature Increases in fibromyalgia and CRPS - published in Pain Medicine as a Letter to the Editor, December 2020 (previously published online in April 2020). People with chronic pain often report that their symptoms are exacerbated by weather conditions, such as cold ambient temperature. However, research on this topic is scarce, and it is not clear if the nature of reports from people with CRPS is different than that of people with fibromyalgia or other pain condition.

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Exploring the impact of pain management programme attendance on complex regional pain syndrome (CRPS) patients' decision making regarding immunosuppressant treatment to manage their chronic pain condition - published in the Scandinavian Journal of Pain, October 2020 (previously published online in August 2020). Patients in tertiary centres are often required to make decisions about treatment options. This study was conducted to explore how prior attendance of a pain management programme might alter their decision making processes.

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Self-Management for Persistent Pain: The Blame, Shame and Inflame Game? - book written by Professor Karen Rodham. Published by Palgrave Macmillan in August 2020. This book critiques the current approach to the self-management of persistent pain. Drawing from the research evidence as well as her practice experience, the author advocates a move away from the terms ‘self’ and ‘management’ towards a more collaborative approach. One which takes account of the life-context of the person who is living with persistent pain. This book explores the shortcomings of the tendency to focus on self-management without taking into account life context and considers how we got here and what can be done. Ideal for researchers and practitioners, especially in the field of health psychology.

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Successful and unsuccessful recruitment and retainment strategies in a UK multicentre drug trial for a rare chronic pain condition which performed above target - published in the British Journal of Pain, August 2020 (previously published online in December 2019). Recruitment into trials in rare chronic pain conditions can be challenging. Drawing on the authors' own experience in conducting the largest academic trial to date in CRPS, this study identifies recruitment and retention strategies for successful trial conduct.

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The role of non-medical therapeutic approaches in the rehabilitation of Complex Regional Pain Syndrome - published online in Current Treatment Options in Rheumatology, July 2020. Non-medical therapeutic approaches are fundamental to the management of CRPS in order to promote the best outcome for patients. This review focuses on three key approaches underpinning CRPS rehabilitation, namely, physiotherapy and occupational therapy, psychological approaches and education and self-management.

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Some bubbles don't burst - blog published on author's own website, July 2020. This reflects on the impact of lockdown for people with pain.

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Fear, boldness and caution: parent effects on how children manage chronic pain - published in PAIN, June 2020. It is well established that parents affect how well children cope with chronic pain and associated disability, yet exactly how that influence happens is not fully understood. This commentary paper looks at a previous study undertaken by Birnie et al.

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What is the incidence of Complex Regional Pain Syndrome (CRPS) Type 1 within four months after wrist fracture in the adult population? A systematic review - published in Hand Therapy, June 2020 (previously published online in March 2020). This literature review found evidence that the reported incidence of CRPS is influenced by choice of diagnostic criteria, along with the study location and/or how the fracture is managed.

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Managing patients with chronic pain during the COVID-19 outbreak: considerations for the rapid introduction of remotely supported (e-health) pain management services - published in PAIN, May 2020. This paper considers four related factors to help guide healthcare professionals caring for patients with chronic pain: (i) the public health consequences of COVID-19 for patients with pain, (ii) the consequences of not treating these patients for the unknown duration of this pandemic; (iii) options for remote assessment and management; and (iv) clinical evidence supporting remote therapies.

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The contribution of motor commands to the pertubations induced by sensorimotor conflicts in fibromyalgia - published in Neuroscience, May 2020 (previously published online in March 2020). Individuals with pain report higher sensory disturbances during sensorimotor conflicts compared to pain-free individuals. This study found that sensitivity to conflicts increased when patients with fibromyalgia performed active movements compared to passive movements.

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The NIHR 70@70 programme: transforming research - article published in the British Journal of Nursing, February 2020.  Nurse and midwife-led and delivered research generates multiple benefits. Additionally, research increases patients' trust in and satisfaction with the care received and promotes perceptions of nursing and midwifery as credible professions. The NIHR 70@70 programme has been introduced to support and develop a cohort of outstanding leaders in research activity.

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The experience of persistent pain in adult cancer survivors: a qualitative evidence synthesis - published in the European Journal of Cancer Care, January 2020. This review concluded that persistent pain is intrinsically interwoven with women's experiences of cancer. Persistent pain was unexpected, and women did not feel supported. Women need more information about persistent pain after cancer treatment and support with self‐management of pain. Ways to best support cancer survivors with persistent pain need exploration and a review of currently available services is required. More research is needed to understand the experiences of men and other cancer groups.

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Autoantibodies produce pain in complex regional pain syndrome by sensitizing nociceptors - published in PAIN, December 2019.  Nociceptors are sensory neurons that respond to damaging stimuli by sending "possible threat" signals to the spinal cord and the brain. Results of this animal study showed that painful hypersensitivity in persistent CRPS is maintained by autoantibodies, which act by sensitizing A and C nociceptors.

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Sensory function and pain experience in arthritis, complex regional pain syndrome, fibromyalgia syndrome and pain-free volunteers: a cross-sectional study - published in The Clinical Journal of Pain, November 2019. This study aimed to identify relationships between sensory function and pain in three common pain conditions.

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Arthritis pain management: a holistic approach - published in Rheumatology, August 2019. Earlier this year, EULAR published recommendations for pain management in patients with inflammatory arthritis and osteoarthritis. Why are such recommendations needed? What are the recommendations? What is their likely impact?

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Complex regional pain syndrome (CRPS) in orthopaedics: an overview - published in Orthopaedics and Trauma, August 2019. This paper provides an overview of the latest understanding of CRPS and national guidelines, explains how to make a diagnosis, describes initial treatment and controversies in orthopaedic care, and explores the implications of CRPS to the orthopaedic team.

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Body perception disturbance and pain reduction in longstanding complex regional pain syndrome following a multidisciplinary rehabilitation program - published in Pain Medicine, August 2019. Clinical guidelines for the treatment of CRPS recommend multidisciplinary rehabilitation, yet limited evidence exists to support the effectiveness of this approach. Body perception disturbance, a common and debilitating feature of CRPS, is recommended by guidelines as important to treat. However, no study has yet explored whether disturbances change in response to multidisciplinary rehabilitation. This study aimed to determine whether there is a change in body perception disturbance and pain following a two-week multidisciplinary rehabilitation programme for CRPS.

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Complex Regional Pain Syndrome: An international survey of clinical practice - published in the European Journal of Pain, August 2019. Published guidelines promote best practice in the treatment and management of CRPS; however, these recommendations are not always applied in clinical practice. An e‐survey was conducted in order to gain an insight into routine CRPS clinical practice. This will help to inform future patient and health professional service delivery, education initiatives and content of clinical guidelines. 

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Experimentally induced pain does not influence updating of peripersonal space and body representations following tool-use - published in PLoS One journal, May 2019. Representations of the body and peripersonal space can be distorted for people with some chronic pain conditions. It is unclear whether induced pain disrupts the mechanisms involved in updating these representations. This study compared performance of tasks under pain, active placebo and neutral conditions.

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Standards for the diagnosis and management of Complex Regional Pain Syndrome: Results of a European Pain Federation task force - published in the European Journal of Pain, April 2019. The European Pain Federation task force present 17 standards of the diagnosis and management of CRPS for use in Europe. These are considered achievable for most countries and aspirational for a minority of countries depending on their healthcare resource and structures.

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Maintained physical activity and physiotherapy in the management of distal upper limb pain - a randomised controlled trial - published in RMD Open (Rheumatic and Musculoskeletal Diseases), March 2019. The epidemiology of distal arm pain and back pain are similar. However, management differs considerably: for back pain, rest is discouraged, whereas patients with distal arm pain are commonly advised to rest and referred to physiotherapy. We hypothesised that remaining active would reduce long-term disability and that fast-track physiotherapy would be superior to physiotherapy after time on a waiting list. Among patients awaiting physiotherapy for distal arm pain, advice to remain active results in better 26-week functional outcome, compared with advice to rest. Also, immediate physiotherapy confers no additional benefit in terms of disability, compared with physiotherapy delivered after 6–8 weeks waiting time. These findings question current guidance for the management of distal arm pain.

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Exploring the relationships between alterations of body image, sense of limb position and sense of limb movement in complex regional pain syndrome - published in The Journal of Pain (American Pain Society), January 2019. The objectives of this study were to assess body perception and the senses of limb position and limb movement in CRPS, and to test whether these variables are related to each other and to pain intensity. From a clinical perspective, these data suggest that these two body representations should be evaluated separately in CRPS, and that interventions aimed at improving body image will not necessarily impact body schema and vice versa. However, more reliable assessment methods of body image in CRPS are needed.

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