Restoration of Tactile Performance in the Affected Hand via High-Frequency Repetitive Sensory Stimulation May Lead to Reduced Pain in some CRPS Patients

Dear Pain Matters blog readers,

Prof. Dr. Christoph Maier and team recently found that restoration of sensation (i.e. tactile performance) in the affected hand via high-frequency repetitive sensory stimulation (HF-rSS) may result in significantly decreased pain in patients with complex regional pain syndrome (CRPS).

Specifically, the Current Pain Intensity decreased by more than 30% in 4 of 16 CRPS patients who underwent HF-rSS of the CRPS-affected hand for 45 minutes a day for 5 consecutive days only.

Significantly improved tactile discrimination in the CRPS-affected hand also occurred in all 16 CRPS patients following HF-rSS intervention.

There were no medication changes in the 16 CRPS patients who had HF-rSS  intervention.

Prof. Dr. Christoph Maier

Featured Image and Above Image:

Sources:  

http://bergmannsheil.bg-kliniken.de/behandlungsspektrum/anaesthesie-intensivmedizin-palliativmedizin-schmerzmedizin/schmerzmedizin.html

http://www.schmerzfreies-krankenhaus.de/kooperationspartner.html

The Study Including Results:

The study involved 20 CRPS patients, 16 who underwent HF-rSS treatment for 45 minutes a day for 5 consecutive days, while another 4 had low-frequency repetitive sensory stimulation.

Targeted electrical stimulation was applied to all the fingertips in the CRPS-affected hand by a custom-made hand pad.

Four (4) of 16 enjoyed significant pain reduction (more than 30% pain reduction) following HF-rSS treatment for 5 consecutive days.  

According to Table 1 in the study by Maier and his team, the following 4 patients had significantly reduced pain intensities immediately following HF-rSS treatment for 5 days (compared to their average pain levels, 4 weeks preceding this treatment):

• Patient #2 (46 years, male; CRPS, right hand, duration = 5 months; fracture/surgery)
  • Average Pain (prior) = 7
  • Current Pain (after) = 0
• Patient #8 (58 years, male; CRPS, left hand, duration = 4 months; surgery)
  • Average Pain (prior) = 6
  • Current Pain (after) = 1

• Patient #9 (60 years, female; CRPS, left hand, duration = 2 months; fracture/surgery)
  • Average Pain (prior) = 10
  • Current Pain (after) = 1

• Patient #15 (60 years, male; CRPS, right hand, duration = 8 months; fracture/surgery)
  • Average Pain (prior) = 9
  • Current Pain (after) = 2

The same Table 1 also listed 2 additional patients with significantly reduced pain following low-frequency repetitive sensory stimulation:

• Patient #19 (58 years, female; CRPS, right hand, duration = 9 months; surgery)
  • Average Pain (prior) = 7
  • Current Pain (after) = 3

• Patient #20 (58 years, male; CRPS, left hand, duration = 4 months; fracture/surgery)
  • Average Pain (prior) = 5
  • Current Pain (after) = 0

It is not known how long these pain reductions lasted.

Summary:

High-frequency repetitive sensory stimulation (HF-rSS) to all fingertips in the CRPS-affected hand:

• to improve sensory loss (i.e. restore sensation including tactile performance); and/or
• to reduce pain in the CRPS-affected hand

may be a useful non-pharmacological (add-on) treatment for some CRPS sufferers.

Maier and his colleagues conceded that while CRPS patients were only tested for 5 consecutive days, greater pain reductions for more CRPS patients may have resulted had the testing period been significantly longer.

This is a fair comment given that a study involving 2 amputees with phantom limb pain resulted in restoration of sensation as well as nil phantom limb pain following ‘prosthetic system treatment’ for (up to) 2 years.

https://painmatters.wordpress.com/2016/08/11/restoration-of-sensation-may-lead-to-reduced-phantom-limb-pain-in-amputees/

Sabina Walker

“Sedare dolorem divinum opus est”
“It is divine to alleviate pain”

Galen, 130-200 C.E.

REFERENCE

(1) David M, Dinse HR, Mainka T, Tegenthoff M, Maier C.

High-Frequency Repetitive Sensory Stimulation as Intervention to Improve Sensory Loss in Patients with Complex Regional Pain Syndrome I.

Frontiers in Neurology. 2015;6:242.

doi:10.3389/fneur.2015.00242.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648023/pdf/fneur-06-00242.pdf

(2) High Frequency Stimulation in Pain Medicine

Kalus, Annegret

Ruhr-University Bochum (No. 163 – 20.11.2015)

http://aktuell.ruhr-uni-bochum.de/pm2015/pm00163.html.en

(3) Hochfrequente Stimulation Hilft Menschen Mit Schmerzsyndrom

Schubert, Christine

CRPS Bayern Morbus Sudeck Selbsthilfegruppe (19.2.2016)

https://by.crps-netzwerk.org/cms/blog/2016/02/19/hochfrequente-stimulation-hilft-menschen-mit-schmerzsyndrom/