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This study examines the prevalence of trigger points in muscles in the thorax in upper limb Complex Regional Pain Syndrome (CRPS) patients, compared to healthy subjects. In addition, we will examine if adding treatment to muscles in the thoracic area (to the regular physical therapy treatment) will alleviate some of the sensitivity in the upper limb in CRPS patients.
This study examines the prevalence of trigger points in muscles in the thorax in upper limb Complex Regional Pain Syndrome (CRPS) patients, compared to healthy subjects. The muscles that will be examined are: Subclavius, Pectoralis minor, Rhomboids, Infraspinatus and Serratus superior posterior.
In addition, we will examine if adding treatment to muscles in the thoracic area (to the regular physical therapy treatment) will alleviate some of the sensitivity in the upper limb in CRPS patients.This will be examined in an A-B-A design: at first the patients will be examined. Then they will recieve conventional physiotherapy treatment for a month. After a month, they will be examined again, and then they will recieve soft tissue massage to the thoracic area for 15 minutes in addition to the conventional physiotherapy treatment. After a month of the combined treatment, the patients will be examined a third and final time.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CRPS patients | Experimental | CRPS patients that will be examined for trigger points in the thoracic muscles. 10 out of the 23 will also be included in the intervention stage and will recieve a month of conventional physiotherapy, and a month of conventional physiotherapy with addition of massage to the thoracic area. |
|
| healthy controls | No Intervention | healthy controls that will be examined for trigger points in the thoracic muscles (and will be compared to the CRPS patients) |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| massage | Diagnostic Test | a 15 minutes thoracic massage will be added to the regular physical therapy treatment |
|
| Measure | Description | Time Frame |
|---|---|---|
| Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire | Questionnaire that examines upper limb function | 10 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Goniometer | shoulder flexion range of motion | 1 minute |
| CRPS severity score (CSS) | form filled by an MD after an interview and examination of a patient |
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Inclusions Criteria for "cases" in stage 1 and all subjects of stage 2:
Inclusions Criteria for "controls" in stage 1:
Exclusion criteria for all subjects in stages 1 and 2:
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| Name | Affiliation | Role |
|---|---|---|
| Jean-Jeaques Vatine, Prof | Reuth Rehabilitation Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Reuth Rehabilitation Hospital | Tel Aviv | Israel |
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| ID | Term |
|---|---|
| D020918 | Complex Regional Pain Syndromes |
| ID | Term |
|---|---|
| D001342 | Autonomic Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D010523 | Peripheral Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
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The observation stage is a case- control study, the treatment stage is an A-B-A design.
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| 20 minutes |
| skin rolling test | 1 minute |
| trigger point examination | 5 minutes |
| NPRS | Numerical Pain Rating Scale | 1 minute |
| Pressure algometer | pressure pain threshold | 10 minutes |
| Allodynia in scapula, arm and forearm | von Frey filaments | 5 minutes |