This study evaluated the effectiveness of two therapeutic approaches-Desensitization Training (DT) and Graded Motor Imagery (GMI)-in reducing wrist pain and improving function in patients with Reflex Sympathetic Dystrophy (RSD). The sample size was calculated using Epitools for one-way ANOVA comparison with two independent groups. A total of 40 participants were randomly assigned into two groups: the DT group and the GMI group, each consisting of 20 patients. The DT group underwent sessions involving progressive tactile stimulation using different textures and temperatures to reduce hypersensitivity and allodynia.

In contrast, the GMI group followed a structured three-phase cognitive rehabilitation protocol including laterality recognition, explicit motor imagery, and mirror therapy, aimed at re-training cortical representation and reducing pain perception. Both groups received same number of sessions. Visual Analogue Scale (VAS), Patient Rated Wrist Evaluation (PRWE) & Specific Questionnaire for two groups is used to for pain and functional assessment involving wrist

Inclusion Criteria:

• Participants aged 18 to 65 years.
• Participants must have a confirmed diagnosis of Reflex Sympathetic Dystrophy (CRPS) Type I, affecting the wrist, according to the Budapest Criteria.
• Participants must experience chronic wrist pain for at least 3 months but not more than 24 months.
• Participants must be able to offer written informed consent and participate in the study willingly.
• Participants must demonstrate sufficient cognitive function to understand the training protocols (assessed via screening tools such as the Mini-Mental State Examination).

Exclusion Criteria:

• Participants who have undergone any surgical intervention for the wrist (other than the injury that led to RSD), or those with traumatic injuries that cause structural damage will be excluded.
• Participants with significant neurological disorders affecting the upper limb.
• Individuals with active psychiatric conditions, such as severe depression, anxiety, or psychosis which may impair participation in the study.
• Participants with poorly controlled medical conditions such as diabetes, cardiovascular disease, or autoimmune disorders that could interfere with treatment outcomes or the ability to participate in the study.