Short- and long-term outcomes of children with complex regional pain syndrome type I treated with exercise therapy

Clin J Pain. 1999 Sep;15(3):218-23. doi: 10.1097/00002508-199909000-00009.


Objective: To report the initial and long-term outcome after an intensive exercise therapy program for childhood complex regional pain syndrome, type I (CRPS).

Design: Prospective follow-up.

Setting: A children's hospital.

Subjects: We followed 103 children (87 girls; mean age = 13.0 years) with CRPS. Forty-nine subjects were followed for more than 2 years (mean = 5 years 3 months).

Interventions: An intensive exercise program (most received a daily program of 4 hours of aerobic, functionally directed exercises, 1-2 hours of hydrotherapy, and desensitization). No medications or modalities were used. All had a screening psychological evaluation, and 79 (77%) were referred for psychological counseling.

Main outcome measures: Outcomes included pain, presence of physical dysfunction, or recurrent episodes of CRPS or other disproportional musculoskeletal pain.

Results: The mean duration of exercise therapy was 14 days, but over the past 2 years has decreased to 6 days. Ninety-five children (92%) initially became symptom free. Of those followed for more than 2 years, 43 (88%) were symptom free (15, or 31 %, of these patients had had a reoccurrence), 5 (10%) were fully functional but had some continued pain, and 1 (2%) had functional limitations. The median time to recurrence was 2 months; 79% of the recurrences were during the first 6 months after treatment.

Conclusion: Intense exercise therapy is effective in initially treating childhood CRPS and is associated with low rate of long-term symptoms or dysfunction.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Exercise Therapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Hydrotherapy
  • Male
  • Prospective Studies
  • Psychological Tests
  • Recurrence
  • Reflex Sympathetic Dystrophy / physiopathology
  • Reflex Sympathetic Dystrophy / psychology
  • Reflex Sympathetic Dystrophy / therapy*
  • Time Factors
  • Treatment Outcome