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Tuesday 24th to Friday 27th April.
British Pain Society annual scientific meeting
Glasgow at the Scottish Exhibition + Conference Centre (SECC)

Professionals:
Tuesday 9th January 2007
Psychology of chronic pain
and suffering (5th Study Day)
Churchill House, 35 Red Lion Square,
London WC1R 4SG

Wednesday 9th May 2007
Opioids and substance
misuse (6th Study Day)
Churchill House, 35 Red Lion Square,
London WC1R 4SG

Medical Literature

Mirror Therapy for Hand Rehabilitation

Swedish research group describes the use of mirror therapy for rehabilitation after hand surgery.

Abstract-- "Treatment with a mirror gives an illusion of function in a missing or non-functioning hand. The method is based on the concept that the central representation of phantoms and body image can change rapidly, and has been described in the treatment of phantom pain and stroke. We show in three pilot cases new applications for the use of the mirror in rehabilitation after hand surgery". Scand J Plast Reconstr Surg Hand Surg. 2005;39(2):104-8. Training with a mirror in rehabilitation of the hand. Rosen B, Lundborg G.

Motor imagery and mirror therapy for CRPS and Phantom Pain.
Motor imagery including mirror box therapy shown to reduced pain and disability in patients with complex regional pain syndrome type I or phantom limb pain.

Neurology. 2006 Nov 2 Moseley GL.
Abstract-"Phantom limb and complex regional pain syndrome type 1 (CRPS1) are characterized by changes in cortical processing and organization, perceptual disturbances, and poor response to conventional treatments. Graded motor imagery is effective for a small subset of patients with CRPS1.

OBJECTIVE: To investigate whether graded motor imagery would reduce pain and disability for a more general CRPS1 population and for people with phantom limb pain.METHODS: Fifty-one patients with phantom limb pain or CRPS1 were randomly allocated to motor imagery, consisting of 2 weeks each of limb laterality recognition, imagined movements, and mirror movements, or to physical therapy and ongoing medical care.

RESULTS: There was a main statistical effect of treatment group, but not diagnostic group, on pain and function. The mean (95% CI) decrease in pain between pre- and post-treatment (100 mm visual analogue scale) was 23.4 mm (16.2 to 30.4 mm) for the motor imagery group and 10.5 mm (1.9 to 19.2 mm) for the control group. Improvement in function was similar and gains were maintained at 6-month follow-up. CONCLUSION: Motor imagery reduced pain and disability in these patients with complex regional pain syndrome type I or phantom limb pain, but the mechanism, or mechanisms, of the effect are not clear".

General review on physiotherapy for CRPS
Musculoskeletal Care. 2005 Dec;3(4):181-200. Links
How effective is physiotherapy in the treatment of complex regional pain syndrome type I? A review of the literature. Smith TO. "Complex regional pain syndrome (CRPS) is a debilitating pain disorder for which patients commonly receive physiotherapy. The objective of this literature review is to assess how effective physiotherapy is in the management of adult and childhood CRPS type I.

An electronic literature search was performed of the databases AMED, Cinahl, Embase, Ovid Medline, Pubmed, PEDro and PsycINFO, from their inception to November 2004. Human subjects clinical trials, written in English, which could assist in answering the research question were included. Twenty-five (of 748) papers met the inclusion criteria and were reviewed.

The review suggests that exercise, motor imagery and mirror feedback exercises, relaxation techniques, acupuncture, electroacupuncture, transcutaneous nerve stimulation and combined treatment programmes may help in the treatment of CRPS type I. However, since numerous methodological weaknesses (e.g. small sample sizes, not employing control groups, not evaluating findings against statistical tests) littered the limited literature, it was not possible to determine the effectiveness of individual treatments. Recommendations are made to develop the evidence base."

Copyright (c) 2005 John Wiley & Sons, Ltd.

General Interest
3D virtual reality

Advanced interface group at Manchester University have described 3D virtual reality software for use by patients with phantom limb pain. For further details visit their site.