Wherever is my arm? Impaired upper limb position accuracy in Complex Regional Pain Syndrome

Pain, body, and space: What do patients with complex regional pain syndrome really neglect?

“…pain, swelling and skin changes in the affected limb, some of these patients tend to ignore or have an altered mental representation of the affected limb (somatoparaphrenia); movements are smaller and less frequent (hypokinesia), and take conscious effort [5][6][7]16]. They have difficulties recognizing their own limb [24] and estimating its position [17], its size [25] and its orientation [34].…”

“…Which spatial coordinates are able to explain the neglect-like symptoms in CRPS, and, more importantly, what can we learn about the spatial perception of pain from these patients? The neglect symptoms of CRPS patients are modified by vision of the limb [17,27]. Patients show mislocalization of the affected and, sometimes, also of the unaffected limbs [17].…”

“…The neglect symptoms of CRPS patients are modified by vision of the limb [17,27]. Patients show mislocalization of the affected and, sometimes, also of the unaffected limbs [17].…”

Imaging and Clinical Evidence of Sensorimotor Problems in CRPS: Utilizing Novel Treatment Approaches

“…Importantly, aberrant mapping reverses as pain diminishes (Maihofner et al 2004;Pleger et al 2005). In light of this, it is unsurprising that pain seems to have a detrimental influence on thoughts, feelings and how individuals perceive their affected body part (Lewis et al 2007;Lewis et al 2010). Fear of someone knocking the painful limb, the unpredictability of symptoms and the patients disordered body perception may lead to social isolation and broken personal relationships which can reduce the patients' capacity to cope with their condition (Bruehl & Chung 2006).…”

“…Furthermore, other signs and symptoms quite quickly develop in the affected limb that would not commonly occur with an inflammatory response, such as dramatic changes in hair and nail growth (Harden et al 2010), significant problems with motor control (Van Hilten et al 2005), neglect and perceived lack of ownership of that limb (Galer et al 1995(Galer et al , 1999Lewis et al 2007; Lewis & McCabe 2010). In addition, recent imaging studies have demonstrated that the motor and sensory cortical maps representing the painful limb become altered (Maihöfner et al 2003;2004) and the magnitude of those changes appears to closely correlate to the intensity of perceived pain and a reduction in tactile acuity.…”