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Body perception disturbance and pain reduction in longstanding complex regional pain syndrome following a multidisciplinary rehabilitation program

Lewis, Jennifer S.; Kellett, Sara; McCullough, Ryan; Tapper, Ashley; Tyler, Chelsey; Viner, Maria; Palmer, Shea


Dr Jenny Lewis
Senior Lecturer in Pain Science and Occupational Therapy

Sara Kellett

Ryan McCullough

Ashley Tapper

Chelsey Tyler

Maria Viner

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Shea Palmer
Professor in Allied Health Professions


Clinical guidelines for the treatment of complex regional pain syndrome recommend multidisciplinary rehabilitation, yet limited evidence exists to support the effectiveness of this approach. Body perception disturbance, a common and debilitating feature of complex regional pain syndrome, is recommended by guidelines as important to treat. However, no study has yet explored whether disturbances change in response to multidisciplinary rehabilitation. We aimed to determine whether there is a change in body perception disturbance and pain following a two-week multidisciplinary rehabilitation program for complex regional pain syndrome.

Retrospective clinical data from complex regional pain syndrome patients who completed the program between September 2014 and December 2016 were extracted and anonymized. Data collected pre- and post rehabilitation comprising the Bath Body Perception Disturbance scale and a pain intensity numerical rating scale were analyzed.

Thirty complete data sets were analyzed from a sample of 50 consecutive patient records. After the program, there was a significant reduction in body perception disturbance (p< 0.0001), strength of negative emotional feelings (p< 0.0001) and pain (p=0.0038). There was a significant correlation between a change in disturbance and pain (r= 0.44, p=0.024). No relationship was found between the duration of symptoms and changes in disturbance (r=0.04, p=0.82).

This study provides evidence that both body perception disturbance and pain reduce following rehabilitation. Findings suggest that targeting these disturbances may be important in reducing pain and a potentially useful measure for recovery. Controlled trials are required to confirm the effectiveness of rehabilitation and determine what factors are responsible for these reductions.

Journal Article Type Article
Publication Date Nov 1, 2019
Journal Pain Medicine
Print ISSN 1526-2375
Electronic ISSN 1526-4637
Publisher Oxford University Press (OUP)
Peer Reviewed Peer Reviewed
Volume 20
Issue 11
Article Number pnz176
Pages 2213-2219
APA6 Citation Lewis, J. S., Kellett, S., McCullough, R., Tapper, A., Tyler, C., Viner, M., & Palmer, S. (2019). Body perception disturbance and pain reduction in longstanding complex regional pain syndrome following a multidisciplinary rehabilitation program. Pain Medicine, 20(11), 2213-2219.
Keywords Anesthesiology and Pain Medicine; Clinical Neurology; General Medicine
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Copyright Statement
This is a pre-copyedited, author-produced version of an article accepted for publication in Pain Medicine following peer review. The version of record is available online at:

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