Behavioural Treatment Reduces Pain Parallel to Restoration of Cortical Reorganization and Tactile Discrimination in Complex Regional Pain Syndrome

Patients with complex regional pain syndrome (CRPS) and intractable pain showed a shrinkage of cortical maps on primary (SI) and secondary somatosensory cortex (SII) contralateral to the affected limb. This was paralleled by an impairment of the 2-point discrimination thresholds. Behavioural treatment over 1 to 6 months consisting of graded sensorimotor retuning led to a persistent decrease in pain intensity, which was accompanied by a restoration of the impaired tactile discrimination and a regain of cortical map size in contralateral SI and SII. This suggests that in CRPS the reversal of tactile impairment and cortical reorganization is associated with a decrease in pain.