Physiotherapy management of post-stroke complex regional pain syndrome (CRPS): a case report on the role of mirror therapy

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BackgroundComplex regional pain syndrome (CRPS) is a chronic pain disorder often affecting the extremities following trauma or stroke, classified into type 1 (without nerve injury) and type 2 (with nerve injury). It manifests as persistent pain, sensory disturbances, and motor dysfunction, particularly in post-stroke patients. Despite its prevalence, effective management remains a challenge, necessitating a multidisciplinary approach.MethodDescriptive and inferential statistical analyses were conducted. The mean and standard deviation were calculated for numerical data, and changes over time were assessed using paired t-tests, with statistical significance set at p < 0.05. A 95% confidence interval was reported for key outcome measures to ensure result reliability.Case presentationThis report examines a 55-year-old male post-stroke patient with left hemiparesis and complex regional pain syndrome (CRPS), experiencing pain in the left shoulder, wrist, and proximal interphalangeal (PIP) joints, along with functional limitations. He underwent mirror therapy combined with a structured home exercise program over nine sessions. Pain levels, measured by the Numerical Pain Rating Scale (NPRS), decreased from 4/10 at rest and 6/10 on movement to 2/10 at rest and 4/10 on movement. ROM significantly improved, with shoulder flexion increasing from 30 to 128° (p = 0.01, 95% CI: 0.005, 0.02), extension from 20 to 30° (p = 0.02), wrist extension from 15 to 32° (p = 0.03), and PIP flexion from 60 to 90° (p = 0.01), with full extension restored (p = 0.04). Circumferential swelling reduced from 23.5 to 21.5 cm, and DASH scores improved from 77.2 to 36.4%. These findings confirm the clinical effectiveness of mirror therapy in enhancing ROM, reducing pain, and improving function in post-stroke CRPS rehabilitation.ConclusionThe case illustrates the efficacy of early mirror therapy in managing CRPS in post-stroke patients, highlighting its potential to alleviate pain and enhance functional recovery. Early intervention is crucial in improving outcomes for CRPS patients, emphasizing the need for timely and comprehensive rehabilitation strategies.