The Management of Complex Regional Pain Syndrome-associated Foot Pain using a Poron Insole, a Sponge Upper Padding, and a Post-operative Shoe: A Case Report

Abstract

Background: Pain from complex regional pain syndrome (CRPS) is frequently refractory to various treatment methods. Here, we present a case wherein foot pain from CRPS I was managed by applying an insole made from poron (a soft polyurethane foam and highly absorbent material for shock reduction), a sponge upper padding, and a post-operative shoe. Case Presentation: A 47-year-old female patient with CRPS I on her left foot complained of pain for a few months, which was aggravated while standing and walking [numeric rating scale (NRS): 8]. She had a history of a linear fracture in the distal portion of the left 1st metatarsal bone 5 months ago, and the pain from CRPS started 2 months after the fracture. We believed that the aggravated pain during standing and walking was allodynia. We utilized a poron insole, a sponge upper padding, and a post-operative shoe to reduce the pressure and friction loading on her left foot. 1 month after this intervention, the patients’ pain during standing and walking was found to have reduced from NRS 8 to NRS 3. At her 3- and 6-month follow-ups, the degree of pain was sustained at NRS 3. Conclusion: We believe that the reduction of allodynia using materials, which can absorb mechanical pressure and friction of the foot, can help manage pain from CRPS.