A prospective, observational study of the natural history of Complex Regional Pain Syndrome Type-1 (CRPS1): Do psychological factors influence outcome?
Could you share a summary of your research project and what inspired you to pursue it?
The project was a prospective study exploring the factors that influence early recovery from a devastating and disabling chronic pain condition, complex regional pain syndrome (CRPS). This project was inspired by years of clinical work with people who have CRPS, and a desire to be able to identify factors that could be useful in the early rehabilitation process to help people recover. We found that amongst people diagnosed with newly-onset CRPS, although symptoms improve over the course of 8 years, almost all improvements occurred in the first 6 months, suggesting this may be an optimal window for treatment. The factors associated with worse outcomes were: female sex, and high scores on measures of pain intensity, disability, anxiety and fear-of-movement at baseline.
How did the Foundation support your research?
The project could not have been done without the grant from the Foundation, which allowed us to carry out all aspects of the project, provide koha to participants and purchase the necessary equipment.
Were there any unique or surprising findings in your research?
This was the first prospective study of people with CRPS as diagnosed by modern diagnostic criteria. It was the first study to demonstrate that both anxiety and fear-avoidance may influence the course of rehabilitation and the course of the condition, highlighting the importance of an integrates holistic understanding of CRPS.
What impact did receiving support from the Foundation have on your career or future research opportunities?
This project formed the main study in my PhD, which has been instrumental in establishing my career in academia, as well as forming lasting collaborations and relationships with other researchers in the CRPS community worldwide.
How has this project contributed to the field, or impacted the wider community?
This research study has provided evidence to support the management of CRPS as a holistic biopsychosocial problem. It has also paved the way for several replications and extensions and systematic reviews on the topic, forming a broader research base. The data from this study were directly incorporated into other studies to assess the suitability of various pain scales for CRPS, and have been cited extensively. It has also spearheaded our own future work looking at how people understand and make sense of CRPS, how people live well with CRPS, and more recently our work has turned to examining the ways virtual reality can be used to change perceptions of the painful limb in people with CRPS.
How would you describe the significance of support from Whau Mental Health Research Foundation for researchers in mental health?
The Whau Mental Health Research Foundation is the principal funder of NZ research dedicated to mental health, it is a crucial support for much needed research in Aotearoa.
Have there been any specific end users or groups who have directly benefited from your research findings?
The end users for this research are the people with CRPS and the clinicians who treat them. The work has directed care to a more holistic understanding of CRPS and also provided an impetus for early management of this challenging condition.
Links to journal articles:
https://onlinelibrary.wiley.com/doi/abs/10.1002/ejp.813
https://www.sciencedirect.com/science/article/pii/S1526590023004376
