Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.63231/2595-0118.202666-en
Brazilian Journal of Pain
Original Article

Effect of somatosensory pain rehabilitation in 153 patients with foot complex regional pain syndrome: retrospective cohort study

Efeito da reabilitação somatossensorial da dor em 153 pacientes com síndrome da dor complexa regional do pé: estudo de coorte retrospectivo

Marie-An Hoang; Sibele de Andrade Melo Knaut; Kelli Maiara Gomes-da-Silva; Tara Lisa Packham; Guillaume Léonard; Claude Jacques Spicher

http://dx.doi.org/10.63231/2595-0118.202666-en BrJP, vol.9, e202666, 2026
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Abstract

BACKGROUND AND OBJECTIVES: Complex regional pain syndrome (CRPS) is a pain condition that presents with tactile hypoaesthesia or paradoxical painful touch-evoked tactile hypoaesthesia – Static Mechanical Allodynia (SMA). There is no data on the efficacy of somatosensory interventions for CRPS of the foot. The aim of the study was to evaluate in clinical practice the efficacy of the method of Somatosensory Pain Rehabilitation (SPR) in patients with CRPS of the foot.

METHODS: This retrospective cohort study included patients with foot CRPS treated with SPR. Two therapeutic approaches were used. Group A: Patients with hypoaesthesia underwent aesthesiography and were given an at-home somatosensory re-learning intervention. Hypoaesthetic was quantified using the Pressure Perception Threshold (PPT) and static 2-Point Discrimination Test (2PDT). Group B: Patients with SMA underwent allodynography and were given at-home interventions to not touch painful territories and Distant Tactile Counter-Stimulation. Once SMA disappeared, the underlying tactile hypoaesthesia was evaluated with PPT, 2PDT. Painful symptoms were measured with the McGill Pain Questionnaire (MPQ). Repeated-measures ANOVA was used to assess SPR effects on pain and hypoaesthesia, with effect sizes calculated.

RESULTS: A total of 153 patients were included (Group A: n=45; Group B: n=108). Mean treatment duration was 6.4 months. In Group B, 79.6% (n=86) experienced SMA resolution. Both groups showed significant post-treatment improvements in PPT, 2PDT and MPQ scores (p<0.001), with large effect sizes.

CONCLUSION: The SPR method, a tailored somatosensory-based intervention guided by individual somatosensory profiles, demonstrated significant improvements in pain and tactile sensibility in patients with CRPS of the foot.

Supplementary material

Keywords

Allodynia; Complex regional pain syndromes; Hypesthesia; Neuralgia

Resumo

JUSTIFICATIVA E OBJETIVOS: A síndrome dolorosa regional complexa (SDRC) pode apresentar hipoestesia tátil ou hipoestesia tátil paradoxalmente dolorosa evocada pelo toque - Alodínia Mecânica Estática (AME). Não há dados sobre a eficácia de intervenções somatossensoriais para SDRC do pé. Este estudo avaliou, na prática clínica, a eficácia do método de Reeducação Somatossensorial da Dor (RSD) em pacientes com SDRC do pé.

MÉTODOS: Estudo de coorte retrospectivo com pacientes tratados pelo método RSD. Dois manejos terapêuticos foram utilizados. Grupo A: pacientes com hipoestesia realizaram estesiografia e um programa domiciliar de reaprendizagem somatossensorial; a hipoestesia foi quantificada pelo Limiar de Percepção de Pressão (PPT) e pelo Teste Estático de Discriminação de Dois Pontos (2PDT). Grupo B: pacientes com AME realizaram alodiniografia e receberam orientações para evitar o toque no território doloroso e realizar contraestimulação tátil à distância. Após resolução da AME, a hipoestesia subjacente foi avaliada usando o PPT e o 2PDT. A dor foi medida pelo Questionário de Dor McGill (MPQ). Os efeitos do método foram analisados por ANOVA de medidas repetidas, com cálculo de tamanhos de efeito.

RESULTADOS: Foram incluídos 153 pacientes (Grupo A: n=45; Grupo B: n=108), com duração média do tratamento de 6,4 meses. No Grupo B, 79,6% (n=86) apresentaram resolução da AME. Ambos os grupos apresentaram melhorias significativas em PPT, 2PDT e MPQ após a intervenção (p<0,001), com tamanhos de efeitos altos.

CONCLUSÃO: O método RSD, uma intervenção somatossensorial personalizada guiada pelo perfil somatossensorial, demonstrou melhorias significativas na dor e na sensibilidade tátil em pacientes com SDRC do pé.

Material suplementar

Palavras-chave

Alodínia; Dor neuropática; Hipoestesia; Síndrome dolorosa complexa regional

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Submitted date:
07/30/2025

Accepted date:
02/24/2026

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