Pain Exposure Physical Therapy (PEPT) in CRPS

Are pain-related fears mediators for reducing disability and pain in Complex Regional Pain Syndrome?

Chronic Regional Pain Syndrome (CRPS-1) has puzzled doctors and therapists alike for decades. Recently a new form of treatment, Pain Exposure Physical Therapy (PEPT) has shown radical and swift improvement of symptoms and function.

Although disability in CRPS-1 reduces significantly after a maximum of 5 treatment sessions of PEPT, the mediating factors are not yet understood. This RCT explores if a reduction of pain-related fears is the mechanism behind this new treatment method. Surprisingly, a significant reduction of fear was observed in conventional and PEPT treatment; there must be other factors explaining the superior results of PEPT in CRPS.


56 patients were treated in this trial; disability (PDI) decreased with 69% in the PEPT group, compared to 37% in the conventional group. Pain (VAS) reduced with 57% and 23%, respectively.

Surprisingly, fear avoidance beliefs (FABQ), catastophizing (PCS), and kinesiophobia (Tampa-11) decreased significantly in both groups. Reduction of fear thus does not explain the working mechanism of PEPT.

> From: Barnhoorn et al., PLoS One 10 (2015-07-23 21:51:39) . All rights reserved to The Author(s). Click here for the online summary.

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