{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T21:08:33Z","timestamp":1773608913965,"version":"3.50.1"},"reference-count":54,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,6,14]],"date-time":"2017-06-14T00:00:00Z","timestamp":1497398400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pain Practice"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Complex regional pain syndrome (CRPS) occurs due to different pathophysiological mechanisms. Presently there is no description of definitive treatment that can resolve the especially recalcitrant motor issues of disability in CRPS type 1 (CRPS\u20101).<\/jats:p><\/jats:sec><jats:sec><jats:title>Case Report<\/jats:title><jats:p>We have herein described the successful management of motor disability with a multimodal approach in a patient with CRPS\u20101 that occurred as a result of a fracture sustained in the lower end of the radius. Sensory\/sudomotor\/vasomotor symptoms were relieved completely by medications and stellate ganglion block in 2 weeks. Ultrasound\u2010guided dry needling secured near\u2010complete improvement of shoulder and hand movements in 45 days. Ultrasound guided intra\u2010articular (radio\u2010ulnar and radio\u2010humeral joint) injections with steroid reduced residual pain and improved forearm movements by 50% initially. The patient continued to receive regular sessions of dry needling, physiotherapy, and cognitive behavioral therapy. By the end of 1 year, the functions of the limb improved remarkably, as did the functional outcome scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this patient with CRPS\u20101, intra\u2010articular injections with steroid reduced nociception in the affected local structures and sensitization in the nervous system; dry needling resolved the myofascial issues; sustained physiotherapy maintained the motor recovery; and behavioral therapy techniques addressed the cognitive and life stress issues. It was concluded that the presenting symptoms in this case were a consequence of interactions between humoral, nervous, and myofascial systems.<\/jats:p><\/jats:sec>","DOI":"10.1111\/papr.12596","type":"journal-article","created":{"date-parts":[[2017,4,23]],"date-time":"2017-04-23T11:22:53Z","timestamp":1492946573000},"page":"273-282","source":"Crossref","is-referenced-by-count":11,"title":["Ultrasound\u2010Guided Intra\u2010articular Injection of the Radio\u2010ulnar and Radio\u2010humeral Joints and Ultrasound\u2010Guided Dry Needling of the Affected Limb Muscles to Relieve Fixed Pronation Deformity and Myofascial Issues around the Shoulder, in a Case of Complex Regional Pain Syndrome Type 1"],"prefix":"10.1111","volume":"18","author":[{"given":"Renuka S.","family":"Pai","sequence":"first","affiliation":[{"name":"Ashirvad Institute for Pain Management and Research Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lakshmi","family":"Vas","sequence":"additional","affiliation":[{"name":"Ashirvad Institute for Pain Management and Research Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,6,14]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/B0-443-07287-6\/50069-2"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(99)00011-1"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ajp.0000194279.36261.3e"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.40.1.57"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(98)90144-7"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002508-199906000-00013"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0b013e3181a11623"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0266-7681(98)80211-8"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0b013e3181958f90"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0274(199606)29:6<602::AID-AJIM4>3.0.CO;2-L"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1185\/030079906X132488"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2001.016009606.x"},{"key":"e_1_2_7_14_1","first-page":"172","volume-title":"Kinesiology of the Musculoskeletal System: Foundations for Physical Rehabilitation","author":"Neumann DA","year":"2002"},{"key":"e_1_2_7_15_1","first-page":"180","volume-title":"Brunstromm's Clinical Kinesiology","author":"Wrist and Hand","year":"1996"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/pme.12381"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2012.01435.x"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/B0-443-07287-6\/50020-5"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e3181e3db38"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2006.09.008"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(96)81973-7"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/pme.12033"},{"key":"e_1_2_7_23_1","doi-asserted-by":"crossref","first-page":"357","DOI":"10.2106\/00004623-199603000-00006","article-title":"Intracarpal soft\u2010tissue lesions associated with an intra\u2010articular fracture of the distal end of the radius","volume":"78","author":"Geissler WB","year":"1996","journal-title":"J Bone Joint Surg Am"},{"key":"e_1_2_7_24_1","doi-asserted-by":"crossref","first-page":"493","DOI":"10.4103\/0019-5413.101031","article-title":"Distal radioulnar joint injuries","volume":"46","author":"Thomas BP","year":"2012","journal-title":"Ind J Orthop"},{"key":"e_1_2_7_25_1","first-page":"241","volume-title":"Harrison's Rheumatology","author":"Brandt KD","year":"2006"},{"key":"e_1_2_7_26_1","first-page":"159","article-title":"Play and players in bone fracture healing match","volume":"6","author":"Marzona L","year":"2009","journal-title":"Clin Cases Miner Bone Metab"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11064-008-9711-z"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-005-0737-8"},{"key":"e_1_2_7_29_1","unstructured":"TaskerDL.Hilton's law. In:TaskerDL ed. Principles of Osteopathy.4th ed. In:Early American Manual Therapy. Version 5.0. 2005.Virginia Beach VA:McMillin Media;1916 www.mcmillinmedia.com\/eamt\/files\/tasker\/taskcont.htm(accessed July 28 2015)."},{"key":"e_1_2_7_30_1","first-page":"493","article-title":"Pulsed radiofrequency of the composite nerve supply to knee as a new technique for relieving osteoarthritic pain: a preliminary report","volume":"17","author":"Vas L","year":"2014","journal-title":"Pain Physician"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/pme.12508"},{"key":"e_1_2_7_32_1","doi-asserted-by":"crossref","first-page":"E163","DOI":"10.36076\/ppj\/2016.19.E163","article-title":"Musculoskeletal ultrasonography in CRPS; assessment of muscles before and after motor function recovery with dry needling as the sole treatment","volume":"19","author":"Vas L","year":"2016","journal-title":"Pain Physician"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11832-014-0563-6"},{"key":"e_1_2_7_34_1","first-page":"257","volume-title":"Gray's Anatomy","author":"Crossman AR","year":"2008"},{"key":"e_1_2_7_35_1","doi-asserted-by":"crossref","first-page":"E227","DOI":"10.36076\/ppj\/2016.19.E227","article-title":"Complex regional pain syndrome\u2010type 1 presenting as deQuervain's stenosing tenosynovitis","volume":"19","author":"Vas L","year":"2016","journal-title":"Pain Physician"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1179\/106698111X13129729552065"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.10-08-02717.1990"},{"key":"e_1_2_7_38_1","first-page":"450","volume-title":"Bonica's Management of Pain","author":"Dommerholt J","year":"2010"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1054\/jpai.2002.125923"},{"key":"e_1_2_7_40_1","first-page":"231","article-title":"Novel microanalytical technique distinguishes three clinically distinct groups: 1) subjects without pain and without myofascial trigger points; 2) subjects without pain and with myofascial trigger point; 3) subjects with pain and myofascial trigger point","volume":"83","author":"Shah JP","year":"2004","journal-title":"Am J Phys Med Rehabil"},{"key":"e_1_2_7_41_1","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-642-05468-6","volume-title":"Muscle Pain: Diagnosis and Treatment","author":"Mense S","year":"2010"},{"key":"e_1_2_7_42_1","volume-title":"Travell & Simons\u2019 Myofascial Pain and Dysfunction: The Trigger Point Manual","author":"Simons DG","year":"1999"},{"key":"e_1_2_7_43_1","first-page":"522","volume-title":"Management of Pain","author":"Gunn CC","year":"2001"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2010.05.090296"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1053\/apmr.2001.24023"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpain.2008.02.006"},{"key":"e_1_2_7_47_1","first-page":"1465","volume-title":"Goodman and Gilman's The Pharmacologic Bass of Therapeutics","author":"Schimmel BP","year":"1996"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(85)90173-3"},{"key":"e_1_2_7_49_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.1990.tb03097.x"},{"key":"e_1_2_7_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3940(85)90372-6"},{"key":"e_1_2_7_51_1","doi-asserted-by":"publisher","DOI":"10.1210\/endo-124-2-687"},{"key":"e_1_2_7_52_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2015\/546497","article-title":"Validation and test\u2010retest reliability of new thermographic technique called thermovision technique of dry needling for gluteus minimus trigger points in sciatica subjects and TrPs\u2010negative healthy volunteers","volume":"2015","author":"Skorupska E","year":"2015","journal-title":"Biomed Res Int"},{"key":"e_1_2_7_53_1","first-page":"56","article-title":"The use of trigger point \u201cdry\u201d needling under ultrasound guidance for the treatment of myofascial pain (technological innovation and literature review)","volume":"5","author":"Bubnov RV","year":"2010","journal-title":"Lik Sprava"},{"key":"e_1_2_7_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2007.10.006"},{"key":"e_1_2_7_55_1","volume-title":"Wheeless\u2019 Textbook of Orthopaedics","author":"Wheeless CR","year":"2008"}],"container-title":["Pain Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fpapr.12596","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/papr.12596","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T16:36:17Z","timestamp":1695573377000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/papr.12596"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,6,14]]},"references-count":54,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018,2]]}},"alternative-id":["10.1111\/papr.12596"],"URL":"https:\/\/doi.org\/10.1111\/papr.12596","archive":["Portico"],"relation":{},"ISSN":["1530-7085","1533-2500"],"issn-type":[{"value":"1530-7085","type":"print"},{"value":"1533-2500","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,6,14]]}}}