Shiny Stiff Surprise

This patient presents to you in the clinic with order to eval and treat for hand pain. She is in extreme pain and unable to move the right hand without great effort. She reports she was bit by a cat on her index finger 6 months prior and has had difficulty using her hand for anything since. She reports that she has trouble sleeping and that even the a/c in her car makes her hand hurt. What might you think is going on with this patient and what treatment interventions will you do?

Moderator's Response
This patient appears to have CRPS. You need to be careful not to exacerbate her symptoms and cause an even greater increase in pain and swelling. You might consider working on the other arm first using mirror therapy. As you progress to the involve are use caution and firm touch vs light touch. Desensitization is also helpful early in ttherapy intervention.

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