Chronic Pain & CRPS Case Studies: What Treatment Actually Looked Like
Real, anonymised accounts of people I've worked with, and what their treatment actually looked like
About these case studies
These are real patients I've treated, with names and identifying details changed to protect their privacy. Each one shows:
- Their symptom profile, and how it affected daily life
- What treatment actually focused on, phase by phase
- How often we met, and for how long
- The setbacks along the way, and what they taught us
- How we worked together, and what that partnership gave them
Nothing here is a template for what should happen to you — your presentation will have its own shape. This collection will keep growing over time, so treat it as an evolving picture of the range of people I work with rather than a fixed set of four.
A brief word on rhythm
A brief word on rhythm, since it varies by presentation. Acute problems tend to need more frequent contact early on, often every one to two weeks through the first month. Longer-standing, complex presentations usually settle into a slower rhythm, often monthly, with a wider check-in roughly every six months to keep us working towards shared goals.
In that longer-term work, patterns and setbacks tend to resurface. Each time, we're usually better placed to recognise them early and let them pass more lightly.
About my background
My clinical focus over the last 18+ years has been CRPS, neuropathic pain and, more recently, CPPS. I co-authored the Graded Motor Imagery Handbook with David Butler and Lorimer Moseley, and I've spent years teaching pain science education, in the tradition of Explain Pain, to clinicians internationally, alongside research at undergraduate and postgraduate level into neuropathic pain. More on my about page.
The case studies
Four people, four very different presentations, and the treatment that actually happened in each.
Acute CRPS in a Teenager, Following a Minor Medical Procedure
A rapid, severe CRPS presentation that began within hours of a routine blood test, and the gradual, patient rebuilding of movement, sleep and confidence.
CRPS Several Months On: Work, Sleep and Returning to Sport
CRPS after a cartilage injury to the knee, undiagnosed for around eighteen months, where stiffness and restriction dominated rather than burning pain.
Complex Persistent Pain With Multiple Medical Involvement
Long-standing, complex persistent pain alongside several other medical conditions, years of medication use, and a careful, collaborative reduction in codeine.
Persistent Hand Pain Alongside Long-Term Litigation
Persistent hand pain after a traumatic injury, with body-wide tension and disrupted sleep, treated while a legal case ran its own course.
Illustrative examples
The four accounts above are real people I've treated. The examples below work differently: these are composites, written to show the typical shape of treatment for presentations not yet covered above — chronic pelvic pain and neuropathic pain.
They are not real patients, and no individual outcome is described. Individual results vary and are influenced by many factors, including how long you've had symptoms, how complex the presentation is, and your own circumstances. Recovery takes active participation and realistic expectations. As real accounts for these presentations become available, they'll replace these examples.
Chronic Pelvic Pain Syndrome
42-year-old male
Initial presentation
- Constant pelvic and perineal pain, worst with sitting
- Severe daily pain
- Unable to work full-time
- Anxiety and sleep disturbance
- Multiple investigations with no clear findings
Treatment approach
- Comprehensive pain assessment identifying physical, psychological, and lifestyle contributors
- Pain education using contemporary pain science
- Graded pelvic floor relaxation and breathing strategies
- Movement pattern retraining
- Cognitive behavioural strategies for pain management
- Gradual return to valued activities
What typically changes
- Pain settled to a level he could work with, rather than one that ran his day
- Sitting became comfortable for extended periods
- Returned to full-time work
- Sleep improved and anxiety eased
- Developed self-management strategies that held up over time
Complex Regional Pain Syndrome (CRPS) — Upper Limb
35-year-old female
Initial presentation
- Severe burning pain in the hand and forearm
- Hypersensitivity to touch and temperature
- Colour and temperature changes in the affected limb
- Fear of movement and protective behaviours
- Previous treatments: multiple pain medications and nerve blocks, with limited benefit
Treatment approach
- Education about CRPS and neuroplasticity
- Graded Motor Imagery programme
- Sensory discrimination training
- Gradual exposure to feared movements and sensations
- Stress management and pacing strategies
- Collaboration with her pain consultant on medication
What typically changes
- Pain became considerably more manageable
- Hand function improved, and she returned to using the hand normally
- Hypersensitivity reduced
- Confident managing flare-ups herself
- Returned to playing the piano
- Able to reduce her medication, working with her prescriber
Post-Prostatectomy Chronic Pain
58-year-old male
Initial presentation
- Persistent pelvic pain following prostate surgery
- Pain with sitting and during intercourse
- Urinary urgency and frequency
- Frustration with lack of improvement
- Impact on relationship and quality of life
Treatment approach
- Detailed assessment of pelvic floor muscle function
- Manual therapy for pelvic floor muscle tension
- Bladder retraining programme
- Relaxation and breathing strategies
- Graded return to physical and sexual activity
- Partner education and involvement
What typically changes
- Pelvic pain reduced substantially
- Sitting tolerance improved
- Bladder function returned to normal
- Resumed his intimate relationship
- Mood and confidence improved
Persistent Lower Limb Pain with Sensitisation
47-year-old female
Initial presentation
- Burning pain in the leg and foot after back surgery
- Multiple failed treatments, including further surgery
- High levels of fear-avoidance
- Reduced mobility and deconditioning
- Low mood and feelings of hopelessness
Treatment approach
- Pain reconceptualisation using contemporary neuroscience
- Graded exposure to feared movements
- Progressive strengthening and conditioning
- Mindfulness-based pain management
- Goal-oriented rehabilitation
- Collaboration with her GP for psychological support
What typically changes
- Pain intensity reduced notably
- Walking tolerance improved greatly, from very short distances to comfortable walks
- Catastrophising reduced and coping improved
- Returned to gardening and social activities
- Developed a realistic but positive outlook
Frequently asked questions
The questions these case studies most often raise.
Explore the conditions behind these cases
Your presentation will have its own shape
If any of these accounts feel familiar, the most useful next step is a conversation about your situation rather than matching yourself to a case.