Can amplified pain be cured or it is just put in remission?

This is purely a matter of semantics. If all your symptoms go away and you are 100% fine, one could say you are cured. Our goal is cure. To say you are in remission gives the subtle and subconscious message that it is always lurking in the background. In the first study below, we documented that at 5 years after treatment 88% of children treated with exercise and counseling were fine. In the second study below 89% of the children fully resolved their symptoms. To say it is curative does not mean 100% of children with amplified pain will respond. This is true of everything in medicine. Not everyone with a staph infection is cured with antibiotics and if they are, they could always get staph again but we don’t say they are in remission. Likewise, some cancers can be removed or completely treated and are cured. You could say they are in remission but since it usually does not return, it is okay to say cured. Too often in medicine we are reluctant to use the word cure, but since many children with amplified pain resolve all symptoms for years, it is not unreasonable to say they are cured. There has also been stigma attached to the word cure with the FDA cracking down on peddlers of “cure-alls” and unscrupulous companies making false claims of curative products.

Adults, and children treated with drugs, generally only have temporary or incomplete benefit so historically physicians have not used the word cure.

Some of our patients have had relapses and that is always frustrating, but these children can respond well to re-treatment. Many of these children can retreat themselves without a full formal program. In the first study cited below, most who had a relapse were able to treat themselves and in the second study below, 5 of 7 children who had a relapse were able to treat themselves. In those who have relapsing amplified pain, there generally is a lot of underlying stress that needs to be addressed in addition to doing the exercise therapy.

  1. Sherry DD, Wallace CA, Kelley C, Kidder M, Sapp L. Short- and long-term outcomes of children with complex regional pain syndrome type I treated with exercise therapy. Clinical Journal of Pain 1999;15:218-23.
  2. Brooke V, Janselewitz S. Outcomes of children with complex regional pain syndrome after intensive inpatient rehabilitation. Pm & R 2012;4:349-54.

Comments are closed.