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sophie a lecturer in this area recommended this article Complex Regional Pain Syndromes : Guidelines For Therapy Stanton Hicks et al Clin J of Pain 14: 155-166 1998 This paper details a logical alogorithm pharmocology/psych/physical restoration -desensitisation . It has a section on dealing with adults and children . I could photocopy and send it to you if you give me your address. I will type a few lines from the above! ' .. the first step primarily involves the development of a theraputic alliance and rapport . Motivation, mobilisation,desenstisation come next. The process of desensitisiation may involve a pharmacologic approach to reduce pain and sensitivity and a process of gentle non nociceptive stimulation involving heat,massage,pressure cold, vibration, movement etc to help restore normal sensory processing. It is essential that movement phobia be overcome and the patient begin to actually move and allow the limbs to be touched' I would say that often the latter point is the most important! Of note is the comment ' it is particularly important to avoid agressive or passive ROM tests, especially in an extremity that is insensate after regional anaesthetic blockade. Maintenance of and a gentle gradual increase in ROM is the goal'. This may not be relevant to you although I know it is for people treated with RSD of the upper limb? All the best .. I think there are many features of CRP that apply to many chronic 'musculoskeletal' patients so the paper has made me think about the management of many people in a much more global way than I did previously . Ian Stevens Glasgow %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%