When instructing a patient with complex regional pain syndrome to perform a home exercise program, which guideline is MOST appropriate?

• A. Pain-free activities, extended periods of time
• B. Pain-free activities, short periods of time
• C. Exacerbating activities, short periods of time
• D. Exacerbating activities, extended periods of time

Answer: (B)

In CRPS, the goal is to reintroduce movement without triggering pain or autonomic flare-ups. The best approach is to have the patient perform activities that are pain-free and keep sessions short, then gradually increase time as tolerance improves. This graded, non-painful exposure helps prevent central sensitization and keeps symptoms from escalating, while still promoting mobility and function. If a activity provokes pain beyond mild discomfort, it should be avoided or adjusted, and progress should be slowed.

Choosing pain-free activities for short periods aligns with this need to respect the area's heightened sensitivity and to build tolerance gradually. Longer or painful sessions can worsen symptoms and push the system back into a heightened pain state.