Development of a new approach of physical therapy based on pathophysiologic mechanisms for chronic pain associated with limb immobilization

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At the present, there is no successful therapy for certain types of refractory chronic widespread pain (CWP), such as complex regional pain syndrome I (CRPS I), and fibromyalgia. We developed the chronic post-cast pain (CPCP) model for the development of a new promising physiotherapy approach based on elucidating the pathology mechanisms for this CWP. We found that the spinal microglial activations play a role in the expansion of the mechanical hyperalgesia to the contralateral side, and that the spinal astrocyte activations are a factor in the maintenance of the mechanical hyperalgesia. It was suggested that the ischemic reperfusion injury/oxidative stress in the fixed hindlimb triggers the onset of the mechanical hyperalgesia and the spinal glial activations in CPCP rats. Further investigation based on this finding may lead to the creation of a basis for clinical application of physiotherapy for CWP.