Editor-in-Chief: Alaa Abd-Elsayed, MD, PhD

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  1. 2021;5;133-136 Understanding Pain Mechanisms in the Rehabilitation of a Mismanaged Posttraumatic Adhesive Capsulitis of Ankle with Complex Regional Pain Syndrome
    Case Report
    Raveena Kini, MPT, and Zoeb Rangwala, BSc.

BACKGROUND: Pain has different input mechanisms, a subsequent central processing and an appropriate output mechanism. Accordingly the pain history of a patient varies, and so should the surgical and rehabilitative management.

CASE REPORT: The case report is based on a 20-year-old woman who had a 3-year-old distal tibiofibular fusion surgery done post traumatic interosseous membrane injury with a conservative approach for other multiligamentous injury of the ankle joint mortise. Despite the initial surgery and rehabilitation, she had episodes of fall due to instability even thereafter. Due to a series of unsuccessful interventions over the years, she developed excessive muscle guarding and capsular stiffness in the ankle joint. Her pain persisted for 3 years and she eventually developed complex regional pain syndrome.

CONCLUSION: This case demonstrates the rehabilitation of a patient based on understanding of the appropriate pain pathways along with the structures involved. It also discusses the etiology of complex regional pain syndrome developed 3 years after her surgery.

KEY WORDS: Adhesive capsulitis, complex regional pain syndrome, multiligamentous injury, ankle joint