Thank you for your reply it was a very useful reference.

In the 1980's I headed a benign chronic pain clinic where we dealt with many chronic pain syndromes and we saw quite a few patients with RSD.

However I retired 20 years ago due to CHD and thought that I might have been left behind and that painful manipulation had been shown to be useful.

Back in the 1980's we used a multi-disciplinary approach that included biofeedback, acupuncture, trigger point therapies, re-education of emotion - posture and job task. We found thermography to be a useful tool especially in the context of seeing what normalised the hand temperature... in effect we tuned our therapies using thermography and galvanic skin responses to give us feedback -both in the immediate and longer term.

The Acupuncture techniques we used were taught at the Nanking Municipal Workers Hospital Nanking 1978. Our team included an anesthetist, physiotherapist, masseur, psychiatrist, psychologist and two China trained medical acupuncturists. We followed up most of our patients to gain an understanding of our results.

I would say that the No Pain = Gain in RSD/CRPS1 is a most useful way to express what I feel.