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Yoshiyuki Hirakawa,1 Akira Fujiwara,2 Ryota Imai,3,4 Yuki Hiraga,1,5 Shu Morioka4,6 1Department of Rehabilitation, Fukuoka Rehabilitation Hospital, Fukuoka City, Fukuoka, Japan; 2Department of Orthopedics, Fukuoka Reha Orthopedic Clinic, Fukuoka City, Fukuoka, Japan; 3School of Rehabilitation, Osaka Kawasaki Rehabilitation University, Kaizuka City, Osaka, Japan; 4Department of Occupational Therapy, International Univesrity of Health and Welfare, Okawa,Fukuoka, Japan; 5Neurorehabilitation Research Centre, Kio University, Nara, City, Nara, Japan; 6Department of Neurorehabilitation, Graduate School of Health Sciences, Kio University, Nara City, Nara, JapanCorrespondence: Yoshiyuki HirakawaDepartment of Rehabilitation, Fukuoka Rehabilitation Hospital, 7-770 Nokata, Nishi-ku, Fukuoka City 819-8551, Fukuoka, JapanTel +81 92 812-1555Fax +81 92 811-0330Email yutsuki0903@yahoo.co.jpAbstract: A woman in her thirties developed complex regional pain syndrome in her left shoulder due to a traffic accident. She demonstrated autonomic nervous symptoms (swelling, sweating, and skin color asymmetry) in her left hand, severe allodynia, neglect-like symptoms (NLS), impaired body image associated with impaired body awareness, and functional impairment of the left shoulder and elbow. She also reported physical self-disgust toward her affected limb, describing it as “reptilian,” as well as aversion to touching others; this body awareness exacerbated her pain and NLS. We therefore conducted stepwise interventions using body shadows. The intervention did not trigger physical self-disgust, enabling formation of body ownership and a body image unaccompanied by pain. Consequently, the patient showed improvements in pain, NLS, and autonomic nervous symptoms.Keywords: pain, neglect-like symptoms, physical self-disgust, body shadow intervention, body image |
