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Journal of Physical Medicine and Rehabilitation

ISSN: 2690-0297

Case Report Open Access

Focal Dystonia in Complex Regional Pain Syndrome: Can Surgery Make Both Better?

Michelle L. Andary1,*, Ian S. Ackers2,3, Cheryl N. Craig4,5,6, Brian G. Loder7, Michael T. Andary2, Geoffrey K. Seidel2,4,5
  • 1Mary Free Bed Rehabilitation Hospital, Grand Rapids, Michigan, USA
  • 2Michigan State University College of Osteopathic Medicine, University of Michigan Health-Sparrow, Lansing, Michigan, USA
  • 3University of Minnesota, Gillette Children’s Specialty Hospital, Saint Paul, Minnesota, USA
  • 4Detroit Medical Center, Rehabilitation Institute of Michigan, Detroit, Michigan, USA
  • 5Wayne State University, Department of Rehabilitation, Detroit, Michigan, USA
  • 6Intermountain Health, Department of Sports Medicine, Provo, Utah, USA
  • 7Fellowship Director, Michigan Minimal Invasive and Reconstructive Foot and Ankle Surgery Fellowship, Department of Podiatric Surgery, Henry Ford Macomb Hospital, Clinton Township, Michigan, USA
+ Affiliations - Affiliations

Corresponding Author

Michelle L. Andary, michelleandary@gmail.com

Received Date: December 08, 2025

Accepted Date: February 06, 2026

Citation:

Andary ML, Ackers IS, Craig CN, Loder BG, Andary MT, Seidel GK. Focal Dystonia in Complex Regional Pain Syndrome: Can Surgery Make Both Better? J Phys Med Rehabil. 2026;8(1):5–9.


Copyright: © 2026 Andary ML, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Objective: This case aims to describe a rare case of complex regional pain syndrome type II (CRPS II) associated with tibial nerve entrapment and dystonia, and to highlight the role of electrodiagnostic (EDX) testing in identifying a potentially treatable peripheral nerve lesion.

Methods: We report a rare case of CRPS II involving the tibial nerve with associated dystonia, painful paresthesia’s, and autonomic changes in the right foot. EDX testing were performed and demonstrated a focal tibial neuropathy at the tarsal tunnel. Based on these findings, the patient underwent surgical decompression of the tarsal tunnel.

Results: Following surgical release, the patient experienced significant improvement in pain, complete resolution of dystonia, and normalization of sensory and functional deficits, with return to baseline functional status.

Conclusion: This case demonstrates that targeted evaluation with EDX testing can identify focal peripheral nerve pathology in select patients with CRPS II, leading to effective surgical intervention. Resolution of CRPS symptoms and associated dystonia after tarsal tunnel release supports further investigation into peripheral mechanisms contributing to dystonia and paresthesia’s in CRPS.

Keywords

Complex regional pain syndrome, Electrodiagnosis, Focal dystonia, Tarsal tunnel syndrome

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