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Figure 3: Cumulative result of serial ultrasound guided dry needling (USGDN) of agonist and antagonist muscles (digital flexors and extensors) with sequential improvement of pain stiffness and weakness in patients of complex regional pain syndrome. Top row: Appearance of the hand on day 3 (left) with the fingers fixed in minimal flexion with inability to further flex the fingers, day 7 (middle) where she is able to flex the fingers. She is squeezing the ball on day 10 (right) after USGDN was initiated on day 1 carried out thrice weekly. Bottom row: Appearance of the hand on day 12 (left) showing a gradual increase in the flexion at the metacarpophalangeal and interphalangeal joints to enable the formation of a fist to hold a dynamometer on day 17 (middle) and with gradual increase in grip strength from 0 pounds per square inch to 4 pounds per square inch by day 22 (right)

Figure 3: Cumulative result of serial ultrasound guided dry needling (USGDN) of agonist and antagonist muscles (digital flexors and extensors) with sequential improvement of pain stiffness and weakness in patients of complex regional pain syndrome. <i>Top row</i>: Appearance of the hand on <i>day 3</i> (<i>left</i>) with the fingers fixed in minimal flexion with inability to further flex the fingers, <i>day 7</i> (<i>middle</i>) where she is able to flex the fingers. She is squeezing the ball on <i>day 10</i> (<i>right</i>) after USGDN was initiated on <i>day 1</i> carried out thrice weekly. <i>Bottom row</i>: Appearance of the hand on <i>day 12</i> (<i>left</i>) showing a gradual increase in the flexion at the metacarpophalangeal and interphalangeal joints to enable the formation of a fist to hold a dynamometer on <i>day 17</i> (<i>middle</i>) and with gradual increase in grip strength from 0 pounds per square inch to 4 pounds per square inch by <i>day 22</i> (<i>right</i>)