http://www.chronic-illness.org/blog/chronic-fatigue-syndromecfscfids-t-shirts-and-gift-ideas
Nijs en kollega's hebben een algemene "rehabilitatieprogramma" ontwikkeld voor
mensen met ME/CVS, fibromyalgie, whiplash en chonische (lage) rugpijn.
Voorlichting, praatsessies, anders denken én huiswerk! vormen de pijlers van die aanpak.
Als wij, de patiënten, anders gaan denken over pijn, neemt de pijn etc. vanzelf af...
Je moet er maar opkomen.
Deze aanpak is zinvol als er sprake is van "centrale sensitisatie" (de overgevoeligheid
van het zenuwstelsel voor prikkels) en "onjuiste" gedachten over ziekte en pijn.
Hoe je die "observaties" hard kunt maken/kunt objektiveren vermelden de auteurs niet.
Volgens dezelfde onderzoeksgroep wijken de koncentraties stikstofoxide,
een belangrijke kandidaat-oorzaak van centrale sensitisatie (Nijs, 2005:
klik hier),
niet af: klik hier.
How to explain central sensitization to patients with 'unexplained' chronic musculoskeletal pain: Practice guidelines.
Man Ther. 2011 May 30. doi:10.1016/j.math.2011.04.005.
Nijs J, Paul van Wilgen C, Van Oosterwijck J, van Ittersum M, Meeus M.
Published online 1 June 2011.
Abstract
Central sensitization provides an evidence-based explanation
for many cases of 'unexplained' chronic musculoskeletal pain.
Prior to commencing rehabilitation in such cases,
it is crucial
to change maladaptive illness perceptions,
to alter maladaptive pain cognitions and
to reconceptualise pain.
This can be accomplished
by patient education about central sensitization and its role in chronic pain,
a strategy known as pain physiology education.
Pain physiology education is indicated when:
- the clinical picture is characterized and dominated by central sensitization; and
- maladaptive illness perceptions are present.
Both are prerequisites for commencing pain physiology education.
Face-to-face sessions of pain physiology education,
in conjunction with written educational material,
are effective for
changing pain cognitions and improving health status
in patients with various chronic musculoskeletal pain disorders.
These include patients
with chronic low back pain, chronic whiplash, fibromyalgia and chronic fatigue syndrome.
After biopsychosocial assessment
pain physiology education comprises of a first face-to-face session
explaining basic pain physiology and contrasting acute nociception versus chronic pain
(Session 1).
Written information about pain physiology
should be provided as homework in between session 1 and 2.
The second session can be used to correct misunderstandings, and
to facilitate the transition from knowledge to adaptive pain coping during daily life.
Pain physiology education
is a continuous process
initiated during the educational sessions and
continued within both the active treatment and during the longer term rehabilitation program.
PMID: 21632273
http://www.manualtherapyjournal.com/article/S1356-689X(11)00073-7/abstract
Met dank aan anoniem voor het aanleveren van een belangrijk deel van de tekst.
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