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Gepubliceerd in: Bijblijven 6/2012

01-08-2012

Pain exposure physical therapy, een veilige en effectieve behandeling voor patiënten met complex regionaal pijnsyndroom type 1

Auteurs: Dr. H. van de Meent, J.P. Frölke

Gepubliceerd in: Bijblijven | Uitgave 6/2012

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Extract

Het complex regionaal pijnsyndroom type 1 (CRPS-1), ook wel posttraumatische dystrofie of sudeckdystrofie genoemd, wordt door de International Association for the Study of Pain gedefinieerd als een pijnsyndroom dat zich kan ontwikkelen na een fysiek trauma en vertoont een disproportioneel beloop van klachten.1 CRPS-1 wordt gekenmerkt door pijn (spontane pijn, allodynie of hyperalgesie), abnormale autoregulatie (temperatuur, huidskleur, transpiratie en oedeem) en op de langere termijn trofische veranderingen van de huid, spieren en skelet.2,3 Voor de behandeling van patiënten met CRPS-1 wordt algemeen een breed pallet van invasieve en medicamenteuze behandeling aangewend. Een heldere lijn in de behandeling ontbreekt omdat er verschillen zijn in opvatting over de diagnose,4,5 pathofysiologie en klinische variabiliteit. In 2006 heeft een multidisciplinaire CBO-werkgroep een Nederlandse richtlijn gepubliceerd.6 In deze richtlijn wordt voor de behandeling van pijn de WHO-pijnladder geadviseerd, met uitzondering van het gebruik van opiaten. In geval van neuropathische pijn kunnen anti-epileptica en tricyclische antidepressiva worden overwogen. Voor de behandeling van ontstekingsverschijnselen worden vrijeradicalenvangers geadviseerd en voor het verbeteren van de perifere doorbloeding vaatverwijders en percutane sympathische blokkades. Ter bestrijding van functionele beperkingen wordt geadviseerd om fysiotherapie en ergotherapie voor te schrijven volgens het ‘with pain, no gain’-principe.6,7
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Metagegevens
Titel
Pain exposure physical therapy, een veilige en effectieve behandeling voor patiënten met complex regionaal pijnsyndroom type 1
Auteurs
Dr. H. van de Meent
J.P. Frölke
Publicatiedatum
01-08-2012
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Bijblijven / Uitgave 6/2012
Print ISSN: 0168-9428
Elektronisch ISSN: 1876-4916
DOI
https://doi.org/10.1007/s12414-012-0049-8

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