[The sensitization model: a method to explain chronic pain to a patient].
Chronic pain is pain without a clear somatic substrate. As a result, patients with chronic pain often do not receive a clear diagnosis following a medical examination. In many patients, having pain without a proper explanation or diagnosis induces stress and the urge to search elsewhere for explanations and treatments. There is growing evidence that many chronic-pain syndromes, such as chronic low-back pain, whiplash and fibromyalgia, share the same pathogenesis: sensitisation of pain-modulating systems in the central nervous system at both spinal and supraspinal level. This central sensitisation is facilitated by numerous factors that contribute to the maintenance of pain in a way that differs from individual to individual. How sensitisation may develop and persist as a result of medical, psychological and social factors calls for research from the perspective of a bio-psycho-social model. If sensitisation is used to explain chronic pain to a patient and the patient understands the relation beween pain and the factors that play a role in the maintenance of the pain, this can lead to acceptation of a treatment learning to cope with these factors.
van Wilgen
C P
CP
Pijnkennis- en Behandelcentrum, afd. Anesthesiologie, Academisch Ziekenhuis, Postbus 30.001, 9700 RB Groningen. c.p.van.wilgen@rev.azg.nl
Keizer
D
D
D002908:Chronic Disease; D006801:Humans; D008959:Models, Neurological; D010146:Pain / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D010147:Pain Measurement; D013315:Stress, Psychological / Q000209:etiology