Graded exposure bij posttraumatische nekpijn en bij klachten van arm, nek en/of schouder

  • J. R. de Jong
  • M. D. F. van Eijsden-Besseling
  • C. M. Rebel

Samenvatting

Pijngerelateerde angst en catastroferen over pijn blijken een rol te spelen bij posttraumatische nekpijn (PTNP) en klachten van arm, nek en/of schouder (KANS). Graded exposure, het klinische equivalent van een typische extinctieprocedure, blijkt een succesvolle behandeling voor patiënten met PTNP of KANS die een verhoogde mate van pijngerelateerde angst rapporteren. Wel blijken patiënten met PTNP meer exposuresessies nodig te hebben. Een mogelijke verklaring hiervoor kan zijn dat PTNP-patiënten naast pijn ook andere klachten rapporteren, zoals tinnitus en duizeligheid. Ook zijn ze het ‘slachtoffer’ van een foutieve actie van iemand anders, waarover nog vaak boosheid bestaat. Voor beide factoren dient tijdens de exposure aandacht te zijn. Een mogelijke klinische verklaring voor het snelle succes bij KANS-patiënten kan zijn dat deze populatie die op de polikliniek revalidatie wordt gezien voor een groot deel bestaat uit hoogopgeleiden en dat de educatie hen sneller het inzicht biedt dat de aanzet is tot gedragsverandering. Hoewel graded exposure vaak wordt beschreven als een gedragsmatige procedure, lijken de gedragsexperimenten binnen de eerste exposuresessies er uiteindelijk voor te hebben gezorgd dat patiënten de veronderstelde schadelijkheid van gevreesde activiteiten opnieuw hebben kunnen evalueren. De ervaring deze activiteiten te kunnen uitvoeren, heeft de patiënten doen beseffen dat de gevreesde negatieve consequenties in feite een overschatting van de dreigwaarde zijn.

Literatuur

  1. Andersen JH, Haahr JP, Frost P. Risk factors for more severe regional musculoskeletal symptoms: a two-year prospective study of a general working population. Arthritis Rheum. 2007;56:1355–64.CrossRefPubMedGoogle Scholar
  2. Arntz A, Claassens L. The meaning of pain influences its experienced intensity. Pain. 2004;109:20–5.CrossRefPubMedGoogle Scholar
  3. Beumer A., Bie RA de, Cate A ten, Doornbos N, Elders LAM, Eijsden-Besseling MDF van. Multidisciplinaire Richtlijn Aspecifieke KANS; 2012. KNGF. http://hr.surfsharekit.nl:8080/repository/app/humanReadable.
  4. Buitenhuis J, Jong PJ de, Jaspers JP, Groothoff JW. Catastrophizing and causal beliefs in whiplash. Spine. 2008;33:2427–33.CrossRefPubMedGoogle Scholar
  5. Christiansen S, Oettingen G, Dahme B, Klinger R. A short goal-pursuit intervention to improve physical capacity: a randomized clinical trial in chronic back pain patients. Pain. 2010;149:444–52.CrossRefPubMedGoogle Scholar
  6. Crombez G, Eccleston C, Damme S van, Vlaeyen JW, Karoly P. The fear avoidance model of chronic pain: the next generation. Clin J Pain. 2012;28:475–83.CrossRefPubMedGoogle Scholar
  7. Dekkers-Sanchez PM, Wind H, Sluiter JK, Frings-Dresen MH. A qualitative study of perpetuating factors for long term sick leave and promoting factors for return to work: chronic work disabled patients in their own words. J Rehabil Med. 2010;42(6):544–52.Google Scholar
  8. Eijsden-Besseling MD van, Peeters FP, Reijnen JA, Bie RA de. Perfectionism and coping strategies as risk factors for the development of non-specific work-related upper limb disorders (WRULD). Occup Med. (Lond). 2004;54:122–7.Google Scholar
  9. Eijsden-Besseling MDF van (2010). Risks and Recommendations in WRULD. Dissertatie; Universitaire pers Maastricht.Google Scholar
  10. Eijsden-Besseling MD van, Bergh KA van den, Staal JB, Bie RA de, Heuvel WJ van den. The course of nonspecific work-related upper limb disorders and the influence of demographic factors, psychologic factors, and physical fitness on clinical status and disability. Arch Phys Med Rehabil. 2010;91:862–7.CrossRefPubMedGoogle Scholar
  11. Feleus A, Dalen T van, Bierma-Zeinstra SM, Bernsen RM, Verhaar JA, Koes BW, et al. Kinesiophobia in patients with non-traumatic arm, neck and shoulder complaints: a prospective cohort study in general practice. BMC Musculoskelet Disord. 2007;8:117.CrossRefPubMedPubMedCentralGoogle Scholar
  12. Ferrari R. Whiplash cultures. CMAJ. 1999;161:368.PubMedPubMedCentralGoogle Scholar
  13. Ferrari R, Russell AS, Carroll LJ, Cassidy JD. A re-examination of the whiplash associated disorders (WAD) as a systemic illness. Ann Rheum Dis. 2005;64:1337–42.CrossRefPubMedPubMedCentralGoogle Scholar
  14. Flor H, Turk DC, Birbaumer N. Assessment of stress-related psychophysiological reactions in chronic back pain patients. J Consult Clin Psychol. 1985;53:354–64.CrossRefPubMedGoogle Scholar
  15. Fritz JM, George SZ, Delitto A. The role of fear-avoidance beliefs in acute low back pain: relationships with current and future disability and work status. Pain. 2001;94:7–15.CrossRefPubMedGoogle Scholar
  16. Gheldof EL, Crombez G, Bussche E van den, Vinck J, Nieuwenhuyse A van, Moens G, Mairiaux P, Vlaeyen JW. Pain-related fear predicts disability, but not pain severity: a path analytic approach of the fear-avoidance model. Eur J Pain. 2010;14(870):e1–9.Google Scholar
  17. Gun RT. The incidence and distribution of RSI in South Australia 1980–81 to 1986–87. Med J Aust. 1990;153 (7):376–80.Google Scholar
  18. Hasenbring MI, Hallner D, Rusu AC. Fear-avoidance- and endurance-related responses to pain: development and validation of the Avoidance-Endurance Questionnaire (AEQ). Eur J Pain. 2009;13:620–8.CrossRefPubMedGoogle Scholar
  19. Health Council of the Netherlands. RSI. The Hague: Health Council of the Netherlands; Publication No 2000/22 E. 2000. 2000. Retrieved from: http://neurologiadeltrabajo.sen.es/pdf/rsi_report_curso2000_nt.pdf.
  20. Holm LW, Carroll LJ, Cassidy JD, Skillgate E, Ahlbom A. Expectations for recovery important in the prognosis of whiplash injuries. PLoS Med. 2008;5:e105.CrossRefPubMedPubMedCentralGoogle Scholar
  21. Huis ‘t Veld RM, Vollenbroek-Hutten MM, Groothuis-Oudshoorn KC, Hermens HJ. The role of the fear-avoidance model in female workers with neck-shoulder pain related to computer work. Clin J Pain. 2007;23:28–34.Google Scholar
  22. Jensen JN, Karpatschof B, Labriola M, Albertsen K. Do fear-avoidance beliefs play a role on the association between low back pain and sickness absence? A prospective cohort study among female health care workers. J Occup Environ Med. 2010;52:85–90.CrossRefPubMedGoogle Scholar
  23. Jong JR de, Vlaeyen JW, Onghena P, Goossens MEJB, Geilen M, Mulder H. Fear of movement/(re)injury in chronic low back pain: education or exposure in vivo as mediator to fear reduction? Clin J Pain. 2005;21:9–17.CrossRefPubMedGoogle Scholar
  24. Jong JR de, Vangronsveld K, Peters ML, Goossens MEJB, Onghena P, Bulté I, Vlaeyen JWS. Reduction of pain-related fear and disability in posttraumatic neck pain: a replicated single case experimental study of exposure in vivo. J Pain. 2008;9(12):1123–34.CrossRefPubMedGoogle Scholar
  25. Jong JR de, Vlaeyen JWS, Eijsden M van, Loo C, Onghena P. Reduction of pain-related fear and increased function and participation in work-related upper extremity pain (WRUEP): effects of exposure in vivo. Pain. 2012;153:2109–18.CrossRefPubMedGoogle Scholar
  26. Karels CH, Bierma-Zeinstra SM, Burdorf A, Verhagen AP, Nauta AP, Koes BW. Social and psychological factors influenced the course of arm, neck and shoulder complaints. J Clin Epidemiol. 2007;60:839–48.CrossRefPubMedGoogle Scholar
  27. Karsdorp PA, Nijst SE, Goossens MEJB, Vlaeyen JW. The role of current mood and stop rules on physical task performance. An experimental investigation in patients with work-related upper extremity pain. Eur J Pain. 2010;14:434–40.CrossRefPubMedGoogle Scholar
  28. Keuter EJW, Minderhoud JM, Verhagen AP, Valk M, Rosenbrand CJGM. De multidisciplinaire richtlijn ‘Diagnostiek en behandeling van mensen met een whiplash associated disorder I of II. Ned Tijdschr Geneeskd. 2009;153:B3.Google Scholar
  29. KNGF. KNGF-richtlijn Whiplash. Ned Tijdschr Fysiotherapie. 2005:115(1).Google Scholar
  30. Koulil S van, Lankveld W van, Kraaimaat FW, Helmond T van, Vedder A, Hoorn H van, et al Tailored cognitive-behavioral therapy and exercise training for high-risk patients with fibromyalgia. Arthritis Care Res. (Hoboken) 2010;62:1377–85.Google Scholar
  31. Leeuw M, Goossens MEJB, Linton SJ, Crombez G, Boersma K, Vlaeyen JWS. The fear-avoidance model of musculoskeletal pain: current state of scientific evidence. J Behav Med. 2007;30:77–94.CrossRefPubMedGoogle Scholar
  32. Mannion AF, Muntener M, Taimela S, Dvorak J. A randomized clinical trial of three active therapies for chronic low back pain. Spine. 1999;24:2435–48.CrossRefPubMedGoogle Scholar
  33. Meulders A, Vansteenwegen D, Vlaeyen JW. The acquisition of fear of movement-related pain and associative learning: a novel pain-relevant human fear conditioning paradigm. Pain. 2011;152:2460–9.CrossRefPubMedGoogle Scholar
  34. Montfoort I, Frens MA, Koes BW, Lagers-van Haselen GC, Zeeuw CI de, Verhagen AP. Tragedy of conducting a clinical trial; generic alert system needed. J Clin Epidemiol. 2008;61:415–8.CrossRefPubMedGoogle Scholar
  35. Morley S, Eccleston C, Williams A. Systematic review and meta-analysis of randomized controlled trials of cognitive behavior therapy and behavior therapy for chronic pain in adults, excluding headache. Pain. 1999;80:1–33.CrossRefPubMedGoogle Scholar
  36. Multidisciplinaire richtlijn aspecifieke Klachten Arm, Nek en/of Schouders; KNGF, CBO, Hogeschool Rotterdam Kenniscentrum Zorginnovatie. 2012. Website: http://www.cbo.nl/.
  37. Nederhand MJ, IJzerman MJ, Hermens HJ, Turk DC, Zilvold G. Predictive value of fear avoidance in developing chronic neck pain disability: consequences for clinical decision making. Arch Phys Med Rehabil. 2004;85:496–501.CrossRefPubMedGoogle Scholar
  38. Nederhand MJ, Hermens HJ, IJzerman MJ, Groothuis KGM, Turk DC. The effect of fear of movement on muscle activiation in post-traumatic neck pain disability. Clin J Pain. 2006;22:519–25.CrossRefPubMedGoogle Scholar
  39. Obelieniene D, Schrader H, Bovim G, Miseviciene I, Sand T. Pain after whiplash: a prospective controlled inception cohort study. J Neurol Neurosurg Psychiatry. 1999;66:279–83.CrossRefPubMedPubMedCentralGoogle Scholar
  40. Peters ML, Vlaeyen JW, Kunnen AM. Is pain-related fear a predictor of somatosensory hypervigilance in chronic low back pain patients? Behav Res Ther. 2002;40:85–103.CrossRefPubMedGoogle Scholar
  41. Rainville P, Bao QVH, Chrétien P. Pain-related emotions modulate experimental pain perception and automatic responses. Pain. 2005;118:306–18.CrossRefPubMedGoogle Scholar
  42. RSI-vereniging. Factsheet Feiten en cijfers RSI. Nijkerk: RSI-vereniging; 2015.Google Scholar
  43. Schrooten M, Vlaeyen JW. Becoming active again? Further thoughts on goal pursuit in chronic pain. Pain. 2010;149:422–3.CrossRefPubMedGoogle Scholar
  44. Schrooten M, Vlaeyen JW, Morley S. Psychological interventions for chronic pain: reviewed within the context of goal pursuit. Pain Manag. 2012;2:1–10.Google Scholar
  45. Seminowicz DA, Davis KD: Cortical responses to pain in healthy individuals depends on pain catastrophizing. Pain. 2006;120:297–306.Google Scholar
  46. Smeets RJEM, Vlaeyen JW, Hidding A, Kester AD, Heijden GJ van der, Geel AC van, et al. Active rehabilitation for chronic low back pain: cognitive-behavioral, physical, or both?: first direct post-treatment results from a randomized controlled trial. BMC Musculoskel Disord. 2006;7:5.CrossRefGoogle Scholar
  47. Spinhoven P, Kuile M ter, Kole-Snijders AM, Hutten Mansfeld M, Ouden DJ den, Vlaeyen JW. Catastrophizing and internal pain control as mediators of outcome in the multidisciplinary treatment of chronic low back pain. Eur J Pain. 2004;8:211–9.CrossRefPubMedGoogle Scholar
  48. Swinkels-Meewisse IE, Roelofs J, Oostendorp RA, Verbeek AL, Vlaeyen JW. Acute low back pain: pain-related fear and pain catastrophizing influence physical performance and perceived disability. Pain. 2006;120:36–43.CrossRefPubMedGoogle Scholar
  49. Vansteenwegen D, Vervliet B, Hermans D, Beckers T, Baeyens F, Eelen P. Stronger renewal in human fear conditioning when tested with an acquisition retrieval cue than with an extinction retrieval cue. Behav Res Ther. 2006;44:1717–25.CrossRefPubMedGoogle Scholar
  50. Versteegen GJ, Kingma J, Meijler WJ, Duis HJ ten. Neck sprain in patients injured in car accidents: a retrospective study covering the period 1970–1994. Eur Spine J. 1998;7:195–200.CrossRefPubMedPubMedCentralGoogle Scholar
  51. Vlaeyen JW, Crombez G, Linton SJ. The fear-avoidance model of pain: we are not there yet. Comment on Wideman et al. ‘A prospective sequential analysisof the fear-avoidance model of pain’ [Pain, 2009] and Nicholas ‘First things first: reduction in catastrophizing before fear of movement’. Pain. 2009;146:222–3.Google Scholar
  52. Vlaeyen JW, Morley SJ. Tailored treatment: it’s not what you think it is. Comment on the article by van Koulil et al. Arthritis Care Res. (Hoboken). 2011;63:921–2.CrossRefGoogle Scholar
  53. Vlaeyen JWS, Linton SJ. Fear avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain. 2000;85:317–32.Google Scholar
  54. Vlaeyen JWS, Linton SJ. Fear-avoidance model of chronic musculoskeletal pain: 12 years on. Pain. 2012;153(6):1144–7.CrossRefPubMedGoogle Scholar
  55. Vos CJ, Verhagen AP, Koes BW. Reliability and responsiveness of the Dutch version of the neck disability index in patients with acute neck pain in general practice. Eur Spine J. 2006;15:1729–36.CrossRefPubMedGoogle Scholar
  56. Wessely S, Nimnuan C, Sharpe M. Functional somatic syndromes: one or many? Lancet. 1999;354:936–9.CrossRefPubMedGoogle Scholar
  57. Wideman TH, Adams H, Sullivan MJ. A prospective sequential analysis of the fear-avoidance model of pain. Pain. 2009;145:45–51.CrossRefPubMedGoogle Scholar

Copyright information

© Bohn Stafleu van Loghum 2017

Authors and Affiliations

  • J. R. de Jong
    • 1
  • M. D. F. van Eijsden-Besseling
    • 2
  • C. M. Rebel
    • 3
  1. 1.Vakgroep Revalidatiegeneeskunde, Adelante afdeling revalidatiegeneeskundeUniversiteit Maastricht, Maastricht UMC+MaastrichtThe Netherlands
  2. 2.Stichting RevalideAmsterdam, UtrechtThe Netherlands
  3. 3.Adelante afdeling revalidatiegeneeskundeMaastricht UMC+MaastrichtThe Netherlands

Personalised recommendations