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Chapter 7 - A Physiotherapeutic, Biopsychosocial Approach to the Management of Patients With Peripheral Neuropathic Pain and Complex Regional Pain Syndrome
Challenging Neuropathic Pain Syndromes
Format: Book Chapter
Publication Date: 2018/01/01/
Publisher: Elsevier
Pages: 43 - 51
Sources ID: 77076
Visibility: Public (group default)
Abstract: (Show)
Background: Neuropathic pain and complex regional pain syndrome are complex responses of the nervous system. The interaction of nociceptive neuropathic input with learned stress responses, beliefs, expectations, and societal pressures make each patient's experience unique. Design: A review of the recent clinical research and scholarly work in the treatment of neuropathic pain was undertaken. Principal Findings: A review of clinical pain research has demonstrated that treatment programs that focus solely on the resolution of neuropathic pain by treating nociceptive generators and symptom modulation have had limited success. Recent studies have demonstrated that coordinated interventions that address the peripheral, central, behavioral, and social generators of the pain experience offer the best opportunity for successful management. Conclusion: A biopsychosocial approach to rehabilitation that uncovers and addresses the nociceptive, psychological, and social triggers of the patient's response is essential to either resolving the pain or building the patient resiliency necessary to manage more persistent pain states. A pain education program structured to the specific needs of the patient is the core component of biopsychosocial rehabilitation. Graded activity, neurosensory training, neuromobilization, bracing/taping, stress management, and pain modulation programs and activities can be important components of the rehabilitation plan. Early intervention after the acute onset of neuropathic pain with an activity-based, comprehensive, biopsychosocial management plan may be effective in preventing more persistent pain states. Rehabilitation plans for both acute and persistent neuropathic pain should focus on building patient self-efficacy, self-management, and resiliency.