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Multifactoriële analyse in de medisch-specialistische revalidatie

  • J. L. Swaan
  • H. R. Schiphorst Preuper
  • R. J. E. M. Smeets
Chapter

Samenvatting

Als een patiënt met chronische pijn wordt verwezen naar de revalidatiearts dan kan er sprake zijn van laag complexe of hoog complexe problematiek. Interdisciplinaire behandeling in de medisch-specialistische revalidatie (MSR) is alleen geïndiceerd bij hoog-complexe problematiek. Bij de vaststelling van de mate van complexiteit van het pijnprobleem maakt de revalidatiearts gebruik van verwijsinformatie (correspondentie, eerder verrichte diagnostiek), neemt een uitgebreide anamnese af, eventueel gecombineerd met korte vragenlijsten, verricht lichamelijk onderzoek en laat zo nodig zelf aanvullende diagnostiek verrichten. Als er voldoende informatie is verzameld, begint het proces van analyse. Voor analyse wordt gebruik gemaakt van de zogenaamde ‘vlaggen’, waarbij de aanwezigheid van rode vlaggen kan wijzen op onderliggende (ernstige) somatische problematiek en de overige vlaggen (geel, oranje, blauw, zwart) te beschouwen zijn als prognostisch relevante factoren. Daarnaast wordt gebruik gemaakt van het exploreren van predisponerende, uitlokkende en onderhoudende factoren als hulpmiddel bij de analyse, waarbij met name de laatste van groot belang zijn voor het bepalen van mogelijke aangrijpingspunten van behandeling. Zo komt de revalidatiearts tot een indicatiestelling voor een interventie en aangrijpingspunten voor behandeling. In dit hoofdstuk worden de predisponerende, uitlokkende en onderhoudende factoren besproken. Onderhoudende factoren kunnen biomedisch, psychologisch en/of sociaal zijn en al deze worden factoren worden uitgebreid toegelicht. Er wordt speciaal aandacht geschonken aan de mogelijk negatieve beïnvloeding door medewerkers uit het (para en peri-)medische circuit.

Literatuur

  1. Abate, M., Vanni, D., Pantalone, A., & Salini, V. (2013). Cigarette smoking and musculoskeletal disorders. Muscle, Ligaments and Tendons Journal, 3, 63–69.Google Scholar
  2. Afari, N., Ahumada, S. M., Johnson Wright, L., Mostoufi, S., Golnari, G., Reis, V., et al. (2014). Psychological trauma and functional somatic syndromes: A systematic review and meta-analysis. Psychosomatic Medicine, 76, 2–11.CrossRefGoogle Scholar
  3. Bishop, A., Foster, N. E., Thomas, E., & Hay, E. M. (2008). How does the self-reported clinical management of patients with low back pain relate to the attitudes and beliefs of health care practitioners? A survey of UK general practitioners and physiotherapists. Pain, 135(1–2), 187–195.CrossRefGoogle Scholar
  4. Breivik, H., Collett, B., Ventafridda, V., Cohen, R., & Gallacher, D. (2006). Survey of chronic pain in Europe: Prevalence, impact on daily life, and treatment. European Journal of Pain, 10, 287–333.CrossRefGoogle Scholar
  5. Burke, N. N., Finn, D. P., McGuire, B. E., & Roche, M. (2017). Psychological stress in early life as a predisposing factor for the development of chronic pain: Clinical and preclinical evidence and neurobiological mechanisms. Journal of Neuroscience Research, 95, 1257–1270.CrossRefGoogle Scholar
  6. Burns, J. W., Post, K. M., Smith, D. A., Porter, L. S., Buvanendran, A., Fras, A. M., et al. (2018). Spouse criticism and hostility during marital interaction: Effects on pain intensity and behaviors among individuals with chronic low back pain. Pain, 159, 25–32.CrossRefGoogle Scholar
  7. Cano, A., Leong, L. E., Williams, A. M., May, D. K., & Lutz, J. R. (2012). Correlates and consequences of the disclosure of pain-related distress to one’s spouse. Pain, 153, 2441–2447.CrossRefGoogle Scholar
  8. Casey, P. P., Feyer, A. M., & Cameron, I. D. (2015). Associations with duration of compensation following whiplash sustained in a motor vehicle crash. Injury, 46, 1848–1855.CrossRefGoogle Scholar
  9. Chou, R., & Shekelle, P. (2010). Will this patient develop persistent disabling low back pain? JAMA, 303, 1295–1302.CrossRefGoogle Scholar
  10. Darlow, B., Fullen, B. M., Dean, S., Hurley, D. A., Baxter, G. D., & Dowell, A. (2012). The association between health care professional attitudes and beliefs and the attitudes and beliefs, clinical management, and outcomes of patients with low back pain: A systematic review. European Journal of Pain, 16, 3–17.CrossRefGoogle Scholar
  11. Dean, E., & Söderlund, A. (2015). What is the role of lifestyle behavior change associated with non-communicable disease risk in managing musculoskeletal health conditions with special reference to chronic pain? BMC Musculoskeletal Disorders, 16, 87.CrossRefGoogle Scholar
  12. Downie, A., Williams, C. M., Henschke, N., Hancock, M. J., Ostelo, R. W. J. G., Vet, H. C. W. de, et al. (2013). Red flags to screen for malignancy and fracture in patients with low back pain: Systematic review. British Medical Journal, 347, f7095.CrossRefGoogle Scholar
  13. Dowrick, C. F., Ring, A., Humphris, G. M., & Salmon, P. (2004). Normalisation of unexplained symptoms by general practitioners: A functional typology. British Journal of General Practice, 54(500), 165–170.PubMedGoogle Scholar
  14. Elbers, N. A., Akkermans, A. J., Lockwood, K., Craig, A., & Cameron, I. D. (2015). Factors that challenge health for people involved in the compensation process following a motor vehicle crash: A longitudinal study. BMC Public Health, 15, 339.CrossRefGoogle Scholar
  15. Elliot, J., Flynn, T., Al-Najjar, A., Press, J., Nguyen, B., & Noteboom, J. T. (2011). The pearls and pitfalls of magnetic resonance imaging for the spine. Journal of Orthopaedic & Sports Physical Therapy, 41, 848–860.CrossRefGoogle Scholar
  16. Engelbert, R. H., Juul-Kristensen, B., Pacey, V., Wandele, I. de, Smeenk, S., Woinarosky, N., et al. (2017). The evidence-based rationale for physical therapy treatment of children, adolescents, and adults diagnosed with joint hypermobility syndrome/hypermobile Ehlers Danlos syndrome. American Journal of Medical Genetics. Part C, Seminars in Medical Geneticsm, 175C, 158–167.CrossRefGoogle Scholar
  17. Ferreira, M., Machado, G., Latimer, J., Maher, C., Ferreira, P., & Smeets, R. J. E. M. (2010). Factors defining care seeking in low back pain – A meta-analysis of population based surveys. European Journal of Pain, 14, 747.e1–747.e7.CrossRefGoogle Scholar
  18. Flor, H., & Turk, D. C. (2011). Chronic pain. An integrated biobehavioral approach. Seattle: IASP Press. ISBN 987-0-931092-90-9.Google Scholar
  19. Generaal, E. (2017). Chronische pijn, de rol van biologische en psychosociale factoren. Nederlandstalig Tijdschrift voor Pijn en Pijnbestrijding, 36, 23–30.Google Scholar
  20. Generaal, E., Vogelzangs, N., Penninx, B. W., & Dekker, J. (2017). Insomnia, sleep duration, depressive symptoms, and the onset of chronic multisite musculoskeletal pain. Sleep, 40(1), 1–10.Google Scholar
  21. Goffaux, P., Lafrenaye, S., Morin, M., Patural, H., Demers, G., & Marchand, S. (2008). Preterm births: Can neonatal pain alter the development of endogenous gating systems? European Journal of Pain, 12, 945–951.CrossRefGoogle Scholar
  22. Gopinath, B., Elbers, N. A., Jagnoor, J., Harris, I. A., Nicholas, M., Casey, P., et al. (2016). Predictors of time to claim closure following a non-catastrophic injury sustained in a motor vehicle crash: A prospective cohort study. Public Health, 16, 421.PubMedGoogle Scholar
  23. Gordon, R., & Bloxham, S. (2016). A systematic review of the effects of exercise and physical activity on non-specific chronic low back pain. Healthcare, 4, 22.CrossRefGoogle Scholar
  24. Grant, G. M., O’Donnell, M. L., Spittal, M. J., Creamer, M., & Studdert, D. M. (2014). Relationship between stressfulness of claiming for injury compensation and long-term recovery: A prospective cohort study. JAMA Psychiatry, 71, 446–453.CrossRefGoogle Scholar
  25. Harris, I., Mulford, J., Solomon, M., Gelder, J. M. van, & Young, J. (2005). Association between compensation status and outcome after surgery: A meta-analysis. JAMA, 293, 1644–1652.CrossRefGoogle Scholar
  26. Harris, I. A., Young, J. M., Jalaludin, B. B., & Solomon, M. J. (2008). The effect of compensation on general health in patients sustaining fractures in motor vehicle trauma. Journal of Orthopedic Trauma, 22(4), 216–220.CrossRefGoogle Scholar
  27. Hartvigsen, J., Hancock, M., Kongsted, A., Louw, Q., Ferreira, M., Genevay, S., et al. (2018). What is low back pain and why we need to pay attention? The Lancet, 1391, 2356–2367.CrossRefGoogle Scholar
  28. Heim, N., Snijder, M. B., Deeg, D. J., Seidell, J. C., & Visser, M. (2008). Obesity in older adults is associated with an increased prevalence and incidence of pain. Obesity (Silver Spring), 16, 2510–2517.CrossRefGoogle Scholar
  29. Henschke, N., Lorenz, E., Pokora, R., Michaleff, Z. A., Quartey, J. N. A., & Oliveira, V. C. (2016). Understanding cultural influences on back pain and back pain research. Best Practice & Research Clinical Rheumatology, 30(6), 1037–1049.CrossRefGoogle Scholar
  30. Hocking, L. J., Morris, A. D., Dominiczak, A. F., Porteous, D. J., & Smith, B. H. (2012). Heritability of chronic pain in 2.195 extended families. European Journal of Pain, 16, 1053–1063.CrossRefGoogle Scholar
  31. Hodges, P. W., & Smeets, R. (2015). Interaction between pain, movement and physical activity: Short-term benefits, long term consequences, and targets for treatment. Clinical Journal of Pain, 31, 97–107.CrossRefGoogle Scholar
  32. Hollander, M. den, Jong, J. R. de, Volders, S., Goossens, M. E. J. B., Smeets, R. J. E. M., & Vlaeyen, J. W. S. (2010). Fear reduction in patients with chronic pain: A learning theory perspective. Expert Reviews of Neurotherapeutics, 10, 1733–1745.CrossRefGoogle Scholar
  33. Holley, A. L., Wilson, A. C., & Palermo, T. M. (2017). Predictors of the transition from acute to persistent musculoskeletal pain in children and adolescents: A prospective study. Pain, 158, 794–801.CrossRefGoogle Scholar
  34. Houben, R. M. A., Gijsen, A., Peterson, J., Jong, P. J. de, & Vlaeyen, J. W. S. (2005). Do health care providers’ attitudes towards back pain predict their treatment recommendations. Differential predictive validity of implicit and explicit attitude measures? Pain, 114, 491–495.CrossRefGoogle Scholar
  35. Janke, E. A., Collins, A., & Kozak, A. T. (2007). Overview of the relationship between pain and obesity: What do we know? Where do we go next? Journal of Rehabilitation Research & Development, 44, 245–262.CrossRefGoogle Scholar
  36. Kendall, N., Linton, S. J., & Main, C. J. (1997). Guide to assessing psychosocial yellow flags in acute low back pain: Risk factors for long-term disability and work loss. Wellington, New Zeeland: Accident rehabilitation and Compensation Insurance of New Zealand and the National Health Committee.Google Scholar
  37. Korff, M. von, Alonso, J., Ormel, J., Angermeyer, M., Bruffaerts, R., Fleiz, C., et al. (2009). Childhood psychosocial stressors and adult onset arthritis: Broad spectrum risk factors and allostatic load. Pain, 143, 76–83.CrossRefGoogle Scholar
  38. Lacourt, T. E., Houtveen, J. A., Smeets, H. M., Lipovsky, M. M., & Doornen, L. J. P. van. (2013). Infection load as a predisposing factor for somatoform disorders: Evidence from a Dutch general practice registry. Psychosomatic Medicine, 75, 759–764.CrossRefGoogle Scholar
  39. Linton, S. J. (2000). A review of psychological risk factors in back and neck pain. Spine (Phila Pa 1976), 25, 1148–1156.CrossRefGoogle Scholar
  40. Littleton, S. M., Hughes, D. C., Gopinath, B., Robinson, B. J., Poustie, S. J., Smith, P. N., et al. (2014). The health status of people claiming compensation for musculoskeletal injuries following road traffic crashes is not altered by an early intervention programme: A comparative study. Injury, 45(9), 1493–1499.CrossRefGoogle Scholar
  41. Luyten, P. (2014). Persistente somatische klachten – Nieuwe inzichten vanuit de dialoog met de neurowetenschappen. Tijdschrift voor Psychoanalyse, 20, 266–276.Google Scholar
  42. Main, C. J., & Burton, A. K. (2000). Economic and occupational influences on pain and disability. In C. J. Main & C. C. Spanswick, (Eds.), Pain management: An interdisciplinary approach (pp. 63–87). Edinburgh, Scotland: Churchill Livingstone.Google Scholar
  43. Main, C. J., Sullivan, M. J. L., & Watson, P. J. (2008). Pain management (2nd ed.). London: Elsevier. ISBN 13:9780443100697.Google Scholar
  44. Menezes Costa, L. D. C., Maher, C. G., McAuley, J. H., Hancock, M. J., & Smeets, R. J. E. M. (2011). Self-efficacy is more important than fear of movement in mediating the relationship between pain and disability in chronic low back pain. European Journal of Pain, 15, 213–219.CrossRefGoogle Scholar
  45. Miller, H. (1961). Accident neurosis. British Medical Journal, 1, 919–925.CrossRefGoogle Scholar
  46. Murgatroyd, D. F., Cameron, I. D., & Harris, I. A. (2011). Understanding the effect of compensation on recovery from severe motor vehicle crash injuries: A qualitative study. Injury Prevention, 17, 222–227.CrossRefGoogle Scholar
  47. Murgatroyd, D. F., Casey, P. P., Cameron, I. D., & Harris, I. A. (2015). The effect of financial compensation on health outcomes following musculoskeletal injury: Systematic review. PLoS One, 10(2), e0117597.CrossRefGoogle Scholar
  48. Muthuri, S. G., Kuh, D., Bendayan, R., Macfarlane, G. J., & Cooper, R. (2016). Chronic physical illness in early life and risk of chronic widespread and regional pain at age 68: Evidence from the 1946 British birth cohort. Pain, 157, 2382–2389.CrossRefGoogle Scholar
  49. Nicholas, M. K., Linton, S. J., Watson, P. J., & Main, C. J. (2011). The “Decade of the Flags” working group. Early identification and management of psychological risk factors (“yellow flags”) in patients with low back pain: A reappraisal. Physical Therapy, 91, 737–753.CrossRefGoogle Scholar
  50. Okifuji, A., & Hare, B. D. (2015). The association between chronic pain and obesity. Journal of Pain Research, 8, 399–408.CrossRefGoogle Scholar
  51. Palmer, S., Bailey, S., Barker, L., Barney, L., & Elliott, A. (2014). The effectiveness of therapeutic exercise for joint hypermobility syndrome: A systematic review. Physiotherapy, 100, 220–227.CrossRefGoogle Scholar
  52. Petre, B., Torbey, S., Griffith, J. W., Oliveira, G. de, Herrmann, K., Mansour, A., et al. (2015). Smoking increases risk of pain chronification through shared corticostriatal circuitry. Human Brain Mapping, 36, 683–694.CrossRefGoogle Scholar
  53. Phillips, C. J. (2009). The cost and burden of chronic pain. British Journal of Pain, 3, 2–5.Google Scholar
  54. Pinheiro, M. B., Ferreira, M. L., Refshauge, K., Maher, C. G., Ordoñana, J. R., Andrade, T. B., et al. (2016). Symptoms of depression as a prognostic factor for low back pain: A systematic review. The Spine Journal, 16, 105–116.CrossRefGoogle Scholar
  55. Prenevost, M. H., & Reme, S. E. (2017). Couples with chronic pain: How do intercouple interactions relate to coping? Scandinavian Journal of Pain, 16, 150–157.CrossRefGoogle Scholar
  56. Rainville, J., Carlson, N., Polatin, P., Gatchel, R. J., & Indahl, A. (2000). Exploration of physicians’ recommendations for activities in chronic low back pain. Spine, 25, 2210–2220.CrossRefGoogle Scholar
  57. Ray, L., Lipton, R. B., Zimmerman, M. E., Katz, M. J., & Derby, C. A. (2011). Mechanisms of association between obesity and chronic pain in the eldery. Pain, 152, 53–59.CrossRefGoogle Scholar
  58. Rivat, C., Becker, C., Blugeot, A., Zeau, B., Mauborgne, A., Pohl, M., et al. (2010). Chronic stress induces transient spinal neuroinflammation, triggering sensory hypersensitivity and long-lasting anxiety-induced hyperalgesia. Pain, 150, 358–368.CrossRefGoogle Scholar
  59. Romano, J. M., Jensen, M. P., Turner, J. A., Good, A. B., & Hops, H. (2000). Chronic pain patient-partner interactions: Further support for a behavioral model of chronic pain. Behavior Therapy, 31, 415–440.CrossRefGoogle Scholar
  60. Salmon, J., & Shilton, T. (2004). Endorsement of physical activity recommendations for children and youth in Australia. Journal of Science and Medicine in Sport, 7, 405–406.CrossRefGoogle Scholar
  61. Scheper, M. C., Pacey, V., Rombaut, L., Adamns, R. D., Tofts, L., Calders, P., et al. (2016). Generalized hyperalgesia in children and adults diagnosed with hypermobility syndrome and Ehlers-Danlos hypermobility type: A discriminative analysis. Arthritis Care and Research, 15, 1–7.Google Scholar
  62. Scheper, M. C., Vries, J. E. de, Juul-Kristensen, B., Nollet, F., & Engelbert, R. H. (2014). The functional consequences of generalized joint hypermobility: A cross-sectional study. BMC Musculoskeletal Disorders, 15, 243.CrossRefGoogle Scholar
  63. Schmidt, A., Corcoran, K., Grahame, R. de, & Williams, A. C. (2015). How do people with chronically painful joint hypermobility syndrome make decisions about activity? British Journal of Pain, 9, 157–166.CrossRefGoogle Scholar
  64. Scott, W., Milioto, M., Trost, Z., & Sullivan, M. J. (2016). The relationship between perceived injustice and the working alliance: A cross-sectional study of patients with persistent pain attending multidisciplinary rehabilitation. Disability and Rehabilitation, 38, 2365–2373.CrossRefGoogle Scholar
  65. Serbic, D., & Pincus, T. (2014). Diagnostic uncertainty and recall bias in chronic low back pain. Pain, 155, 1540–1546.CrossRefGoogle Scholar
  66. Smeets, R. J. E. M., Wade, D., Hidding, A., Leeuwen, P. J. C. M. van, Vlaeyen, J. W. S., & Knottnerus, J. A. (2006). The association of physical deconditioning and chronic low back pain: A hypothesis-oriented systematic review. Disability and Rehabilitation, 28, 673–693.CrossRefGoogle Scholar
  67. Smeets, R. J. E. M., & Wittink, H. (2007). Editorial: The deconditioning paradigma for chronic low back pain unmasked? Pain, 130, 201–202.CrossRefGoogle Scholar
  68. Spearing, N. M., Connelly, L. B., Gargett, S., & Sterling, M. (2012). Does injury compensation lead to worse health after whiplash? A systematic review. Pain, 153, 1274–1282.CrossRefGoogle Scholar
  69. Steenstra, I. A., Verbeek, J. H., Heymans, M. W., & Bongers, P. M. (2005). Prognostic factors for duration of sick leave in patients sick listed with acute low back pain: A systematic review of the literature. Occupational and Environmental Medicine, 62, 851–860.CrossRefGoogle Scholar
  70. Stone, J., Wojcik, W., Durrance, D., Carson, A., Lewis, S., MacKenzie, L., et al. (2002). What should we say to patients with symptoms unexplained by disease? The “number needed to offend”. British Medical Journal, 325, 1449–1450.CrossRefGoogle Scholar
  71. Street, T. D., & Lacey, S. J. (2015). A systematic review of studies identifying predictors of poor return to work outcomes following workplace injury. Work, 51, 373–381.CrossRefGoogle Scholar
  72. Sullivan, M. J., Feuerstein, M., Gatchel, R., Linton, S. J., & Pransky, G. (2005). Integrating psychosocial and behavioral interventions to achieve optimal rehabilitation outcomes. Journal of Occupational Rehabilitation, 15, 475–489.CrossRefGoogle Scholar
  73. Verbunt, J. A., Smeets, R. J. E. M., & Wittink, H. (2010). Cause or effect? Deconditioning and chronic low back pain. A topical review. Pain, 149, 428–430.Google Scholar
  74. Verhagen, A. P., Downie, A., Maher, C. G., & Koes, B. W. (2017). Most red flags for malignancy in low back pain guidelines lack empirical support: A systematic review. Pain, 158, 1860–1868.CrossRefGoogle Scholar
  75. Vlaeyen, J. W. S., & Linton, S. J. (2006). Editorial. Are we “fear-avoidant”? Pain, 124, 240–241.CrossRefGoogle Scholar
  76. Werkgroep Pijnrevalidatie Nederland, Nederlandse Vereniging van Revalidatieartsen (2017). Position paper. Medisch specialistische revalidatie bij chronische pijn aan het houdings-en bewegingsapparaat.Google Scholar
  77. Wertli, M. M., Eugster, R., Held, U., Steurer, J., Kofmehl, R., & Weiser, S. (2014). Catastrophizing—A prognostic factor for outcome in patients with low back pain: A systematic review. The Spine Journal, 11, 2639–2657.CrossRefGoogle Scholar
  78. World Health Organization (2001). International classification of functioning, disability and health. ICF. Geneva: WHO Publishing.Google Scholar

Standaarden en Richtlijnen

  1. NHG-Standaard Aspecifieke lage rugpijn (2005).Google Scholar
  2. Richtlijn Lumbosacraal radiculair syndroom. NHG (2005).Google Scholar
  3. Richtlijn handelen van de bedrijfsarts bij werknemers met aspecifieke lage rugklachten. NVAB (2006).Google Scholar
  4. Ketenzorgrichtlijn Aspecifieke Lage Rugklachten (2010).Google Scholar
  5. KNGF-richtlijn. Klachten aan de arm, nek en/of schouder (KANS) (2010).Google Scholar
  6. GGZ richtlijn SOLK en somatoforme stoornissen (2011).Google Scholar
  7. Multidisciplinaire richtlijn aspecifieke Klachten Arm, Nek en/of Schouders (2012).Google Scholar
  8. KNGF-richtlijn Lage rugpijn (2013).Google Scholar
  9. NHG-Standaard Somatisch Onvoldoende verklaarde Lichamelijke Klachten (SOLK) (2013).Google Scholar
  10. Zorgstandaard chronische pijn (2017).Google Scholar

Copyright information

© Bohn Stafleu van Loghum is een imprint van Springer Media B.V., onderdeel van Springer Nature 2019

Authors and Affiliations

  • J. L. Swaan
    • 1
  • H. R. Schiphorst Preuper
    • 2
  • R. J. E. M. Smeets
    • 3
  1. 1.Rijndam Revalidatie RotterdamRotterdamNederland
  2. 2.afdeling RevalidatiegeneeskundeRijksuniversiteit Groningen, Universitair Medisch Centrum GroningenGroningenNederland
  3. 3.Libra Revalidatie en AudiologieUniversiteit MaastrichtMaastrichtNederland

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