Nijs Ún van Houdenhove:


"onterechte pijnbeleving" moet worden behandeld






Woorden schieten te kort bij zulk een eendrachtig opgeschreven biopsycho-bla-bla ....




From acute musculoskeletal pain to chronic widespread pain and fibromyalgia:

Application of pain neurophysiology in manual therapy practice.

Man Ther. 2008 May 27. [Epub ahead of print]

Nijs J, Van Houdenhove B.


During the past decade, scientific research has provided new insight into the development from an acute, localised musculoskeletal disorder towards chronic widespread pain/fibromyalgia (FM).


Chronic widespread pain/FM is characterized by sensitisation of central pain pathways. An in-depth review of basic and clinical research was performed to design a theoretical framework for manual therapy in these patients.


It is explained that manual therapy might be able to influence the process of chronicity in three different ways.

  1. In order to prevent chronicity in (sub)acute musculoskeletal disorders,
  2. it seems crucial to limit the time course of afferent stimulation

    of peripheral nociceptors.

  3. In the case of chronic widespread pain

    and established sensitisation of central pain pathways,

    relatively minor injuries/trauma at any locations

    are likely to sustain the process of central sensitisation

    and should be treated appropriately with manual therapy

    accounting for the decreased sensory threshold.

    Inappropriate pain beliefs should be addressed

    and exercise interventions should account for the process of central sensitisation.

  4. However, manual therapists ignoring the processes
  5. involved in the development and maintenance of chronic widespread pain/FM

    may cause more harm then benefit to the patient

    by triggering or sustaining central sensitisation.



PMID: 18511329 [PubMed - as supplied by publisher]