Evidence based rehabilitation in chronic pain syndromes

Kronik ağrı sendromu kompleks bir durum olup etyolojisinin net olmaması ve değişik tedavilere iyi yanıt alınamaması ile hekimler tarafından büyük bir bilinmezlik olarak kabul görmektedir. Kronisite, beklenen iyileşme sürecinden sonra da ağrının devam etmesi şeklinde yorumlanır. Hastaların yaşamı üzerine kronik ağrının etkisi hafif kısıtlanmadan bağımsızlığın tümden kaybedilmesine kadar değişen bir yelpazede ortaya çıkar. Kronik ağrı sendromlarının rehabilitasyonu çok alanlı yaklaşım gerektirir ve fizyoterapi, uğraşı terapisi, manuel terapi, akuaterapi, bilişsel/davranışsal terapi, biofeedback, psikoterapi ve diğer birçok yeni tedavi yöntemini içerir. Son yıllarda, kronik ağrı tedavisine bakış büyük oranda değişmiş ve en iyi yaklaşımın çok alanlı olduğu, rehabilitatif sürecin tedaviye dahil edilmesi gerektiği anlaşılmıştır. Tedavi protokolü bireysel olarak planlanmalı ve gerektiğinde modifiye edilmelidir. Birçok metodun kombine edilmesi söz konusu ise de özellikle yeni tedavi seçenekleri üzerinde uzun dönemde yapılmış kanıta dayalı çalışmalara ihtiyaç vardır.

Kronik ağrı sendromlarında kanıta dayalı rehabilitasyon

Chronic pain syndrome (CPS) is a complex condition that presents a major challenge to physicians because of its unknown etiology and poor response to all kinds of therapies. It has been suggested that chronicity should be considered when pain persists longer than the acceptable healing time. The impact of chronic pain on patients lives varies from minor limitations to complete loss of independence. The rehabilitation in CPSs is multi-disciplinary and involves physical, occupational, and manual therapy, aquatherapy, cognitive/behavioral therapy, biofeedback, psychotherapy, and some new therapies. In recent years, the point of view in chronic pain management has changed substantially and CPS is managed best with a multidisciplinary approach, including a rehabilitative process. The treatment protocol should be planned and modified individually. A combination of several methods has been tried, but long-term evidence-based studies are needed for new treatment modalities.

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