P-3-07-15
MEDICAL AND VOCATIONAL REHABILITATION FOR PATIENTS WITH PERSISTENT PAIN; PROBLEMS AND ACHIEVEMENTS
Jan T Ekholm (Karolinska Institute, Stockholm, Sweden)
In Sweden there is too high numbers of sick-pensioners due to chronic pain syndromes. The purpose of this paper is to look at the rehabilitation process of patients with persistent pain and to focus on some of the sub-phases during which there are considerable obstacles for a reduction of disability, and particularly for returning to work. Reasons for improved clinical pain diagnosis in rehabilitation medicine will be presented. The last phase before decision about sick-pension entails medical and non-medical rehabilitation. The non-medical parts are rehabilitation made by e.g. the National Social Insurance System and by the employers. Problems occur if the different contributions are not well co-ordinated. It is concluded that multidisciplinary research is needed to solve some of the problems.
P-3-08-01
THE IMPORTANCE OF MYOFASCIAL PAIN SYNDROME [MPS] IN THE TREATMENT OF REFLEX SYMPATHETIC DYSTROPHY AND CAUSALGIA
TY Lin, MJ Teixeira, LA Rogano, EI Lin, ST Imamura, R Mattar Jr.
Pain Clinic, Physical Medicine & Reabilitation Division, IOT, Hospital das Clinicas of University of Sao Paulo. Sao Paulo, Brazil.
Purpose: MPS is very often associated with several pain syndromes, including reflex sympathetic dystrophy and causalgia (Comple Regional Pain Syndrome, CRPS, Type I and II). Eighty four patients presenting CRPS (59 of Type I and 25 of Type II) of the upper limbs were evaluated. The purpose of the present study is to identify the incidence of MPS in these patients and the relevance of treatment of the MPS.
Method: All patients had neurological and physiatric evaluations. The diagnosis of MPS was made by the presence of trigger points and reflex zones. The multidisciplinary treatments of MPS consisted of association of NSAIDS, psychotropics, physical therapy, acupuncture and/or infiltration of trigger points with 1% lidocaine.
Results: MPS was found in cervical region and upper limbs in 82.1% of the patients, and in 24.6% there was the typical picture of fibromyalgia. The treatment of MPS resulted in significant improvement of pain and function of the affected limb in 70.0% of the cases.
Conclusion: MPS is a very common disfunction in patients with CRPS Type 1 and II. The correct diagnosis and treatment are essential and result in reduction of the need of invasive procedures and in improvement of the pain and the function of the upper limbs of the patients.
