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Chronic pain, even without a clear cause
Pain that lasts longer than three months while scans and tests show nothing in particular. Or an old injury that has healed but still hurts. That is not imagination. With long-lasting pain, the way the nervous system processes pain signals changes: it becomes more sensitive, and ordinary stimuli hurt. Alexander Kudus is a pain physiotherapist and treats chronic pain from that knowledge, combined with thorough physical examination.
Does this sound familiar?
• Pain that moves or spreads, without anything being "broken".
• Pain that gets worse with stress, poor sleep or fatigue.
• Several practitioners already; every treatment helped briefly or not at all.
• You have started avoiding movements for fear of more pain.
• Diagnosed with "unexplained pain", fibromyalgia or told "it is all in your head".
Assessment: the body and the factors that keep pain going
As always, we begin with examination of the whole musculoskeletal system, because even in chronic pain a treatable physical cause is sometimes overlooked. We also map what keeps the pain going: sleep, stress and breathing, load and capacity, and your own expectations and worries about the pain. For this we use validated questionnaires, such as the Örebro questionnaire.
We ask you to track your complaints for a few weeks, for example with WeerBody (b10.life/weergevoeligheid) and, if you sleep badly, the online sleep diary. That way we see together what influences your pain.
Treatment
Treatment consists of explaining how pain works (pain education), gradually building up movement and load, and where needed treatment of muscles and joints, breathing and sleep. We work with methods that have good evidence, such as Pain Neuroscience Education and Acceptance and Commitment Therapy (ACT). The goal is not only less pain, but above all being able to do more of what matters to you.
If an approach is needed that falls outside our expertise, we work with specialised colleagues in Amsterdam and arrange a warm handover.
Practical
• No referral needed; reimbursed through your supplementary insurance for physiotherapy. For chronic conditions on the basic-insurance list, reimbursement from the 21st session is possible with a referral.
• Intake 60 minutes; bring previous reports.
• English, German and Dutch.
Tool: WeerBody — track your complaints and the weather