MethodSomatosensory Rehabilitation of Neuropathic Pain
Somatosensory Rehabilitation of Neuropathic Pain (SRNP - #NeuroPainRehab) is a method to test and treat somatosensory disorders of Neuropathic Pain Patients (NPP). The aim of somatosensory rehabilitation is to increase the quality of touch or even normalize the sensation of touch in the case of neuropathic pain due to peripheral nerve lesions. Because, when hypoesthesia decreases, neuropathic pain decreases. The assessment of partial tactile hypoaesthesia (axonotmesis) is based on the concept of the largest cutaneous distribution of the nerve branch.
1). The first phase is the mapping which outlines the hypoaesthetic territory - aesthesiography.
2). The second phase is the regular and rigorous assessment of the quality of hypoaesthesia in terms of pressure perception threshold. This is an important part of this rehabilitation.
Sometimes, the hypoaesthetic territory is masked by a patch of skin which is painful to touch and is therefore not accessible. Since 1979, this stimulus induced pain is to be called in medicine: allodynia or touch-evoked neuropathic pain. The original definition comes from Merskey and Bogduk (1994) “pain due to a stimulus which does not normally provoke pain.” In such situations, while doing the diagnostic testing of axonal lesions at the first occupational or physical therapy session, the two point discrimination test is impossible, because it induces pain. “This conflict between hypersensitivity and hypoaesthesia is commonly seen in the clinical setting in patients with CRPS.”
The presence of mechanical allodynia, hinders other physical treatments. For the reason that, any contact on the hypersensitive territory, although it can be bearable in the moment, can induce several hours of a very painful post-effect or even several sleepless nights. This hypersensitivity to touch is induced by the peripheral nerve lesion of the large myelinated A-beta neurofibers.
In other words, after a peripheral nerve lesion, aberrant sprouting occurs in the dorsal horn which can explain that a non-noxious stimulus is perceived as being noxious. This is one of the explanatory models of the different mechanisms of peripheral, subcortical and cortical sensitization. Somatosensory Rehabilitation of Neuropathic Pain can reverse these mechanisms of the somaesthetic nervous system - even many years after the lesion.
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Tome 20, Volume 2
E-news in PDF
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Martin WINCKLER, médecin et écrivain
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[formatted_address] => 1215 Ch. du Tremblay #260, Longueuil, QC J4N 1R4, Canada
)
[website] => https://cliniquecmi.com/cliniques-physiotherapie/longueuil-physio/
[email] => amandeepn@cliniquecmi.com
[country] => Canada
[city] => J4N 1R4 Longueuil
[tel] => +1 450-442-1018
[address] => 1215 chemin Du Tremblay, bureau 260
[firstname] => Amandeep
[lastname] => NANDHRA
)
Array
(
[mapAddress] => Array
(
[latitude] => 48.8677946
[longitude] => 2.296931
[zoom] => 8
[formatted_address] => 22 bis Rue Georges Bizet, 75116 Paris, France
)
[website] =>
[email] =>
[country] => France
[city] => 75116 PARIS
[tel] => 06 60 40 42 73
[address] => 22 bis rue Georges Bizet
[firstname] => Fanny
[lastname] => CARN
)
Array
(
[mapAddress] => Array
(
[latitude] => 47.0483548
[longitude] => 7.621217200000046
[zoom] => 0
[formatted_address] => Oberburgstrasse 54, 3400 Burgdorf, Switzerland
)
[website] =>
[email] => nkl@livenet.ch
[country] => switzerland
[city] => 3400 BURGDORF
[tel] => +41 34 423 23 90
[address] => Regionalspital Burgdorf
[firstname] => Karin
[lastname] => LUETHI
)
Array
(
[mapAddress] => Array
(
[latitude] => 45.3989564
[longitude] => -71.93462559999999
[zoom] => 14
[formatted_address] => 20 Rue de Carillon, Sherbrooke, QC J1J 2K8, Canada
)
[website] =>
[email] => lgoulet01@gmail.com
[country] => Canada
[city] => J1J2K8 SHERBROOKE
[tel] => 450-917-0900
[address] => Clinique de la main de l'Estrie 20, rue de Carillon
[firstname] => Laurence
[lastname] => GOULET
)
Array
(
[mapAddress] => Array
(
[latitude] => 12.855418
[longitude] => 77.57063579999999
[zoom] => 14
[formatted_address] => 312, Anjanapura 80 Feet Rd, BDA layout, Anjanapura 10th Block, Lal Bahadur Shastri Nagar, Bengaluru, Karnataka 560062, India
)
[website] =>
[email] =>
[country] =>
[city] =>
[tel] =>
[address] =>
[firstname] => Deepak
[lastname] => SHARAN
)
Array
(
[mapAddress] => Array
(
[latitude] => 49.6011363
[longitude] => 3.4152864999999792
[zoom] => 0
[formatted_address] => Route de Saint-Nicolas, 02410 Saint-Gobain, France
)
[website] =>
[email] => ergo.dom@crrfstgobain.fr
[country] => France
[city] => 02410 SAINT-GOBAIN
[tel] => +33 3 23 38 78 00
[address] => Rte Saint-Nicolas
[firstname] => Céline
[lastname] => LANGLOIS
)
Array
(
[mapAddress] => Array
(
[latitude] => 49.926791523067266
[longitude] => 2.402410807031261
[zoom] => 14
[formatted_address] => 1238 Route nationale, 80260 Poulainville, France
)
[website] =>
[email] => wagner.ergo@gmail.com
[country] => France
[city] => 80800 DAOURS
[tel] => 0033 6 78 79 62 14
[address] => 2 route de Bussy-Les-Daours
[firstname] => Gautier
[lastname] => WAGNER
)
Array
(
[mapAddress] => Array
(
[latitude] => 46.7997899
[longitude] => 7.154646
[zoom] => 14
[formatted_address] => Rue Hans-Geiler 6, 1700 Fribourg, Switzerland
)
[website] =>
[email] =>
[country] => switzerland
[city] => 1700 Fribourg
[tel] => 026 2500 622
[address] => Rue Hans-Geiler 6
[firstname] => Gautier
[lastname] => WAGNER
)
Array
(
[mapAddress] => Array
(
[latitude] => 48.4393442
[longitude] => 1.4438974
[zoom] => 14
[formatted_address] => 3 Rue de Genève, 28110 Lucé, France
)
[website] =>
[email] =>
[country] => France
[city] => 28110 LUCE
[tel] => 0033 6 89 60 15 92
[address] => 3, rue de Genève
[firstname] => Anne
[lastname] => BARRES
)
Array
(
[mapAddress] => Array
(
[latitude] => 46.227638
[longitude] => 2.213749
[zoom] => 3
[formatted_address] => France
)
[website] =>
[email] =>
[country] =>
[city] =>
[tel] =>
[address] =>
[firstname] => Anne
[lastname] => BARRES
)
Array
(
[mapAddress] => Array
(
[latitude] => 47.2416708
[longitude] => 6.039795
[zoom] => 14
[formatted_address] => France,7, chemin des Monts de Bregille Haut,25000,Besançon
)
[website] =>
[email] => ergotherapie.crrfb@salinsdebregille.com
[country] => France
[city] => 25000 Besançon
[tel] => +33 3 81 65 86 86
[address] => 7, chemin des Monts de Bregille Haut
[firstname] => Dominique
[lastname] => SAGNIEZ
)
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