Samenvatting

Background: Chronic pain affects a large proportion of the population. A global consensus among physiotherapists and other health professionals is lacking in the definition, assessment, prevention and treatment of chronic pain.
Objectives: The aim of this systematic review was to determine a concise definition of chronic pain, gather valuable assessment tools for a proper diagnosis and to develop a treatment plan based upon pain and functional disability to increase the quality of chronic pain prevention and management.
Search strategy: Medline, PEDro, Cochrane reviews, CINAHL, physiotherapy and pain organizations' WebPages were searched.
Selection criteria: Systematic reviews, randomized controlled clinical trials (RCT's) and literature from texts and WebPages that described the definition, treatments and assessments for physiotherapy of chronic pain.
Main results: There is strong evidence that exercise therapy is the most effective treatment for chronic pain. Manual therapy and Hydrotherapy may also play a secondary role. Conventional Physiotherapy such as modalities (electrotherapy, heat, cold and ultrasound), massage and traction have insufficient evidence to justify their use in chronic pain treatment. There is further evidence to support that the combination of psychological treatments with physiotherapy can lower the risk of a long-term disability developing. An emphasis on the reduction of pain only re-directs the attention of the patient away from functionality. Therefore treatment must focus on functional activities directed at improving the patient's participation in society.