The end of chronic pain

Patients with constant pain symptoms and extreme fear of this pain can be treated effectively by repeatedly exposing them to 'scary' situations. This is the conclusion of Dutch researcher Jeroen de Jong. Patients with pain conditions such as post-traumatic dystrophy, which can affect all tissues and functions of the limbs, can benefit from this in-vivo exposure therapy. Dr. De Jong obtained his PhD from Maastricht University on 25 November.

In-vivo exposure therapy involves patients repeatedly undertaking activities and making movements in a way they consider threatening and would normally avoid. In his various studies, Jeroen de Jong discovered that patients undergoing such therapy not only become less scared of the pain, but actually feel less pain. However, the most striking fact was that the physiological symptoms of post-traumatic dystrophy – oedema, skin discoloration and excess perspiration – improved significantly. In addition, patients were able to make certain movements and carry out activities they would have considered impossible before.

In the Netherlands, 20,000 people are estimated to suffer from chronic post-traumatic dystrophy. This condition is characterised by a relatively innocent injury that causes persistent pain in the affected limb and can eventually lead to the patient losing the use of their arm or leg.

Fear of pain

Many patients with chronic pain are scared to cause more pain and to make certain movements that they have associated with this pain before. People suffering from post-traumatic dystrophy may, for example, stop using a hand. Test subjects participating in in-vivo exposure therapy learned that they could make the movements without harmful effects. Jeroen de Jong also invited patients with chronic lower back pain and post-traumatic neck pain to undergo in-vivo exposure therapy. All groups were found to benefit substantially from this form of therapy.

The benefit of in-vivo exposure therapy had been demonstrated in patients with chronic lower back pain before, but De Jong was the first to show that this treatment can also drastically improve the lives of many other pain patients. The results of the studies in his thesis have a significant impact on the diagnosis of, approach to and treatment of chronic pain.