8. おわりに

近年，痛みに関する研究結果は飛躍的に進歩しており，認知行動療法や集学的アプローチの重要性も示されている．しかし，本邦のリハビリテーション現場においては一部の機関を除いて未だ十分に臨床応用されておらず，疼痛除去に対するスタンダードが確立されているとは言い難い．

急性痛では，不必要な安静・固定・不動は，その後の慢性痛につながる可能性があるため，可及的早期に低負荷から段階的に漸増していく運動療法の介入により，ADL を拡大して社会参加を促すことにより，痛みに曝される期間を最小限としていく．慢性期では，今できることから徐々に活動を増やさせさせ，運動継続が可能なプログラムを立案して，過度に不安を助長させずに，成功体験による自信回復と賞賛を糧として痛みの悪循環を断つことがセラピストとして重要となる．

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