Multimodale Schmerztherapie

Arnold, B.; Brinkschmidt, T.; Casser, Hans-Raimund; Gralow, I.; Irnich, D.; Klimczyk, K.; Müller, G.; Nagel, Bernd; Pfingsten, M.; Schiltenwolf, Marcus; Sittl, Reinhard; Söllner, Wolfgang

doi:10.1007/s00482-008-0741-x

Cited by 192 publications

(58 citation statements)

References 35 publications

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“…Additionally, depression and psychosomatic disorders are common in patients receiving multidisciplinary pain programs. Hence, with the existence of these risk factors, an operative intervention is not recommended due to the increased incidence of developing postoperative pain and chronicity [7,9,10,[25][26][27]. With regard to our observations, the steady levels of MPSS chronicity stages demonstrated the high psychosocial influence in both investigated groups.…”

Section: Discussionmentioning

confidence: 76%

“…Therefore, patients with chronic low back pain constitute an increasing challenge for every professional who treats spinal disorders. The management of chronic low back pain consists of a range of different intervention strategies, including physical therapy, occupational therapy, surgery, and pharmacological treatment, along with adjunctive treatment modalities, such as epidural steroid injections, acupuncture, and other alterative medical therapies [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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Impact of a multidisciplinary pain program for the management of chronic low back pain in patients undergoing spine surgery and primary total hip replacement: a retrospective cohort study

et al. 2014

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Background: Low back pain is a very common disorder. In this field chronic low back pain represents a special challenge. The management of chronic low back pain consists of a range of different intervention strategies. Usually operative intervention should be avoided if possible. However, there are constellations were surgical therapy in patients with chronic low back pain seems to be meaningful. The aim of this study was to investigate the clinical outcomes after spine surgery and hip replacement in patients with chronic low back pain after undergoing a structured rehabilitation program including cognitive -behavioral therapy. Methods: From January 1, 2007 to January 1, 2010 patients were indicated for total hip replacement (THA) or spine surgery after receiving inpatient multidisciplinary pain programs including cognitive -behavioral therapy at our orthopedic institute with a specialized unit for the rehabilitation of chronic pain patients. Indications for surgery were based on the synopsis of clinical and imaging findings and on positive effects after local injections during the multidisciplinary pain program. The tools for assessment included follow-up at 6 and 12 months and analyses of pain, chronicity, physical functioning and depression. Results: Of the 256 patients admitted for multidisciplinary pain program, fifteen were indicated to benefit from a surgical intervention during multidisciplinary pain program. Ten patients received spine surgery. THA was indicated in five patients. In all cases, the peri-and postoperative clinical courses were uneventful. Only two of the patients subjected to spine surgery and three patients who had THA were improved after 12 months. One patient reported a worsened condition. All patients presented with good functional outcomes and normal radiological findings. Conclusions: The indication for surgical intervention in patients with chronic low back pain and degenerative diseases must be critically assessed. THA in this cohort should focus on functional aspects, such as the improvement of range of motion, rather than the reduction of pain. Spine surgery in chronic low back pain patients after multidisciplinary pain program including cognitive -behavioral therapy cannot be recommended due to its questionable success.

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Section: Discussionmentioning

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Impact of a multidisciplinary pain program for the management of chronic low back pain in patients undergoing spine surgery and primary total hip replacement: a retrospective cohort study

et al. 2014

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“…Die multimodale integrative Schmerztherapie wurde von der Ad-hoc-Kommission "Multimodale interdisziplinäre Schmerztherapie" der Deutschen Schmerzgesellschaft als "gleichzeitige, inhaltlich, zeitlich und in der Vorgehensweise aufeinander abgestimmte umfassende Behandlung von Patienten mit chronifizierten Schmerzsyndromen bezeichnet, in die verschiedene somatische, körperlich übende, psychologisch übende und psychotherapeutische Verfahren nach vorgegebenem Behandlungsplan mit identischem, unter den Therapeuten abgesprochenem Therapieziel eingebunden sind" [1].…”

Section: Was Bedeutet "Multimodale Schmerztherapie"?unclassified

“…Zur Basis der Implementierung optimierter Prozessabläufe in der Schmerztherapie zählen u. a. standardisierte und überprüfbare Struktur-sowie Prozessqualitätsmerkmale [17]. Diese wurden für die multimodale Schmerztherapie im Jahr 2009 in einem ersten Schritt definiert [1]. Betrachtet man die gegenwärtige Versorgungssituation der Schmerzmedizin in Deutschland, so fällt auf, dass eine Vielzahl von Einrichtungen unter dem Label "multimodale Schmerztherapie" auftreten, ohne dass die geforderten Qualitätsmerkmale erkennbar erfüllt werden.…”

Section: Was Bedeutet "Multimodale Schmerztherapie"?unclassified

Multimodale Schmerztherapie

Sabatowski

Kaiser

2012

Schmerz

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“…Different practical, somatic, physical, practical psychological and psychotherapeutic methods are integrated according to a standardised treatment plan, taking into account the therapeutic target agreed among the therapists (14).…”

Section: Introductionmentioning

confidence: 99%

Multi-Modal Pain Therapy of Fibromyalgia Syndrome with Integration of Systemic Whole-Body Hyperthermia – Effects on Pain Intensity and Mental State: A Non-Randomised Controlled Study

Romeyke¹,

Stummer²

2014

Journal of Musculoskeletal Pain

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Objectives: This controlled study evaluates a multi-modal pain therapy for treating severe progressions of fibromyalgia [FMS] syndrome. The aim is to establish whether the use of multi-modal therapy with inclusion of whole-body hyperthermia represents a useful therapeutic addition to inpatient therapy of FMS syndrome at a high level of chronification. Methods: The study involved 130 patients who fulfilled the criteria of the American College of Rheumatology [ACR] for FMS and whose disease showed severe progression. One group of patients [HTG] received whole-body hyperthermia, while the control group [CG] did not. The main parameters of the study were pain intensity and the mental state of the patients. Further study parameters were the diagnoses additional to FMS syndrome and the therapy density of the treatment provided in the two groups. Results: The integration of whole-body hyperthermia into the multi-modal pain therapy showed superior pain reduction [p ¼ 0.023] and an improvement in the mental state of the patients [p ¼ 0.055]. In addition to the primary disease, the patients presented with an average of 6.7 accompanying diseases, primarily from major diagnostic categories 8 [diseases and disturbances of the musculoskeletal system and connective tissues], 19 [mental diseases and disturbances] and 10 [endocrine, nutritional and metabolic diseases]. Analysis of the therapy density of the inpatient multi-modal pain therapy revealed a close-meshed and high-frequency therapy. Conclusions: Multi-modal pain therapy was also found to be a highly effective therapy option in the case of severely progressive FMS syndrome. Extension of the multi-modal therapy setting to include whole-body hyperthermia can be considered as a useful and effective complement for pain relief and stabilisation of the mental state.

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Multimodale Schmerztherapie

Cited by 192 publications

References 35 publications

Impact of a multidisciplinary pain program for the management of chronic low back pain in patients undergoing spine surgery and primary total hip replacement: a retrospective cohort study

Impact of a multidisciplinary pain program for the management of chronic low back pain in patients undergoing spine surgery and primary total hip replacement: a retrospective cohort study

Multimodale Schmerztherapie

Multi-Modal Pain Therapy of Fibromyalgia Syndrome with Integration of Systemic Whole-Body Hyperthermia – Effects on Pain Intensity and Mental State: A Non-Randomised Controlled Study

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