Multimodale Schmerztherapie bei chronischen und chronifizierenden Rückenschmerzen

Mesrian, A.; Neubauer, E.; Pirron, P.; Schiltenwolf, Marcus

doi:10.1007/s00337-005-0341-0

Cited by 12 publications

(9 citation statements)

References 26 publications

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“…Also the British Pain Society states in their guidelines for pain management programmes for adults [33], that higher age should not be treated as exclusion criteria and discrimination should be avoided. Regarding therapy success it has been shown, that there is no strong association between therapy success and age, but a trend that younger patients are more likely to profit from psychological therapy than older ones [22,34]. bold: significant p < 0.01; a 1 = female, 0 = male ; b 1 = higher education qualification ( > 12 years school education), 0 = < 12 years school education; c 1 = yes, 0 = no Patients who were treated interdisciplinary more often had already undergone one or more rehabilitation treatments.…”

Section: Discussionmentioning

confidence: 99%

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Access to Pain Management Programs: A Multifactorial Analysis of the Pathways of Care for Chronic Pain Patients in the University Clinic Erlangen

et al. 2019

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Background Different treatment options are offered for patients suffering from chronic pain, which differ in intensity and costs: 1) monodisciplinary treatment, mostly in outpatient care and 2) interdisciplinary treatment with the option of participating in pain management programs as outpatients or inpatients. The present work investigates how patients at the University Clinic Erlangen receiving monodisciplinary treatment differ from those receiving interdisciplinary treatment (research question I) as well as how patients participating in a pain management program differ from those who do not (research question II). The aim is to generate insights into whether the differences between the patient groups under various treatment modalities reflect the officially defined criteria for the indication of chronic pain management programs. Methods Routine data of 1,833 patients treated from January 2008 to March 2013 at the University Clinic Erlangen were analyzed. After univariate preanalyses and checks for multicollinearity, the remaining variables were used for the final multivariate model (multiple binary logistic regression) for research question I and II. Results Research question I: Patients getting interdisciplinary treatment were more often employed, had higher affective experience of pain, more often regarded their pain as treatable, had more often participated in at least one pain-associated rehabilitation treatment in the past, were younger and rarely had application for retirement in consideration. Research question II: Patients who participated in a pain management program were more often female, more often employed, described their pain as mainly located at the upper part of the body, had more concomitant symptoms, were more often diagnosed with musculoskeletal pain and rarely had a retirement request pending. Conclusions It could be shown that patients in the analyzed pathways of care mainly differed in demographic variables, and regarding pain management programs, also in the type of pain. Differences between patients in different treatment paths reflecting the officially defined indication criteria for chronic pain management programs were detectable only to a minor extent. Clearer and operational practical guidance should help support the clinical decision to assign patients to different treatment options and close the gap between theory and practice.

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Section: Discussionmentioning

confidence: 99%

“…In how far the pending retirement request constitutes a conflict of interest in the treatment of pain, has been discussed intensely in the field of pain research. There are studies indicating that the success of interdisciplinary approaches to pain management is remarkably lower when a retirement request is pending [34,38].…”

Section: Discussionmentioning

confidence: 99%

Access to Pain Management Programs: A Multifactorial Analysis of the Pathways of Care for Chronic Pain Patients in the University Clinic Erlangen

et al. 2019

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“…Die Behandlung im ambulanten Set ting ist insgesamt anscheinend ähnlich effektiv wie stationäre Maßnahmen. Ge rade unter Berücksichtigung der Ergeb nisse für stationäre Therapieprogramme [12,15] scheint eine ambulante verhal tenstherapeutische Einzeltherapie weni ger negativ durch Rentenbegehren be einflusst zu werden. Eine mögliche Er klärung könnte in der geringeren Bedeu tung sozialmedizinischer Beurteilungen in einer ambulanten Behandlung im Ver gleich zum Auftrag einer stationären The rapie [1] liegen.…”

Section: Schmerztagebuchunclassified

“…Welche Patienten von einer bestimmten Therapiekompo nente besonders profitieren, bleibt bis lang jedoch weitgehend unbeantwortet [19]. Während im stationären Umfeld die Befundlage bei verschiedenen Therapie ansätzen eher einheitlich darauf hinweist, dass der Rentenwunsch des Patienten ei nen ungünstigen Faktor für den Therapie erfolg darstellt [12,15], ist die Befundlage hinsichtlich des Einflusses des Rentenbe gehrens in der ambulanten Therapie noch nicht hinreichend untersucht.…”

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Rentenbegehren und Therapie chronischer Rückenschmerzen

Trapp

Glombiewski

Hartwich-Tersek

et al. 2008

Schmerz

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“…Obschon diverse als wirksam und kosteneff ektiv erwiesene Rehabilitationskonzepte f ü r den chronischen R ü ckenschmerz etabliert sind, scheint im Spiegel des wachsenden Bedarfs und zugleich zunehmend begrenzter personeller und fi nanzieller Ressourcen die aktive Suche nach Optimierungspotenzial innerhalb bestehender Versorgungs-Strategien des chronischen R ü ckenschmerzes n ö tig und vielversprechend [28,29] . Ein anerkannter Ansatz besteht in der multimodalen Schmerztherapie [16,22] , welche aktive physiotherapeutische Ma ß nahmen unter sportmedizinischem Bezug mit verhaltenstherapeutisch orientierten kognitiven Inhalten kombiniert [19,30,31] . In diesen Programmen werden die biologisch-somatischen, die psychologischen und sozialen Komponenten des Schmerzgeschehens simultan adressiert.…”

Section: Introductionunclassified

Randomisierte klinische Studie zur Wirksamkeit einer Kombination aus Matrix/Rhythmus-Therapie und multimodaler stationärer Schmerztherapie bei Patienten mit chronischen lumbalen Rückenschmerzen

Krummenauer¹,

Konrad²,

Prate³

et al. 2011

Phys Rehab Kur Med

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&Purpose: A randomized controlled clinical trial was implemented to evaluate the eff ectiveness of combined Matrix / Rhythmus therapy (rhythmic relaxation of muscle and connective tissue, 8 -12 Hz) and multimodal indoor rehabilitation in patients suff ering from chronic low back pain as well as of degenerative changes of the lumbal spine confi rmed morphologically by x-ray and / or MR, when compared to the multimodal pain therapy combined with a sensoric stimulation by means of a massage ball. Patients and Methods: A total of 73 patients was randomized onto the respective combined therapeutic schemes according to a block randomisation scheme. According to the trial ' s inclusion criteria all patients suff ered from chronic low back pain and showed morphological degenerations. All patients received a 12 days indoor multimodal pain therapy, which was complemented with a fi ve session schedule of the Matrix / Rhythmus therapy for the intervention group and a fi ve ses sion schedule of a sensomotoric therapy for the control group. On admis sion, two weeks later on withdrawal from the indoor rehabilitation, and three months afterwards the study patients were asked to undergo a questionnaire assessment including the Oswestry questionnaire. The change of the Oswestry total score [ % ] three months after vs. before therapy was defi ned as the primary clinical endpoint of the investigation. The patients in the control group showed a median age of 57 years vs. 54 years in the intervention group (47 % vs. 49 % females, respectively); 33 % vs. 27 % of the patients were classifi ed stage III of chronicity staging according to MPSS. Results: On admission, the control patients reported a median Oswestry index of 54 % , on withdrawal of 63 % and on recall of 61 % . The intervention group showed respective median Oswestry estimates of 64 % , 67 % and 71 % . The

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Multimodale Schmerztherapie bei chronischen und chronifizierenden Rückenschmerzen

Cited by 12 publications

References 26 publications

Access to Pain Management Programs: A Multifactorial Analysis of the Pathways of Care for Chronic Pain Patients in the University Clinic Erlangen

Access to Pain Management Programs: A Multifactorial Analysis of the Pathways of Care for Chronic Pain Patients in the University Clinic Erlangen

Rentenbegehren und Therapie chronischer Rückenschmerzen

Randomisierte klinische Studie zur Wirksamkeit einer Kombination aus Matrix/Rhythmus-Therapie und multimodaler stationärer Schmerztherapie bei Patienten mit chronischen lumbalen Rückenschmerzen

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