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  • Title: [A chronic pain patient: modern diagnosis and concept of therapy].
    Author: Sandner-Kiesling A, Schöpfer A.
    Journal: Psychiatr Danub; 2010 Sep; 22(3):459-64. PubMed ID: 20856193.
    Abstract:
    Approximately 80 per cent of primary care patients seek their physician's attention due to pain. A fifth of the population suffers from chronic pain with medium to high intensity, and longer than 3 months. Especially those patients are treated insufficiently when only non-opioids and opioids are applied. Therefore it is necessary to tailor pain therapy by using an interdisciplinary, multimodal treatment regimen. This article presents a holistic concept to chronic pain treatment by using the five columns of pain therapy. Based on the bio-psycho-social approach, pharmaceutical, complimentary (first column), physio- and psychotherapeutic (2(nd) and 3(rd) column), social and invasive interventions (4(th) and 5(th) column) have to be considered. The 1(st) column includes the WHO ladder, in chronic pain patients with a large focus on co-analgesics like antidepressants or antiepileptics. Based on the individual history and factors achieved from the bio-psycho-social diagnosis, components of these 5 therapeutic are selected, always in agreement with the patient, and put together to one interdisciplinary therapeutic concept.
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