Chronic pain pain therapy at vilshofen hospital

Chronic pain – what to do?

He is a specialist in chronic pain: Dr. Stephen Saam. Acute pain has a warning function. Are an important reaction for the body. However, with prolonged pain, they lose this warning function and chronification occurs. A disease of its own develops, the chronic pain. According to estimates by the German Pain Society, around eight to 16 million people in Germany suffer from chronic pain. In the interview, Dr. med. Stephanus Saam, specialist in orthopedics and medical director of the inpatient department for multimodal inpatient pain therapy at Vilshofen Hospital, questions about chronic pain.

What is chronic pain? How do you distinguish between acute and chronic pain??

Dr. SaamPain, which occurs in many different ways, is one of the most unpleasant but also one of the most important human sensations. Acute pain is a warning signal and indicates that something is wrong. Take the example of toothache: at the latest when the pain becomes unpleasant, most people go to the dentist to have the cause clarified and, in the best case, eliminated. It is different with longer lasting pain, for example with pronounced degenerative spinal changes. In the long run, pain loses its actual warning function and becomes chronic. In most cases, we speak of chronic pain when the symptoms last longer than six months. For such a disease, however, it is not always possible to find an organic background that fully explains its extent. Scientific studies have shown that the severity of back pain does not correspond to the changes that can be seen on an X-ray or MRI scan. However, further imaging studies on the brains of pain patients showed that the extent of discomfort is related to the activation of pain centers in the brain. This means that if organic findings do not correspond to the experience of pain, emotional and psychosocial stress factors must be considered as causal factors.

How chronic pain develops?

Dr. SaamChronic pain can be caused by organic changes, for example in the spine in the form of arthrosis, narrowing of the spinal canal and disc degeneration, or in the large joints. This results in muscular deficits all over the body, which further drive chronification. Chronic pain is typically also influenced by private or professional problems. Conversely, chronic pain also leads to psychological problems. Therefore, a multimodal, i.e. multifaceted approach is particularly important in treatment.

What are the risk factors for chronicity of pain?

Dr. SaamThe risk factors that can lead to chronic pain include occupational stress, lack of exercise and obesity, as well as a genetic disposition, i.e. an unusual predisposition in the hereditary material.

Millions of people suffer from chronic pain – but it can take years to find the right treatment. (Photo: pathdoc, fotolia)

How is chronic pain diagnosed?

Dr. Saam: A chronic pain syndrome can be diagnosed during clinical history taking. Together with the patient, the disease is analyzed in detail from both the medical and psychological sides. Previous therapies are discussed. Tested for effectiveness. Normally, no further organ diagnostic examinations are necessary. However, if there is a medical indication, these will of course be arranged. As part of the diagnosis, we also use special questionnaires that confirm the clinical picture or also provide new findings.

What promises the best chances of success in treatment?

Dr. SaamWhile acute pain can be treated simply and unimodally, chronic pain presents a therapeutic challenge. Since the disease is very complex, success can only be achieved with a multimodal treatment team. This means that therapy components of different disciplines are combined with each other. The goal is to avoid surgery if possible, to prevent further chronicity and to erase the pain from the pain memory. The best chance of success is a combination of physical therapy, orthopedic functional therapy and psychological support.

How does interdisciplinary complex therapy work?

Dr. SaamBased on the key findings, an intensive 14-day therapy program is put together individually for each of our patients. The goal is to significantly reduce the symptoms and prevent further chronicity. In therapy, we follow the interdisciplinary approach of the Association of Non-Surgical Orthopedic Manual Medicine Acute Clinics (ANOA). This means that treatment is carried out on an interdisciplinary basis by a team consisting of psychologists, occupational therapists, physiotherapists, algesiology-trained staff, medical pain therapists and orthopedists.

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