title: [A chronic pain patient: modern diagnosis and concept of therapy].
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.
authors.affiliation: Univ. Klinik für Anästhesiologie und Intensivmedizin, Medizinische Universität Graz, Graz, Austria. andreas.sandner@medunigraz.at
authors.forename: Andreas
authors.initials: A
authors.lastname: Sandner-Kiesling
authors.forename: Andreas
authors.initials: A
authors.lastname: Schöpfer
mesh_terms: D000465:Algorithms; D000700:Analgesics / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000627:therapeutic use; D002908:Chronic Disease; D003131:Combined Modality Therapy; D000529:Complementary Therapies; D003299:Cooperative Behavior; D019091:Critical Pathways; D004359:Drug Therapy, Combination; D006801:Humans; D033183:Interdisciplinary Communication; D009369:Neoplasms / Q000503:physiopathology; D009407:Nerve Block; D010146:Pain / Q000175:diagnosis* / Q000523:psychology / Q000534:rehabilitation*; D010348:Patient Care Team; D026741:Physical Therapy Modalities; D011613:Psychotherapy; D014944:World Health Organization
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid