Treat back pain in an interdisciplinary manner

Together against pain: Treat back pain effectively
With non-specific low back pain, sufferers often experience years of doctor's odyssey without medical professionals discovering the real reasons for the disease and treating them appropriately. Many patients are considered to be out of therapy.

"The remedy here is an interdisciplinary approach, that is, a team of specialized doctors who look at all the symptoms and make targeted diagnoses," says Dr. Reinhard Schneiderhan, orthopedic surgeon from Munich and president of the German Spine League. The causes of back pain range from neurological disorders to rheumatic diseases and psychological problems.

Chronic does not mean incurable

Often there is no one trigger for suffering in the back. In the sensitive network of vertebrae, ligaments, tendons and muscles, even the smallest changes have great effects. Because of this complexity, it is often not possible to find a clear source, which in the worst case leads to chronic complaints in which the spinal cord continuously sends pain signals. If this condition persists for more than three months, a so-called pain memory is formed and nerves are more sensitive to stimuli. Then even the slightest touch is enough to trigger complaints. In exceptional cases, it doesn't even need a trigger because the brain stores the memory trail and the pain is no longer a warning signal, but becomes a disease itself.

“Every symptom has an origin, the search for it is often only more complex and complex than initially thought. There is usually a combination of different factors that can only be clarified by looking at different disciplines together, ”emphasizes Dr. Schneiderhan. Finally, in addition to physical factors such as incorrect and excessive stress, external influences, such as stress, also affect the spine.

In order to treat people with chronic pain in the best possible way, so-called "multimodal" programs involve not only the treating orthopedic surgeon, but doctors from a wide range of disciplines. Pain therapists, neurosurgeons, radiologists, neurologists and general practitioners, but also physiotherapists and psychologists look at existing symptoms from their perspective. After the orthopedist's first thorough medical history, the radiologist usually comes into play. A wide variety of imaging methods are available to further limit the causes. These include X-rays, useful for analyzes on bones and joints, computer tomography, which makes bony structures and soft tissue visible in three dimensions, and magnetic resonance imaging, which represent all types of tissue and the central nervous system.

Assemble puzzle pieces

If there are no improvements as a result of the then prescribed conservative measures, such as physiotherapy or heat treatments, minimally invasive options are used. Examples of this are the use of a spinal catheter, treatment with a heat probe or therapy with the aid of a micro laser. If necessary, the team also consults a psychotherapist to include all conceivable factors. Only when all options are unsuccessful are surgical interventions considered. “Patients also save a lot of time in interdisciplinary centers because all examinations can be carried out during the regular practice visit. Additional appointments and journeys are unnecessary and the holistic treatment is in the focus from the start, ”says Dr. (sb, pm)

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