Chronic Pain: Therapy

Therapy for chronic pain depends on the cause.

General measures

  • Sufficient sleep (7-9 hours every night) improves pain tolerance, i.e. leads to less pain sensation!
  • Exercise regularly during the day, but avoid intense exercise after 6:00 p.m.Physical activity and exercise in adult chronic pain significantly improves physical function.
  • Nicotine restriction (refrain from tobacco use) – smoking can contribute to pain in the long term; it slows healing processes, worsens blood circulation and increases the risk of degenerative disc processes, for example, and is thus often a cause of lumbalgia (back pain).
  • Alcohol restriction (abstaining from alcohol consumption) – Alcohol leads to a not deep sleep (reduces the important REM phases and leads to sleep through disorders). The result is not enough restful sleep.
  • Do not drink caffeinated beverages after lunch.
  • Aim for normal weight! Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in a medically supervised weight loss program.
  • Create a buffer zone between the working day and going to bed.
  • Sleep hygiene:
    • Avoiding physical overexertion after 18:00.
    • Not eating or drinking large amounts of food three hours before bedtime
    • Go to bed at the same time every day and always get up at the same time.
    • Half an hour before going to bed try to relax, for example, with a warm bath (34-36 ° C). You can also add relaxation-promoting additives to the bath water such as lemon balm, valerian and hops.
    • A comfortable sleeping bed as well as a quiet room are important conditions for a good night’s sleep.
    • Bedroom completely darken if possible. Light sources from the outside can be easily eliminated by opaque curtains or blinds.
    • Noise pollution can be reduced with the help of earplugs or soundproofing.
    • Fresh and cool air should prevail in the bedroom: Avoid extreme temperatures – it should be cool, but not too cold. An ambient temperature of 16 to 18 ° C is optimal.

Regular checkups

  • Regular medical checkups

Nutritional medicine

  • Nutritional counseling based on nutritional analysis
  • Nutritional recommendations according to a mixed diet taking into account the disease at hand. This means, among other things:
    • Daily total of 5 servings of fresh vegetables and fruits (≥ 400 g; 3 servings of vegetables and 2 servings of fruits).
    • Once or twice a week fresh sea fish, i.e. fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
    • High-fiber diet (whole grains, vegetables).
  • Other specific dietary recommendations depending on the cause of chronic pain.
  • Selection of appropriate foods based on the nutritional analysis.
  • See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
  • Detailed information on nutritional medicine you will receive from us.

Sports Medicine

  • Endurance training (cardio training) and strength trainingNote: Both endurance exercise and strength training an analgesic effect (analgesic effect). In addition to the autonomic nervous system, endogenous opioids and cannabinoids, so-called endorphins and endocannabinoids, are involved. But at the same time, this means that athletes are altogether more pain-tolerant compared to non-athletes, and thus there is a slight risk that the load limit of the body is exceeded.
  • Preparation of a fitness or training plan with suitable sports disciplines based on a medical check (health check or athlete check).
  • Physical activity and exercise for chronic pain in adults significantly improves physical function.
  • For detailed information on sports medicine, please contact us.

Psychotherapy

  • Pain can be associated with various anxieties, but also with depression or aggression.For this reason, cognitive behavioral therapy (CBT) with coping strategies for pain may be indicated. Furthermore, relaxation techniques such as progressive relaxation, autogenic training or Tai Chi Chuan can be used.
  • Behavioral therapy also relieves pain in opioid-dependent patients.
  • Mind-body procedures: Meditation (Cohen d value (measure of effect size; value of 1.0 equals one standard deviation difference): 0.70), hypnosis (Cohen d value 0.54), suggestion (Cohen d value 0.68), and cognitive behavioral therapy (CBT) (Cohen d value 0.43)(CBT); reduction in opioid dose (Cohen d value of 0.26 (0.08 to 0.44); effects strength significant, magnitude rather weak).
  • Detailed information on psychosomatics (including stress management) is available from us.

Note: Psychotherapeutic treatment approaches can be used in the therapy of neuropathic pain of any cause. So far, however, a 30% reduction in pain is not provable due to insufficient data [S2k guideline].

Complementary treatment methods

  • In complementary pain therapy, the methods of classical medicine (surgery, etc.) are supplemented with natural procedures, such as:
    • Acupuncture
    • Biofeedback
    • Electrotherapy
    • Frequency therapy
    • High tone therapy
    • Low-level laser therapy
    • Neural therapy
    • Soft laser treatment
    • Proliferation therapy – reparative and regenerative injection procedure for the treatment of pain in joints and musculoskeletal system.
  • Cognitive strategies – counting backwards (this requires the cooperation of left and right insular cortex) and thinking of something beautiful, leads to pain relief.
  • Mirror therapy – to reduce chronic pain in patients with inflammatory rheumatic diseases through changes in body perception and representation.