«Don't give up! Even with long-standing pain, there is hope for improvement, either through reassessment and a new therapy concept or by improving pain management mechanisms.»
Prof Dr Stephan Gadola, Head Physician Rheumatology & Pain Medicine
Welcome to our blog
24. September 2024
Where to go for chronic pain?
"A thorough examination!" advises Professor Stephan Gadola. It is not uncommon for therapy to be "relaunched" and previous treatment blockages to be resolved. You can find out more on 17 October at 5 pm at a public lecture at Bethesda Hospital.
You are head physician for rheumatology and pain medicine. What can pain sufferers expect at Bethesda Hospital?
Prof. Dr Dr Stephan Gadola, Head of Rheumatology and Pain Medicine: A careful, respectful assessment and clear treatment concepts, often combined with an anatomical localisation of the cause of the pain. The basis is a precise, problem-oriented medical history and a clinical examination, supplemented by modern imaging and laboratory analyses. Sometimes we also diagnose an independent chronic pain syndrome; the WHO classification has only recently created a new code for this. Either way, we lay the foundation for rationalised treatment.
Prof Dr Stephan Gadola, Head Physician Rheumatology & Pain Medicine
How do you proceed?
Modern pain treatment combines several therapy modules in a multimodal approach. Physiotherapy is often central, and I deliberately put it at the beginning. How often do we hear in the initial consultation: "Physiotherapy didn't help", but then realise that it didn't work optimally! This is because rational, consistent physiotherapy with an individual exercise programme can achieve a lot. Exercise and strength building strengthen self-efficacy in chronic pain.
Further therapy modules?
Drug therapy should be adapted to the dominant pain mechanism as far as possible. We carry out infiltrations in joints, soft tissue or near nerves, for example in the case of pain in the spine, using imaging methods such as ultrasound or X-rays. We also work with drugs or electric current to affect pain-conducting nerve fibres.
Other therapeutic components are taken from surgery, psychosomatics and psychotherapy.
Do you give opioids?
We generally only start opioid therapy in cases of unbearable pain after massive slipped discs or bone fractures due to osteoporosis. At the same time, we help chronic pain patients to withdraw from or reduce opioids as inpatients.
Your message to pain sufferers?
Don't give up! Even with long-standing pain, there is hope for improvement, either through reassessment and a new therapy concept or by improving pain management mechanisms. We also see time and again how successful rational therapy can make us forget the "pain memory".