Kaiser Ulrike, Nagel Bernd, Petzke Frank, Pfingsten Michael, Gärtner Anne, Isenberg Thomas, Augustin Katharina, Martin Carolin, Lindena Gabriele
Medizinische Fakultät und Universitäts SchmerzCentrum, Universitätsklinik Carl Gustav Carus Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland.
Ambulanz, Tagesklinik,·Stationäre Behandlung, DRK Schmerz-Zentrum Mainz, Auf der Steig 16, 55131, Mainz, Deutschland.
Schmerz. 2021 Feb;35(1):45-52. doi: 10.1007/s00482-020-00527-0. Epub 2021 Jan 15.
The current healthcare provision in Germany is established, in particular, for the diagnostics and treatment of chronic pain conditions; however, the current aim is to initiate the diagnostic and therapeutic approaches oriented towards the biopsychosocial pain model in the early stages of pain, i.e. before the onset of chronification, for patients with pain and a risk of chronification in order to actively avoid chronification processes. In this context, multiple risk factors play an important role for the diagnostic and therapeutic approaches as well as for the interdisciplinary multimodal pain therapy developed for this purpose. The Global Year of the International Association for the Study of Pain (IASP) 2020 addressed the prevention of (chronic) pain, a welcome opportunity to provide a short review of the evidence for and clinical experiences with timely diagnostic and therapeutic options and to summarize the current framework conditions and scientific recommendations for Germany. At the end of this article the implications for future research are summarized, particularly for the treatment of patients with pain and risk of chronification.
德国目前的医疗保健服务主要是针对慢性疼痛病症的诊断和治疗;然而,当前的目标是针对有疼痛且有慢性化风险的患者,在疼痛的早期阶段,即在慢性化开始之前,启动以生物心理社会疼痛模型为导向的诊断和治疗方法,以便积极避免慢性化过程。在这种情况下,多种风险因素对于诊断和治疗方法以及为此目的开发的跨学科多模式疼痛治疗都起着重要作用。2020年国际疼痛研究协会(IASP)全球年关注(慢性)疼痛的预防,这是一个提供关于及时诊断和治疗选择的证据及临床经验的简短综述,并总结德国当前的框架条件和科学建议的契机。在本文结尾,总结了对未来研究的启示,特别是对于疼痛和有慢性化风险患者的治疗。