Within a multidisciplinary pain center, treatment possibilities include pharmacological treatment, rehabilitation programs, cognitive behavioral therapy, psychological counseling, as well as minimally invasive interventional techniques such as epidural steroid administration, (pulsed) radiofrequency and implantable neurostimulators, and drug delivery pumps. Comparison between the practices in Belgium and the Netherlands revealed that where multidisciplinary pain clinics are less well-implanted, the health care costs for low back pain are higher due to a more intensive use of surgery and consequently, the long-term management of failed back surgery syndrome.
Data show that when the available treatment possibilities are used in a multidisciplinary and step-wise approach, more invasive surgical treatment options may be avoided, resulting in considerable savings of health care budgets.
"Patients should be aware that medical imaging and spine surgery are not always the mandatory steps in the management of lower back pain," states Jan Van Zundert, MD. "Psychological counseling and cognitive behavioral therapy offers the possibility to have better insight in the patient's perception on what causes pain and how to improve physical activity. Percutaneous interventional techniques can be used when conventional treatment fails. The patient might work together with health care professionals to achieve a satisfactory level of pain reduction and quality of life."
Low back pain may become a chronic disease in approximately 8% of patients. Researchers suggest that physicians with different specialties should work together to establish a diagnostic and treatment program for each individual patient, including multidisciplinary and intradisciplinary consultation that would allow for avoiding invasive treatment options where less invasive modalities may still be effective.
This study is published in the September 2005 issue of Pain Practice. Media wishing to receive a PDF of this study please contact firstname.lastname@example.org.
Jan Van Zundert, MD is currently preparing a PhD in the Academic Hospital Maastricht (The Netherlands) on "The use of pulsed radiofrequency in the treatment of chronic pain." Since September of 2000, he has worked in Ziekenhuis Oost-Limbur, Genk, Belgium. He has had a scientific affiliation with the department of Pain Management of the University Hospital Maastricht, Maastricht, The Netherlands, since 2001. Dr. Van Zundert can be reached for questions and interviews at email@example.com.
About the Journal
Pain Practice, the official journal of the World Institute of Pain, publishes international multidisciplinary articles on pain that provide its readership with up-to-date knowledge of the research, evaluation methods, and techniques of pain management. The present literature on pain medicine is diverse and published in a variety of basic and clinical specialty journals. For a practitioner to subscribe to all the venues needed to cover the field of pain medicine would be impractical, if not impossible. Likewise, the literature search can be cumbersome, costly, and entirely unavailable in some areas. As a thorough, multidisciplinary journal, Pain Practice is a convenient, cost-effective way to resolve these dilemmas.
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