Therapie des chronischen Rückenschmerzes unter Berücksichtigung psychosozialer Faktoren

Lea Henn; Jochen Hardt

doi:10.1055/a-0813-2086

PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie, Inhaltsverzeichnis

Psychother Psychosom Med Psychol 2019; 69(08): 313-322
DOI: 10.1055/a-0813-2086

Übersicht

Therapie des chronischen Rückenschmerzes unter Berücksichtigung psychosozialer Faktoren

Therapy of Chronic Back Pain Considering Psychosocial Aspects

Lea Henn

¹Medizinische Psychologie und Medizinische Soziologie, Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Mainz

,

Jochen Hardt

¹Medizinische Psychologie und Medizinische Soziologie, Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Mainz

› Institutsangaben

Abstract

Zusammenfassung

Chronische Schmerzen, darunter v. a. Rückenschmerz als häufigste Lokalisation, zählen zu den bedeutsamsten medizinischen Leiden weltweit. Die Kosten für das Gesundheitssystem sind dabei erheblich. Zugleich sind die derzeit noch häufig angewendeten Therapieansätze, die oftmals aus einer alleinigen symptomatischen Behandlung bestehen, wenig erfolgversprechend. In 80–85% der Fälle lassen sich keine morphologischen Anhaltspunkte für eine mögliche Ätiologie finden, sodass in diesem Fall von „nicht-spezifischen“ Rückenschmerzen gesprochen wird. Insgesamt betrachtet lässt sich die Genese chronischer Rückenschmerzen am besten durch einen multifaktoriellen Entstehungsmechanismus erklären, in den eine Kombination aus biopsychosozialen, biographischen, neurobiologischen, genetischen und kognitiven Faktoren mit einbezogen wird. Aus diesem Grund zeigt eine multimodal ausgerichtete Therapie die beste Wirksamkeit, weil sie die verschiedenen Aspekte der Schmerzentstehung berücksichtigen kann.

Abstract

Chronic pain and especially back pain rank among the most meaningful medical conditions worldwide. This leads to extensive costs in medical care systems. In about 80–85% of cases there is no morphologic evidence for a possible pain etiology, hence such forms are called „non-specific back pain“. Therapies with a pure focus on symptomatic aspects are not effective to treat non-specific pain. The origin of chronic back pain can be best explained via a multi causal mechanism with a combination of bio-psycho-social, biographical, neurobiological, genetic, and cognitive factors. Since various aspects of the pain genesis have to be considered, multidisciplinary treatment shows much better results.

Schlüsselwörter

Rückenschmerz - Ätiologie - Somatoforme Schmerzstörung - Leitlinie - Multimodale Therapie

Key words

back pain - etiology - somatoform pain disorder - guideline - multimodal therapy

Volltext

Referenzen

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