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Aktuelle Rheumatologie 2015; 40(05): 359-367
DOI: 10.1055/s-0035-1548867
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© Georg Thieme Verlag KG Stuttgart · New York

Chronische zervikale Schmerzsyndrome. Vorstellung eines multimodalen interdisziplinären stationären Behandlungskonzepts (ANOA-Konzept)

Chronic Cervical Pain Syndromes. Introduction to a Multimodal Interdisciplinary Inpatient Treatment (ANOA) Concept
K. Niemier
1   Schmerztherapie, Klinik für Manuelle Therapie, Hamm
,
H.-C. Hogrefe
2   Klinikum Landau SÜW, Bad Bergzabern
› Author Affiliations
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Publication History

Publication Date:
16 July 2015 (online)

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Correction to:

Erratum: Chronische zervikale Schmerzsyndrome. Vorstellung eines multimodalen interdisziplinären stationären Behandlungskonzepts (ANOA-Konzept)Aktuelle Rheumatologie 2015; 40(05): e2-e2
DOI: 10.1055/s-0035-1565065

Zusammenfassung

Chronische zervikale Schmerzsyndrome beruhen in der Regel auf einer komplexen Befundlage. Funktionelle, psychosoziale und morphologische Befunde führen in unterschiedlichster Kombination zu chronischen Schmerzerkrankungen. Um eine gezielte Therapiestrategie zu entwickeln, bedarf es einer multimodalen interdisziplinären Diagnostik. In dieser können die unterschiedlichsten Einflussfaktoren herausgearbeitet, gewertet und in ein gezieltes Therapieprogramm umgesetzt werden. Das ANOA-Konzept verbindet die multimodale Schmerztherapie mit der Differenzialdiagnostik und –Therapie der pathogenetisch wichtigen Funktionsstörungen des Bewegungssystems. Diese werden nicht nur als Auslöser oder Sekundärphänomen chronischer Schmerzen verstanden, sondern als eigenständiger Einflussfaktor.

Abstract

The reasons for chronic cervical pain syndromes are complex. Dysfunctions of the locomotor system, psychosocial influences and morphological findings are responsible for the development of chronic pain syndromes. In order to treat these syndromes successfully, a therapeutic strategy is needed. Such a strategy should be developed after a multidisciplinary diagnostic work-up. The different pathological influences on the pain syndrome are evaluated and then transformed into a therapeutic concept. The ANOA concept integrates classical multimodal pain concepts with the pathogenetically important muscular-skeletal dysfunctions (MSD). MSD are not only the trigger or secondary to the pain syndrome but also an important player in the development of the chronic pain.

Schlüsselwörter

chronischer Nackenschmerz - chronische Schmerzsyndrome - ANOA - Muskuloskeletale Dysfunktionen - Multimodale Schmerztherapie

Key words

chronic cervial pain - chronic pain syndromes - ANOA - muscular-skeletal dysfunctions - multimodal pain therapy
 

  • Literatur

  • 1 http://de.statista.com/statistik/daten/studie/207851/umfrage/anteil-der-erwerbstaetigen-mit-berufsbedingten-ruecken-schulter-und-nackenschmerzen-in-euopa/
    PubMed
  • 2 http://de.statista.com/statistik/daten/studie/201892/umfrage/anteil-der-haeufigsten-ursachen-fuer-chronische-schmerzen-in-europa/
    PubMed
  • 3 Wenig CM, Schmidt CO, Kohlmann T et al. Costs of back pain in Germany. European Journal of Pain 2009; 13: 280-286
    CrossrefPubMedGoogle Scholar
  • 4 Niemier K, Seidel W, Pioch E et al. Sommerfeld Assessment System: Intoduction and evaluation of a multiprofessional assessment system for the differential diagnosis of chronic musculoskeletal pain syndromes. JOM 2003; 25: 21-26
    PubMedGoogle Scholar
  • 5 El-Metwally A, Salminen JJ, Auvinen A et al. Prognosis of non-specific musculoskeletal pain in preadolescents: a prospective 4-year follow-up study till adolescence. Pain 2004; 110: 550-559
    CrossrefPubMedGoogle Scholar
  • 6 Radebold A, Cholewicki J, Polzhofer GK et al. Impaired postural control of the lumbar spine is associated with delayed muscle response times in patients with low back pain. Spine 2001; 26: 724-730
    CrossrefPubMedGoogle Scholar
  • 7 Saur P, Hildebrandt J, Pfingsten M et al. Das Göttinger Rücken Intensiv Programm (GRIP) – ein multimodales Behandlungsprogramm für Patienten mit chronischen Rückenschmerzen, Teil 2. Somatische Aspekte
    PubMedGoogle Scholar
  • 8 Hodges PW, Richardson CA. Inefficient muscular stabilization of the lumbar spine associated with low back pain. A motor control evaluation of the transverse abdominis. Spine 1996; 21: 2640-2650
    CrossrefPubMedGoogle Scholar
  • 9 Niemier K, Ritz W., Seidel W. Der Einfluss muskuloskeletaler Funktionsstörungen auf chronische Schmerzsyndrome des Bewegungssystems. Schmerz 2007; 21: 139-145
    CrossrefPubMedGoogle Scholar
  • 10 Linton SJ, Andersson MA. A randomized trial of cognitive-behaviour intervention and two forms of information for patients with spinal pain. Spine 2000; 25: 2825-2831
    CrossrefPubMedGoogle Scholar
  • 11 Gatchel RJ, Bernstein D, Stowell AW et al. Psychosocial differences between high-risk acute vs. chronic low back pain patients. Pain practice 2008; 8: 91-97
    CrossrefPubMedGoogle Scholar
  • 12 Niemier K, Ritz W, Amelung P et al. Evaluierung der funktionellen muskuloskeletalen Diagnostik als Bestandteil eines multiprofessionellen Diagnostiksystems für Patienten mit chronischen und chronifizierungsgefährdeten Schmerzen des Bewegungssystems. Manuelle Medizin 2007; 45: 123-127
    CrossrefPubMedGoogle Scholar
  • 13 Niemier K, Seidel W. Funktionelle Schmerztherapie des Bewegungssystems. Springer; 2. Auflage 2010
    Google Scholar
  • 14 Niemier K. Multimodal, Multimodal, polypragmatic and expensive – Evaluation of treatments for chronic low back pain. Manuelle Medizin 2012; 50: 16-27
    CrossrefPubMedGoogle Scholar
  • 15 Wiesel SW, Tsourmas N, Feffler HL et al. A study of computer assisted tomography. The incidence of positive cat scans in an asymptomatic group of patients. Spine 1984; 9: 549-551
    CrossrefPubMedGoogle Scholar
  • 16 Boden SD, McCowin PR, Davis DO et al. Abnormal magnetic-resonance scans of the cervical spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am 1990; 72: 1178-1184
    PubMedGoogle Scholar
  • 17 Maus T. Imagin the back pain patient. Phys Med Rehabil Clin N Am 2010; 21: 725-766
    CrossrefPubMedGoogle Scholar
  • 18 Jarvic JJ, Hollingworth W, Heagerty P et al. The longitudinal assessment of imaging and disability of the back (LAID Back) study. Spine 2001; 26: 1158-1166
    CrossrefPubMedGoogle Scholar
  • 19 Modic MT, Obuchowski NA, Ross JS et al. Acute low back pain and radiculopathy: MR imaging findings and their prognostic role and effect on outcome. Radiology 2005; 237: 597-604
    CrossrefPubMedGoogle Scholar
  • 20 Deyo R, Mirza S, Turner Y. Overtreating chronic back pain: time to back off?. J Am Board Fam Med 2009; 22: 62-68
    CrossrefPubMedGoogle Scholar
  • 21 Jarvic JG, Hollingworth W, Martin B et al. Rapid Magnetic resonance imaging vs. radiographs for patients with low back pain. JAMA 2003; 289: 2810-2818
    CrossrefPubMedGoogle Scholar
  • 22 Kendrick D, Fielding K, Bentley E et al. Radiography of the lumbar spine in primary care patients with low back pain: randomised controlled trial. BMJ 2001; 322: 400-405
    CrossrefPubMedGoogle Scholar
  • 23 Pfingsten M., Franz C, Hildebrandt J et al. Das Göttinger Rücken Intensiv Programm (GRIP) – ein multimodales Behandlungsprogramm für Patienten mit chronischen Rückenschmerzen. Teil 3. Psychosoziale Aspekte. Schmerz 1996; 10: 326-344
    PubMedGoogle Scholar
  • 24 Nguyen TH, Randolph DC, Talmage J et al. Long-term outcomes of lumbar fusion among workers compensation subjects. Spine 2011; 36: 320-331
    CrossrefPubMedGoogle Scholar
  • 25 Webster BS, Verma S, Pransky GS. Outcomes of workers compensation claimants with low back pain undergoing intradiscal electrothermal therapie. Spine 2004; 29: 435-441
    CrossrefPubMedGoogle Scholar
  • 26 http://www.versorgungsleitlinien.de/themen/kreuzschmerz
    PubMed
  • 27 Fullen BM, Doody C, David Baxter G et al. Chronic low back pain: non-clinical factors impacting on management by Irish doctors. Ir J Med Sci 2008; 177: 257-263
    CrossrefPubMedGoogle Scholar
  • 28 Fullen BM, David Baxter G, O’Donnovan BGG et al. Doctors attitudes and beliefs regarding acute low back pain management: A systematic review. Pain 2008; 136: 388-396
    CrossrefPubMedGoogle Scholar
  • 29 Lang E, Eisele R, Kastner S et al. Ergebnisqualität der ambulanten Versorgung von Patienten mit chronischen Rückenschmerzen. Schmerz 2000; 14: 146-159
    CrossrefPubMedGoogle Scholar
  • 30 Bronfort 1 G, Haas M, Evans R et al. Effectiveness of manual therapies: the UK evidence report. Chiropr Osteopat 2010; 18: 3 DOI: 10.1186/1746-1340-18-3.
    CrossrefPubMedGoogle Scholar
  • 31 Leininger BD, Evans R, Bronfort G. Exploring Patient Satisfaction: A Secondary Analysis of a Randomized Clinical Trial of Spinal Manipulation, Home Exercise, and Medication for Acute and Subacute Neck Pain. J Manipulative Physiol Ther 2014; pii: S0161-4754(14)00146-8 DOI: 10.1016/j.jmpt.2014.08.005. [Epub ahead of print]
    PubMedGoogle Scholar
  • 32 Schroeder J, Kaplan L, Fischer DJ et al. The outcomes of manipulation or mobilization therapy compared with physical therapy or exercise for neck pain: a systematic review. Evid Based Spine Care J 2013; 4: 30-41 DOI: 10.1055/s-0033-1341605.
    PubMedGoogle Scholar
  • 33 Bryans R, Decina P, Descarreaux M et al. Evidence-based guidelines for the chiropractic treatment of adults with neck pain. J Manipulative Physiol Ther 2014; 37: 42-63 DOI: 10.1016/j.jmpt.2013.08.010. Epub 2013 Nov 19
    CrossrefPubMedGoogle Scholar
  • 34 Furlan AD, Yazdi F, Tsertsvadze A et al. Complementary and alternative therapies for back pain II. Evid Rep Technol Assess (Full Rep) 2010; 194: 1-764
    PubMedGoogle Scholar
  • 35 Miller J, Gross A, D’Sylva J et al. Manual therapy and exercise for neck pain: A systematic review. Man Ther 2010; [Epub ahead of print]
    PubMedGoogle Scholar
  • 36 D’Sylva J, Miller J, Gross A et al. Manual therapy with or without physical medicine modalities for neck pain: a systematic review. Man Ther. 2010; 15: 415-433 DOI: 10.1016/j.math.2010.04.003. Epub 2010 Jun 9
    CrossrefPubMedGoogle Scholar
  • 37 Cross KM, Kuenze C, Grindstaff TL et al. Thoracic spine thrust manipulation improves pain, range of motion, and self-reported function in patients with mechanical neck pain: a systematic review. J Orthop Sports Phys Ther 2011; 41: 633-642 DOI: 10.2519/jospt.2011.3670. Epub 2011 Aug 31
    CrossrefPubMedGoogle Scholar
  • 38 Koes BW. Manual therapy for neck pain: increasing evidence for effectiveness. Ned Tijdschr Geneeskd. 2012; 156: A4599
    PubMedGoogle Scholar
  • 39 Hildebrand J. Relevance of nerve blocks in treating and diagnosting low back pain – is the quality decisive?. Schmerz 2001; 15: 474-483
    CrossrefPubMedGoogle Scholar
  • 40 Henschke N, Kuijpers T, Rubinstein SM et al. Injection therapy and denervation procedures for chronic low-back pain: a systematic review. Eur Spine J 2010; 19: 1425-1449
    CrossrefPubMedGoogle Scholar
  • 41 Slipman CW, Bhat AL, Gilchrist RV et al. A critical review of the evidence for the use of zygapophysial injections and radiofrequency denervations in the treatment of low back pain. The Spine J 2003; 3: 310-316
    CrossrefPubMedGoogle Scholar
  • 42 Niemier K. Long term effects of repeated interventional therapies in the treatment of patients witch chronic pain syndromes – retrospective study. Schmerz 2012; 26: 185-191
    CrossrefPubMedGoogle Scholar
  • 43 http://de.statista.com/statistik/daten/studie/182503/umfrage/die-zehn-haeufigsten-operationen-an-krankenhauspatienten/
    PubMed
  • 44 http://www.aerzteblatt.de/archiv/142635/Endoprothetik-und-Wirbelsaeuleneingriffe-Uneinheitliches-Versorgungsgeschehen?s=wirbels%E4ulenoperationen#
    PubMed
  • 45 Cherkin CC, Deyo RA, Loeser JD et al. An international comparison of back surgery rates. Spine 1994; 19: 1201-1206
    CrossrefPubMedGoogle Scholar
  • 46 Brox JI, Sorensen R, Friis A et al. Randomized clinical trial of lumbar instrumented fusion and cognitive intervention and exercises in patients with chronic low back pain and disc degeneration. Spine 2003; 28: 1913-1921
    CrossrefPubMedGoogle Scholar
  • 47 Mirza SK, Deyo FA. Systematic review of randomized trials comparing lumbar fusion surgery to nonoperative core for treatment of chronic back pain. Spine 2007; 32: 816-823
    CrossrefPubMedGoogle Scholar
  • 48 Carreon LY, Glassman SD, Howard J. Fusion and nonsurgical treatment for symptomatic degenerative disease: a systematic review of Ostwestry Disability Index and MOS short form-36 outcomes. The Spine Journal 2008; 8: 747-755
    CrossrefPubMedGoogle Scholar
  • 49 Atlas SJ, Keller RB, Chang YC et al. Surgical and nonsurgical management of sciatica secundaryto lumbar disc herniation: Five Years outcome from the main lumbar spine study. Spine 2001; 26: 1179-1187
    CrossrefPubMedGoogle Scholar
  • 50 Atlas SJ, Keller RB, Chang YC et al. Long term outcomes of surgical and nonsurgical management of sciatica secundaryto lumbar disc herniation: 10 Years results from the main lumbar spine study. Spine 2005; 30: 927-935
    CrossrefPubMedGoogle Scholar
  • 51 Weber H. Lumbar disk herniation. A controlled, prospective study with ten years of observation. Spine 1983; 8: 131-140
    CrossrefPubMedGoogle Scholar
  • 52 Atlas SJ, Keller RB, Wu YA et al. Long term outcomes of surgical and nonsurgical management of lumbar stenosis: 8 to 10 Years results from the main lumbar spine study. Spine 2005; 30: 936-9943
    CrossrefPubMedGoogle Scholar
  • 53 Fritzell PF, Hägg OH, Wessberg P et al. Lumbar Fusion vs. Nonsurgical Treatment for low back pain. A multicenter randomized controlled trial from the Swedish lumbar spine study. Volwo award in clinical studies. Spine 2001; 26: 2521-2532
    CrossrefPubMedGoogle Scholar
  • 54 Lurie JD, Birkmeyer NJ, Weinstein JN. Rates of advanced spinal imaging and spine surgery. Spine 2003; 28: 616-620
    PubMedGoogle Scholar
  • 55 Judge A, Murphy RJ, Maxwell R et al. Temporal trends and geographical variation in the use of subacromial decompression and rotator cuff repair of the shoulder in England. Bone Joint 2014; 192: 66-73
    PubMedGoogle Scholar
  • 56 Ketola TM, Hanzlikova M, Leppänen L et al. No evidence of long-term bennefits of arthroscopic acromioplasty in the treatment of shoulder impingement syndrome: Five year results of a randomized controlled trial. Bone Joint Res 2013; 2: 132-139
    CrossrefPubMedGoogle Scholar
  • 57 Arnold B, Brinkschmidt T, Casser H-R et al. Multimodale Schmerztherapie für die Behandlung chronischer Schmerzsyndrome. Ein Konsensuspapier der Ad-hoc-Kommission multimodale Schmerztherapie der Deutschen Schmerzgesellschaft zu den Behandlungsinhalten. Schmerz 2014; 28: 459-472
    CrossrefPubMedGoogle Scholar
  • 58 Scascighini L, Thoma V, Dober-Spielmann S et al. Multidisciplinary treatment for chronic pain: a systematic review of interventions and outcomes. Rheumatoloy 2008; 47: 670-678
    PubMedGoogle Scholar
  • 59 Niemier K, Seidel W, Pioch E et al. Sommerfeld Assessment System: Intoduction and evaluation of a multiprofessional assessment system for the differential diagnosis of chronic musculoskeletal pain syndromes. JOM 2003; 25: 21-26
    PubMedGoogle Scholar
  • 60 Pioch E, Seidel W. Manuelle Medizin bei chronischen Schmerzen. Manuelle Medizin 2003; 41: 91-104
    PubMedGoogle Scholar
  • 61 Pioch E, Seidel W. Manuelle Medizin bei chronischen Schmerzen. Evaluation eines stationären Behandlungskonzeptes. Schmerz 2003; 17: 34-43
    CrossrefPubMedGoogle Scholar
  • 62 Gerbershagen HU, Lindena G, Korb J et al. Gesundheitsbezogene Lebensqualität bei Patienten mit chronischen Schmerzen. Schmerz 2002; 16: 271-284
    CrossrefPubMedGoogle Scholar