[Chronic pain management under daily clinical conditions]

For lack of specialized pain centers patients with chronic pain are referred to medical, neurological or geriatric departments. One third of these patients are dissatisfied with pain management during stay in hospital (patients interviews 1998). To improve this situation, a pain management system was developed and tested under daily clinical conditions.

If the history-taking resulted chronic pain (longer than 3 months), the first step was staging the chronicity of pain by the Mainz Pain Staging System. In case of advanced chronic pain (stages II or III), a comprehensive history-taking of the patient's pain including psychometric tests (ADS, SES, PDI) followed. For each patient we worked out an individual and interdisciplinary therapy. To verify the results, each patient was interviewed on the day before dismissal.

27,8% of our patients in half a year period (n = 381) suffered from chronic pain. By pain management activities we were able to rise significantly the satisfaction of the patients with pain therapy.

It is necessary to search consequently for chronic pain. Especially elder people do not mention their suffer, often believing, that pain is an unavoidable sign of old age. Concentrating on medical reports alone is not adequate for chronic pain and even can aggravate the condition to a significant extent. Chronic pain can neither be explained nor treated without integrating psychological and social factors. A routine diagnostic- and therapy-practice facilitates an interdisciplinary pain therapy, raises the therapeutic capability of the staff and increases the therapeutic outcome.