Chronic pain therapy: an evolution from solo-interventions to a holistic interdisciplinary patient approach

The treatment of chronic pain patients has changed over years. Anaesthesiologists treat pain patients, their skills in locoregional anaesthesia techniques and their pharmacological knowledge being a unique resource to reduce pain. However, the International Association for the Study of Pain provides more and more scientific evidence that chronic pain is a biopsychosocial event and that its diagnosis and treatment should be considered in a multidisciplinary frame. Nevertheless, in practice we can't deny the fact that there are several steps in the process in which the patient himself decides if he wants such an approach or not. The 'motivating' phase is a very important pretherapy and basic condition to start up a holistic pain treatment. Therefore, at the Ghent University Hospital Pain Clinic, we focused in a first step how to motivate our pain patients to take part in a multidisciplinary diagnostic examination, the second step is motivate them for an interdisciplinary treatment when it is indicated. We diagnose the four most important pain components: the sensory, myofacial, autonomic and psychosocial problems. The patient who is initially examined by the anaesthesiologist, will also be evaluated by the psychologist and the physician in rehabilitation medicine. By this way each component is mapped and a final (holistic) diagnosis can be made. In a weekly half-a-day meeting, the different specialists discuss the patients and put forward an interdisciplinary treatment plan. On several moments, the patients' treatment progress will be discussed and redirected if necessary. So, we hope to obtain an optimal result and avoid overtreatment and too invasive pain treatment.