[Multimodal pain therapy. Current situation]

Area of Science:

• Pain Management
• Rehabilitation Medicine
• Health Services Research

Background:

• Multidisciplinary pain management is a recognized approach for complex chronic pain.
• Its efficacy and cost-effectiveness, particularly for chronic low back pain, are supported by evidence.
• Existing models often align with a biopsychosocial framework.

Purpose of the Study:

• To highlight the established efficacy of multidisciplinary pain management.
• To identify significant shortcomings in the definition and quality of current multidisciplinary pain treatment programs.
• To underscore the lack of consensus on specific therapeutic strategies and outcome measurement tools.

Main Methods:

• Review of existing literature, studies, reviews, and meta-analyses on multidisciplinary pain treatment.
• Comparison of current practices with established standards (e.g., German Pain Society).
• Identification of areas lacking consensus, including definitions, quality metrics, and therapeutic tools.

Main Results:

• Multidisciplinary programs demonstrate superiority over unimodal therapy for chronic pain, notably chronic low back pain.
• Significant gaps exist in defining "multimodal" and "multidisciplinary" treatments and ensuring structural/process quality.
• No consensus prevails on specific interventions, responder identification, or measurement tools.

Conclusions:

• Despite proven efficacy, current multidisciplinary pain management faces challenges in standardization and consensus.
• Further multicenter collaborative efforts are essential to address these shortcomings.
• Developing clear definitions, quality standards, and validated measurement tools is crucial for advancing patient care.