Researchers Recommend Multidisciplinary Approach Of Low Back Pain

Within a multidisciplinary pain center, treatment possibilitiesinclude pharmacological treatment, rehabilitation programs, cognitivebehavioral therapy, psychological counseling, as well as minimallyinvasive interventional techniques such as epidural steroidadministration, (pulsed) radiofrequency and implantableneurostimulators, and drug delivery pumps. Comparison between thepractices in Belgium and the Netherlands revealed that wheremultidisciplinary pain clinics are less well-implanted, the health carecosts for low back pain are higher due to a more intensive use ofsurgery and consequently, the long-term management of failed backsurgery syndrome.

Data show that when the available treatment possibilities areused in a multidisciplinary and step-wise approach, more invasivesurgical treatment options may be avoided, resulting in considerablesavings of health care budgets.

"Patients should be aware that medical imaging and spinesurgery are not always the mandatory steps in the management of lowerback pain," states Jan Van Zundert, MD. "Psychological counseling andcognitive behavioral therapy offers the possibility to have betterinsight in the patient's perception on what causes pain and how toimprove physical activity. Percutaneous interventional techniques canbe used when conventional treatment fails. The patient might worktogether with health care professionals to achieve a satisfactory levelof pain reduction and quality of life."

Low back pain may become a chronic disease in approximately 8%of patients. Researchers suggest that physicians with differentspecialties should work together to establish a diagnostic andtreatment program for each individual patient, includingmultidisciplinary and intradisciplinary consultation that would allowfor avoiding invasive treatment options where less invasive modalitiesmay still be effective.

This study is published in the September 2005 issue of Pain Practice. 

Jan Van Zundert, MD is currently preparing a PhD in the AcademicHospital Maastricht (The Netherlands) on "The use of pulsedradiofrequency in the treatment of chronic pain." Since September of2000, he has worked in Ziekenhuis Oost-Limbur, Genk, Belgium. He hashad a scientific affiliation with the department of Pain Management ofthe University Hospital Maastricht, Maastricht, The Netherlands, since2001.

About the Journal

Pain Practice, the official journal of the World Institute of Pain,publishes international multidisciplinary articles on pain that provideits readership with up-to-date knowledge of the research, evaluationmethods, and techniques of pain management. The present literature onpain medicine is diverse and published in a variety of basic andclinical specialty journals. For a practitioner to subscribe to all thevenues needed to cover the field of pain medicine would be impractical,if not impossible. Likewise, the literature search can be cumbersome,costly, and entirely unavailable in some areas. As a thorough,multidisciplinary journal, Pain Practice is a convenient, cost-effective way to resolve these dilemmas.

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