Pain Medicine
Types of Pain & Causes
Chronic and Complex Pain Syndromes
Specialized Diagnosis and Treatment for Chronic Pain
Chronic pain is pain that persists for months or recurs repeatedly—often without any clearly identifiable acute cause.
Complex pain syndromes often arise when several factors interact: physical changes, the nervous system, previous injuries or surgeries, and prolonged strain or stress.
A specialized pain medicine evaluation helps to understand these connections and plan a targeted treatment.
Typical Situations / Questions
Patients come to us for:
- Pain that lasts longer than three months
- Back pain with no clear findings on imaging
- diffuse or fluctuating pain patterns
- Pain Following Surgery or Injury
- burning, stabbing, or electric-shock-like pain
- Pain that does not improve despite several attempts at treatment
- increasing limitations on daily life, sleep, or the ability to work
Often, those affected have already undergone numerous tests and treatments—without a satisfactory explanation or lasting improvement.
Our Approach: 1. Specialized pain management evaluation
Chronic pain is fundamentally different from acute pain. Over time, the nervous system can become more sensitive, and pain signals can take on a life of their own or intensify.
The pain assessment therefore focuses on:
- detailed analysis of the progression of pain
- Detailed description of the nature, intensity, and extent
- Assessment of Possible Neuropathic Components
- Review of Previous Diagnostic and Therapeutic Approaches
- Assessment of Psychosocial Stressors
- Evaluation of Drug Efficacy and Side Effects
The goal is not just to ask, “Where does it hurt?” but rather:
Why does the pain exist—and what keeps it going?
Our Approach: 2. Individualized Treatment Planning
The treatment of complex pain syndromes is tailored to the individual and is often multimodal. Depending on the findings, the following may be used:
- tailored combination drug therapy
- Adjustment or Optimization of Existing Pain Medication
- Treatment of Neuropathic Pain Components
- Interventional procedures (e.g., nerve blocks, botulinum toxin injections)
- local therapies
- Consultation on invasive procedures for selected indications
- close collaboration with physical therapy
- Psychosomatic or psychiatric support as needed
The goal is not only to reduce pain, but also to improve function, physical capacity, and quality of life.
Who is it particularly suitable for?
- People with chronic or recurring pain
- Patients with multiple causes of pain
- Individuals with unclear or conflicting test results
- People whose pain is increasingly limiting their daily lives
- Patients who have not responded adequately to previous treatments
Neuropathic Pain (Scar tissue, postherpetic neuralgia, nerve entrapment)
Neuropathic pain is not caused by an acute injury to muscles, joints, or organs, but rather by damage to or irritation of the nerves themselves. It is also referred to as nerve pain.
They often feel different from “traditional” pain: burning, stabbing, electric, or shooting—sometimes accompanied by numbness or hypersensitivity of the skin.
Typical examples include scar pain, pain following shingles (postherpetic neuralgia), or pain caused by nerve entrapment syndromes.
Many people with this condition find that conventional pain relievers do not provide sufficient relief. A specialized pain management evaluation can be crucial in such cases.
How do nociceptive and neuropathic pain differ?
In pain medicine, a basic distinction is made between nociceptive and neuropathic pain.
Nociceptive pain results from actual or impending tissue damage—for example, due to inflammation, osteoarthritis, muscle injuries, or after a fall. In these cases, so-called nociceptors (pain receptors) in the tissue respond to stimuli.
Neuropathic pain, on the other hand, is caused by damage to or malfunction of the nerve itself. The pain is therefore not triggered by the tissue, but by a disturbance in the transmission or processing of pain within the nervous system.
This distinction is important because the treatment differs significantly.
Typical Situations / Questions
Patients often report:
- burning, stabbing, or electric-shock-like pain
- sudden, sharp bouts of pain
- Skin hypersensitivity (touch is perceived as painful)
- Numbness or "pins and needles"
- Pain around a scar—even long after surgery
- Persistent pain after shingles
- Radiating pain caused by nerve compression (e.g., in the spine or extremities)
A common characteristic is that the pain often persists longer than the initial trigger would suggest—or that it continues without any visible tissue damage.
Why undergo a specialized pain evaluation?
Neuropathic pain is often initially evaluated by a neurologist or orthopedist—and that makes sense.
- Neurology assesses whether there is a nerve dysfunction or an underlying neurological disorder.
- Orthopedics determines whether there is a structural or mechanical cause (e.g., a disc problem, narrowing, joint changes).
However, if pain persists, takes on a life of its own, or continues despite treatment of the underlying cause, a purely structural or neurological assessment is often no longer sufficient.
This is where specialized pain medicine comes into play.
The focus is on:
- Detailed analysis of the nature of the pain (burning, stabbing, electric-like, dull)
- Systematic assessment of changes in sensation (hypersensitivity, numbness, allodynia)
- Distinction between nociceptive (tissue pain) and neuropathic (nerve pain) components
- Assessment of possible triggers (surgery, infection, nerve compression, injury)
- Assessment of Mechanisms Leading to Chronicity and Raising Public Awareness
- An Examination of Pain Processing in the Nervous System
Pain medicine doesn't just ask: Where does the pain originally come from?
But also: Why does it persist? The goal is to precisely understand the underlying mechanism of pain—because neuropathic and chronic pain require a different, often combined, treatment approach than classic inflammatory pain. Especially in cases of complex or long-lasting symptoms, pain medicine therefore complements neurology and orthopedics—not as a competitor, but as a specialized extension.
Possible Treatments
Treatment is tailored to each individual and may include:
- Specific drug therapy for neuropathic pain
(e.g., medications that affect pain processing in the nervous system) - tailored combination therapies
- topical treatments such as high-dose capsaicin patches
- Ultrasound-guided nerve blocks
- Treatment of Nerve Compression in Collaboration with Orthopedics
- Interdisciplinary care for chronic conditions
Not every type of neuropathic pain can be completely reversed. Often, the goal is to significantly reduce pain intensity, decrease hypersensitivity, and restore quality of life.
Who is it particularly suitable for?
- People with burning or electric-shock-like pain
- Patients with persistent pain following surgery or injury
- People with postherpetic neuralgia
- People with scar pain
- Patients with nerve entrapment syndromes
- People for whom traditional pain relievers are not effective enough
Neuropathic pain is complex—but treatable. A targeted, specialized evaluation is the first step toward more effective treatment.
Complex Regional Pain Syndrome (CRPS)
Complex Regional Pain Syndrome (CRPS) is a specific form of chronic pain that usually develops after an injury, surgery, or even seemingly minor incidents such as a sprain or a fracture.
Typically, the pain is unusually severe —more severe than the original injury would suggest—and it does not subside as much as expected, even though the injury has already healed medically.
Many people affected feel that “something isn’t right,” but for a long time they don’t receive a clear explanation for their symptoms.
CRPS is rare but treatable—especially if it is detected as early as possible. A specialized evaluation can help clarify the situation and enable targeted treatment.
When should CRPS be considered?
CRPS usually affects an arm or a leg—often a hand or a foot. Typical signs include:
- persistent, burning, or deep, piercing pain
- Extreme sensitivity to touch (even a light touch or clothing causes pain)
- Swelling of the affected area
- Changes in skin color (reddish, bluish, mottled)
- Temperature differences compared to the other side
- increased or decreased sweating
- Limited range of motion or increasing stiffness
- Tremors, loss of strength, or unsteadiness when moving
These changes often also affect what is known as the autonomic nervous system (that is, the involuntary part of the nervous system that controls blood flow, body temperature, sweating, and other automatic bodily functions).
Many patients describe the feeling that their bodies are “overreacting” or are no longer regulating themselves properly.
Why does CRPS develop?
CRPS is not a figment of the imagination, nor is it a mental illness.
An injury is usually followed by an inflammatory response and then healing. In CRPS, this healing process appears to become unbalanced.
It is believed that this results in a dysregulation of the nervous system:
- Pain signals are processed with excessive intensity
- The autonomic nervous system remains in a state of alert.
- Blood flow and inflammatory responses are impaired
- In a sense, the brain “learns” to experience more intense pain
It is not yet fully understood why this happens to some people and not to others. Presumably, several factors are at play: individual pain processing, stress levels, the type of injury, and neurobiological characteristics.
It is important to note that the onset of CRPS does not mean that someone is “too sensitive”—it is a complex neurobiological reaction.
Why a Specialized Pain Evaluation Is Important
CRPS is often diagnosed late because the symptoms seem unusual and can change over time.
The goal of a pain assessment is to:
- to identify the typical combination of pain, autonomic changes, and movement disorders
- to rule out other causes
- to assess the stage of the disease
- to initiate early, targeted treatment
Especially in the early stages, there is a good chance of positively influencing the outcome.
Treatment Options
Treatment for CRPS is usually multimodal and tailored to the individual. It may include:
- Specific pharmacological pain management
- Targeted pain management interventions
- Close collaboration with physical therapy to maintain mobility
- Measures to Regulate the Nervous System
- Psychosomatic support for chronic stress
The goal is to reduce pain, maintain or regain mobility, and prevent the symptoms from worsening.
Headaches and facial pain
Headaches and facial pain can be extremely distressing. Many people who suffer from them find the pain agonizing and difficult to explain, and it is often misunderstood by those around them as “invisible” or “exaggerated.”
When pain dominates one’s thoughts, the next attack is feared, or everyday stimuli such as light, touch, or chewing become a burden, a feeling of helplessness often sets in.
In pain medicine, we take a differentiated approach to headaches and facial pain and recognize them as serious neurological and pain-related conditions.
Common Types of Headaches and Facial Pain
Headaches and facial pain can have a wide variety of causes. These include, among others:
Headache
- Migraine (throbbing, usually on one side, accompanied by nausea or sensitivity to light)
- Tension headaches (dull and pressing, often on both sides)
- chronic daily headaches
- medication-induced headaches
Facial pain
- Trigeminal neuralgia (sudden, electric-shock-like episodes of pain in the face)
- Atypical facial pain (persistent pain that is difficult to classify)
- Neuropathic pain following surgery or dental treatment
- Pain Associated with the Temporo-Mandibular Joint
- Postherpetic pain in the face (following shingles)
Many of those affected have a long history of dental visits, neurological evaluations, or imaging tests—often without a satisfactory explanation or lasting improvement.
This is often extremely stressful for those affected, especially when—despite repeated dental treatments —no cause can be “found,” the problem does not improve, or it even worsens because the sensitive nervous system becomes increasingly irritated.
What causes this pain?
Headaches and facial pain are not always caused by visible structural damage. Often, several factors are at play:
- Hypersensitivity of Certain Pain Pathways
- Irritation or dysfunction of the facial nerves
- chronic muscle tension in the head, neck, or jaw area
- Stress and vegetative (autonomic nervous system) overactivation
- Chronic Pain Resulting from Repeated Episodes of Pain
The face, in particular, has a high concentration of sensitive nerves. Even minor changes can cause severe pain.
If pain persists for a long time, the nervous system can “take on a life of its own”—the pain continues even when the original cause is no longer present.
Our Approach – Specialized Pain Assessment
In cases of chronic head and facial pain, a purely neurological or dental assessment is often insufficient.
As part of a pain management evaluation, we determine:
- What type of pain is it? (Migraine, neuropathic, muscular, combined)
- Are there any signs of nerve pain?
- What role do muscle tension, stress, or autonomic nervous system dysregulation play?
- Is the pain already chronic?
- Which treatments have helped so far—and which haven't?
The goal is to understand each person's individual pain profile—not just the diagnosis, but also the mechanism behind it.
Treatment Options
Treatment depends on the type of pain and may include:
- Specific drug therapy (e.g., for migraine or neuropathic pain)
- tailored combination therapies
- local treatment methods (e.g., injections or botulinum toxin)
- Treatment of Muscle Hyperactivity
- Concomitant Treatment of Autonomic Dysregulation
- interdisciplinary collaboration with neurology, physical therapy, or psychiatry
It’s important to note that the goal is not just pain relief, but regaining the ability to function in daily life, improve concentration, and enhance quality of life.
Who is it particularly suitable for?
- People with chronic or recurring headaches
- Patients with facial pain for which there is no clear explanation
- People with trigeminal neuralgia or neuropathic facial pain
- People who feel that their pain is not being taken seriously
- Patients who have not responded to treatment or who have a complex history of pain
Abdominal Pain & Visceral Pain
When Your Stomach Hurts—and No One Can Find a Clear Cause
Abdominal pain is one of the most common and, at the same time, most distressing types of pain. Some episodes occur suddenly and have a clear cause. Others persist for months or years—despite repeated examinations, normal test results, and various treatment attempts.
Visceral pain refers to pain that originates in internal organs (e.g., the stomach, intestines, bile ducts, or organs in the lower abdomen). This type of pain often feels different from muscle or joint pain—it tends to be deep, pressing, cramping, or diffuse.
Many people with these symptoms eventually feel that their complaints are no longer being taken seriously, especially when “nothing is found.”
Common Occasions & Complaints
- recurring or persistent abdominal pain
- Pressure, a feeling of fullness, or cramping pain
- Pain in different parts of the abdomen
- Bloating or changes in digestion
- Pain After Eating
- Pain Despite Normal Gastroscopy or Colonoscopy Results
- Persistent symptoms following infections or surgeries
- Lower abdominal pain with no clear gynecological or urological cause
How can this kind of pain occur?
How can this kind of pain occur?
Abdominal and visceral pain can have various causes:
1. Organic causes
For example, inflammation, irritable bowel syndrome, surgical scars, adhesions, or functional disorders.
2. Hypersensitivity of the internal organs
Some people develop what is known as visceral hypersensitivity—which means that their stomach or intestines send pain signals earlier and more intensely than in other people.
Even normal stretching or digestive processes are then experienced as painful.
3. Chronic Changes in the Nervous System
When pain persists for a long time, the pain system itself can change. The nervous system becomes “more alert” and reacts more quickly—even when there is no longer any acute inflammation.
4. Stress and Stressors
The abdomen is very sensitive to stress. This is because the gut and the nervous system are closely connected (“gut-brain axis”).
Prolonged internal tension can affect mobility, blood flow, and pain processing in the abdomen.
Important: If no dangerous cause is found, that does not mean the pain is“imaginary.” The pain is real—it’s just that the mechanism is more complex.
Why is a pain evaluation necessary for abdominal pain?
One pain management evaluation is particularly useful when:
- despite numerous studies, “nothing conclusive” has been found
- the pain keeps coming back or has become chronic
- Treatments only help in the short term
- the pain has taken on a life of its own
- Fear, avoiding physical activity, or constantly focusing on symptoms dictate daily life
Many people who are affected eventually hear things like, “Physically, everything is fine.” And yet the pain is real—and debilitating.
In such situations, it is no longer just a matter of a single organ, but often of a pain and nervous system that has become hypersensitive. This is precisely where pain medicine comes in: It looks not only at where it hurts, but also at why the pain persists —and which combination of medication, nerve-related, and complementary treatments can help alleviate it.
Possible Treatment Approaches in Pain Medicine
- Targeted pharmacological pain management (e.g., for neuropathic or chronic pain)
- Medications for Regulating Bowel Motility
- Treatment of Scarring or Adhesion-Related Symptoms
- Nerve blocks in selected cases
- Combination with psychosomatic physical therapy
- Support for Stress Management and Pain Coping
- interdisciplinary collaboration with gastroenterology, gynecology, or psychiatry
The goal is not only to reduce the intensity of pain, but also:
- Greater confidence in one's own body
- less fear of pain
- greater durability for everyday use
- Regaining Quality of Life
Who is it particularly suitable for?
- People with chronic or recurring abdominal pain
- Patients with unclear findings despite extensive diagnostic testing
- People with irritable bowel syndrome symptoms and severe pain
- Patients with Persistent Symptoms Following Surgery
- People who feel that their pain is not understood
Stomach pain isn't "just a sensitive stomach" or "just stress." It's often a sign of a sensitive, overburdened, or dysregulated system—and it's precisely this system that can be understood and treated.
Specialized Procedures
Pharmacological Pain Management & Pharmacogenetics
This is where specialized pain management comes into play—and, if necessary, pharmacogenetics as well.
Typical Situations / Questions
- Pain medication is not effective enough
- Severe side effects occur
- Several medications must be taken together
- There is uncertainty regarding long-term therapy (e.g., with opioids)
- Different doctors have proposed different approaches
- Many medications are already being taken for other conditions
- There is a desire for a personalized, transparent treatment plan
Why Pain Management Is Often Complex
Pain is not a uniform phenomenon.
- Nociceptive pain results from tissue damage or inflammation.
- Neuropathic pain is caused by nerve damage or dysfunction.
- Chronic pain often alters how the nervous system processes pain.
Not every medication is effective for every type of pain. Some active ingredients affect signal transmission in the nervous system, while others have anti-inflammatory or muscle-relaxing effects. A combination therapy is often recommended.
There is also another important factor: interactions.
Many patients with pain also take medications for conditions such as high blood pressure, diabetes, depression, heart rhythm disorders, or other chronic illnesses. Pain medications can:
- influence each other's effects
- Exacerbate side effects
- affect the metabolism of other medications
- increase the risk of bleeding, fatigue, circulatory problems, or strain on the organs
Careful evaluation is essential, especially when multiple medications are being taken at the same time. Specialized pain management therefore also involves keeping track of all medications—not just the pain reliever alone.
What is pharmacogenetics?
- how a person absorbs medication,
- how quickly they are broken down in the body,
- how effective they are
- and how likely it is that side effects will occur.
- is broken down too quickly → has too little effect
- is broken down too slowly → has too strong an effect or causes side effects
- When activated in a modified way → it produces unexpected effects
Pharmacogenetics typically examines genes that encode so-called cytochrome P450 enzymes (e.g., CYP2D6, CYP2C19). These enzymes play a role in the metabolism of a wide variety of medications.
What exactly is being studied?
- How effective certain drug-metabolizing enzymes are
- Whether someone has a "slow," "normal," or "fast" metabolism
- Whether certain active ingredients might be unsuitable or pose a greater risk
- What dosage might be appropriate
So the question isn't "whether" a medication works, but how each individual's body responds to it.
Why is pharmacogenetics particularly important in pain medicine?
Pain medicine is particularly complex because:
1. Many pain medications are broken down by the same enzyme systems
Antidepressants, anticonvulsants, opioids, and some co-analgesics, in particular, are metabolized by CYP enzymes.
2. Pain management often involves combination therapy:
Taking multiple medications at the same time increases the risk of interactions—and genetic factors can exacerbate these.
3. Effects and side effects vary greatly from person to person
Two people with the same pain may react completely differently to the same medication.
4. Chronic pain requires long-term treatment
Small differences in metabolism can have major effects over the course of years.
5. “Treatment resistance” can sometimes be explained by genetic factors
If medications repeatedly fail to work or are poorly tolerated, a genetic factor may be at play.
What does this mean for patients?
- to shorten the trial-and-error process
- Better Classification of Side Effects
- Adjust dosages more precisely
- to deliberately avoid certain active ingredients
- Make complex medication regimens safer
It is no substitute for clinical experience—but it can serve as an important additional basis for decision-making in difficult or unclear cases.
In short: Pharmacogenetics reveals why a drug works well for one person—and for another, barely at all or with severe side effects.
Especially in pain medicine, where individual differences are particularly pronounced, this can make a decisive difference.
Pharmacogenetics in specialized pain management means,
- analyze the nature of the pain in detail
- Comprehensively review current medications
- Consider Interactions in Pain Management
- Consider possible interactions with other necessary long-term treatments
- Combining Active Ingredients in a Sensible, Transparent, and Balanced Way
- Ensure compatibility and long-term safety
- use pharmacogenetic testing when it appears medically appropriate
The goal is not to prescribe as many medications as possible, but rather to provide a personalized treatment plan that strikes a balance between efficacy, safety, and practicality in daily life.
A well-tailored medication regimen is often an important component—but rarely the only measure. The goal is always a holistic treatment plan that is sustainable for the individual.
Who is it particularly suitable for?
- People with chronic or complex pain
- Patients for whom previous pain medications have been ineffective
- People with severe side effects
- People taking multiple medications at the same time
Local Pain Treatments
(Qutenza, botulinum toxin)
Chronic pain is often caused by hypersensitivity or dysfunction in the nervous system. When traditional pain medications are not effective enough or are not well tolerated, there are now targeted local treatment options that act directly at the site of the pain.
At our practice, we offer modern, well-established procedures, in particular:
- Qutenza® (8% capsaicin patch)
- Botulinum Toxin Injections for Pain Syndromes
These treatments target the affected nerve structures directly and can effectively relieve pain—they are generally well tolerated and do not put a strain on the entire body.
Qutenza® (8% capsaicin patch)
How It Works
Capsaicin is an active ingredient derived from chili peppers. In high concentrations, it specifically targets certain pain fibers in the skin. These fibers are temporarily “calmed,” so that pain signals are transmitted with less intensity.
Indications
- Nerve pain (neuropathic pain), e.g.:
- after shingles
- in cases of polyneuropathy (e.g., in diabetes)
- after surgery or injury
- Localized, burning, or stabbing pain
Treatment Process
- The painful area of skin is precisely identified
- If necessary, the skin is numbed with a local anesthetic beforehand
- The patch is applied for 30 or 60 minutes
- You may experience a sensation of warmth or a burning sensation during use
- After that, the skin is cleansed
Treatment is provided on an outpatient basis at the clinic.
Treatment interval
- The effects usually set in within a few days
- Often lasts 2–3 months or longer
- A repeat is possible if necessary
Expected Effect
The goal is to significantly reduce pain in the treated area.
In many cases, the need for pain medication can also be reduced.
Botulinum Toxin in Pain Management
Mechanism of Action
Botulinum toxin acts on nerve endings and affects the transmission of signals.
This results in:
- relaxation of overactive muscles
- and a direct pain-relieving effect
Indications
- Chronic Migraine
- Tension-type headaches
- Muscle-related pain (e.g., neck, back)
- Pain Caused by Muscle Tension (Trigger Points)
- Selected Types of Nerve Pain
Treatment Process
- The active ingredient is injected into specific points using fine needles
- The treatment usually takes only a few minutes
- It is generally well tolerated
Treatment interval
- Effects begin to be felt after about 3–7 days
- Maximum effect after about 2 weeks
- Duration of action: 2–4 months
- Can be repeated regularly
Expected Effect
- Reduction in the intensity and frequency of pain
- Relaxing Tense Muscles
- For migraines: fewer days with headaches
Who are these procedures suitable for?
These therapies are particularly suitable for:
- localized pain
- Nerve pain
- insufficient effectiveness of pain medication
- or if medications are not well tolerated
Individualized Treatment Planning
Before each treatment, we conduct a thorough pain assessment.
Together, we’ll select the most appropriate form of therapy—tailored to your symptoms and your personal situation.
The goal is to provide long-term pain relief and improve quality of life in everyday life.
Ultrasound-Guided Nerve Blocks
For certain types of pain, it may be beneficial to specifically target the nerves involved in causing the pain. Ultrasound-guided nerve blocks are a proven method for doing so.
In this procedure, a medication is administered precisely near a nerve to temporarily block or reduce pain transmission.
What is a nerve block?
Mechanism of Action
In a nerve block, a local anesthetic—often combined with an anti-inflammatory medication—is injected directly into a nerve or the area surrounding it.
This results in:
- the transmission of pain signals is inhibited
- reduces irritation or inflammation around the nerve
Whether this form of therapy is appropriate is determined on a case-by-case basis as part of a thorough psychiatric evaluation.
Why Ultrasound?
- Nerves, muscles, and blood vessels are visible on an ultrasound
- The needle is tracked in real time
- The medication can be precisely targeted to the correct location
This means:
- greater accuracy
- often a better and longer-lasting effect
- greater safety, as key structures are preserved
- usually requires a smaller amount of medication
What is this treatment used for?
- Back pain that radiates (e.g., sciatica)
- Neck Pain
- Shoulder Pain
- Nerve pain (e.g., following surgery or injury)
- Pain Near the Joints
- Pain in the area of the ribs or abdominal wall
In addition, the treatment can help pinpoint the cause of the pain more precisely.
Treatment Process
- Positioning Depending on the Affected Area
- Visualization of the target structure using ultrasound
- Skin Disinfection
- Targeted injection using a fine needle under direct visualization
The treatment usually takes only a few minutes and is performed on an outpatient basis. Pain relief often begins shortly afterward.
How often are treatments administered?
- Depending on the symptoms, a single treatment may be sufficient
- It is often a good idea to apply the treatment several times at intervals
- The exact procedure is determined on a case-by-case basis
Expected Effect
- Rapid pain relief
- Improving Mobility
- Breaking the Cycle of Pain
The effect may be temporary or—depending on the cause—may last longer.
Who is this treatment suitable for?
Ultrasound-guided nerve blocks are particularly indicated for:
- Localized pain with suspected nerve involvement
- acute pain spikes
- chronic symptoms that do not respond adequately to other treatments
Individualized Treatment Planning
The goal is effective pain relief and a lasting improvement in daily functioning.
Consultation on Invasive Pain Management (SCS)
For some types of chronic pain, conservative treatments such as medication, physical therapy, or local injections are not sufficient. In such cases, invasive pain management may be considered.
One important option is spinal cord stimulation (SCS) —also known as “spinal cord stimulation” or a “pain pacemaker.”
What is SCS?
In spinal cord stimulation, a thin electrode wire is placed near the spinal cord. Targeted electrical stimuli are delivered via a small pulse generator.
These substances affect the transmission of pain signals in the nervous system, so that pain is perceived as less intense.
Who is SCS a good fit for?
SCS may be an option for:
- chronic nerve pain (neuropathic pain)
- Persistent pain following spinal surgery (“Failed Back Surgery Syndrome”)
- complex regional pain syndrome (CRPS)
- Circulatory disorders accompanied by pain (in selected cases)
The general requirement is:
- a long-standing course of pain
- inadequate response to other treatments
What does the consultation include?
The decision to pursue invasive treatment requires particularly careful evaluation.
As part of the consultation, the following will take place:
- A detailed analysis of your medical history to date
- the assessment of whether SCS can, in principle, be useful
- Information on the procedure, benefits, and potential risks
- Discussion of Alternative Treatment Options
It is important to make a realistic assessment of the chances of success.
Procedure for a Possible Treatment
Treatment takes place at specialized centers and generally consists of two steps:
1. Test Phase-
- Temporary Placement of the Electrodes
- Over the course of several days, we will assess whether sufficient pain relief has been achieved
Goal of the Therapy
SCS does not aim for complete freedom from pain, but rather for:
- a significant reduction in pain intensity
- Improving Sleep and Daily Life
- Improving Quality of Life
In many cases, the need for pain medication can also be reduced.
Our Role in Consulting
We can help you with:
- determining whether invasive treatment is appropriate
- preparing for possible treatment
- and the targeted referral to and communication with specialized centers
Individual Decision-Making
The decision to undergo SCS is always a personal one and is made together with you, based on a thorough medical evaluation.
The goal is to find a treatment strategy that is right for you and sustainable.
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