Long-term efficacy of multimodal pain therapy for chronic back pain

Background. The day clinic for pain therapy at the Orthopedic Clinic of the University Heidelberg has been in existence since 2001. In the context of multimodal pain therapy patients with chronic and chronically recurring pain of the musculoskeletal system are treated. Methods. The present prospective long-term study investigated the effects of therapy using the following outcome parameters: pain intensity, disability, depression, functional capacity and vitality. For this purpose patients with low back pain (n = 59) were questioned in writing at four measurement times: start of therapy (t0), completion of therapy (t1), 6 months (t2) and 10 years (t3) following therapy. Of the examined patients 78% were in chronification stages I and II, according to the Mainz pain staging system (MPSS) of Gerbershagen. Aim. The main aim of the study was to examine the effects of multimodal pain therapy in the long term. Results. In the short, medium and long term significant differences were found in the outcome parameters with low to high effect sizes (d = 0.36-1.85). There was a continuous improvement of the pain intensity in the long term, and 10 years after pain therapy the effect size for the currently asked pain intensity was d = 1.28. Conclusion. Multimodal pain therapy is an effective method for the treatment of chronic back pain. It not only leads to short and medium-term improvements but also proves to be efficient in the long term. This form of pain therapy seems to lead to long-term success, particularly for patients with low-grade chronification.