Pain therapy for a better quality of life

What is pain therapy and when is it necessary?

Pain therapy encompasses all therapeutic measures to reduce pain.
It includes the diagnosis as well as the treatment and relief of pain and can include a variety of approaches: Medication, physical therapy, psychological interventions as well as invasive and complementary medical procedures.
Pain therapy is particularly important when pain interferes with daily life or becomes chronic, for example in the case of injuries, operations or certain illnesses.

What types of pain are there?

There are two main types of pain: acute and chronic pain.
Acute pain is a warning signal from the body that indicates an injury or danger and usually only lasts for a short time.
Chronic pain, on the other hand, lasts longer than three months and is considered a disease in its own right, which is associated with a severe impairment of quality of life.

What requirements must be met in order to start pain therapy?

Pain therapy makes sense if at least three of the following points apply:

• Impairment of quality of life
• Ineffectiveness of individual pain therapies
• Drug addiction
• concomitant mental illnesses
• Underlying physical illnesses such as diabetes or heart problems

The necessity is also evaluated and confirmed by a doctor.

What role does a holistic approach play in pain therapy?

As pain is multifactorial, a holistic approach is essential.
The combination of conventional medical and complementary approaches leads to a lasting reduction in pain.
The holistic approach recognizes that pain triggers complex biochemical reactions in the body that must be interrupted in order to prevent further damage.

How does pain therapy at the Nuhr Medical Center take into account the patient’s overall state of health?

Pain therapy at the Nuhr Medical Center integrates a comprehensive analysis of the patient’s state of health.
We take physical, psychological and social aspects into account, enabling us to provide you with customized, holistic treatment that is precisely tailored to your needs.
Our aim is to alleviate both physical and psychological stress.

Multimodal pain therapy

What is multimodal pain therapy?

Multimodal pain therapy is an interdisciplinary approach to the treatment of pain.
It takes into account physical, mental, emotional and social factors.
As chronic pain is often caused by a combination of different factors, this form of therapy is particularly suitable.
It is based on the bio-psycho-social model of pain.

How are different therapeutic approaches combined to ensure effective pain treatment?

Multimodal pain therapy combines various methods to treat pain comprehensively.
Medication, physiotherapy, psychological support and other methods are combined in order to alleviate the pain as best as possible.

Which disciplines are involved in multimodal pain therapy?

An interdisciplinary team works together in multimodal pain therapy.
Specialists (e.g. neurology, orthopaedics, anaesthesiology), physiotherapists, occupational therapists and complementary physicians are often involved.
This collaboration enables holistic and effective pain treatment.

Outpatient pain therapy

How does outpatient pain therapy work?

In outpatient pain therapy, patients can take advantage of various treatment measures without having to stay in hospital.
In the pain outpatient clinic, they have the opportunity to receive individual therapy tailored to their needs in a relaxed environment.

What are the advantages of outpatient therapy compared to inpatient treatment?

Outpatient pain therapy offers the advantage that patients do not have to leave their familiar surroundings.
They can continue their everyday lives and are not tied to an inpatient stay.
In addition, treatments can be planned flexibly and are individually tailored to the needs of our patients.

What treatment options are offered on an outpatient basis?

Various treatments are available to you as part of outpatient pain therapy at the NUHR Medical Center.
These first include a thorough medical examination in order to draw up a suitable treatment plan.
Further treatments include arsonvalization according to Dr. Nuhr, a special electrical therapy for pain relief, as well as therapeutic gymnastics in the form of individual movement exercises.
Low-frequency treatment with gentle current pulses and low-level laser therapy, in which light is used to promote healing, are also included.
Manual therapies that promote mobility and extensions to relieve pressure on the spine can also be used.

Inpatient pain therapy

When does inpatient pain therapy make sense?

Inpatient pain therapy is particularly useful when patients suffer from chronic pain that cannot be adequately treated on an outpatient basis.
This includes, for example, nerve pain, low back pain caused by herniated or bulging discs, osteoporosis, osteochondrosis, Scheuermann’s disease and rheumatic diseases.

How does an inpatient stay for pain therapy work?

The inpatient stay at the NUHR Medical Center begins with a detailed medical examination, which serves as the basis for an individual treatment plan.
Regular check-ups are carried out during the stay to monitor progress and adjust the treatment if necessary.
The treatment is based on a combination of physical, complementary, movement and mental therapy.

What are the advantages of inpatient treatment compared to outpatient treatment?

Patients benefit from staying at the NUHR Hotel, which offers a comfortable and relaxing environment.
In addition to medical treatment, full board is provided and patients can concentrate fully on their recovery without the distractions of everyday life.

Invasive pain therapy

What is invasive pain therapy and when is it used?

Invasive pain therapy uses techniques that directly affect nerves or the nervous system, which can alleviate or eliminate pain.
These methods are used when other therapies are not effective enough or the pain is very severe.
The procedures include blockades of nerves or nerve plexuses as well as the use of drug pumps or electrical stimulation devices.
Invasive pain therapy is used in particular for chronic pain that is difficult to treat, tumor pain or after back surgery.

What invasive methods of pain relief are available?

There are various invasive methods of pain relief that are used particularly for chronic and difficult-to-treat pain.
One option is intrathecal pain therapy, in which painkillers are administered directly into the spinal cord to relieve particularly severe pain.

Another method is spinal cord stimulation (SCS), in which electrical probes are inserted near the spinal cord to interrupt the transmission of pain signals.
This treatment is often used for chronic back pain or phantom pain after amputations.
Subcutaneous target stimulation (STS) works in a similar way, but is mainly used for back pain, tension headaches or trigeminal neuralgia.

An additional method is radiofrequency therapy, in which nerves are “immobilized” by targeted heat, which stops the transmission of pain.
It is a safe alternative to chemical interventions.

Are there any risks or side effects with invasive procedures?

Yes, as with all medical procedures, there are risks and side effects with invasive pain therapies, for example:

• Infections at the injection site
• Bleeding or hematomas
• Nerve damage or paralysis
• Incorrect positioning of devices such as pumps or stimulators
• Side effects due to the medication administered (e.g. opiates)

Drug-based pain therapy

What role do drugs play in pain therapy?

Medication plays a role particularly in cases of long-term or chronic pain.
They serve to alleviate pain, but do not replace other important approaches such as physiotherapy.
Painkillers alone often do not eliminate the causes or accompanying factors such as mental stress or muscular misalignments.
The focus is on finding an optimal balance between effective pain relief and tolerable side effects.

Which medications are used in pain therapy?

Various medications are used in pain therapy, which are graded according to the intensity of the pain.
The World Health Organization (WHO) has developed a simple scheme for this:

• Non-opioid painkillers are usually used for mild pain, such as headaches or muscle pain.
  These include common medications such as paracetamol or ibuprofen.
• If the pain is more severe, such as moderate pain, weak opioids such as tramadol are used in combination with the non-opioid painkillers.
  This combination helps to control the pain better.
• For very severe pain, such as that which can occur after serious injuries or operations, strong opioids such as morphine are required.
  These are then often used in addition to non-opioid painkillers.

How do the drugs affect the perception of pain?

Medication influences the perception of pain as it blocks or alters the transmission or processing of pain signals in the nervous system.
This often happens by influencing neurotransmitters in the brain and spinal cord.
In order to minimize side effects, low doses are usually started and gradually increased until an optimal balance between pain relief and tolerance is achieved.

What side effects can occur?

The most common side effects of pain medication are

• Tiredness
• Dizziness
• Nausea
• Digestive problems (e.g. constipation with opioids)

Dronabinol pain therapy and cannabis

What role does dronabinol play in pain therapy?

Dronabinol is a pharmaceutical form of THC (tetrahydrocannabinol).
It is often used for chronic pain patients when conventional therapies are not sufficiently effective.
These include patients with serious illnesses such as cancer, multiple sclerosis or chronic neuropathic pain.
Dronabinol is primarily used to relieve pain, loss of appetite and nausea.

How does dronabinol work and what types of pain is it suitable for?

Dronabinol acts on the endocannabinoid system in the body, which plays an important role in the regulation of pain, inflammation and other physiological processes.
By activating cannabinoid receptors (especially CB1 and CB2 receptors), dronabinol influences the perception of pain, leads to muscle relaxation and can have analgesic effects.
It is particularly effective for neuropathic pain (nerve pain) and spastic conditions such as those associated with multiple sclerosis.

Are there differences between dronabinol and other cannabis-based medicines?

Dronabinol is pure THC, while other cannabis-based medicines such as Sativex contain both THC and CBD (cannabidiol).
THC has a psychoactive effect, while CBD mainly has anti-inflammatory and calming properties without causing psychoactive effects.

How is cannabis used in pain therapy?

Cannabis is mainly used for neuropathic pain and spastic conditions.
Patients can use various forms of cannabis preparations, such as dronabinol drops, nabiximols spray or oily full extracts.

What studies and scientific findings are there on the effectiveness of cannabis for pain?

The scientific evidence on the effectiveness of cannabis in pain therapy is still developing, but there are already some studies that confirm a pain-relieving effect for certain types of pain.
Studies show moderate benefits of cannabis, particularly for neuropathic pain, which is difficult to treat.

Is cannabis suitable for all types of pain?

Cannabis is not suitable for all types of pain.
While it is promising for neuropathic pain and spasticity, it is less effective for acute pain and tissue pain such as muscular pain or inflammatory diseases such as rheumatoid arthritis.

Physiotherapy and medical training therapy

How does physiotherapy support pain therapy?

Physiotherapy is an important part of pain therapy.
This is because the exercise, massage or heat applications used in physiotherapy strengthen the muscles, tendons and joints and improve mobility.
This reduces acute and chronic pain and supports the healing process.

What techniques are used in physiotherapy to relieve pain?

Various techniques are used in physiotherapy, such as

• Manual therapy
• Massage
• Stretching exercises
• Cold and heat therapy
• Electrotherapy
• Movement exercises

How can physiotherapy help to relieve pain in the long term?

Physiotherapy can relieve pain in the long term by correcting muscular imbalances, improving mobility and introducing targeted strengthening exercises to stabilize joints.
Through regular training, the body learns to tolerate pain better, while muscle development and improved posture minimize the risk of relapses and new episodes of pain.

What is medical training therapy and how does it help with chronic pain?

Medical training therapy is a controlled and individual training program under physiotherapeutic supervision that is used specifically for rehabilitation and pain treatment.
It promotes muscle development, mobility and endurance, which is particularly important for chronic pain such as back pain.

What exercises are performed in medical training therapy?

In medical training therapy, various exercises are performed that are tailored to the individual needs of the patient, such as

• Strength training
• Coordination and balance exercises
• Endurance training
• Functional exercises
• Free exercises with Therabands, exercise balls or self-weight exercises

What role does physical activity play in pain control?

Regular exercise strengthens the body, gets the circulation going and produces natural painkillers called endorphins.
This helps to make the joints more flexible, reduce inflammation and decrease sensitivity to pain.

Arsonval streams

What are Arsonval currents and how do they work in pain therapy?

Arsonval currents are special high-frequency alternating currents that are used in electrotherapy.
They operate in the range from 100 kHz to 400 kHz and do not generate muscle contractions.
Instead, they act on the tissue through heat and stimulation.
These currents help to improve blood circulation, relieve pain and support the healing of tissue.

What types of pain is this method suitable for?

Arsonval currents are mainly used for the following types of pain:

• Chronic muscle and joint pain
• Back pain and neck pain
• Neuropathic pain
• Migraine and tension headaches
• Post-traumatic pain

Is there scientific evidence for the effectiveness of Arsonval currents?

Scientific evidence on the effectiveness of Arsonval currents in pain therapy is limited.
While some studies indicate positive effects, particularly in terms of improving circulation and pain relief through thermal effects, there is a lack of large-scale, high-quality clinical studies that clearly demonstrate efficacy.