Comprehensive nature of rise and maintenaince of chronic pain needs comprehensive treatment based on biopsychosocial approach. That way addressing substantial factors, which have impact on pain, its maintenaince and treatment. The pain manifests itself except sensoric component also in behavior, in cognition and emotions. That is why only one isolated treatment approach can not touch all troubles related to pain. Multidisciplinary treatment of pain is based on restoring of well-being, ability to work and join social life also with pain. Article describes basic outline of multidisciplinary pain treatment, which is based on team cooperation: information from all team make diagnosis, team formulates and realises complex rehabilitative plan and team members are willing learn from each other. All team members are compeer each other and have the same respect. The team presents itself in principles jointly, treatment needs effective and integrated management, agreement in treatment philosophy, in methods and also enthusiastic members. Each team member contributes by specific part to global treatment of patient. The article describes also what is typical pain management centre like: with specified rooms and basic standard program: in-patients usually takes from 3 to 4 weeks, out-patients can hold longer. The article presents two concrete examples of application of multidisciplinary treatment in Centre of Pain Management in St Thomas´ Hospital in London and Multidisciplinary Pain Centre of University of Washington in Seattle. Basic treatment principles are: pharmacotherapy, physiotherapy and psychotherapy. In the treatment are integrated: medical and psychosocial factors, which support direcly or indirecly somatic and emotional condition and rehabilitation (how behavior influence activity, ie. what patient can do and what cannot do because of pain). The treatment is based on readiness and activity of patient to cooperate on the treatment. Treatment strategies look on individual problems of each patient: each patient is differently rectricted in functioning, has other type of pain and pain behavior, emotional reaction, other type of lesion, invalidity and working troubles. Successful treatment always influence individually all above mentioned problems related to chronic pain. The article sums up results of studies of multidisicplinary pain treatment fruitfulness and criteria of fruitfulness.

Oddělení psychologie Fakultní nemocnice v Motole Praha

Multidisciplinary chronic nonmalignant pain management

Lit.: 21