“Chronic Pain; Impact of Chronic Pain on a Societal, Personal, and Treatment Level”

Sixteen percent of the population in Europe suffers from chronic pain. The largest share of chronic pain is chronic low back pain. The extent of the problem for society, patients and pain treatment is the subject of this dissertation. Some results: If acute back pain has not disappeared within 3 months, chances are high (60%) that the back pain will not recover spontaneously. Chronic discogenic low back pain patients have moderate severe pain, a lot of physical restraints and a low quality of life. They cost society € 8000 per person per year. The methylene blue intradiscal injection is not cost-effective.

Neuromodulation treatment reduces pain by 30% on average for at least eleven years. For many pain syndromes, the (cost) effectiveness of neuromodulation still has to be proven through research. When treating chronic pain, the practitioner should take into account the content and type of expectations of the patient. Expectations can be expressed as hope, norm, need or as an opportunity. Only the expectations expressed as probability calculations influence the treatment result.