Within a multidisciplinary pain centre, treatment possibilities include pharmacological treatment, rehabilitation programs, cognitive behavioural therapy, psychological counselling, as well as minimally invasive interventional techniques such as epidural steroid administration, radiofrequency and implantable neurostimulators, and drug delivery pumps. Comparison between the practices in Belgium and the Netherlands revealed that where multidisciplinary pain clinics are less well-implanted, the health care costs for low back pain are higher due to a more intensive use of surgery and consequently, the long-term management of failed back surgery syndrome.

Data show that when the available treatment possibilities are used in a multidisciplinary and step-wise approach, more invasive surgical treatment options may be avoided, resulting in considerable savings of health care budgets.

"Patients should be aware that medical imaging and spine surgery are not always the mandatory steps in the management of lower back pain," states Jan Van Zundert, MD. "Psychological counselling and cognitive behavioural therapy offers the possibility to have better insight in the patient's perception on what causes pain and how to improve physical activity. Percutaneous interventional techniques can be used when conventional treatment fails. The patient might work together with health care professionals to achieve a satisfactory level of pain reduction and quality of life."

Researchers suggest that physicians with different specialties should work together to establish a diagnostic and treatment program for each individual patient, including multidisciplinary and intradisciplinary consultation that would allow for avoiding invasive treatment options where less invasive modalities may still be effective.

MEDICA.de; Source: Blackwell Publishing Ltd.