Treating chronic pain

Patient und Ärztin im Gespräch

Pain that just won’t go away puts a huge strain on the patient. However, there are ways out of this apparently hopeless situation.

Why pain becomes chronic

Whether the pain is felt when sitting, standing or in bed: if it doesn’t ease after several months, it is defined as chronic pain. The list of causes for chronic pain is long: tumour pain, osteoporosis, osteoarthritis, neuropathic pain, injuries, back pain and headaches are just a few of them. But a cause isn't always identifiable. “An MRI doesn't reveal anything in these cases, and yet the pain is there.” It is precisely then, according to Dr Hoederath, pain specialist at the Hirslanden Klinik Stephanshorn, that it’s important to take patients seriously, so that they don’t withdraw into their pain.

According to studies, 16% of Swiss people suffer from chronic pain. And that is important information for my patients: to know that they aren't alone.
Petra Hoederath, MD, Pain Specialist Hirslanden Klinik Stephanshorn

Say goodbye to pain

The range of therapy options available is as wide as the range of causes: “There is no ONE therapy for chronic pain,” says the pain specialist. “The form of therapy applied depends on the cause. From drug therapy, physiotherapy, surgery, radiofrequency therapy and neuromodulation to complementary methods such as acupuncture or chiropractic, there is a wide variety of possibilities”. In collaboration with her interdisciplinary team, she is always looking for the right combination of therapies for her patients. It's important to dive deep, because “with many of those affected, their mental health also suffers.”

Dr Hoederath is a pain specialist and neurosurgeon at the Hirslanden Klinik Stephanshorn. Her greatest pleasure is when patients can reduce high-dose medication or leave the clinic with lower levels of pain.

Painkillers: the solution?

To relieve acute pain, a common painkiller can be useful as a short-term solution. “There are different types of pain that need to be treated differently,” the specialist warns. If it’s a nerve pain, for example, common painkillers are of little help and may even trigger other complaints. “Apart from this, it’s important for the patient to know exactly what type of pain it is. Once it has been identified, the patient feels that they are being taken seriously. And that’s already an important part of pain therapy.”

A cocktail of medications

It becomes particularly difficult “when patients take more and more medication over the years and end up with a whole cocktail of different medications.” In such cases, the pain specialist likes to consult with interdisciplinary team colleagues and work with a pharmacist to develop the best form of therapy for the patient.

Even if the pain never goes away completely, we can often at least reduce pain with the right combination of therapies.
Petra Hoederath, MD

Does pain memory exist?

Acute pain can develop into chronic pain. This chronification is related to pain memory: the body remembers long-lasting or severe pain and forms a pain memory. Pain memory refers to the biochemical, functional and morphological changes in the central nervous system that result from repeated or prolonged experiences of pain. This causes the patient to feel pain even when the original cause no longer exists. In other words, the pain has lost its warning function.

Taking preventive action against chronic pain

Education is an important aspect here too. It helps to know what chronic and acute pain is and what the difference is between the two. It’s also important not to be afraid of physical exercise. If nothing is broken or demonstrably damaged, the person should definitely stay active, because over-protection is often counterproductive. “The more I don't move, the more the muscles recede and the worse the pain gets,” says Dr Hoederath.


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