Relieving muscular pain: Evidence-based methods and innovative therapeutic approaches.

Dr. Müller-Schwefe, after so many years of practical experience, what do you see as the main causes of muscular pain, such as back pain?

The main cause is definitely a lack of exercise. The core problem is that the human body is still designed as a savannah and steppe runner. However, modern working life has turned us into true sedentary animals. This inappropriate posture means that part of the musculoskeletal system not only atrophies, but also causes massive pain due to shortened muscles and malfunctioning joints and ligaments. This leads to people experiencing more and more pain and therefore moving less and less. This creates a vicious circle from which it is difficult to escape without professional help.

What role do modern and evidence-based training therapies play in the pain therapy treatment of pain patients with muscular problems?

Effective therapies, such as FPZ therapy, have the great advantage that patients with musculoskeletal pain are treated very specifically and receive intensive training therapy tailored to their needs. And at an intensity that is not possible or available in the standard care provided by statutory health insurance physicians. Therapies that also rely on a careful initial analysis at the start of treatment allow the doctor and therapist to specifically address the patient's deficits. This leads to very good results, which can also be seen in the final or initial analysis of the premium therapies.

What other measures do you use in combination with these premium therapies?

As pain physicians, we always have to assess the extent to which patients are chronified. For people who are not yet very chronic, it is crucial that they find a training concept that is acceptable and effective for them and that works in the long term. For chronic patients with additional factors such as stress and depression, for example, the back muscles act like a vacuum cleaner for psychological trauma. We then rely on accompanying measures such as behavioral therapy, biofeedback, acupuncture, electrostimulation or post-isometric relaxation techniques as part of multimodal pain therapy. However, active training is also a decisive factor for this patient group. The aim of pain therapy is to put patients in a state in which they can actively exercise again, participate in life and take control of their own destiny.

In order to appeal to a broader patient target group and enable even more people to live a pain-free life, digital services are increasingly entering the healthcare market. Online prevention courses and mobile apps are very popular. What do you think of this trend?

A thorough physical examination of pain patients and a detailed assessment of their medical history is and remains the basis of any therapy. However, it is crucial for the long-term success of therapy that patients learn to take responsibility for their own health. This is where apps and platforms can make a very good contribution. In addition to a targeted exercise program that can be completed flexibly in terms of time, exercisers receive expert help with questions and problems. Some mobile apps also offer the additional advantage that sensors can be used to indicate problems at an early stage and appropriate exercises and measures can be recommended in a targeted manner.

However, some critics believe that digital prevention and/or supplementary courses would neglect the personal relationship between doctor or therapist and patient. How do you respond to this?

I don't see it that way. In my opinion, the modern and reputable offers all provide good communication options with the accompanying specialists, for example by email, telephone, chat and community. In any case, I can only strongly advise a pain patient against using untested lay courses from large video platforms or social media profiles for their own health care. From an expert's point of view, this often leads to a worsening of the (pain) situation and thus significantly increases the risk of chronification.