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[Manual medicine in chronic pain -- evaluation of an inpatient medical concept].

OBJECTIVE
The influence of an inpatient manual medical concept for patients suffering from chronic muscular skeletal pain syndromes on the quality of life and on target parameters of a biopsychological and social concept of pain (VAS, PDI, CES-D) was investigated. Furthermore, it was looked at the predictability of treatment outcome according to the Mainz Pain Stages.


METHOD
211 patients of the Clinic for Manual Medicine were included in the study. Selected parameters such as pain intensity (VAS), pain distribution, disability in daily life (PDI), quality of life (SF-36) and grade of depression (CES-D) were evaluated on admission, discharge and 6 weeks after treatment. The patients were divided into groups according to the Mainz Pain Stages and compared to patients on the hospital waiting list (control group).


RESULTS
The patients were well distributed within the Mainz Pain Stages. It was shown that the manual therapy concept influenced different parameters dependent on the Main Pain Stages.For Stage 1 and 2 the deduction in pain intensity was greatest, while for stage 3 the reduction in disability (PDI) was the most significant outcome.


CONCLUSION
The therapeutic target should depend on the chronicity of the pain syndrome. Early interdisciplinary intervention, especially after increase in pain distribution is necessary to minimize chronicity. The Mainz Pain Stages are useful for the prediction of treatment outcome but still need further investigation for this group of patients.