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SIP 2017 - Presentation & Statement

Prof. Thomas R. Tölle – Technische Universität München, Germany

"Chronic pain should be regarded as a disease in its own right."

Prof. Thomas R. Tölle
Center for Interdisciplinary Pain Medicine „am Klinikum rechts der Isar“
Technische Universität München

Pain: a disease in its own right

Pain is an elementary and universal symptom of almost all diseases that can affect mankind.
In 2001, the European Pain Federation (EFIC) declared: “Acute pain, such as that following surgery, constitutes a signal to a conscious brain about the presence of noxious stimuli and/or ongoing tissue damage..., and (this) is reasonably classified as a symptom of underlying tissue damage or disease. However, in many patients pain persists long after its usefulness as an alarm signal has passed, and indeed, often long after the tissue damage has healed. Chronic pain in these patients is probably not directly related to their initial injury or disease condition, but rather to the secondary changes including ones that occur in the pain detection system”.

Regardless of the medical views on the bio-psycho-social backgrounds of chronic pain in the current literature, and having in mind that pain is a horizontal problem affecting all medical disciplines, for the purpose of policy-, budget- and resource allocation chronic pain should be regarded as a disease in its own right. While acute pain by definition is a brief and selflimiting process, chronic pain comes to dominate the life of the patients concerned with it and often also family, friends and caregivers. Chronic and recurrent pain is a specific healthcare problem, leading to typical co-morbidity, such as sleep disturbances, anxiety, depression and low self-esteem and often sets the stage for the emergence of a set of physical and psychosocial changes adding to the individual and societal impact of pain.

In order to meet the challenges caused by the societal impact of pain we will need to implement individualized health care delivery systems. This can be very simple support for some patients, while for other patients it might need an intensive multimodal approach. Although in recent years the topic of pain and pain management has moved into the consciousness of the media and drew more attention from politics, we must forcefully strive for an overall European strategy. Now, with the growing knowledge about the societal impact of pain, the health policy needs to act and address pain prevention and management as a key health policy focus of the EU.

Thomas Tölle is a Professor of Neurology at the Technische Universität München, Germany. He is a neurologist and psychologist by training. He was formerly also appointed as Professor of Medical Psychology and Neurobiology at the Ludwig-Maximilians-University in Munich. He set up an interdisciplinary research group for clinical and experimental research into pain, focusing primarily on the neurobiological mechanisms of neuronal plasticity, pharmacological treatment and central imaging with fMRI and PET. His research and clinical interests also include the prevention and treatment of chronic neuropathic pain and he is spokesman and runs the headoffice of the German Research Network for Neuropathic Pain (DFNS). Prof. Tölle has authored many peer reviewed publications and lectures on many aspects of pain medicine all over the world, served as the president of the German IASP chapter and will chair the scientific program committee for the EFIC European Pain Congress in 2017 in Copenhagen.