Paliatívna medicína a liečba bolesti 2e/2025
Multimodal pain management. Integration of algesiological procedures into palliative care
A multimodal approach to the treatment of pain is now an imperative in modern medicine, not a treatment or method of choice. Pain, especially chronic pain, is conceptualized in a bio-psycho-social-spiritual framework, and precisely because of this complexity, a unimodal treatment strategy is almost always associated with suboptimal pain control. The following article provides an insight into the issue of implementing a multimodal model of pain treatment in patients with oncological disease (cancer pain) and in non-oncological patients (non-cancer pain), with various diseases: chronic heart failure, COPD, interstitial lung diseases, neurodegenerative diseases (e.g. ALS, Parkinson’s disease, MS), dementia, renal or hepatic insufficiency. The multimodal approach to the treatment of pain is becoming part of internationally valid recommended procedures in the treatment of pain (IASP, EFIC) and consists of several pillars: pharmacological and non-pharmacological procedures, interventional algesiology procedures. psychological and spiritual support, education, rehabilitation, as well as complementary or alternative medicine procedures. As in pain medicine, so in palliative medicine, optimal results in pain treatment are achieved by an individualized and dynamically titrated multimodal treatment strategy that affects all dimensions of pain, respects the psychological and social determinants of the individual, and takes into account the spiritual needs of patients and their family, not only in the context of their diagnosis, but also in the context of their fragility.
Keywords: palliative medicine, pain medicine, pain treatment, multimodal pain treatment, interdisciplinary care, palliative care
