Exercise therapy at the Baltic Sea, © TMV/H2F

When pain becomes chronic, everyday life becomes a torment for those affected. Not only are they exposed to constant pain stimuli, they often have to live with the incomprehension of friends and acquaintances. This is often a physical and psychological burden, which in the long term can lead to further symptoms of the disease, such as depression.

When pain becomes chronic, everyday life becomes a torment for those affected. Not only are they exposed to constant pain stimuli, they often have to live with the incomprehension of friends and acquaintances. This is often a physical and psychological burden, which in the long term can lead to further symptoms of the disease, such as depression.

Time off is often a blessing for people with chronic pain. During a stay at a health resort in Mecklenburg-Vorpommern, the pain can be alleviated through special therapies and offers in one of the state's renowned clinics. Relaxation exercises and conversations with other sufferers help to regain inner peace.

Natural pain therapies

Whether back pain, fibromyalgia or migraine: Mecklenburg-Vorpommern's natural pharmacy has a selection of effective remedies for pain therapy in the form of mud, brine and Baltic Sea mud. Thalassotherapy and climatotherapy, in which the natural conditions of the Baltic Sea coast unfold their effectiveness, also prove beneficial for numerous indications with chronic pain.

Mud baths

In the field of balneotherapy, mud treatment is one of the established methods of pain therapy for diseases of the locomotor system. Muscle pain and arthrosis can also be treated well with mud. Natural moor peloids (moor dissolved in water) relaxes, among other things, muscles, tendons, ligaments and connective tissue and develops an analgesic, anti-inflammatory and circulation-promoting effect. For the treatment of chronic wear and tear of joints or spine, osteoporosis as well as numerous other clinical pictures there are different, individual offers in Mecklenburg-Vorpommern. These include, depending on the indication, mud baths, packs, mud kneading or mud treading.

Baltic Sea mud

Silt extracted from the bottom of the salty Baltic Sea is an important element of thalassotherapy. As a bath, pack or mask, the processed, mineral-rich healing clay from the bottom of the sea unfolds a deeply penetrating warmth with pain-relieving effects. After all, natural silt stores heat much longer than water and also releases it more evenly. Thus, the comforting warmth of Baltic Sea silt flows through the body, relieving muscular tension and supporting pain therapy for chronic arthritis, fibromyalgia and muscle pain.

Brine baths

In addition to the health-promoting salt water of the Baltic Sea, Mecklenburg-Vorpommern also has several thermal springs. Baths and other treatments with this saline, very pure water pumped from the depths support the healing process for back pain and other indications associated with chronic pain.

Specially prepared brine with a salt content of more than 20 percent also allows for floating baths, also known as floating, which can contribute to deep relaxation and lower individual pain levels as part of pain therapy.

Overcoming chronic pain

Probably everyone suffers from knee pain, headaches or back pain at some point in their lives. However, if the pain persists for a longer period of time or if treatment does not lead to any improvement, sleep disorders, psychological stress and depression can be the result. In Mecklenburg-Vorpommern, specialists help sufferers cope with chronic pain.

Individual pain therapy in Greifswald

While pain centers at hospitals primarily treat acute pain, for example after operations, the SHORT CARE Clinic Greifswald specializes in chronic pain. With its multimodal, individualized pain therapy, the clinic's interdisciplinary care concept also addresses pain patients with advanced chronification. Various modules, including infusions, acupuncture, massage and psychoanalysis/therapy, are used to alleviate pain.

Headache Center North-East

The Headache Center North-East is a joint institution of the Clinic and Polyclinic for Neurology and the Institute for Medical Psychology and Medical Sociology of the University Medical Center Rostock. It deals with chronic or rare head and facial pain. It combines the expertise of neurologists, psychiatrists and psychologists and works closely with radiologists, surgeons, dentists, ophthalmologists and ENT specialists as well as specialists from other departments of the University Medical Center Rostock. A well-founded diagnosis is followed by a pain therapy tailored to the patient's needs. In addition, the Headache Center is also available as a supra-regional contact for physicians in private practice to support the diagnosis of unclear, complex cases.

With the healing power of moor

Moor applications are considered an effective pain therapy for patients with chronic pain such as migraine, back pain or knee pain. In Mecklenburg-Western Pomerania, two peatlands in particular have been used for healing purposes for centuries: from the Conventer lowlands near Bad Doberan and the Mecklenburg-Western Pomerania border valley near Bad Sülze. Locally, modern spa clinics - the Moorbad Bad Doberan and the Medianklinik Bad Sülze - offer mud treatments to pain patients according to an individual therapy plan. In addition, there are various health programs, also in the preventive field.

Interview with Peter Kupatz, MD

Arthroscopy (endoscopy) to treat the meniscus is one of the most frequently performed operations in Germany. The aim of this procedure is to make the knee joint pain-free and able to bear weight again. If possible, an attempt is made to reconstruct the normal anatomical conditions as well as possible. However, even if the pain in the knee persists for a longer period of time, surgery is not necessarily required. In certain cases, therapy without surgery is sufficient.

Is too much surgery being performed in Germany?

"You can't make that sweeping statement," says Peter Kupatz, MD, who runs a practice for orthopedics and sports medicine in Bad Doberan. "You always have to look at which surgery is performed for which condition. In this country, we have a relatively 'high-brow' health care system with many offers, which allows for quick decisions. For example, while in the UK you wait three months for an artificial knee joint, in this country surgery is often possible within two weeks."

Surgery or not?

Opinions differ about the benefits of meniscus surgery, especially among sufferers. Some argue that every meniscus tear requires surgery. Almost as often, it is countered that in many cases of meniscus injury, surgery is not necessary. Dr. Kupatz explains that it depends on the type of injury. "Here you have to differentiate already: Is there an acute tear, for example, in a young adult playing soccer, or is it meniscal degeneration in an older osteoarthritis patient - there are massive differences in surgical indications."

"Certain conditions require a surgical approach," Dr. Kupatz continued. "If there is a clear indication for surgery, various aspects must be considered together. This always includes first the anamnesis, i.e., the description of the complaints, as well as a clinical examination. Finally, appropriate imaging takes place and then - if necessary - a recommendation for or against surgery. The decision must then be made by the patient."

Individual assessment necessary

What is certain is that the method of treatment for a meniscus lesion depends on various influencing factors, which can be evaluated using the "Guideline Meniscus Disease" of the German Society for Orthopedics and Trauma Surgery (DGOU). The choice of therapy depends on the severity of the pain, the age of the patient, and the requirements for the load-bearing capacity of the menisci. Every patient is different. And so the decision for or against surgery must always be made on an individual basis. Dr. Kupatz explains it with the following example: "If we are dealing with clear allocations of complaints, examination findings and imaging, then the answer to the question 'conservative or surgical?' often emerges very precisely.

Two examples for the knee joint:

Dr. Kupatz: 1. A 25-year-old patient complains of persistent pain at the medial joint space of the left knee joint since a twisting trauma during a soccer game two weeks ago. Clinical meniscus tests are clearly positive. MRI shows a basket handle tear of the medial meniscus. Here, surgery (arthroscopy) is primarily indicated.

Dr. Kupatz: 2. A 25-year-old patient has been complaining of pain on the inside of the left knee joint for four weeks. A twisting of the left ankle had occurred 14 days before while playing soccer. There is restriction of knee hyperextension and localized tenderness at the medial joint space and at the insertion of the medial ligament. Of the meniscus tests reviewed, four are negative and two are positive. The radiologist finds a change on MRI that he interprets as a tear of the medial meniscus. Here, surgery is not a priority, as the further course also confirms: The treating orthopedist initially prescribes physiotherapy six times to eliminate the extension defect. The physiotherapist treats a pelvic dysfunction of the sacroiliac joint (sacroiliac joint) on the left as well as a blockage of the left lower ankle joint, which occurred after the soccer trauma and was responsible for the knee complaints. The patient quickly becomes symptom-free - and stays that way."

Before deciding on surgery, alternatives should be carefully considered, as knee operations are definitely risky. This applies to both subsequent impairments to the joint and the risk of infection. Get detailed advice from your treating physician or, if necessary, get an additional opinion (second opinion).

"I'm a fan of second opinions," Kupatz says, "Our healthcare system is so highly specialized today that it's easy to get a second medical opinion. Legislators have also responded to this and paved the way for patients to get a second opinion before certain surgeries at the expense of their public health insurance - that is, without having to pay for them privately."

For rheumatic diseases peat applications can provide relief, © TMV/H2F

Natural Remedies and Therapies from Mecklenburg-Vorpommern

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For Ayurveda doctor Dr. Shetty, yoga on the beach is important for a feeling of well-being - but soccer has also become, © TMV/Mirko Boy

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Pain is an alarm signal from the brain

Keeping muscles and joints fit with exercise

Mecklenburg-Vorpommern offers even more than proven specialists and naturally available remedies for effective pain therapy. For those who suffer from chronic back pain, fibromyalgia, migraine or other chronic pain will find a variety of incentives for active movement in the midst of varied and often natural landscapes. Walks, hikes and bicycle tours not only strengthen muscles and joints. Excursions along the Baltic Sea coast or in the Mecklenburg Lake District provide unforgettable experiences of nature and many new impressions, thus also alleviating the psychological stress of chronic pain.

Dealing with chronic pain

Will it go away again - or is it already chronic pain? This question comes before any pain therapy. The basic distinction as to whether a pain disorder is already present is: while acute pain "only" affects the body, chronic pain in the case of arthrosis, fibromyalgia and co. also affects the psyche and the social environment.

Acute or chronic?

External or internal processes such as injuries or inflammations can trigger acute pain that is temporary, clearly localized and easily treatable. But acute pain can also last longer and turn into chronic pain. In chronic pain, however, the affected area can often be described less specifically. For example, in a disease such as fibromyalgia, the pain repeatedly passes through other regions and affects the muscles as well as the joints or the back. It is not uncommon for chronic pain to be accompanied by side effects such as sleep or anxiety disorders, lack of concentration or listlessness. In addition, the temporal progression of the pain disease intensifies interactions in the entire organism, whereby the sensitivity to pain is increasingly increased or the pain tolerance decreases further and further.

Chronification of pain

Doctors and therapists use the "Gerbershagen classification" to differentiate between acute and chronic pain and to determine the severity of a pain disorder. This scheme contains five axes, each with a further subdivision into three stages.

The first deals with the temporal course, intensity and duration of the pain condition. This is followed by questions about localization and clear classification of the pain, individual behavior in taking medication, type and extent of use of medical help, and family structures and stability of the social environment. This overall view provides specialists with decisive approaches for designing an effective pain therapy.

German Pain Questionnaire

As the largest European professional society in the field of pain, the German Pain Society developed the "German Pain Questionnaire". This supplements the medical findings in preparation of a therapy for chronic pain. Chronic pain is understood as a multidimensional complex and somatic, psychological and social factors are recorded. In addition, the questionnaire also takes into account statements on subjective pain perception, personal lifestyle and dietary habits, stress levels and social environment for a comprehensive analysis of the pain situation.