The opening of the Centre for Interdisciplinary Pain Medicine at the Herzogin Elisabeth Hospital in Braunschweig (Brunswick) attracted attention for several reasons: a highly specialised additional facility was set up here in the Clinic for Anaesthesiology and Intensive Care, which took medical care to a new level beyond just the area of southeastern Lower Saxony. In addition, Professor Dr med. Christoph Wiese, a renowned expert in pain medicine, was appointed as its director.
The organisation is known as the ZIS-HEH in Braunschweig: the Centre for Interdisciplinary Pain Medicine at the Herzogin Elisabeth Hospital. As the city's leading healthcare location, the hospital, ultra-modern yet well over a hundred years old, features an innovative facility: several pain medicine departments work closely together here to provide patients with chronic pain disorders with optimum and appropriate pain management.
The following aspect alone is particularly pioneering: the new centre focuses on a holistic treatment approach that goes hand in hand with a multi-modal pain treatment concept, which is tailored entirely to the individual needs of each patient.
Closely interlinked: interdisciplinary centre
The Clinic for Anaesthesiology and Intensive Care, the Orthopaedic Clinic and the Physiotherapy Department of the Herzogin Elisabeth Hospital are particularly closely interlinked here and always have the patient's well-being in mind. The expert nursing staff are also always integrated into the processes. Since the intensive communication and cooperation between the departments is entirely focused on the patients, repeat examinations are practically excluded.
For these modern medical and therapeutic approaches, the Centre for Interdisciplinary Pain Medicine has the perfect director: Professor Dr med. Christoph Wiese, Head Physician at the Clinic for Anaesthesiology and Intensive Care of the Herzogin Elisabeth Hospital since 2015, focuses on the field of pain medicine and is regarded as an absolute expert in this field. The consultant in anaesthesiology, Master of Health and Business Administration (MHBA), who, in 2016, was also appointed supernumerary professor at the University of Regensburg, has undergone training in a wide range of fields.
Many additional qualifications: special pain medicine and more
This makes it possible for him to focus on the right aspect in each case because he has several additional qualifications. These include emergency medicine and palliative medicine, as well as special intensive care and psychosomatic basic care. In addition, Professor Wiese also holds the qualification of Chief Emergency Physician and ERC ALS Instructor. And of course: he is a consultant in the field of special pain medicine.
As director, Professor Dr med. Christoph Wiese relies on the combined expertise of his dedicated team, who always have the outpatient and inpatient treatment goals at ZIS-HEH in view. As such, it is important to consider what multi-modal holistic pain therapy is all about: the primary goal here is not freedom from pain. It is, above all, a question of recognising the possibilities for having a positive influence on pain and of developing concepts to ascertain how patients can continue going about their everyday lives taking with them the positive gains achieved together.
Holistic treatment approach
This means that the individual multi-modal pain therapy concepts at the Centre for Interdisciplinary Pain Medicine not only take physical conditions and problems into account in the holistic treatment approach. At the ultra-modern facility in Braunschweig, consideration is also given to feelings and all social aspects are incorporated. This sounds complex, and it is. However, it is the only way to explain the successes with which ZIS-HEH repeatedly builds upon its reputation. After all, there are many different aspects that contribute to a pain disorder.
In order to cover the entire spectrum of pain medicine at the highest level, the Centre for Interdisciplinary Pain Medicine essentially divides pain therapy into four pillars. The first pillar is acute pain therapy: following an operation at the HEH, all patients receive individualised pain therapy which first alleviates the pain and then contributes to the fastest possible restoration of function. The treatment of any pain starts during the operation stage. As early as at this stage, patients are given painkillers at the hospital which remain effective after the operation. Pain intensity is measured in the recovery room using the NRS scale and treated right away. On the ward, treatment is continued according to standardised schemes in consultation with ward doctors, nurses and patients. Whether drug therapy standards, patient-controlled procedures such as "pain pumps" or "pain catheters", i.e. local anaesthetic procedures, are now used in acute pain treatment depends on several factors.
The second pillar of pain therapy is the pain consultation service, which focuses on specific questions related to pain medicine. Professor Dr med. Christoph Wiese and his team find the best individual pain treatment and the best medication to reduce pain as much as possible, as always in close cooperation with the relevant departments. And, at the pain outpatient department, the third pillar, there is the rare opportunity at the hospital in Braunschweig to receive pain-related medical advice and holistic treatment. After prior consultation, a possible multi-modal pain treatment programme is determined.
For Professor Wiese, the patient themselves is the most important component of the treatment. Therefore, he always takes the time to understand the personal wishes of his patients and, together with other consultants, to design the pain treatment plan as individually as possible.
As an experienced pain physician, Professor Dr med. Christoph Wiese has an excellent understanding of the many treatment techniques of holistic pain medicine. Whether dynamic deep muscle stimulation, intervention techniques (e.g. PDA, facet joint infiltration, ISG infiltration, GLOA to the superior cervical ganglion, GLOA to the stellate ganglion, singular nerve blocks, special nerve catheters) and infusion therapies (e.g. NMDA receptor blocking, special infusions against nerve pain) or even hypnotherapy and homeopathic-based case histories and therapies, Professor Wiese always strives to identify the optimal individual treatment plan. The applied therapy may also include Korean hand acupuncture, traditional body acupuncture, skull acupuncture, magnetic field therapy, mycotherapy (so-called biological response modifiers), complementary therapies, ultrasound therapy, extracorporeal shock wave therapy (ESWT), trigger point shock wave therapy (TrSWT), specially developed local infiltration procedures (TLIA) and transcutaneous electrical nerve stimulation.
Physio, psychology, occupational therapy, nursing: interdisciplinary team
In acute pain, clear physical causes can usually be identified. In the case of a chronic pain disorder, the situation is completely different and that is why the fourth pillar of pain therapy is often used here: in outpatient and inpatient multi-modal pain therapy (IMST, MMST), in which emotions and social structures play a role in addition to physical problems, the entire interdisciplinary team is called upon. Following initial pain therapy and psychological assessments, doctors, nurses, physiotherapists, occupational therapists and psychologists with special training discuss which treatment best corresponds to the individual requirements.
To ensure that multi-modal pain therapy can be carried out in all its aspects, Professor Wiese estimates an inpatient stay of just over three weeks. During this phase of multi-modal inpatient pain therapy (MMST), the well-designed therapy plan is implemented. Professor Wiese believes that this treatment can only be successful if the patients actively cooperate. In addition, it is absolutely necessary to continue the treatment concept after the patient is discharged.
Positive: patients actively cooperate
The level of willingness of patients who entrust themselves to the care of the Centre for Interdisciplinary Pain Medicine at the Herzogin Elisabeth Hospital to cooperate is high. As soon as people realise that, in addition to aspects of pain relief and the optimisation of pain medication, it is also about changing the pain experience and perception of pain, improving the individual's way of dealing with their pain condition and activating their own healing powers, things become clear: what happens here can lead to a huge increase in quality of life and physical performance on a permanent basis. It can mean a return to everyday life and work and thus promote participation in social life. However, the remit of the Centre for Interdisciplinary Pain Medicine at the traditional hospital in Braunschweig goes even further than this.
For Professor Dr med. Christoph Wiese, it is important that he and his team are constantly improving, in other words, that he intensively engages in research and promotes training. As part of Professor Wiese's teaching and research activities, he also works with the Regensburg University Hospital. The chief physician also sees the establishment of uniform standards as an important task in order to maintain and even build upon on the high standard of treatment in the long term.