Ein biopsychosoziales Modell zum Beckengürtelschmerz: aktuelle evidenzbasierte Sichtweise

Zusammenfassung

Beckengürtelschmerz wird heute als Oberbegriff für die Patienten stark beeinträchtigende muskuloskelettale Schmerzen der Beckenregion verwendet. In der Mehrzahl der Fälle findet sich kein ursächlicher, klar definierbarer pathologischer Prozess. Die Betrachtung dieser Störungen aus einem biomedizinischen Blickwinkel ist einer der für die schlechten Behandlungsergebnisse bei vielen Patienten mit Beckengürtelschmerzen verantwortlichen Faktoren. Das aktuelle Verständnis von chronischen Schmerzen als multidimensionale biopsychosoziale Störung deckt sich mit der Präsentation von Beckengürtelschmerzen. Biopsychosoziale Faktoren können auf komplexe Top-down-/Bottom-up-Weise mit der Steuerung von Schmerzen und dem Schmerzverhalten interagieren. Eine gründliche Untersuchung auf der Grundlage dieses biopsychosozialen Modells ermöglicht die Diagnose und Klassifizierung der Beckengürtelschmerzen. Der Prozess beeinflusst einen kognitiv-funktionellen Behandlungsansatz, der speziell auf die zugrunde liegenden Mechanismen ausgerichtet ist, die diese Störung aufrechterhalten.

Abstract

Pelvic girdle pain (PGP) is now used as an umbrella term for musculoskeletal disorders in pain in the region of the pelvis and are associated with disability. For the majority of subjects there is no readily identifiable pathological process underlying PGP, and approaching these disorders from a biomedical standpoint is one of the factors that has resulted in poor outcomes for many subjects with PGP. Contemporary understanding of chronic pain as multidimensional biopsychosocial disorders is consistent with how PGP disorders present. Biopsychosocial factors may interact in a complex top-down/bottom-up manner to drive pain and pain behaviours. Thorough assessment based on this biopsychosocial model allows for diagnosis and classification of subjects with PGP disorders. This process will inform a cognitive-functional approach to management that specifically targets the underlying mechanisms driving the disorder.

Schlüsselwörter

Beckengürtelschmerz - Klassifizierung - biopsychosoziales Modell - Schmerzverhalten

Key words

pelvic girdle pain - classification - biopsychosocial model - pain behaviour

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