Early Risk Diagnosis to Prevent Chronic Pain: Challenges in personalized prevention and therapy

Pia-Maria Wippert, University of Potsdam, Germany

In 2015, approximately 540 million people were affected by an activity-limiting low back pain (LBP) at some point during the year. In Germany alone, around 15 million people are currently affected by chronic pain. Approximately 4 - 5 million of them suffer from particular severe impairments, showing a serious pain career. The timely appearance of pain together with fatigue and depression symptoms additionally provokes a high comorbidity rate and enormous health-care costs. Productivity loss is estimated at 4.3 billion EUR per year in Berlin-Brandenburg, due to 20 days for affected persons of incapacity to work.

There is sufficient evidence that psychosocial risk factors play a significant role in the development of chronic pain after an acute pain event. Therefore, the recommendations of the National Guidelines for the Diagnosis and Treatment of Low Back Pain [NVL], highlight the necessity of an early identification of such risk constellations and further, a diagnostic tool which enables personalized therapy suggestions and prevention strategies.

Over several years the professorship has been engaged in the development of such early diagnostic tools. Having succeeded in developing a short screening instrument based on a few questions to the patient, we recently developed a screening based on biomarkers. While the latter is still undergoing further validation, the questionnaire is already implemented in personalized patient routines in Germany and tested for a broad transfer in standardized care management routines (e.g. in rehabilitation after-care, or decision making for patient pathways). In addition, the diagnostic tool is being translated for English and French-speaking regions and should also be available for patient routines in 2021. Insurance companies (e.g. German Pension Insurance) show a high interest, hoping to reduce the high costs due to back pain in the future. The contribution will give an overview about current knowledge and research results.