Zusammenfassung
Der Umgang mit medizinisch ungeklärten Symptomen gehört zum Alltag der ärztlichen
Tätigkeit. Besonders schwierig sind chronische Schmerzen einzuordnen und zu behandeln,
die in der Diagnostik keine ausreichende Erklärung für die Ursache der Schmerzen bieten.
Diese Übersicht fasst die aktuelle Literatur zur Entstehung medizinisch ungeklärte
Symptome mit Schmerzen, der Aufrechterhaltung der Beschwerden und der möglichen Behandlungsoptionen
zusammen. Der Umgang mit dem Schmerz, das Katastrophisieren, Coping oder die Möglichkeit
der Akzeptanz beeinflussen ganz wesentlich die Arbeitsfähigkeit und Alltagstauglichkeit
der Patienten. Das Gelingen ihres Lebens beruht nicht nur auf den körperlichen Aspekten
des Schmerzes. Der Einfluss auf die soziale Rolle, die Wahrnehmung und Wertschätzung
des Selbst ist von höchster Bedeutung und bietet Ansätze zur Therapie.
Abstract
It is part of daily medical practice to encounter unsolved medical symptoms. It is
particularly difficult to deal with and treat chronic pain when there is no sufficient
explanation for its cause. This overview summarises the current knowledge about the
origin of medically unexplained symptoms with pain, chronic complaints and the possible
options for treatment. The ability to work and cope on a daily basis is significantly
influenced by the patient's way of dealing with pain (catastrophising, coping or accepting).
Living with chronic pain touches not only on the physical aspects, but influences
significantly the social role, the perception and value of self, which has to be considered
with regard to possible therapeutic solutions.
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Ludwig Schelosky
Medizinische Klinik, Neurologie und klinische Neurophysiologie, Kantonsspital Münsterlingen,
Spital Thurgau AG
Postfach
8596 Münsterlingen, Schweiz
Email: ludwig.schelosky@stgag.ch