Multicausal pain therapy is a combined treatment concept in which the organism is viewed as a unit. And is always used when conventional, classic treatment methods fail, or when the person affected is resistant to therapy, or is suspected from a therapeutic perspective.

Multicausal means “caused by many factors” or “chronic pain conditions caused or triggered by many different causes.

If you consider that medicine always speaks of a body unit (organism), then it makes sense to identify this organism as a multi-causal cause, to create a treatment concept and to implement it using all possible means.

In plain language, the person affected must be open to new ways and approaches and trust the therapy, especially when existing diagnoses and their causes suddenly fade into the background.

Depending on the pain conditions and holistic medical history. Here are some choices:

• Osteopathy (cranial, visceral, parietal, myofacial)
• Manipulative techniques (manual), as well as drop techniques, activator techniques
• Shock wave therapy
• PPT (thermotherapy/myofascial)
• Simultaneous therapy
• HRV (Stress and Emotional Test)
• Alternatively medical laboratory tests in Germany – (hair, saliva, dried blood, stool examination for microbiome if necessary!)
• Orthomolecular medicine / nutritional medicine
• Hydro-colon therapy
• Elimination/detoxification
• and much more.

We would like to use an example to describe how far the approaches of multi-causal pain therapy go. So that other therapists can understand what lies behind multi-causal pain therapy, we also briefly describe anatomical connections.

Example

Chronic pain patient. Female, 46 years old, with left shoulder pain, radicular arm pain radiating into the biceps (raducular means nerve root-related), tingling in the finger and wrist pain. Cervical spine pain with visual findings (X-ray / MRI DG. Compression syndrome in segment C 5 -6), operation one and a half  years ago in cervical spine segment C 5 -6, ventral surgical incision with cage (cage – vertebral body replacement made of titanium) in the mentioned segment. After surgery, there was initially significant improvement in biceps pain.

Shoulder pain / cervical spine pain only slightly improved. Continued physical therapy with no improvement in postoperative symptoms. Finger tingling continues unchanged, wrist pain unchanged. Therefore, another operation, after ENG (electroneurography (ENG), the conductivity of the nerves (NLG) is examined and assessed in polyneuropathies or intervertebral disc herniations). DG. CTS (carpal tunnel syndrome – (caused by a narrowing of the median nerve in the middle arm). After two operations – only occasional little finger pain and tingling. The other fingers are only a little numb in the area of the fingertips, the wrist pain has disappeared. However, after about three months of severe elbow pain, as well as a new addition: pain in the upper thoracic spine.

A total of two operations as well as conservative physiotherapy (also private – Bowen / manual forms of therapy and others) were carried out over a period of approx. 3 years. The person concerned is not satisfied with this long period of time and the actual success.

All in all, her problems have improved by approximately 40-45%. Depending on the weather conditions/season and the well-being of those affected.

The affected person contacted us about multi-causal pain therapy.

In the initial conversation, she described her pain conditions and her previous therapy to us and brought all her findings and images with her. She quickly realized that we weren’t really addressing her actual problem of left shoulder/arm pain. Rather, we talked about holistic aspects and her life situation (work and private life) and looked for multi-causal causes that are related to her chronic pain. In addition to the known symptoms, the following abnormalities were very important to us.

– Undersupply of the thyroid gland (hypothyroidism) Nodule formation in the thyroid flaps, which became apparent during the operation of the cage in the segment.

– For about three and a half years, pain in the upper abdomen (stomach region) which was without clinical findings (gastroscopy and others), the pressure pain in the epigastrium increases especially under stress. She also suffers from heartburn. She occasionally suffers from panic attacks. Since her husband separated from her, she has been busy with her two small children and is finding it difficult to cope with the situation.

– At the same time, her menstrual cycle disorders began to occur. Blood counts related Hormones were within limits.

Further procedure for multi-causal pain therapy:

From an anatomical point of view, we saw a connection between the stomach and the esophagus and the cervical spine (segment C 3 -5 phrenic nerve – in addition to the diaphragm innervation, it also works for the stomach and liver capsule, as well as other organs). A connection could also be established, pain in the upper thoracic spine ( TH 6 -9 ) originating from these segments and the sympathetic supply to the stomach.

Due to the mass of the thyroid nodules or the gastric dysfunction, an ascending chain could be established via the esophagus and anterior cervical facia (area of the surgical incision) to the cervithoracic junction. Which, in addition to myofascial causes, could be responsible for the elbow pain.

We treated these findings three times with osteopathic treatment techniques and had partial success after the first one. This was of great importance for further therapy and built trust with the patient, who was initially very skeptical.

As we continued, we wanted to know how high the stress index of those affected was. We therefore carried out an HRV measurement (stress test) to assess the stress index of the autonomic nervous system in order to also obtain information regarding the neurohumural index. (Neurohumeral means “through hormones acting on nerves”).

As expected, all values were not within the normal range, especially the neurohumural index was considered very high. We therefore arranged for a saliva sample. Hormone status (ovaries and adrenal glands) – the blood values for the thyroid were taken by her family doctor, as was the TSH value, which comes from the pituitary gland.

After all reports were presented, it was clear that there was a hormonal axis shift which should be balanced and balanced with orthomolecular medicine / dietary changes and other naturopathic preparations.

In the further course, osteopathic treatments, simultaneous therapy and others were treated in a cycle of three weeks. Furthermore, Omega 3 / Vit. E in high doses (against pain and inflammation), selenium / zinc, copper and thyrosine (armino acid), magnesium, B 6 for hypothyroidism, and enzymes to improve the stomach are used.

The affected person has been being treated with us for 6 months now, and the pain mentioned above has all disappeared thanks to the holistic, multi-causal pain therapy. The affected person is also undergoing orthomolecular therapy with us. She feels significantly more stable in terms of stress through adrenal strengthening, as well as craniosacral therapy and meditation.

The thyroid nodules have reduced by more than 50%.

The cycle disorders and menstrual bleeding are now normal for her age.

At the beginning, the person affected never thought that this was all related to her shoulder/arm pain. We would like to thank you for the trust you have placed in us and will continue to provide support and advice in the future.

Only through trust could this person be helped holistically. Be open to new paths and new treatment approaches. Your body will thank you.

The only thing that disrupts multi-causal pain therapy is the attitude of the person affected towards holistic approaches!!

Interested? Make an appointment today for multi-causal pain therapy.

If you are a therapist yourself and want to stand out from your competition, then take a look at our homepage under Academy. From January 2025, a 12-month compact training course “Specialist therapist for multi-causal pain therapy” will be available to you.

Your NMC team Krk