Skip to main content

Epidemiologie von nicht tumorbedingten chronischen Schmerzen in Deutschland

Epidemiology of chronic non-malignant pain in Germany

Der Schmerz volume 25, pages 26–44 (2011)Cite this article

Zusammenfassung

Hintergrund

Obwohl verbreitet, liegen Angaben zu epidemiologischen Aspekten chronischer Schmerzen nur eingeschränkt vor. Ziel der Arbeit ist es, Informationen zu nicht tumorbedingten chronischen Schmerzen in Deutschland darzustellen.

Methoden

Sieben Datenbanken (1995–2009) und weitere Quellen wurden durchsucht, um relevante Arbeiten zu chronischen Schmerzen (>3 Monate) zu finden. Die Auswahl erfolgte nach Aktualität, Größe, Repräsentativität und Qualität.

Ergebnisse

Die Prävalenz chronischer Schmerz in Deutschland beträgt rund 17% und variiert je nach Ursache. Besonders häufig sind Nacken-, Schulter- und Rückenschmerzen.

Chronische Schmerzen haben einen direkten Einfluss auf Lebensqualität (LQ), Krankheitstage und -kosten.

Viele medikamentöse und nichtmedikamentöse Therapien werden eingesetzt. Die Behandlung ist oft nicht adäquat, 13–51% der Patienten erhalten eine ungenügende Schmerztherapie.

Schlussfolgerung

Chronische Schmerzen sind ein häufiges Problem. Sie nehmen Einfluss auf die LQ der Patienten und verursachen nicht unerhebliche Behandlungskosten. Die Therapie erfolgt oft nicht adäquat. Mehr Forschung ist erforderlich, um vorhandene Wissenslücken zu schließen. Der Transfer von Forschungsergebnissen in die Praxis sollte verstärkt werden.

Abstract

Background

Although chronic pain is a common health problem, epidemiological data are rare. The aim of this study is to present information on chronic, non-malignant pain in Germany.

Methods

In order to identify relevant studies on chronic pain (>3 months) a total of 7 databases were searched in the timeframe from 1995 to 2009. Representative, recent, comprehensive and valid studies were selected.

Results

The prevalence of chronic pain in Germany is estimated to be 17% and varies according to the underlying cause of the disease. Neck, shoulder and back pain are the most common forms. Chronic pain has a direct impact on quality of life (QoL), days off work and costs. A variety of drugs and non-drug treatments are used. However, treatment is often inadequate with 13–51% of the patients receiving insufficient pain therapy.

Conclusions

Chronic pain is a common problem which influences the QoL of patients resulting in high costs for the health system. Treatment is often inadequate. More research is needed to close knowledge gaps. The transfer of research results into clinical practice should be improved.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Abb. 1
Abb. 2
Abb. 3

Notes

  1. Angaben aus dem Statistischen Jahrbuch für 2007: >18 Jahre: n=68.247.754; >14 Jahre: n=71.757.751; >15 Jahre: n=70.936.141; 18–80 Jahre: n=64.301.298; > 40: n=45.717.600; arbeitende Bevölkerung im Alter zwischen 40–54: n=15.794.000; 51% weiblich.

  2. Nicht ausschließlich zu chronischen Schmerzen. Einzige Studien mit bevölkerungsbezogenen Angaben zu Schulter- und Nackenschmerzen. Wird durch Komarahadi et al. [15] verwendet.

  3. Keine Studie repräsentativ für die Gesamtbevölkerung, jedoch Angaben zum Anteil von Patienten mit neuropathischen chronischen Schmerzen und Hochrechnung auf Daten des Bundesgesundheitssurveys [14].

  4. Als Berechnungsgrundlage für die Hochrechnung zur Schätzung der Prävalenz der diabetischen Neuropathie in der Gesamtbevölkerung verwendet.

  5. Keine Angaben zur Gesamtbevölkerung. Enthält Angaben zu verschiedenen Schmerzdiagnosen.

Abbreviations

ANOVA:

„analysis of variance”

BIP:

Bruttoinlandsprodukt

BMI:

Body-Mass-Index

CDSR:

Cochrane Database of Systematic Reviews

CENTRAL:

Cochrane Central Register of Controlled Trials

CRD:

Centre for Reviews and Dissemination

CS:

Chronifizierungsstadium

DARE:

Database of Abstracts of Reviews of Effects

DT:

Duncan-Test

EMBASE:

Excerpta Medica Database

EU NHWS:

EU National Health and Wellness Survey

GBPRN:

German Back Pain Research Network

GEK:

Gmünder Ersatzkasse

GIN:

Guidelines International Network

HTA:

Health Technology Assessment

ICD:

International Statistical Classification of Diseases and Related Health Problems

IMS:

Intercontinental Marketing Services

KI:

Konfidenzintervall

LFESSQ:

London Fibromyalgia Epidemiology Study Screening Questionnaire

m:

männlich

MEDLINE:

Medical Literature Analysis and Retrieval System Online

min:

Minute

MNSI:

Michigan Neuropathic Screening Instrument

MPSS:

Mainz Pain Staging System

MW:

Mittelwert

n:

Anzahl

NRS:

numerische Ratingskala

Ovid:

Ovid Technologies, Inc.

p:

„probability“ (Wahrscheinlichkeit)

RKI:

Robert-Koch-Institut

S.:

Schmerz(en)

SD:

„standard deviation“ (Standardabweichung)

SE:

„standard error“ (Standardfehler)

SF:

Short Form Health Survey

TENS:

transkutane elektrische Nervenstimulation

VA:

ANOVA (s.o.)

VAS:

visuelle Analogskala

w:

weiblich

WHO:

World Health Organisation (Weltgesundheitsorganisation)

Literatur

  1. Breivik H, Collett B, Ventafridda V et al (2006) Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain 10(4):287–333

    Article  PubMed  Google Scholar 

  2. NICE (2008) Do Once and Share: Pain Assessment. URL: http://www.library.nhs.uk/palliativeSearchResults.aspx?tabID=289&optID=66&pgIndex=1&. National Institute for Health and clinical Excellence. http://www.library.nhs.uk/palliativeViewResource.aspx?resID=280345&tabID=289 (letzter Zugriff 20.09.2008)

  3. von Altmann EE, Egger DG, Pocock M et al (2008) The Strengthening of the Reporting of Observational Studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol 61(4):344–349

    Article  Google Scholar 

  4. Centre for Reviews and Dissemination (2008) Systematic Reviews. CRD’s guidance for undertaking reviews in health care. Centre for Reviews and Dissemination, University of York

  5. Bellach B-M, Ellert U, Radoschewski M (2000) Epidemiologie des Schmerzes – Ergebnisse des Bundes-Gesundheitssurveys 1998. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 43:424–431

    Article  Google Scholar 

  6. Berger A, Toelle T, Sadosky A et al (2009) Clinical and economic characteristics of patients with painful neuropathic disorders in Germany. Pain Pract 9(1):8–17

    Article  PubMed  Google Scholar 

  7. Beutel ME, Weidner W, Brahler E (2004) Chronic pelvic pain and its comorbidity. Urologe A 43(3):261–267

    Article  CAS  PubMed  Google Scholar 

  8. Branco JC, Bannwarth B, Failde I et al (2010) Prevalence of fibromyalgia: A survey in five European countries. Semin Arthritis Rheum 39:448–453

    Article  PubMed  Google Scholar 

  9. Chrubasik S, Junck H, Zappe HA, Stutzke O (1998) A survey on pain complaints and health care utilization in a German population sample. Eur J Anaesthesiol 15(4):397–408

    CAS  PubMed  Google Scholar 

  10. Freynhagen R, Baron R, Tolle T et al (2006) Screening of neuropathic pain components in patients with chronic back pain associated with nerve root compression: a prospective observational pilot study (MIPORT). Curr Med Res Opin 22(3):529–537

    Article  PubMed  Google Scholar 

  11. Hauser W, Schmutzer G, Glaesmer H, Brahler E (2009) Prevalence and predictors of pain in several body regions. Results of a representative German population survey. Schmerz 23(5):461–470

    Article  CAS  PubMed  Google Scholar 

  12. Heidemann C, Kroll L, Icks A et al (2009) Prevalence of known diabetes in German adults aged 25–69 years: results from national health surveys over 15 years. Diabet Med 26(6):655–658

    Article  CAS  PubMed  Google Scholar 

  13. Kern U, Busch V, Rockland M et al (2009) Prevalence and risk factors of phantom limb pain and phantom limb sensations in Germany. A nationwide field survey. Schmerz 23(5):479–488

    Article  CAS  PubMed  Google Scholar 

  14. Kohler M, Ziese T (2004) Telefonischer Gesundheitssurvey des Robert Koch-Instituts zu chronischen Krankheiten und ihren Bedingungen. Robert Koch-Institut, Berlin

  15. Komarahadi F, Baumeister H, Maurischat C, Harter M (2006) Distribution of pain parameters for chronic pain patients in comparison to the general population. Schmerz 20(2):108–118

    Article  CAS  PubMed  Google Scholar 

  16. Neuhauser H, Ellert U, Ziese T (2005) Chronic back pain in the general population in Germany 2002/2003: prevalence and highly affected population groups. Gesundheitswesen 67(10):685–693

    Article  CAS  PubMed  Google Scholar 

  17. Nickel R, Egle UT, Schwab R (2002) Diagnostic subgroups and psychosocial characteristics in chronic non-malignant pain patients referred to an out-patient pain center. Psychother Psychosom Med Psychol 52(9–10):378–385

    Google Scholar 

  18. Raspe A, Matthis C, Heon-Klin V, Raspe H (2003) Chronic back pain: more than pain in the back. Findings of a regional survey among insurees of a workers pension insurance fund. Rehabilitation 42(4):195–203

    Article  CAS  PubMed  Google Scholar 

  19. Schneider S, Schmitt G, Mau H et al (2005) Prevalence and correlates of osteoarthritis in the FRG. Orthopäde 34:782–790

    Article  CAS  PubMed  Google Scholar 

  20. Schneider S, Schmitt G, Richter W (2006) Prevalence and correlates of inflammatory arthritis in Germany: data from the first national health survey. Rheumatol Int 27(1):29–38

    Article  CAS  PubMed  Google Scholar 

  21. Thiem U, Schumacher J, Zacher J et al (2008) Prevalence of musculoskeletal complaints and self-reported joint osteoarthritis in the population of Herne: a telephone survey. Z Rheumatol 67(5):432–439

    CAS  PubMed  Google Scholar 

  22. Ziegler D, Rathmann W, Dickhaus T et al (2009) Neuropathic pain in diabetes, prediabetes and normal glucose tolerance: The MONICA/KORA Augsburg surveys S2 and S3. Pain Med 10(2):393–400

    Article  PubMed  Google Scholar 

  23. Consumer Health Sciences (2009) The Pain Market: EU Big 5 Core Therapeutic Report; National Health and Wellness Survey 2008. Princeton, NJ

  24. Bauknecht M, Braun B, Müller R (2009) GEK-Bandscheiben-Report – Vorsorgungsforschung mit GEK-Routinedaten. Schwäbisch Gmünd

  25. Latza U, Pfahlberg A, Gefeller O (2002) Impact of repetitive manual materials handling and psychosocial work factors on the future prevalence of chronic low-back pain among construction workers. Scand J Work Environ Health 28(5):314–323

    PubMed  Google Scholar 

  26. Neubauer E, Pirron P, Junge A et al (2005) What questions are appropriate for predicting the risk of chronic disease in patients suffering from acute low back pain?. Z Orthop Ihre Grenzgeb 143(3):299–301

    Article  CAS  PubMed  Google Scholar 

  27. Meister W, Neiss A, Gross G et al (1998) Demography, symptomatology, and course of disease in ambulatory zoster patients. A physician-based survey in Germany. Intervirology 41(6):272–277

    Article  CAS  PubMed  Google Scholar 

  28. Becker A, Seitz R, Jacobi E, Leidl R (2001) Cost evaluation by a patient questionnaire: pilot study of a weekly cost diary. Rehabilitation 40(1):12–20

    Article  CAS  PubMed  Google Scholar 

  29. Bolten W, Kempel-Waibel A, Pforringer W (1998) Analysis of the cost of illness in backache. Med Klin 93(6):388–393

    Article  CAS  Google Scholar 

  30. Frettloh J, Maier C, Gockel H, Huppe M (2003) Validation of the German Mainz pain staging system in different pain syndromes. Schmerz 17(4):240–251

    Article  CAS  PubMed  Google Scholar 

  31. Gerbershagen HU, Lindena G, Korb J, Kramer S (2002) Health-related quality of life in patients with chronic pain. Schmerz 16(4):271–284

    Article  CAS  PubMed  Google Scholar 

  32. Grobe TG, Dörning H, Schwartz FW (2010) Barmer GEK Arztreport. Report No.: Band 1

  33. Hampel P, Moergel MF (2009) Staging of pain in patients with chronic low back pain in inpatient rehabilitation: Validity of the Mainz pain staging system of pain chronification. Schmerz 23(2):154–165

    Article  CAS  PubMed  Google Scholar 

  34. Michalski D, Hinz A (2006) Severity of chronic back pain: Assessment with the Mainz pain staging system. Schmerz 20:198–209

    Article  CAS  PubMed  Google Scholar 

  35. Pfingsten M, Schops P, Wille T et al (2000) Classification of chronic pain. Quantification and grading with the Mainz pain staging system. Schmerz 14(1):10–17

    Article  CAS  PubMed  Google Scholar 

  36. Schmidt CO, Schweikert B, Wenig CM et al (2009) Modelling the prevalence and cost of back pain with neuropathic components in the general population. Eur J Pain 13(10):1030–1035

    Article  PubMed  Google Scholar 

  37. Wenig CM, Schmidt CO, Kohlmann T, Schweikert B (2009) Costs of back pain in Germany. Eur J Pain 13(3):280–286

    Article  PubMed  Google Scholar 

  38. Schulte E, Hermann K, Berghofer A et al (2010) Referral practices in patients suffering from non-malignant chronic pain. Eur J Pain 14(3):308–308

    Article  PubMed  Google Scholar 

  39. Basler HD, Hesselbarth S, Kaluza G et al (2003) Comorbidity, multiple medication, and well-being in elderly patients with chronic pain. Schmerz 17(4):252–260

    Article  CAS  PubMed  Google Scholar 

  40. Frießem CH, Willweber-Strumpf A, Zenz MW (2009) Chronic pain in primary care. German figures from 1991 and 2006. BMC Public Health 9:299

    Article  PubMed  Google Scholar 

  41. Becker A, Breyer R, Kolling W et al (2007) Low back pain in practice: What do general practitioners do and what orthopaedists? Z Allgemeinmed 83(2):44–50

    Article  Google Scholar 

  42. Lang E, Eisele R, Bickel A et al (1999) Structure quality in outpatient care of chronic pain patients. Schmerz 13(2):102–112

    Article  CAS  PubMed  Google Scholar 

  43. Renker EK, Schluter J, Neubauer E, Schiltenwolf M (2009) Therapy of patients with chronic back pain. Prescriptions-contentment-outcome. Schmerz 23(3):284–291

    PubMed  Google Scholar 

  44. Lang E, Katalinic A, Sittl R et al (1997) Outpatient management of chronic pain in Middle Franconia. Schmerz 11(2):101–107

    Article  CAS  PubMed  Google Scholar 

  45. Maier C, Schaub C, Willweber-Strumpf A, Zenz M (2005) Long-term efficiency of opioid medication in patients with chronic non-cancer-associated pain. Results of a survey 5 years after onset of medical treatment. Schmerz 19:410–417

    Article  CAS  PubMed  Google Scholar 

  46. Junker U, Sarnow E, Leverkus F (2008) Treatment of patients with chronic pain due to degenerative or inflammatory joint disorders with tilidine/naloxone sustained release tablets after insufficient analgesic pretreatment. Med Welt 59(1–2):42

    Google Scholar 

  47. Häuser W, Grulke N, Michalski D et al (2009) Intensity of limb pain and fatigue in fibromyalgia syndrome, depressive disorders and chronic back pain. A criterion for differentiation. Schmerz 23(3):267–274

    Article  PubMed  Google Scholar 

Download references

Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehung hin: Die vorliegende Arbeit wurde durch die Grünenthal GmbH in Auftrag gegeben und finanziert. Grünenthal wurde die Möglichkeit gegeben, den Entwurf dieser Arbeit zu kommentieren, wobei die Autoren volle Freiheiten bezüglich Inhalt und Ausgestaltung der Publikation hatten.

Author information

Authors and Affiliations

  1. Kleijnen Systematic Reviews Ltd, Unit 6, Escrick Business Park, Riccall Road, Escrick, YO19 6FD, York, UK

    R. Wolff & J. Kleijnen MD, PhD

  2. Researcher in Systematic Reviews, Berlin, Deutschland

    C. Clar

  3. Researcher in Systematic Reviews, Hannover, Deutschland

    C. Lerch

  4. Care and Public Health Research Institute (CAPHRI), Universität Maastricht, Maastricht, Niederlande

    J. Kleijnen MD, PhD

Authors
  1. R. Wolff
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. Clar
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. Lerch
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. Kleijnen MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. Kleijnen MD, PhD.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Wolff, R., Clar, C., Lerch, C. et al. Epidemiologie von nicht tumorbedingten chronischen Schmerzen in Deutschland. Schmerz 25, 26–44 (2011). https://doi.org/10.1007/s00482-010-1011-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00482-010-1011-2

Schlüsselwörter

  • Schmerz
  • Chronische Erkrankung
  • Epidemiologie
  • Prävalenz
  • Inzidenz

Keywords

  • Pain
  • Chronic disease
  • Epidemiology
  • Prevalence
  • Incidence