Task Force on Multimodal Pain Treatment Defines Terms for Chronic Pain Care
Dec 14, 2017
The IASP Council in October approved new definitions aimed at clarifying terminology for different multicomponent treatment approaches, following the recommendations of a Presidential Task Force on Multimodal Pain Treatment.
Responding to concerns about potential confusion in the terminology often used to describe approaches to treating chronic pain, the task force unanimously agreed to definitions of the terms “unimodal,” “multimodal,” “multidisciplinary,” and “interdisciplinary.” Clarification was essential, task force members agreed, because the lines had become blurred over the years as pain treatment centers with different types of specialists used the terms interchangeably.
Following are the definitions:
- Unimodal treatment is defined as a single therapeutic intervention directed at a specific pain mechanism or pain diagnosis. For example: the application of exercise treatment by a physiotherapist.
- Multimodal treatment is defined as the concurrent use of separate therapeutic interventions with different mechanisms of action within one discipline aimed at different pain mechanisms. For example: the use of pregabalin and opioids for pain control by a physician; the use of NSAID and orthosis for pain control by a physician.
- Multidisciplinary treatment is defined as multimodal treatment provided by practitioners from different disciplines. For example: the prescription of an anti-depressant by a physician alongside exercise treatment from a physiotherapist, and cognitive behavioral treatment by a psychologist, all the professions working separately with their own therapeutic aim for the patient and not necessarily communicating with each other.
- Interdisciplinary treatment is defined as multimodal treatment provided by a multidisciplinary team collaborating in assessment and treatment using a shared biopsychosocial model and goals. For example: the prescription of an anti-depressant by a physician alongside exercise treatment from a physiotherapist, and cognitive behavioral treatment by a psychologist, all working closely together with regular team meetings (face to face or online), agreement on diagnosis, therapeutic aims and plans for treatment and review.
The international task force consisted of experienced members of multidisciplinary and interdisciplinary pain treatment services and research teams from such backgrounds as pain medicine, orthopedics, physical therapy, anesthesiology, and clinical psychology. Members of the task force, which conducted its work from December 2015 through May 2017, were Michael Nicholas, Takahiro Ushida, Mark Wallace, Amanda Williams, Harriet Wittink, Robert Edwards, and M.R. Rajagopal. Ulrike Kaiser and Kathleen Sluka chaired the group.