Manual Medicine

Chronic pain is not limited to areas of the body that are physically damaged, such as the spine or joints. The pain system often takes on a life of its own. This is because repeated pain stimuli can cause certain nerve cells in the spinal cord to react with increasing sensitivity. As a result, the pain becomes more severe than the actual damage and even spreads to other areas.

The wide dynamic range (WDR) neuron plays an important role in this. You can think of it as a control centre: it collects incoming pain signals and further processes them. If this control centre is activated repeatedly, its stimulus threshold drops, meaning it reacts more quickly and strongly.

This sets in motion an upward spiral where what begins as localised pain develops into a hypersensitive pain system, which intensifies and spreads the symptoms. This is what experts refer to as the “wind-up phenomenon”.

New method to calm the pain centre

In the Manual Medicine department, we are tackling this exact point with a new method. Using ultrasound-guided injections with a local anaesthetic, we temporarily switch off entire blocks with overactive pain signals. Although this technique originated in anaesthesia, we do not use it as anaesthesia for surgery, but specifically for therapeutic purposes to interrupt overactive pain signals.

The aim is to calm the “control centre” in the spinal cord. If the permanent transmission of stimuli is stopped for a certain time, the pain system can regulate itself again. The pain spiral is interrupted, turning “wind-up” into “wind-down”. This means that the treatment not only works while the drug is present in the body, but beyond that. 

For many patients, this means lasting pain relief – often even in cases where previous treatments have not helped. At the same time this method offers an alternative to cortisone and expands the treatment options for chronic pain.