The optimal combination therapy for chronic pain has to be ajusted individually to the exact combination- diagnosis

To treat complex chronic pain conditions effectively and according to the bio-psycho-social pain model, it is necessary
to accept that in every chronic pain disease we have to face multiple different causes being responsible for this pain.

So - if the "cause-cake" always consists of more pieces of cake than one, the logical consequence is, that the "therapy-cake" should also consist of more pieces than one, in order to get a better overall effect. It makes sense to use different therapeutic modalities according to different affected zones respectively tissues.

The disturbed muscle will react to acupuncture, acupressure, triggerpoint-therapy, shockwave-therapy or triggerpoint-infiltration. The irritated segmental joint will need additional Manual Therapy or local infiltration. But if the nerve root is inflamed and swollen, just special spinalcord-near nerve blockades can heal the inflammation. However, I might additionally use acupuncture in this paindiagnosis to detone the sore muscles and to improve the blood flow in deeper muscle-zones and an WHO-adequate systemic pain medication.