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Chronische Schmerzen und Dermoneuromodulation (DNM)

Neue klinische Argumentation in der manuellen Therapie

Chronic pain and dermoneuromodulation (DNM)

New clinical argumentation in manual therapy

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Die Dermoneuromodulation (DNM) ist eine neue klinische Argumentation in der manuellen Therapie. Sie hilft bei chronischen Schmerzen durch die Förderung der Fähigkeit des Klienten, seinen Schmerz herunterzuregulieren, um eine stärker integrierte Funktion und Plastizität der Sinnesfunktionen des Gehirns zu fördern. Grundannahmen sind, dass Gewebe und Struktur manualtherapeutisch nicht verändert werden können, ohne sie zu beschädigen. Das Nervensystem ist das zentrale Regulationssystem. Es wird nicht die Anatomie, sondern die Physiologie im biopsychosozialen Kontext behandelt. Ziel der DNM ist es, den peripheren nozizeptiven Input zu verringern, die absteigende Hemmung zu erhöhen und die Selbstwirksamkeit aufzubauen.


Dermoneuromodulation (DNM) is a new clinical argumentation in manual therapy. DNM supports the treatment of chronic pain by promoting the client’s ability to downregulate pain to promote more integrated function and plasticity of the brain’s sensory functions. Basic assumptions are that manual therapeutically, tissue and structure cannot be changed without damaging them. The nervous system is the central regulatory system. Not the anatomy but rather the physiology is treated in a biopsychosocial context. The aim of DNM is to reduce peripheral nociceptive input, to increase decreasing inhibition, and to build self-efficacy.

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  1. Berterame S, Erthal J, Thomas J et al (2016) Use of and barriers to access to opioid analgesics: a worldwide, regional, and national study. Lancet 387:1644–1656.

    Article  PubMed  Google Scholar 

  2. Bishop MD, Torres-Cueco R, Gay CW et al (2015) What effect can manual therapy have on a patient’s pain experience? Pain Manag 5:455–464.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Björnsdotter M, Morrison I, Olausson H (2010) Feeling good: on the role of C fiber mediated touch in interoception. Exp Brain Res 207:149–155.

    Article  PubMed  Google Scholar 

  4. Blickenstaff C (2011) Letter to the editor. J Man Manip Ther 19:238.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Borrell-Carrió F, Suchman AL, Epstein RM (2004) The biopsychosocial model 25 years later: principles, practice, and scientific inquiry. Ann Fam Med 2:576–582.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Butler DS, Moseley GL (2013) Explain pain, 2. Aufl. Noigroup Publication, Adelaide, Australia

    Google Scholar 

  7. Chae Y, Olausson H (2017) The role of touch in acupuncture treatment. Acupunct Med 35:148–152.

    Article  PubMed  Google Scholar 

  8. Corbetta M, Shulman GL (2002) Control of goal-directed and stimulus-driven attention in the brain. Nat Rev Neurosci 3:201–215.

    Article  CAS  PubMed  Google Scholar 

  9. Diener I, Kargela M, Louw A (2016) Listening is therapy: patient interviewing from a pain science perspective. Physiother Theory Pract 32:356–367.

    Article  PubMed  Google Scholar 

  10. Gifford L (1998) Pain, the tissues and the nervous system: a conceptual model. Physiotherapy 84:27–36.

    Article  Google Scholar 

  11. Gliedt JA, Schneider MJ, Evans MW et al (2017) The biopsychosocial model and chiropractic: a commentary with recommendations for the chiropractic profession. Chiropr Man Therap 25:16.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Grundy PF, Roberts CJ (1984) Does unequal leg length cause back pain? A case-control study. Lancet 2:256–258.

    Article  CAS  PubMed  Google Scholar 

  13. Jacobs DF, Silvernail JL (2011) Therapist as operator or interactor? Moving beyond the technique. J Man Manip Ther 19:120–121.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Lederman E (2011) The fall of the postural-structural-biomechanical model in manual and physical therapies: exemplified by lower back pain. J Bodyw Mov Ther 15:131–138.

    Article  PubMed  Google Scholar 

  15. Liljencrantz J, Olausson H (2014) Tactile C fibers and their contributions to pleasant sensations and to tactile allodynia. Front Behav Neurosci 8:37.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Louw A, Zimney K, O’Hotto C, Hilton S (2016) The clinical application of teaching people about pain. Physiother Theory Pract 32:385–395.

    Article  PubMed  Google Scholar 

  17. Lumley MA, Cohen JL, Borszcz GS et al (2011) Pain and emotion: a biopsychosocial review of recent research. J Clin Psychol 67:942–968.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Lundblad LC, Olausson HW, Malmeström C, Wasling HB (2010) Processing in prefrontal cortex underlies tactile direction discrimination: an fMRI study of a patient with a traumatic spinal cord lesion. Neurosci Lett 483:197–200.

    Article  CAS  PubMed  Google Scholar 

  19. Melzack R (1999) From the gate to the neuromatrix. Pain Suppl 6:S121–S126.

    Article  Google Scholar 

  20. Morrison I, Löken LS, Minde J et al (2011) Reduced C‑afferent fibre density affects perceived pleasantness and empathy for touch. Brain 134:1116–1126.

    Article  PubMed  Google Scholar 

  21. Ochsner KN, Silvers JA, Buhle JT (2012) Functional imaging studies of emotion regulation: a synthetic review and evolving model of the cognitive control of emotion. Ann N Y Acad Sci 1251:E1–24.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Olausson H, Wessberg J, Morrison I et al (2010) The neurophysiology of unmyelinated tactile afferents. Neurosci Biobehav Rev 34:185–191.

    Article  PubMed  Google Scholar 

  23. Pope MH, Bevins T, Wilder DG, Frymoyer JW (1985) The relationship between anthropometric, postural, muscular, and mobility characteristics of males ages 18–55. Spine 10:644–648.

    Article  CAS  PubMed  Google Scholar 

  24. Quintner JL, Cohen ML, Buchanan D et al (2008) Pain medicine and its models: helping or hindering? Pain Med 9:824–834.

    Article  PubMed  Google Scholar 

  25. Sauver SJLDOBP, Warner DO, Yawn BP et al (2013) Why patients visit their doctors: assessing the most prevalent conditions in a defined American population. Mayo Clin Proc 88:56–67.

    Article  Google Scholar 

  26. van Tulder MW, Assendelft WJJ, Koes BW, Bouter LM (1997) Spinal radiographic findings and nonspecific low back pain. Spine 22:427–434.

    Article  PubMed  Google Scholar 

  27. Classification of chronic pain, second edition (revised) – IASP. Zugegriffen: 15. Okt. 2019

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Correspondence to Martin Roth.

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M. Roth gibt an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Dieser Beitrag beruht auf einem Vortrag, gehalten auf dem Kongress „Chronische vertebragene Schmerzsyndrome – Multimodalität versus Polypragmasie“ im Juli 2019 in Pörtschach

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Roth, M. Chronische Schmerzen und Dermoneuromodulation (DNM). Manuelle Medizin 58, 39–45 (2020).

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