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Considering the frequency and importance of chronic pain conditions, the suffering associated with it, and the somatic, mental, and social (especially occupational) impairments, all new preventive and therapeutic approaches that have a chance of success, as well as Internet methods for documentation and treatment, are welcome.

A point of criticism of the work by Lin et al. (1) is that a pain therapy with a rational and serious foundation requires an adequate diagnostics. Further, and especially for ongoing cases, pain therapy should not be used as a stand-alone treatment, as described for ACTonPain in the article summary, but always only as a component within the patient-therapist relationship.

Patients with chronic pain often have very complex problems requiring instrumentally and ethically differentiated measures and recurring examinations, and—last but not least—pain management and ethical competence (2).

It should also be emphasized that distinct types of chronic pain have to be treated very differently. For example, cluster headaches with a chronic course are treated in a completely different way than trigeminal neuralgia or myoarthropathies of the masticatory system with facial pain. A panacea is not in sight.

DOI: 10.3238/arztebl.2018.0208a

PD Dr. med. Roland Wörz

Bad Schönborn, Germany

woerz.roland@t-online.de

Conflict of interest statement

The author declares that no conflict of interest exists.

1.
Lin J, Paganini S, Sander L, Lüking M, Ebert DD, Buhrman M, Andersson G, Baumeister H: An Internet-based intervention for chronic pain—a three-arm randomized controlled study of the effectiveness of guided and unguided acceptance and commitment therapy. Dtsch Arztebl Int 2017; 114: 681–8 VOLLTEXT
2.
Wörz R: Schmerz und Ethik. Remscheid: Rediroma-Verlag 2016.
1.Lin J, Paganini S, Sander L, Lüking M, Ebert DD, Buhrman M, Andersson G, Baumeister H: An Internet-based intervention for chronic pain—a three-arm randomized controlled study of the effectiveness of guided and unguided acceptance and commitment therapy. Dtsch Arztebl Int 2017; 114: 681–8 VOLLTEXT
2.Wörz R: Schmerz und Ethik. Remscheid: Rediroma-Verlag 2016.

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