Schmerz最新文献

{"title":"[Recommendations for practitioners managing temporomandibular pain : On the shortcomings of a physician list].","authors":"Jens Christoph Türp, Gerd Antes","doi":"10.1007/s00482-026-00981-2","DOIUrl":"https://doi.org/10.1007/s00482-026-00981-2","url":null,"abstract":"<p><strong>Background: </strong>Temporomandibular disorders (TMDs) affect nearly 4% of the population in Germany. Temporomandibular pain is the main clinical manifestation and requires guideline-based diagnosis and management. The Stern Physician List 2026 is intended to help patients identify qualified healthcare providers. This study examined whether orthodontists listed as offering TMD therapy provide evidence-based care for TMD patients.</p><p><strong>Methods: </strong>Websites of all orthodontists mentioned in the 2026 list with the designation \"TMD therapy\" were systematically analyzed. Information on symptoms, etiology, diagnosis, and therapy was evaluated against the guidelines of the American Academy of Orofacial Pain.</p><p><strong>Results: </strong>Of 104 orthodontists, 70 (67%) reported offering TMD therapy, but only 32 websites (46%) provided relevant information. Most content deviated from current evidence. Occlusal factors were frequently presented as the primary cause, while history-taking and psychosocial assessment were not addressed.</p><p><strong>Conclusions: </strong>The self-reported TMD therapy designation does not indicate provider qualification or guidelines adherence. The analyzed websites showed substantial discrepancies from evidence-based care standards and may contribute to over-, under-, or mistreatment. Unverified self-report information should therefore be omitted from such lists.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149195931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Critical Life Events in the Developement of Chronic Musculoskeletal Pain : Results of a qualitative study].","authors":"Esther Maria Vitt, Jane Schulz, Michael Brinkers, Kay Niemier","doi":"10.1007/s00482-026-00978-x","DOIUrl":"https://doi.org/10.1007/s00482-026-00978-x","url":null,"abstract":"<p><strong>Background: </strong>Chronic pain is highly relevant for health services. Scientific data show the relevance of psychosocial factors; however, these factors are often ignored in primary diagnostics and therapy.</p><p><strong>Aim: </strong>The aim of the study was to explore, through semi-structured interviews, which critical life events as well as psychosocial and occupational factors patients with chronic musculoskeletal pain reported in temporal association with the onset or progression of their pain. In addition, the study aimed to examine the extent to which patients' subjective causal attributions differed from the findings of the interdisciplinary multimodal assessment.</p><p><strong>Method: </strong>Qualitative study. Semi structured interviews with patients with chronic pain of the locomotor system. Codes for relevant factors were developed and assigned to patient quotes from the interviews.</p><p><strong>Results: </strong>Several differences occurred between patients' assumptions of causes of pain of the loco motor system and the results of the interdisciplinary assessment. In particular, the assessment of physical fitness and the influence of psychosocial factors were different between patients and specialists. Furthermore, evidence of a high relevance of psychosocial factors and critical life events could be shown.</p><p><strong>Discussion: </strong>A good clinical history including psychosocial factors and critical life events as well as early patient education is essential in the initial therapy of patients with pain of the locomotor system.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Anger-related interventions for treatment of chronic pain : A systematic review].","authors":"Anne Juliane Körner, M Díaz Palacios, B Schönbach, R Sabatowski","doi":"10.1007/s00482-025-00911-8","DOIUrl":"10.1007/s00482-025-00911-8","url":null,"abstract":"<p><strong>Theoretical background: </strong>Negatively experienced emotions, especially anger, influence pain-related variables and impair the quality of life. Although a variety of treatment approaches exist there is still no comprehensive overview of anger-related interventions for chronic pain and which effects with respect to anger-specific and pain-specific variables can be detected.</p><p><strong>Methods: </strong>To answer these questions, a systematic review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The review included a comprehensive literature search that identified and analyzed relevant studies on anger-related interventions for primary chronic pain. These studies were compared with respect to the interventions used, the variables studied and the results obtained.</p><p><strong>Results: </strong>In the extracted studies (n = 5) significant positive effects of specific anger-related interventions on both pain-related and anger-related variables could be demonstrated.</p><p><strong>Discussion: </strong>Anger-focused treatment approaches are consequently considered a promising therapeutic option for chronic pain. To optimize their application in clinical practice further research on the effects and mechanisms of anger-related interventions is recommended.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"344-353"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145490111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The implementation of an adaptive multimodal interdisciplinary pain therapy exemplified by a medical care center (MVZ) structure in Dresden].","authors":"B Schönbach, T Kupke, U Ludwig, R Scharnagel, R Sabatowski","doi":"10.1007/s00482-026-00936-7","DOIUrl":"10.1007/s00482-026-00936-7","url":null,"abstract":"<p><p>Chronic pain is characterized by high and increasing prevalences and is associated with significant functional impairments and substantial healthcare costs. Qualitative and quantitative gaps in patient care are manifested as patient dissatisfaction, increased follow-up costs and the promotion of further chronification processes. Interdisciplinary multimodal pain therapy considers the underlying biopsychosocial factors of chronic pain conditions and is considered the evidence-based gold standard of treatment. Corresponding treatment approaches are time-consuming and personnel-intensive and are predominantly available in (partial) inpatient settings within standard care. Therefore, suitable care structures are needed for outpatient care that are based on the concept of interdisciplinary multimodal pain therapy and enable targeted treatment. To date, such approaches have primarily been implemented within the framework of pilot projects and selective contracts. Significant obstacles include inadequate reimbursement and billing options within the standardized fee schedule, which do not adequately reflect interdisciplinary collaboration. Using the example of a medical care center (MVZ) structure, a model for adaptive, multimodal, interdisciplinary pain therapy is presented. This model addresses the complex treatment requirements of chronic pain patients, enables the needs-based allocation of personnel resources and promotes structured collaboration among the participating medical disciplines. A central element is a diagnostic and therapeutic process that is continuously optimized through feedback loops, in which multimodal therapy elements are coordinated across disciplines and linked via shared digital files and case discussions.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"361-368"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Commonplace and yet underestimated: The demanding treatment of chronic back pain : Evidence-based diagnostics, treatment and critical reflection of the guidelines].","authors":"Axel Gassen, Julia Wölfle-Roos","doi":"10.1007/s00482-026-00965-2","DOIUrl":"10.1007/s00482-026-00965-2","url":null,"abstract":"<p><p>Back pain is among the leading causes of disability and work absenteeism worldwide. Approximately 85-90% of cases are classified as non-specific and mostly show an innocuous trajectory. Decisive for the guideline-conform management are the structured differentiation of specific causes, early identification of chronicity risk factors and an activating biopsychosocial treatment approach. Imaging should only be performed when clinically indicated. Exercise therapy represents the central conservative treatment modality. Pharmacotherapies are mainly used to support active rehabilitation strategies. Interdisciplinary multimodal programs improve long-term function, participation and quality of life, particularly in chronic pain conditions. Interventional procedures can be meaningful in selected patients with clearly defined indications.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"401-410"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148970917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Pain and pain management in a nursing home : Results of a cross-sectional study].","authors":"Eva Pichler, Daniela Schoberer, Doris Eglseer, Wolfgang Strobl, Manuela Hödl","doi":"10.1007/s00482-025-00919-0","DOIUrl":"10.1007/s00482-025-00919-0","url":null,"abstract":"<p><strong>Background: </strong>Nursing home residents frequently experience pain as a result of diseases. As posited by Egle et al., the bio-psycho-social model asserts that pain can affect individuals in various ways. Nevertheless, the various dimensions of pain are often not considered in pain management, and in numerous instances, pain is not even recognized by nursing professionals. The objective of the present study is to assess the prevalence of pain and the interventions implemented to reduce pain in an Austrian nursing home.</p><p><strong>Methods: </strong>For this descriptive cross-sectional study, convenience sampling in an Austrian nursing home was used. The focus of the data collection was to assess the prevalence, intensity, and duration of pain as well as the interventions used by the nurses to reduce pain.</p><p><strong>Results: </strong>Of 121 nursing home residents, 67 participated in the study: 39 residents had pain, whereby the majority had chronic pain. In total, 64 interventions were implemented, whereby most were pharmacological.</p><p><strong>Conclusion: </strong>Nonpharmacological interventions play an important role in pain management. However, they were seldom used by nursing staff. The results of the study were discussed with nursing staff at the nursing home and based on the discussion, a summary of nonpharmacological interventions was created. The so-called \"toolbox\" is freely available and is intended to support nursing staff in deciding with nursing home residents which interventions to use to reduce pain.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"385-393"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Chronic opioid intoxication may lead to life-threatening misdiagnoses in palliative care patients].","authors":"Maja Falckenberg, Friedemann Nauck, Christoph Maier","doi":"10.1007/s00482-026-00925-w","DOIUrl":"10.1007/s00482-026-00925-w","url":null,"abstract":"","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"394-397"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146053107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Education for medication overuse headache : Results of a systematic literature review].","authors":"Hans-Christoph Diener, M Graf, H Löhr, P Kropp","doi":"10.1007/s00482-025-00891-9","DOIUrl":"10.1007/s00482-025-00891-9","url":null,"abstract":"<p><strong>Background: </strong>Medication overuse headache (MOH) is often found in patients with chronic migraine as a result of worsening migraine accompanied by increasing amounts of acute medications. MOH is a relevant problem in clinical practice and the current German guideline on MOH recommends educational intervention to guide patients to reduce acute medication use.</p><p><strong>Objectives: </strong>The aim was to investigate published approaches for education in MO (medication overuse) and MOH.</p><p><strong>Methods: </strong>A systematic literature search was conducted in PubMed. Publications were included in which details for education for the prevention and treatment in MO or MOH were described. The educational approaches were analyzed thematically.</p><p><strong>Results: </strong>Twelve publications were included in this analysis. The described educational measures were effective in reducing or preventing MO or MOH. The educational content was heterogeneous, but some common topics were included in most of the educational approaches. These can be categorized in \"education on the OH or MOH concept\", \"risk factors\" and \"treatment options\". In few publications, additional topics related to \"agreement on treatment\" were mentioned.</p><p><strong>Conclusion: </strong>Education is effective in patients with medication overuse or medication overuse headache, but approaches differ. The overview presented here can be used as a basis to develop a structured educational approach for MOH.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"354-360"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Migraine patients treated with CGRP(R) antibodies : Are they different from patients treated with nonspecific oral prophylaxis? Analysis from the DMKG headache registry].","authors":"Ruth Ruscheweyh, Gudrun Goßrau, Tim Patrick Jürgens, Victoria Ruschil, Torsten Kraya, Thomas Dresler, Charly Gaul, Jörg Scheidt, Lars Neeb","doi":"10.1007/s00482-025-00899-1","DOIUrl":"10.1007/s00482-025-00899-1","url":null,"abstract":"<p><strong>Background: </strong>Antibodies against CGRP or its receptor (eptinezumab, erenumab, fremanezumab, galcanezumab, from here on: \"CGRP(R) antibodies\") are modern migraine preventives. German statutory health insurance covers CGRP(R) antibodies only for patients refractory to other preventive therapies. Thus, the effect of this regulation on patient selection was investigated, as well as the effect of a change of insurance coverage for erenumab in October 2022.</p><p><strong>Methods: </strong>In total, 759 patients with CGRP(R) antibody treatment were compared with 961 patients prescribed nonspecific oral migraine preventive medicines (amitriptyline, betablocker, flunarizine, topiramate) from the DMKG Headache Registry.</p><p><strong>Results: </strong>Patients with CGRP(R) antibodies had more prior preventive therapies that were insufficiently effective or tolerated compared to patients prescribed nonspecific oral preventive medicines (p < 0.001). Moreover, they had longer disease duration (p < 0.001), more often suffered from chronic migraine (p = 0.002), had more severe headache days (p = 0.004) and acute medication days (p = 0.04), lower quality of life (p < 0.05), more comorbidities (p = 0.001), and fewer of them were working (p < 0.001). After change of insurance coverage, treatment with erenumab shifted towards less refractory patients (p < 0.001) with shorter disease duration (p < 0.001), who were less severely affected compared to patients with other CGRP(R) antibodies (e.g., headache days p = 0.01; disability p = 0.005).</p><p><strong>Conclusion: </strong>CGRP(R) antibodies are prescribed for to patients affected by exceedingly severe migraine. Insurance coverage has a significant effect on use of medicines for migraine prevention.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"369-376"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Current level of knowledge about pain among German physiotherapy lecturers].","authors":"S Honsell, A Bassimtabar","doi":"10.1007/s00482-025-00916-3","DOIUrl":"10.1007/s00482-025-00916-3","url":null,"abstract":"<p><strong>Background: </strong>Pain is the leading cause of disease burden and disability worldwide. Physiotherapy plays a major role in the treatment of people with pain; however, there appears to be a lack of knowledge in this area.</p><p><strong>Aim: </strong>The aim of the nationwide study was to quantify the pain knowledge and postural, structural and biomechanical (PSB) orientation of physiotherapy lecturers (PL) in Germany.</p><p><strong>Methods: </strong>An online test, which included the German version of the revised Neurophysiology of Pain Questionnaire (rNPQ-D) and the Essential Knowledge of Pain Questionnaire (EKPQ), in which the achieved score is given from 0-100%, was answered by N = 184 PLs (n = 165 physiotherapists, n = 19 physicians) using SoSci Survey. A satisfactory result is achieved when at least 90% of participants achieve a score of at least 66.67%.</p><p><strong>Results: </strong>The mean score of the rNPQ‑D was 73.91% ± 13.11% and of the EKPQ 42.03% ± 20.78%, with statistically significant lower scores in the EKPQ (p < 0.001; d = 1.594). In both tests less than 90% of participants achieved a score of at least 66.67% (rNPQ-D: 79.89% of participants; EKPQ: 13.59% of participants). Teaching physicians achieved significantly lower scores in the EKPQ than teaching physiotherapists (p < 0.05; d = 0.494). The PLs who achieved their highest educational qualification abroad achieved higher scores than PLs with their highest educational qualification in Germany (rNPQ-D: p < 0.05 and d = 0.666; EKPQ: p < 0.05 and d = 0.649). Academized PLs achieved higher scores on average than nonacademized PLs, which was significant for the rNPQ‑D (p < 0.05, d = 0.38). Neither the professional and teaching experience of the PLs nor the number of their further training courses were related to the level of the respective test scores. The PLs with specific further training, such as manual lymphatic drainage, fascia therapy or physiotherapy according to Bobath, achieved significantly lower scores.</p><p><strong>Conclusion: </strong>The knowledge of German PLs about pain is deficient and strongly PSB-oriented, despite the responsible task of correctly imparting knowledge to future physiotherapists. In addition to the education and further training of physiotherapists, a comprehensive implementation of modern pain neuroscience knowledge in the curricula should be strived for.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"377-384"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145638200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}