Schmerz最新文献

{"title":"[Nocebo effects in the context of visceral pain].","authors":"Karla Großek, Marion Bachmann","doi":"10.1007/s00482-026-00940-x","DOIUrl":"10.1007/s00482-026-00940-x","url":null,"abstract":"","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"398-400"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729852","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 influence of diagnostic labels on treatment preferences of people with musculoskeletal pain : A systematic literature review].","authors":"Melanie Rupitsch, Sabine Monsberger, Jean-Pascal Grenier","doi":"10.1007/s00482-025-00876-8","DOIUrl":"10.1007/s00482-025-00876-8","url":null,"abstract":"<p><strong>Background: </strong>Patients often report uncertainty about the information provided by physicians and physiotherapists, as well as difficulties in making decisions regarding medical interventions. Making autonomous and informed decisions requires clear explanations about the condition, its associated limitations, prognosis, and treatment options.</p><p><strong>Objective: </strong>This systematic review aimed to investigate how common diagnostic labels for the same musculoskeletal pathology influence the perceived severity of a condition and patients' treatment preferences.</p><p><strong>Methods: </strong>Systematic literature search in MEDLINE (via PubMed), the Cochrane Library, and the PEDro database.</p><p><strong>Results: </strong>Healthy individuals as well as patients associate diagnostic labels suggesting pathoanatomical damage in musculoskeletal pain syndromes with more pain, greater disability, and a perceived need for advanced imaging and invasive interventions. Overall, there is a significant correlation between diagnostic labels and patients' treatment preferences.</p><p><strong>Discussion: </strong>Diagnostic labels such as \"low back pain episode,\" \"persistent hip pain,\" and \"bursitis,\" which do not suggest severe structural damage, are often associated with a better prognosis and less perceived need for invasive interventions or advanced imaging. In contrast, labels indicating structural damage (e.g., \"degeneration\") can trigger fear, avoidance behaviour, and catastrophizing. Using labels that promote self-efficacy and convey a positive prognosis could therefore be a valuable strategy to improve care for patients with musculoskeletal pain.</p><p><strong>Conclusion: </strong>Severe-sounding diagnostic labels are associated with a preference for more invasive treatments, catastrophizing tendencies, and a perceived need for advanced imaging in individuals with musculoskeletal pain.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"335-343"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568101","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":"[Analgesics and supportive care in the last month of life : Retrospective analysis of outpatient prescriptions using BARMER data from patients with oncological diseases (2016-2021)].","authors":"Ekaterina Slotina, Bianka Ditscheid, Franziska Meissner, Ursula Marschall, Winfried Meissner, Ulrich Wedding, Antje Freytag","doi":"10.1007/s00482-026-00968-z","DOIUrl":"https://doi.org/10.1007/s00482-026-00968-z","url":null,"abstract":"<p><strong>Background: </strong>In Germany, various forms of outpatient palliative care (PC) for oncological patients have been established for years. However, no data is available on how prescription rates of analgesics and supportive care vary depending on the specific form of outpatient PC.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed data from 158,035 deceased statutory health insurance patients with advanced cancer between 2016 and 2021. Three groups were analyzed: patients without outpatient PC, with general outpatient PC or particularly qualified and coordinated PC (AAPV/BQKPmV), and with specialized outpatient PC (SAPV). The study focused on the prescription rates of various medication groups according to ATC codes (nonopioid and opioid analgesics, antineuropathic medication, antiemetics, systemic steroids, stool-regulating measures) and their combinations in the last month of life.</p><p><strong>Results: </strong>SAPV patients showed the highest prescription rates, e.g., strong opioids (71.8%), followed by AAPV/BQKPmV (47.2%) and patients without PC (22.5%). The prescription rates for all supportive medications showed similar patterns. An inverse pattern was observed for weak opioids: SAPV (5.8%), AAPV/BQKPmV (8.9%), and no PC (9.1%). The guideline-adherent combination of strong opioid analgesics and laxatives was implemented in less than half of the cases in SAPV (44.2%) and even less frequently in AAPV/BQKPmV (32.4%).</p><p><strong>Conclusion: </strong>This study provides comprehensive insights into medication prescription practices in outpatient PC in the last month of life, for the first time. The high prescription rates in SAPV reflects more intensive medication treatment of patients with possibly more complex symptoms in this specialized form of PC.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991228","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":"[Virtual cognitive-perceptual home training program for chronic pain of the upper extremities].","authors":"Juliane Lamprecht, Lilit Flöther, Alexander Fischer, Susanne Saal","doi":"10.1007/s00482-026-00970-5","DOIUrl":"https://doi.org/10.1007/s00482-026-00970-5","url":null,"abstract":"<p><strong>Background: </strong>Cognitive and perceptual treatment approaches represent an adjunctive nonpharmacological treatment option for people with chronic pain. One treatment approach is based on the graded motor imagery (GMI) theory, which integrates several cognitive-perceptual methods into a staged concept.</p><p><strong>Aim: </strong>In this study, the technical and practical feasibility of a prototype for a virtual reality (VR)-based home training program incorporating key elements of GMI theory was evaluated for the first time under real-world conditions in patients with chronic unilateral pain of the upper extremities.</p><p><strong>Material and methods: </strong>Patients with chronic pain used the application for 5 days per week for a maximum of 30 min over a period of 6 weeks. Technical and application-related aspects of the implementation, user acceptance and pain perception were assessed.</p><p><strong>Results: </strong>A total of 13 pain patients could be included in the study, 7 patients completed the intervention and 6 discontinued prematurely, predominantly due to issues associated with the VR application. The daily training duration of 30 min was perceived as too long and the mirrored exercises were considered particularly strenuous. Pain perception changed only marginally over the course of the intervention. The technology proved to be highly error-prone.</p><p><strong>Discussion: </strong>The implementation of cognitive-perceptual strategies in a VR environment as an innovative treatment approach for patients with chronic pain requires further technical and content-related optimization and will be the subject of a prospective pilot study.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148970960","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":"[Opioid use disorders during long-term opioid treatment : Risk factors and action approaches in patients with chronic nontumor pain from an outpatient medical perspective].","authors":"Silke Neusser, Anja Niemann, Nils Frederik Schrader, Nikola Blase, Milena Weitzel, Carina Abels, Christian Speckemeier, Anja Neumann, Cordula Riederer, Joachim Nadstawek, Wolfgang Straßmeir, Jürgen Wasem","doi":"10.1007/s00482-026-00971-4","DOIUrl":"https://doi.org/10.1007/s00482-026-00971-4","url":null,"abstract":"<p><strong>Background: </strong>Long-term opioid use (> 3 months) can be an important element in the treatment of patients with chronic nontumor pain but it is also discussed in association with risks for the development of opioid use disorder. This analysis aims to explore the risk factors for opioid use disorder in long-term opioid treatment, barriers for its identification and starting points for different solutions to overcome these barriers from a medical perspective.</p><p><strong>Methods: </strong>A cross-sectional postal survey was sent in Autumn 2021 to 1854 physicians involved in outpatient treatment in Germany. A random sample of 1300 physicians were drawn from the pool of an address service and all members of the Professional Association of Physicians and Psychological Psychotherapists in Pain and Palliative Medicine in Germany (BVSD, n = 554) were contacted. A reminder was sent out in January 2022.</p><p><strong>Results: </strong>A total of 422 physicians participated in the survey, one third were primary care physicians (33%) and 65% had received additional training \"specialist pain therapy\". On a scale from 1 = full approval to 5 = full rejection, treatment of chronic pain by different physicians was perceived as the most important risk factor for opioid use disorder (mean (MW): 1.33, standard deviation (SD): 0.596). Further important risk factors were treatment specific. Intentional disguise by the patient (MW 1.73/SD 0.888) and opioid prescriptions by different physicians (MW 1.79/SD 0.635) were perceived as major hurdles for the identification of opioid use disorder. Regular prescription controls (MW 1.37/SD 0.648) and periodical patient contact (MW 1.49/SD 0.654) were perceived as the most important approach to reveal opioid use disorders.</p><p><strong>Discussion: </strong>The present study gives a quantification of structural and treatment-specific risk factors in the German context. This could serve as an important foundation for the development of a health policy approach to tackle these hurdles. The results indicate that fostering transparency and communication are important aspects.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148970976","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 management in people with dementia : Recognizing pain and providing supportive care].","authors":"Patricia Teresa Hollfelder, Albert Lukas","doi":"10.1007/s00482-026-00969-y","DOIUrl":"https://doi.org/10.1007/s00482-026-00969-y","url":null,"abstract":"<p><p>Pain in dementia is frequently underrecognized, although early and reliable detection is fundamental to any effective pain management. Structured assessment combines subjective scales (for Mini-Mental State Examination [MMSE] ≥ 10) with observer-based scales (for MMSE < 10), evaluated both at rest and during movement. Responsive behaviors may indicate pain, making differentiated observation essential. Multimodal therapy includes both non-pharmacological and pharmacological interventions. Criteria lists for potentially inappropriate medications support risk-adapted prescribing. Opioids are not standard therapy for chronic non-cancer pain and should only be used when clearly indicated, after exhausting other treatment options, and under regular reassessment of benefits and risks. The principle of \"start low, go slow\" is central to analgesic therapy in patients with dementia.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920906","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":"[Interventional pain treatment in Austria : Results of a survey among specialized pain therapists].","authors":"Markus Köstenberger, S Leis, B Ganser, W Pipam, J Benrath, R Likar","doi":"10.1007/s00482-026-00964-3","DOIUrl":"https://doi.org/10.1007/s00482-026-00964-3","url":null,"abstract":"<p><strong>Background: </strong>Interventional procedures are an integral component of multimodal pain management; however, their clinical use and indications remain controversial due to heterogeneous evidence regarding their efficacy. Until now, no systematic data have been available on the prevalence and clinical practice of interventional pain management techniques in Austria.</p><p><strong>Objective: </strong>The aim of this study was to assess the current clinical practice of interventional pain management in specialized pain centers in Austria and to discuss these findings in the context of the available evidence.</p><p><strong>Methods: </strong>An anonymous, web-based questionnaire was distributed to specialized pain physicians holding the Austrian diploma in \"Specialized Pain Therapy\" (Spezielle Schmerztherapie). Participants were surveyed regarding the frequency of use, procedural techniques and indications for interventional pain management procedures. The questionnaire included sympathetic and sensory nerve blocks, neuraxial techniques, intrathecal drug delivery, spinal cord stimulation, auricular vagus nerve stimulation and botulinum toxin injections.</p><p><strong>Results: </strong>Of the 51 pain centers contacted, 22 participated in the survey (response rate: 43.1%). The most frequently performed procedures were selective nerve root blocks, facet nerve blocks and plexus blocks. Sympathetic blocks and neuromodulation techniques were used less frequently. Most procedures were performed using anatomical landmarks and ultrasound guidance, while imaging techniques such as computed tomography (CT) or fluoroscopy (C-arm guidance) were used selectively. The leading indications were neuropathic pain syndromes and conditions with a neuropathic pain component, particularly radicular back pain, complex regional pain syndrome (CRPS), postherpetic neuralgia and cancer-related pain.</p><p><strong>Conclusion: </strong>Interventional pain management is widely used in specialized pain centers in Austria, particularly for selected neuropathic pain syndromes. These findings highlight the importance of interventional techniques as part of multimodal pain management while also illustrating the discrepancy between their widespread clinical use and the limited supporting evidence. Structured patient selection and further high-quality scientific evaluation of interventional pain management procedures are warranted.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814010","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":"[Addiction problems in outpatient palliative care in Germany : A survey among palliative care teams].","authors":"Jannis Eersink, Julian Maul, Nils Heuser, Astrid Morin, Martin Gschnell, Christian Volberg","doi":"10.1007/s00482-025-00868-8","DOIUrl":"10.1007/s00482-025-00868-8","url":null,"abstract":"<p><strong>Background: </strong>In palliative care, the focus of treatment is on controlling the patient's symptoms. To achieve this, drugs with addictive potential are often used. This can lead to addiction problems, as palliative care patients are surviving longer these days than they did a decade ago.</p><p><strong>Aims: </strong>This study investigates whether drug misuse and substance abuse are perceived as a problem in specialised outpatient palliative care teams.</p><p><strong>Materials and methods: </strong>A cross-sectional questionnaire survey was conducted among all German specialised outpatient palliative care teams (n = 366). Data were analysed descriptively.</p><p><strong>Results: </strong>A total of 129 palliative care teams (35.2%) participated in the survey. Of these, 49.6% stated that an estimated 1-5% of their patients suffer from medication dependency and 65.9% estimate that 1-5% of their patients have drug abuse issues. In all, 69.8% of palliative care teams do not screen their patients for the presence of addiction, while 3.1% do so regularly. If an addiction problem is present, 65.9% of the teams do not take any action.</p><p><strong>Conclusion: </strong>According to the available data, addiction is not considered a problem in German palliative care. However, it should be noted that almost no palliative care team screens patients for the presence of addiction, although more than half of the teams estimate that at least some patients have an addiction problem. Further research is needed here, as new therapies may help palliative care patients to live longer. It would be important for the development of palliative care and the quality of life of those affected to evaluate how to protect patients from iatrogenically induced substance abuse.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"304-312"},"PeriodicalIF":0.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13391713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143410166","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":"[Diagnostics and surgical treatment of peripheral nerve lesions].","authors":"Joachim Oertel, Dörthe Keiner","doi":"10.1007/s00482-026-00955-4","DOIUrl":"10.1007/s00482-026-00955-4","url":null,"abstract":"<p><p>Traumatic peripheral nerve lesions are defined as loss of nerve function due to the effects of external violence. They are relatively rare but can lead to severe sensorimotor deficits. Further impairments can occur due to soft tissue and bony injuries. Peripheral nerve lesions require a long clinical convalescence period and neurological deficits are often permanent. In recent years, the approach to treating peripheral traumatic nerve lesions has shifted towards early, active treatment upon detection of a structural lesion. This includes surgical reconstructive procedures aimed at restoring the lost functions as effectively as possible. High resolution ultrasound and magnetic resonance neurography have emerged as complimentary tools in the past years. Thus, early detection of structural lesions is possible, which contributes to the strategy of early surgery.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"315-325"},"PeriodicalIF":0.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148472567","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":"[Postoperative pain and sex/gender-current findings of the past decade].","authors":"Stefan Floren, Daniel Segelcke, Esther Pogatzki-Zahn","doi":"10.1007/s00482-026-00953-6","DOIUrl":"10.1007/s00482-026-00953-6","url":null,"abstract":"<p><strong>Background: </strong>Sex and gender affect pain perception but their role in postoperative pain remains unclear and is not addressed in current guidelines.</p><p><strong>Objectives: </strong>This scoping review summarizes evidence from the past ten years on sex-related differences in postoperative pain (patient-reported outcome (PRO), opioid consumption) and evaluates their relevance.</p><p><strong>Materials and methods: </strong>Systematic search in Medline® (March 2015-18 August 2025); 106 studies included.</p><p><strong>Primary outcome: </strong>acute pain intensity (≤ 3 weeks).</p><p><strong>Secondary outcomes: </strong>subacute/chronic postsurgical pain and opioid use.</p><p><strong>Results: </strong>Of the 106 studies included, 44 covered acute pain. In most of them women reported higher pain intensity-particularly after thoracic surgery and orthopedic procedures; several analyses confirmed female sex as an independent predictor for postoperative pain. Studies related to subacute pain (5/106) reported slightly higher pain intensity ratings in women, and the results in chronic pain studies (44/106) were mixed, with more severe pain in women after visceral surgeries. While results for acute opioid consumption (16/106) were heterogeneous, for the long-term postoperative course, studies (9/106) consistently reported a higher persistence of analgesic/opioid use in women.</p><p><strong>Conclusions: </strong>Sex is a relevant factor regarding pain-related outcome parameters after surgery, and its impact is influenced by the postoperative timeframe and type of surgery. Further studies with standardized, sex-stratified endpoints are required to enable gender-sensitive patient care.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"295-303"},"PeriodicalIF":0.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259550","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}