Schmerz最新文献

{"title":"Schmerz, Geschlecht und Gender – Annäherung an ein noch (zu) wenig verstandenes Thema.","authors":"Esther Pogatzki-Zahn, Bianca Raffaelli","doi":"10.1007/s00482-026-00962-5","DOIUrl":"10.1007/s00482-026-00962-5","url":null,"abstract":"","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":"40 4","pages":"253-255"},"PeriodicalIF":0.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550258","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":"[Often overlooked: social factors in chronic pain : Development and use of a questionnaire on social stressors in people with chronic pain].","authors":"André Ljutow, Gunther Landmann, Tim Reck, Karin Schwerzmann, Yannick Rothacher","doi":"10.1007/s00482-026-00948-3","DOIUrl":"https://doi.org/10.1007/s00482-026-00948-3","url":null,"abstract":"<p><strong>Background: </strong>Although social stress factors are common in people with chronic pain, they are often not recorded or treated.</p><p><strong>Aim of the study: </strong>A questionnaire developed by us on the presence of social stress factors is to be examined for its correlation with the questions commonly used in pain questionnaires (regularly completed in advance).</p><p><strong>Materials and methods: </strong>The available data sets were collected between November 2017 and October 2018. The primary aim of using the questionnaire was to test its practicality in everyday clinical practice and its acceptance among patients. A total of 122 questionnaires on the presence of social stress factors were used for the evaluation, together with the pain questionnaire.</p><p><strong>Results: </strong>The elements of the pain questionnaire showed varying degrees of correlation with the total score for social stressors. Significant correlations with high significance were found in both univariate and multivariate regression analysis for the Chronic Pain Grading Scale according to von Korff and for the questionnaire on habitual well-being.</p><p><strong>Discussion: </strong>The presence of social stress factors cannot be predicted by the parameters of the pain questionnaire alone, although clear correlations are evident in some cases. Social aspects receive too little attention both in assessment and in therapy itself in multidisciplinary pain treatment facilities, even though the role of social factors as an independent and equivalent factor in the development of chronic pain has been proven. This questionnaire serves as a screening tool and, to our knowledge, is the first questionnaire for assessing social stress factors in patients with chronic pain in German-speaking countries.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200172","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":"[Prospective, multicenter study of the outcome of complex regional pain syndrome after 12 months].","authors":"H Hofbauer, A Brinkmann, E Maurer, B Weber, G Hänle, P Steffen","doi":"10.1007/s00482-024-00837-7","DOIUrl":"10.1007/s00482-024-00837-7","url":null,"abstract":"<p><strong>Background and objectives: </strong>Complex regional pain syndrome (CRPS) can lead to severe pain and limited functionality in the long term. Guidelines should help to optimize treatment procedures. It should be investigated which outcome is achieved after 1 year with guideline-based therapy.</p><p><strong>Materials and methods: </strong>In a prospective multicenter study, 40 patients with newly diagnosed CRPS were examined to determine how their pain and functional limitations changed within 1 year. In addition, it was investigated whether the time of diagnosis and invasive measures influence these outcome parameters.</p><p><strong>Results: </strong>All patients received physiotherapy and/or ergotherapy, treatment with glucocorticoids and/or bisphosphonates 29 (72.5%); various invasive measures were carried out in 13 (32.5%). After 1 year, both pain and functionality were significantly improved; two-thirds reported a tolerable average pain intensity. Severe functional impairment according to von Korff disability points was found after 1 year in 9 (22.5%), and a moderate or severe impairment according to medical evaluation in 6 (15%) and 3 (7.5%) patients, respectively. Earlier diagnosis and corresponding earlier start of treatment correlated with better outcome in terms of pain and functionality according to von Korff, but not according to medical evaluation. The influence of invasive procedures on the outcome parameters tended to be low.</p><p><strong>Conclusion: </strong>Guideline-based treatment led to a good outcome in terms of pain and functionality in the majority of patients. Early diagnosis correlated with better outcome, so suspected cases should be referred quickly to a medical facility with appropriate expertise.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"212-219"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13272273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142353118","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":"[Conservative combination therapy of sciatica due to lumbar disc herniation with mechanical physiotherapy (McKenzie), gabapentin, and transforaminal epidural injections].","authors":"Manuela Jäntsch-Rieckert, Oliver Rommel, Verena Kästner, Lotte Maercklin-Rommel, Georg Jäger","doi":"10.1007/s00482-024-00824-y","DOIUrl":"10.1007/s00482-024-00824-y","url":null,"abstract":"<p><strong>Background: </strong>Treatment of sciatica due to lumbar disc herniation can be surgical or conservative. Conservative management has been described to be effective in 90% of patients; however, in most studies no consistent treatment concept was used.</p><p><strong>Objectives: </strong>In the present study, we evaluated the effect of a combined nonsurgical management (McKenzie physiotherapy, gabapentin, and periradicular injections) in 40 patients during a 10-day inpatient treatment.</p><p><strong>Methods: </strong>In addition to the neuro-orthopedic examination, pain severity at rest and after walking were assessed. The Oswestry pain disability scale, the pain severity scale, and the painDETECT scale were examined to assess neuropathic pain components. The duration of incapacity for work and the requirement of a later surgery were recorded. Examinations were performed on the day of admission, on days 3, 6, 10, and 84, 3 months after discharge.</p><p><strong>Results: </strong>During conservative treatment, a continuous reduction of pain and an improvement of the straight leg raise test as well as finger-to-floor distance could be documented. As the three treatment options were introduced with a time delay, it could be demonstrated that all significantly contributed to the improvement. All treatments were tolerated without side-effects and persistent improvement after 12 weeks. On admission, 32% of patients revealed a neuropathic pain component which decreased to 7% at the follow-up. A total of 28 patients showed impaired muscle strength on admission, which decreased to 7 patients on follow-up. Electromyography revealed pathological results in 70% of patients examined. A significant improvement of quality of life (Oswestry Disability Index [ODI]) could be observed and the patients returned to work after 5.8 weeks. Only 3/40 patients required surgical management due to persistent pain.</p><p><strong>Conclusion: </strong>The combined nonsurgical operative treatment program is effective and well tolerated.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"220-228"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13272271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971796","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":"[Peripheral nerve stimulation-A new perspective in surgical pain treatment].","authors":"Ute Bäzner, Rezvan Ahmadi","doi":"10.1007/s00482-026-00933-w","DOIUrl":"10.1007/s00482-026-00933-w","url":null,"abstract":"<p><strong>Background: </strong>Peripheral nerve stimulation (PNS) has been a part of neuromodulation for decades. New systems and advancements have the potential to bring renewed focus to this subfield and alter the risk profile for patients.</p><p><strong>Objective: </strong>To illustrate the mechanism of action, present stimulation options and areas of application and explore future perspectives.</p><p><strong>Material and methods: </strong>Description and discussion of current options and systems for PNS based on the literature.</p><p><strong>Results: </strong>The PNS is a targeted and straightforward method for treating certain pain syndromes. New stimulation parameters and modalities as well as the use of newly developed wireless systems or specially designed devices with very small pulse generators offer new possibilities in this area.</p><p><strong>Conclusion: </strong>Direct stimulation of the affected nerve can provide an individually tailored solution for patients. New systems and stimulation modalities constitute a milestone in this subfield of neuromodulation. Overcoming the limitations of older technologies leads to improved patient safety and comfort. As such, PNS can become an important cornerstone in the treatment of chronic pain.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"180-185"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13272251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594428","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":"[Pontine glioma with headache-Sure?]","authors":"Heike Zabel","doi":"10.1007/s00482-025-00867-9","DOIUrl":"10.1007/s00482-025-00867-9","url":null,"abstract":"","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"229-232"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449160","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":"Mitteilungen der Österreichischen Schmerzgesellschaft.","authors":"","doi":"10.1007/s00482-026-00947-4","DOIUrl":"https://doi.org/10.1007/s00482-026-00947-4","url":null,"abstract":"","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":"40 3","pages":"246"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259487","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":"[Radiofrequency denervation of the spine and the sacroiliac joint : A systematic literature search according to GRADE with new German S3 guideline].","authors":"Stephan Klessinger, Hans-Raimund Casser, Sebastian Gillner, Holger Koepp, Andreas Kopf, Martin Legat, Katharina Meiler, Heike Norda, Markus Schneider, Matti Scholz, Phillipp J Slotty, Volker Tronnier, Martin Vazan, Karsten Wiechert","doi":"10.1007/s00482-024-00799-w","DOIUrl":"10.1007/s00482-024-00799-w","url":null,"abstract":"<p><strong>Background: </strong>This article summarizes the results of the German guideline on radiofrequency denervation of the facet joints and the sacroiliac joint. Evidence on the indications, test blocks and technical parameters are presented.</p><p><strong>Objective: </strong>The aim is to avoid overtreatment and undertreatment, which is also of socioeconomic importance.</p><p><strong>Material and method: </strong>A systematic evaluation of the literature was carried out according to the grading of recommendations assessment, development and evaluation (GRADE) approach. A multidisciplinary guideline group has developed recommendations and statements.</p><p><strong>Results: </strong>Statements and recommendations were given for 20 key questions. There was an 87.5% consensus for 1 recommendation and 100% consensus for all other recommendations and statements. The guideline was approved by all scientific medical societies involved. Specific questions included the value of the medical history, examination and imaging, the need for conservative treatment prior to an intervention, the importance of test blocks (medial branch block and lateral branch block), choice of imaging for denervation, choice of trajectory, the possibility to influence the size of the lesion, stimulation, the possibility of revision, sedation and decision support for patients with anticoagulants, metal implants and pacemakers and advice on how to avoid complications.</p><p><strong>Conclusion: </strong>Selected patients can benefit from well-performed radiofrequency denervation. The guideline recommendations are based on very low to moderate quality of evidence.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"200-206"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13272228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139997286","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":"[Pain management during pregnancy : A balancing act between benefits and risks].","authors":"Wolfgang E Paulus","doi":"10.1007/s00482-026-00943-8","DOIUrl":"10.1007/s00482-026-00943-8","url":null,"abstract":"<p><p>Pain management during pregnancy poses a considerable challenge in everyday clinical practice. The relief of maternal discomfort must be weighed against the potential risks of using medication (nonsteroidal anti-inflammatory drugs, paracetamol, steroids, opioids, gabapentinoids). The current data on congenital anomalies, complications during pregnancy, neonatal adaptation or withdrawal symptoms, and long-term psychomotor developmental disorders in children exposed in utero must be taken into account. However, refraining from treating chronic maternal pain during pregnancy can also cause problems for the child's development. Given the limited research findings, prescribing physicians must clarify the advantages and disadvantages of treatment strategies through informed, joint decision-making with their patients. This overview is intended to serve as an evidence-based guide for optimizing pain management during pregnancy while minimizing risks to offspring.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"233-242"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147875418","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":"[Dorsal root ganglion stimulation in neuromodulation-Evidence, indications and clinical application].","authors":"Matthias Hubert Morgalla, Dirk Rasche","doi":"10.1007/s00482-026-00932-x","DOIUrl":"10.1007/s00482-026-00932-x","url":null,"abstract":"<p><strong>Background: </strong>Dorsal root ganglion stimulation (DRGS) has become established as a specialized neuromodulation technique for focal neuropathic pain syndromes, such as complex regional pain syndrome (CRPS), peripheral nerve injuries as well as groin and knee pain. It enables targeted segmental coverage, selective stimulation of hard to reach dermatomal areas and improves daily functioning and treatment adherence.</p><p><strong>Objective: </strong>The aim of this work is to present the current evidence on DRGS, analyze its clinical fields of application and evaluate its effectiveness, safety, quality of care, and economic aspects.</p><p><strong>Material and methods: </strong>A review of the relevant literature was conducted, including randomized controlled trials (RCTs), reviews, cohort studies and clinically significant case reports. Key outcomes assessed included pain reduction, function, quality of life, patient selection, technique, adverse events and the cost-benefit ratio.</p><p><strong>Results: </strong>The results of RCTs confirm response rates ≥ 50% and a pain reduction >80% in CRPS and similar pain conditions. Observational studies confirm sustained effects, improved quality of life and reduced medication dependency. The infection rates range between 2-5%. The electrodes for DRGS can be placed with high precision. Advantages include low stimulation amplitudes, high energy efficiency and stable therapeutic effects.</p><p><strong>Conclusion: </strong>The DRGS is an evidence-based, selective treatment option with high therapeutic potential for focal neuropathic pain. It offers high response rates, functional improvements and a favorable safety profile. Technical innovations and expanded indications further enhance the clinical utility. Critical factors remain careful patient selection, structured follow-up and further studies on long-term efficacy and cost-effectiveness.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"186-191"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582174","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}