IF 1.1 4区医学

Schmerz Pub Date : 2024-10-01 Epub Date: 2023-07-19 DOI: 10.1007/s00482-023-00731-8

J Wölfle-Roos

{"title":"[Atlas block and alar ligament lesion-Underestimated or overrated?]","authors":"J Wölfle-Roos","doi":"10.1007/s00482-023-00731-8","DOIUrl":"10.1007/s00482-023-00731-8","url":null,"abstract":"Background: Disorders of the upper cervical spine, most notably lesions of the alar ligament and atlas block, are associated with numerous symptoms, especially as reported in the lay press. Thus, physicians are often confronted with patients who see in them a monocausal origin of complex complaints and hope for a quick remedy.Objective: This review article presents the currently available evidence-based literature on atlas block and alar ligament lesions in order to adequately appreciate their significance.Material and methods: Summary and critical evaluation of an extensive review of the literature on the diagnostics, clinical presentation, and treatment of disorders of the upper cervical spine.Results: The current literature shows that alar ligament lesions are caused only by extremely high-speed trauma and that the reliability of their detection on magnetic resonance imaging (MRI) is moderate at best. As several studies have failed to demonstrate a correlation between symptoms and abnormalities of the alar ligaments on MRI, surgical stabilization of the upper cervical joints is not indicated. The diversity of symptoms associated with atlas block may be explained by the convergence of afferent neurons originating in C1-C3 on several cranial nerve nuclei found in neuroanatomical studies, but this association has yet to be proven. First studies show that highly significant improvements in cervical pain and range of motion can be achieved by means of manual therapy of the upper cervical spine with lasting effects even after 6 months.Conclusion: The importance of alar ligament lesions has often been overrated in the past; however, a more nuanced multifactorial understanding of the disorder should be conveyed to the patient. An atlas block should be considered mainly as a possible cause of pain and restricted range of motion of the cervical spine and in this context manual therapy can be an effective treatment option.","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"352-358"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11420371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9840382","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}

引用次数: 0

[Spiritual interventions in multimodal pain management]. [多模式疼痛管理中的精神干预]。

IF 1.1 4区医学

Schmerz Pub Date : 2024-10-01 Epub Date: 2024-01-15 DOI: 10.1007/s00482-024-00788-z

Kristin Kieselbach, Ursula Frede

{"title":"[Spiritual interventions in multimodal pain management].","authors":"Kristin Kieselbach, Ursula Frede","doi":"10.1007/s00482-024-00788-z","DOIUrl":"10.1007/s00482-024-00788-z","url":null,"abstract":"If we understand chronic pain not only as a disease but also as an existential crisis, it seems logical and reasonable to consider spiritual aspects in the treatment process. Spirituality is understood as an umbrella term for all activities and experiences that give meaning and significance to people's lives-irrespective of their religious affiliation. So far, spiritual aspects have been considered therapeutically mainly in the palliative context. According to current survey-based studies of pain patients, the inclusion of spiritual themes in therapy leads to an improvement in quality of life and pain tolerance and is moreover explicitly desired by those patients. A consistent expansion of multimodal treatment approaches in the sense of a biopsychosocial-spiritual concept has not yet been implemented. The following basic attitudes and behaviors are relevant for practical implementation: openness to spiritual themes and authenticity, taking a spiritual history, listening, standing firm, activation of values, use of motives from religion, mythology, and art. Professional competence generally involves all practitioners, but may also require qualified professionals for specialized assistance. The integration of authentic spiritual assistance into multimodal pain management should help to stabilize self-esteem and the experience of identity of the patients through resource activation and identification of burdensome spiritual beliefs. The detailed integration and investigation of the efficiency of spiritual interventions in multimodal pain therapy require further research.","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"304-316"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11420278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139466857","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}

引用次数: 0

[Is the relationship between depressive symptoms and work-related factors mediated by pain self-efficacy in non-specific chronic low back pain?] [非特异性慢性腰背痛患者的抑郁症状与工作相关因素之间的关系是否受疼痛自我效能感的影响？］

IF 1.1 4区医学

Schmerz Pub Date : 2024-10-01 Epub Date: 2023-03-09 DOI: 10.1007/s00482-023-00701-0

Petra Hampel, Anne Neumann

{"title":"[Is the relationship between depressive symptoms and work-related factors mediated by pain self-efficacy in non-specific chronic low back pain?]","authors":"Petra Hampel, Anne Neumann","doi":"10.1007/s00482-023-00701-0","DOIUrl":"10.1007/s00482-023-00701-0","url":null,"abstract":"Background: The transition from acute to non-specific chronic low back pain (CLBP) is especially associated with psychological factors. However, working mechanisms of psychological factors have been little examined in non-specific CLBP, especially the mediator effect of pain self-efficacy.Objective: Does pain self-efficacy mediate the long-term prediction of work-related factors by depressive symptoms?Methods: Within the framework of an exploratory secondary analysis, simple mediation analyses were conducted to longitudinally predict prognosis of gainful employment, as well as subjective physical and mental work ability by depressive symptoms mediated by pain self-efficacy in 382 inpatients with non-specific CLBP.Results: The findings suggest that depressive symptoms prior to rehabilitation predicted levels of all three work-related factors 24 months after rehabilitation, and pain self-efficacy 12 months after rehabilitation mediated this relationship.Conclusion: To improve the success of work-related rehabilitation in the long-term, pain self-efficacy in particular, but also depressive symptoms should be targeted by treatments of non-specific CLBP.","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"335-342"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11420306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9137764","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}

引用次数: 0

[Treatment of trigeminal neuralgia: more evidence urgently needed]. [三叉神经痛的治疗：急需更多证据]。

IF 1.1 4区医学

Schmerz Pub Date : 2024-10-01 Epub Date: 2024-08-14 DOI: 10.1007/s00482-024-00821-1

Ruth Ruscheweyh, Janne Gierthmühlen, Dennis M Hedderich, Gudrun Goßrau, Stefan Leis

引用次数: 0

[Attitudes toward digital tools in pain medicine : Survey of German Pain Society health professional members and members of self-help groups]. [对疼痛医学数字工具的态度：对德国疼痛协会健康专业成员和自助团体成员的调查]。

IF 1.1 4区医学

Schmerz Pub Date : 2024-10-01 Epub Date: 2023-03-20 DOI: 10.1007/s00482-023-00708-7

Janosch A Priebe, Philipp Stachwitz, Julia Hagen, Anne Boltres, Katharina K Haas, Philipp Schuster, Julia Wendlinger, Mike Papenhoff, Thomas Isenberg, Jorg F Debatin, Thomas R Toelle

{"title":"[Attitudes toward digital tools in pain medicine : Survey of German Pain Society health professional members and members of self-help groups].","authors":"Janosch A Priebe, Philipp Stachwitz, Julia Hagen, Anne Boltres, Katharina K Haas, Philipp Schuster, Julia Wendlinger, Mike Papenhoff, Thomas Isenberg, Jorg F Debatin, Thomas R Toelle","doi":"10.1007/s00482-023-00708-7","DOIUrl":"10.1007/s00482-023-00708-7","url":null,"abstract":"Digital medicine has increasing influence on the German healthcare system. In times of social distancing during the ongoing coronavirus disease 2019 (COVID-19) pandemic, digital tools enable health professionals to maintain medical care. Furthermore, digital elements have potential to provide effective guideline-oriented treatment to a broad range of patients independently from location and time. This survey was used to assess the attitudes of members of the German Pain Society (health professionals) and of associated self-help groups (patients) towards digital medicine. It was sent out as an online survey to health professionals in September 2020 and to patients in February 2021. The survey referred especially to present usage, attitude and potential concerns regarding particular digital elements. Furthermore, technical affinity was assessed. In total, 250 health professionals and 154 patients participated in the survey. The results show that-although digital elements are already known-a substantial proportion of health professionals still lack broad transfer to regular treatment. The potential of digital tools seems to be recognized by both groups; interestingly, patients consider digital medicine as more useful than health professionals. Nevertheless, concerns about for example data security or digital competence remain in both groups. Taken together, our results indicate that disruptive changes, as the implementation of digital medicine in the healthcare system, have to be guided by intense education and channeled by political policies in order to successfully integrate digital elements into medicine on a long-term basis. This would be in favor for all involved parties and is demanded especially by patients.","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"343-351"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10027278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9513138","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}

引用次数: 0

[Clinical study PEPCA : The effect of standardized preoperative patient education for patient-controlled regional analgesia on postoperative pain]. [临床研究 PEPCA：患者自控区域镇痛的标准化术前患者教育对术后疼痛的影响]。

IF 1.1 4区医学

Schmerz Pub Date : 2024-10-01 Epub Date: 2023-02-07 DOI: 10.1007/s00482-023-00698-6

Tobias Bacher, Andre Ewers

{"title":"[Clinical study PEPCA : The effect of standardized preoperative patient education for patient-controlled regional analgesia on postoperative pain].","authors":"Tobias Bacher, Andre Ewers","doi":"10.1007/s00482-023-00698-6","DOIUrl":"10.1007/s00482-023-00698-6","url":null,"abstract":"Background: Patient-controlled analgesia (PCA) is a well-established form of postoperative pain management. One form of administration is patient-controlled regional analgesia (PCRA), where local anesthetics are administered via peripheral regional catheters; however, a prerequisite is that the patients are instructed on its use. A multitude of sources recommend that these instructions are given before surgery as preoperative training on pain management procedures has been shown to significantly reduce patients' postoperative pain and increase their well-being.Objective: The aim was to assess the effect of guideline-assisted preoperative patient education for PCRA on postoperative pain in patients undergoing orthopedic surgery compared to unstructured postoperative standard instructions.Material and methods: A controlled study with two randomized samples and a postinterventional survey was conducted. Overall, 73 patients with PCRA catheters for orthopedic surgery were enrolled in the study. The 37 participants in the interventional group (IG) received guideline-based structured instructions on PCRA use as well as a handout immediately before the surgical intervention. The 36 patients in the control group (CG) received postoperative instructions in the anesthesia recovery room. Pain was documented according to the numerical rating scale (NRS) at 2h (t1), 6h (t2), and 24h (t3) after surgery.Results: There were no statistically significant differences in the average pain scores between the two groups; however, there were lower mean pain scores in the IG at t1 and t3.Conclusion: A significant reduction of pain in the IG could not be shown. Further studies concerning this topic with larger samples and adapted points in time are recommended.","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"328-334"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11420383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10664125","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}

引用次数: 0

[Additional experience with medicinal treatment of trigeminal nerve pain]. [药物治疗三叉神经痛的其他经验]。

IF 1.1 4区医学

Schmerz Pub Date : 2024-10-01 Epub Date: 2024-08-14 DOI: 10.1007/s00482-024-00820-2

Wolfgang Liedtke

引用次数: 0

[Prospective, multicenter study of the outcome of complex regional pain syndrome after 12 months]. [复杂性区域疼痛综合征 12 个月后疗效的前瞻性多中心研究]。

IF 1.1 4区医学

Schmerz Pub Date : 2024-09-28 DOI: 10.1007/s00482-024-00837-7

H Hofbauer, A Brinkmann, E Maurer, B Weber, G Hänle, P Steffen

{"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":"https://doi.org/10.1007/s00482-024-00837-7","url":null,"abstract":"Background and objectives: 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.Materials and methods: 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.Results: 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.Conclusion: 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.","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Current knowledge of German physiotherapy trainees and students on pain and the influence of a teaching intervention]. [德国物理治疗受训人员和学生对疼痛的认知现状及教学干预措施的影响]。

IF 1.1 4区医学

Schmerz Pub Date : 2024-09-28 DOI: 10.1007/s00482-024-00832-y

Ahura Bassimtabar, Martin Alfuth

{"title":"[Current knowledge of German physiotherapy trainees and students on pain and the influence of a teaching intervention].","authors":"Ahura Bassimtabar, Martin Alfuth","doi":"10.1007/s00482-024-00832-y","DOIUrl":"https://doi.org/10.1007/s00482-024-00832-y","url":null,"abstract":"Background: In order to properly inform patients about their pain and initiate targeted therapies, it is important for physiotherapists to learn about the latest scientific evidence on pain during their training.Aim: This study aimed to assess the pain knowledge of German physiotherapy trainees and students. In addition, the influence of a teaching intervention (Pain Neuroscience Education, PNE) on their pain knowledge was investigated.Methods: An online test was performed, which contained the German versions of the revised Neurophysiology of Pain Questionnaire (rNPQ-D) and the Essential Knowledge of Pain Questionnaire (EKPQ). This test was completed by physiotherapy trainees and students (N = 279) in their final semester of vocational education or graduation under virtual supervision. After the test, a sub-cohort of physiotherapy trainees (n = 31) received a four-hour online teaching intervention (PNE), whereupon two retests took place.Results: The mean rNPQ-D score (63.8%) was significantly higher than the mean EKPQ score (28.4%) (p < 0.001). There was a significant positive correlation between the scores of rNPQ-D and EKPQ (r = 0.365, p < 0.001). Undergraduate students from university (n = 142) achieved significantly higher scores in both questionnaires (p < 0.001) compared to trainees from vocational schools (n = 137). In the sub-cohort, the online teaching intervention significantly improved the scores of both questionnaires immediately (p < 0.001) and six weeks after intervention (p < 0.001).Conclusion: The knowledge of German physiotherapy students about pain seems to be insufficient for an evidence-based treatment of pain patients. A PNE-based online learning program with the latest scientific evidence can significantly improve physiotherapy students' knowledge about pain.","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142353117","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}

引用次数: 0

[N-Check: nerve check to document chemotherapy-induced peripheral neuropathy (CIPN) in incurable cancer]. [N-Check：记录无法治愈的癌症患者化疗引起的周围神经病变（CIPN）的神经检查]。

IF 1.1 4区医学

Schmerz Pub Date : 2024-09-23 DOI: 10.1007/s00482-024-00828-8

Annabell Syben, Sascha Weber, Iris Appelmann, Roman Rolke

{"title":"[N-Check: nerve check to document chemotherapy-induced peripheral neuropathy (CIPN) in incurable cancer].","authors":"Annabell Syben, Sascha Weber, Iris Appelmann, Roman Rolke","doi":"10.1007/s00482-024-00828-8","DOIUrl":"https://doi.org/10.1007/s00482-024-00828-8","url":null,"abstract":"Chemotherapy-induced polyneuropathy (CIPN) encompasses a spectrum of symptoms ranging from hypoesthesia with impaired gait, stance and fine motor skills to painful dysesthesia and allodynia and significantly impairs the quality of life of those affected. In the present pilot study, quantitative sensory testing (QST) was used to investigate CIPN as a common adverse effect of cytostatic drugs in patients with incurable cancer. The QST is a standardized examination procedure that is not yet routinely used in cancer patients. It is used to examine thermal and mechanical perception and pain thresholds to record the subjectively experienced pain phenotype. In the N‑Check pilot project, the QST was used before and after tumor-specific, potentially CIPN-inducing treatment and the data collected was compared in a pre-post analysis. In addition, the specific effects of CIPN on the health-related quality of life of patients treated primarily with a palliative intention were recorded using the Functional Assessment for Cancer Therapy-General (FACT-G) questionnaire. Overall, the patients showed significant heat hypoalgesia after chemotherapy as a sign of damage to small nerve fibers. In addition, there were signs of deterioration of the quality of life. The feasibility of QST in patients with incurable cancer and palliative, neurotoxic chemotherapy was demonstrated in this pilot study.","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308511","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}

引用次数: 0

Schmerz最新文献