Schmerz最新文献

{"title":"[Additional experience with medicinal treatment of trigeminal nerve pain].","authors":"Wolfgang Liedtke","doi":"10.1007/s00482-024-00820-2","DOIUrl":"10.1007/s00482-024-00820-2","url":null,"abstract":"","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"359-361"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976537","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":"https://doi.org/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":""},"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}

{"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":"<p><strong>Background: </strong>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.</p><p><strong>Aim: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>","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}

{"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":"<p><p>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.</p>","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}

{"title":"[Avoidance-endurance fast screen : AEFS validation with one- and two-level response scaling in healthy subjects].","authors":"Sonja V Baumermann, Christina Titze, Monika I Hasenbring","doi":"10.1007/s00482-024-00836-8","DOIUrl":"https://doi.org/10.1007/s00482-024-00836-8","url":null,"abstract":"<p><strong>Background and objectives: </strong>Chronic pain affects an enormous number of patients in Germany. Therefore, early detection is important using easy, quick and reasonable screening methods. The avoidance-endurance fast screen is currently available in two different versions: one asking for pain-related behaviour in light and severe pain and the other assessing overall severe pain-related behaviour. In this study we aim to examine the agreement between both scales and for the first time describe the role of protective psychological features such as resilience and self-compassion in this model.</p><p><strong>Materials and methods: </strong>Epidemiological cross-sectional study (n = 278) of a healthy cohort occasionally experiencing pain (< 3 months). The analysis was done using standard descriptive statistics, correlations (Spearman's rho) and deductive statistics (t-tests and one-factor ANOVA with post hoc Bonferroni correction) and effect sizes (Cohen's d). Matching of the instruments was calculated with Cohen's kappa.</p><p><strong>Results: </strong>The results showed a moderate agreement for the two versions. A validity check of the subgroups resulted in comparable findings. The one-level version scored higher in terms of pain persistence which caused subgroup changes from adaptive to eustress-endurance responses and from fear-avoidance to distress-endurance responses. The distress-endurance subgroup had significantly lower values of the trait self-compassion.</p><p><strong>Conclusions: </strong>Based on the results of this study, the quality of agreement between the two AEFS versions is considered strong. Without the comparison between mild and strong pain, endurance behaviour was reported more often. According to these findings, overestimation of pain persistence behaviour using the one-level version might result. Therefore, future studies should re-evaluate the cut-offs. As reported in previous studies, protective psychological features showed the highest scores in the eustress-endurance subgroup.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294422","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":"[Influence of health care crises on the treatment of cancer pain: a presentation using the example of the COVID-19 pandemic from the provider's perspective].","authors":"Frederik Dombrowski, Stefan Wirz, Hannes Hofbauer, Pascal Kowark, Joachim Erlenwein, Ulrike Stamer, Kristin Kieselbach","doi":"10.1007/s00482-024-00826-w","DOIUrl":"https://doi.org/10.1007/s00482-024-00826-w","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic led to significantly restricted access to pain medicine services. Patients with cancer-related pain are considered a vulnerable group in terms of care deficits. A questionnaire among providers providing treatment to this group was used to assess limitations and solutions in this critical situation.</p><p><strong>Materials and methods: </strong>The online survey, developed by the 'Tumour Pain Working Group' of the German Pain Society using the Delphi method, included questions on site structure, pandemic-related care problems, and burdens experienced by those treating patients. It was distributed several times via the mailing lists of the German Pain Society and the 'Palliative Medicine Working Group' of the German Society of Anaesthesiology and Intensive Care Medicine.</p><p><strong>Results: </strong>In all, 175 fully completed questionnaires were analysed. Over 75% of participants reported pandemic-related staff shortages and closures of pain medicine facilities, with 32% of facilities temporarily not treating elective pain patients and 13% not treating any emergencies. Care was hampered by numerous logistical problems such as very frequent pandemic-related cancellations by patients or in the transmission of prescriptions. Alternative forms of consultation by telephone or telemedicine, rarely used before the pandemic, were reported by 79 and 31% of respondents respectively, but deficiencies were noted. In addition, 52.1% of respondents complained of severe and 26.8% of moderate psychological stress due to the pandemic, and 74.1% evaluated working conditions as moderately to severely difficult. Medical training was still possible for 86% through format changes.</p><p><strong>Conclusion: </strong>The COVID-19 pandemic revealed numerous deficits in the care of patients with cancer-related pain, as well as burdens on healthcare providers. The development of new concepts could help to ensure better care in future crisis situations.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140961","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":"Wir gestalten Zukunft : Abstracts des Deutschen Schmerzkongresses 2024: 16.–19. Oktober 2024 im CC Rosengarten, Mannheim.","authors":"","doi":"10.1007/s00482-024-00827-9","DOIUrl":"10.1007/s00482-024-00827-9","url":null,"abstract":"","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"1-92"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294423","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":"[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":"https://doi.org/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":""},"PeriodicalIF":1.1,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitteilungen der Deutschen Schmerzgesellschaft e.V.","authors":"","doi":"10.1007/s00482-024-00822-0","DOIUrl":"10.1007/s00482-024-00822-0","url":null,"abstract":"","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":"38 4","pages":"293-294"},"PeriodicalIF":1.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724371","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":"[Tetrahydrocannabinol (THC) in patients with fibromyalgia syndrome (FMS) : A retrospective study of changes in pain, psychometric variables, and analgesic consumption during inpatient interdisciplinary multimodal pain therapy (IMPT)].","authors":"Horst Bettstetter, Arne Schäfer","doi":"10.1007/s00482-023-00727-4","DOIUrl":"10.1007/s00482-023-00727-4","url":null,"abstract":"<p><strong>Background: </strong>Since March 1, 2017, medical cannabis (MC) can be prescribed nationwide in Germany. To date, there have been a number of qualitatively different studies on the effectiveness of MC in fibromyalgia syndrome (FMS).</p><p><strong>Objective: </strong>The aim of the study was to investigate the effectiveness of THC in the course of interdisciplinary multimodal pain therapy (IMPT) on pain and several psychometric variables.</p><p><strong>Materials and methods: </strong>For the study, in the period 2017-2018, all patients in the pain ward of a clinic who were suffering from FMS and were treated in a multimodal interdisciplinary setting were selected based on inclusion criteria. The patients were examined separately according to groups with and without THC about pain intensity, various psychometric parameters and analgesic consumption during the stay.</p><p><strong>Results: </strong>Of the 120 FMS patients included in the study, 62 patients (51.7%) were treated with THC. In the parameters of pain intensity, depression, and quality of life, there was a significant improvement in the entire group during the stay (p < 0.001), which was significantly greater through the use of THC. In five of the seven analgesic groups examined, the dose was reduced or the drug discontinued significantly more often in the patients treated with THC.</p><p><strong>Conclusion: </strong>The results provide indications that THC can be considered as a medical alternative in addition to the substances previously recommended in various guidelines.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"259-266"},"PeriodicalIF":1.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11271422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9964589","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}