Der Schmerz
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Medical treatment with effective opioids for patients who suffer chronic pain is greatly lacking in Germany, as is supported by the documentation from Sorge and Zenz. The author comments on this documentation and adds an account of his own experience with the provision of opioid prescriptions over a period of almost 6 years. He asserts that the number of patients who suffer from pain has increased and argues for extending the indications for opioid therapy to include noncancer patients, giving reasons why pure morphine preparations are to be preferred. Finally, the author expresses his belief that only an expanded and appropriate application of today's concepts regarding treatment with analgesics and opioids will be able to clear the way for a liberalization of the laws regulating the prescription of opioids.
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Practitioners often rely on physiodiagnostic indicators to corroborate the hypothesis of a muscular origin of headache. Although these indicators have been widely applied, their reliability and validity have seldom been tested empirically in headache sufferers. In a controlled double blind study, two trained raters palpated muscle tension and latent and active myogeloses of the left and right trapezius and sternocleidomastoideus muscles and measured passive head rotation flexibility. ⋯ In keeping with the hypothesis, the various parameters of active myogeloses very clearly differentiated between the experimental groups. The hypothesis turned out not to be true for the parameters of head rotation flexibility. In subjects suffering from tension headache, no correlations could be found between the number of myogeloses of the right trapezius muscle and parameters recorded in long-term EMGs of this muscle, and no correlations could be found between the total number of myogeloses and the chronicity of headache.
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74 pop/rock/jazz musicians and 100 classical musicians were investigated by means of a specially designed questionnaire. Several social, musical, pain-, and health-related questions were asked. ⋯ Specific instruments showed specific muscolosceletal pain patterns. 55% of the musicians in the classical field were treated by an orthopedic surgeon, whereas 43% of rock-pop-jazz musicians chose no therapy, although they suffered from pain. Only 32% of the classical musicians showed good compliance; 64% believe that medical therapy is not adjusted to the needs of musicians. 98% of the classical musicians and 89% of rock-pop-jazz musicians wish to have a doctor who is specially trained to deal with the needs of musicians.