Der Schmerz
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Review Meta Analysis
[Recommendations for treatment of fibromyalgia : Where will we stand in 10 years?]
This article elucidates changes in the recommended diagnostics and therapy of fibromyalgia (FM). The recommendations from major internationally recognized guidelines are compared with the newest recommendations of the European League Against Rheumatism (EULAR) that in contrast to the guidelines surprisingly recommend physical exercise after patient education for all FM patients. ⋯ Finally, we try to predict how patients will be treated 10 years from now, for which knowledge from the guidelines and the initial approaches that diagnosed heterogeneity in FM are included. Empirically based questions will drive mechanism-based approaches as opposed to simply reacting to symptoms, in order to meet the challenge of an individual, mechanism-oriented treatment.
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The wrist and hand form a highly complex organ that is of great importance in almost all daily activities. The hand serves as a tool and an organ of sense. ⋯ Almost all structures of the hand are easily accessible for clinical examination, i. e. inspection, palpation and clinical tests, including dynamic testing. Diagnostic imaging completes the examination procedure.
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This article presents the case of a 33-year-old female patient with exacerbation of a pre-existing tension type headache. The exacerbation occurred within the scope of an infection and persisted after the infection had receded. The excessive diagnostic approaches went on for weeks and only finally came to an end with the diagnosis of a pregnancy. The impacts of hormonal changes on headaches caused by pregnancy are discussed as well as postinfection events.
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Review Meta Analysis
[Chronic low back pain and psychological comorbidity : A review].
Back pain is a common, disabling problem in Germany. Previous research has evaluated associations between low back pain (LBP), depression, and fear. ⋯ The results can improve the understanding of the complexity of LBP perception and its therapy. The generalization of the results is limited. To cover the correlation of psychosocial and lifestyle factors and pain perception of LBP, further research is required. To obtain a clearer picture of pain perception in persons with LBP, standardized pain assessment would be beneficial. In addition, we recommend that future studies follow standardized procedures to allow greater comparability.
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Randomized Controlled Trial
[Treatment of fibromyalgia syndrome with gamma-hydroxybutyrate : A randomized controlled study].
The etiology of fibromyalgia syndrome is not yet fully understood. Current hypotheses suggest a potential role of gamma-hydroxybutyrate (GHB) in influencing endocrinological abnormalities in patients with fibromyalgia. ⋯ Administration of low dose GHB did not yield clinical improvements in female outpatients with fibromyalgia. General improvement in the course of treatment may have resulted from operant behavioral pain therapy. Future studies on GHB should control hypothetical risk factors for identification of non-responders.