Der Schmerz
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Remote consultations through phone or video are gaining in importance for the treatment of musculoskeletal pain across a range of health care providers. However, there is a plethora of technical options for practitioners to choose from, and there are various challenges in the adaptation of clinical processes as well as several special considerations regarding regulatory context and patient management. Practitioners are faced with a lack of high-quality peer-reviewed resources to guide the planning and practical implementation of remote consultations. ⋯ This Clinical Update draws together best-practice evidence in a practically applicable format, enabling therapists who are working with people with pain to directly apply this knowledge to their individual clinical settings and the requirements of their patients.
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Multicenter Study
[Validation of the German version of the Fear-Avoidance Beliefs Questionnaire (FABQ-D) for shoulder disorders].
With a prevalence of up to 30%, shoulder disorders form the third largest group of musculoskeletal complaints worldwide. Their formation and development are influenced by psychosocial factors such as movement-related fear. One of the internationally most common measurements for quantifying fear of movement is the Fear-Avoidance Beliefs Questionnaire (FABQ). ⋯ The FABQ‑D is a reliable measurement tool. The construct validity should be further investigated in future studies. This study reproduced results from previous studies in other populations. The FABQ‑D appears to be an adequate measurement tool for quantifying fear of movement in patients with shoulder disorders.
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Complex regional pain syndrome (CRPS) affects 10-15% of patients following injuries (fractures, surgery) to the outer extremities and people after a stroke. The affected area hurts, is inflamed and lacks strength, while mobility and sensitivity are restricted. Complementary medicine as part of integrative medicine offers additional effective treatment options. ⋯ Integrative, complementary medical therapy options support the CRPS patient in coping with their disease and the related pain. These options can play an important role in the multimodal, interdisciplinary treatment of this disease.
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The development of local anesthetics revolutionized the performance of painful interventions. Local anesthetics have an effect on voltage-gated sodium channels in nerve fibers and modulate the conduction of impulses. With respect to the chemical structure, local anesthetics can be divided into amide and ester types. ⋯ Severe adverse events include cardiotoxicity and neurotoxicity. In addition to basic measures, such as the monitoring and securing of vital parameters, lipid infusion represents a treatment option in cases of intoxication. The recent developments of local anesthetics are particularly concerned with the reduction of toxicity and prolonging the duration of action.