Der Schmerz
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Interdisciplinary multimodal pain therapy (IMPT) is mostly run in a group setting to encourage the exchange of experiences between patients and thus facilitate the change of pain-related attitudes and behavior. As is known from psychotherapy research, the fellow patients in a therapy group have a relevant influence on the success of the therapy for the individual patient. ⋯ Despite methodological limitations our results suggest that in patient groups of an IMST, patients with therapy experience and those with advanced cognitive behavioral methods for pain management should be combined with novices and patients who are still at the beginning of coping with the chronic pain disorder.
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Chronic pain affects around 3 million people in Germany. The drug therapies used are only effective to a limited extent and sometimes have considerable side effects. ⋯ Combined with evidence-based complementary medicine, MBM as mind-body medicine in integrative and complementary medicine (MICOM) is an effective instrument for self-efficacy and self-care with very few side effects. The reduction of stress plays a key role in this process.
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In Germany, headache is one of the illnesses that most frequently leads to health impairments and to consultation with physicians. Even in children, headache is often associated with restricted activities of daily life. Nevertheless, the level of care for headache disorders is disproportionate to the medical needs. ⋯ The safety of the therapeutic options is also classified. These methods include physiotherapy, neural therapy, acupuncture, homeopathy, phytotherapy and the intake of dietary supplements. For children and adolescents with headaches, there are studies in the field of dietary supplements for coenzyme Q10, riboflavin, magnesium and vitamin D, which indicate specific effects in the reduction of headaches.
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Osteoarthritis of the knee (gonarthritis) represents a medical challenge. ⋯ Complementary treatment approaches, such as acupuncture, tai chi/qigong, topical naturopathic self-treatment and leeches (with limitations) can, in addition to behavioral changes, exercise therapy and short-term pharmacological treatment, be important evidence-based components of integrative pain management concepts, e.g. in terms of an interdisciplinary multimodal pain treatment (IMPT). Besides pain reduction and functional improvement they promote the internal control conviction through the possibility of self-treatment and self-exercise.
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Case Reports
[Electrotherapeutical stellate ganglion block on a patient with complex regional pain syndrome of the upper limb].
The case of a 51-year-old patient with complex regional pain syndrome (CRPS) of the left hand after radius distortion is reported. Anticonvulsant therapy was difficult in this case due to persisting epilepsy with already dual therapy (lamotrigine and brivaracetam) at high dosage. ⋯ A ganglion blockage could not be clinically confirmed in the absence of Horner syndrome, but neuropathic pain and hyperhidrosis could be positively influenced. This case report summarizes the electrode positions used, current parameters, pitfalls and therapy limitations and discusses them in relation to the literature.