Der Schmerz
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Multicenter Study Observational Study
[Capsaicin 8 % cutaneous patches for phantom limb pain : Results from everyday practice (non-interventional study).]
Post amputation pain presents a challenge for pain physicians and is often detrimental to the patient's quality of life. ⋯ Capsaicin 8 % cutaneous patches seem to be effective and safe for the treatment of post amputation pain, notably in patients suffering from phantom limb pain.
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In pain therapy neurostimulation procedures have replaced the previously used lesional methods with only very few exceptions. This is especially true for neuropathic pain, i.e. pain which occurs as a direct consequence of a lesion or disease of the somatosensory system. Nowadays, various stimulation procedures are included in the neurosurgical and anesthesiological armamentarium for pain therapy, depending on the site of damage. This article gives an overview of the currently used invasive stimulation procedures and the indications.
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Persistent chronic pain leads to cortical changes in areas involved in the recognition of emotions. Wand et al. suggest a close correlation between the affective pain component and the extent to which these changes occur. As a consequence, the emotion profile may be influenced and difficulties in emotional communication may arise. ⋯ The results suggest changes in the recognition of emotions and that patients with CLBP show signs of alexithymia. Further studies with larger sample sizes are required to confirm the detected trends.
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Case Reports Comparative Study
[Comparison of two screening questionnaires for patients with low back pain : Collation of risk factors for chronification].
Screening for risk factors for chronic low back pain (LBP) (yellow flags) is recommended by clinical guidelines. Various questionnaires to assess yellow flags have been proposed. ⋯ Both screening questionnaires for chronic LBP have insufficient diagnostic and prognostic validity for routine use in ambulatory care. Further studies are needed to improve diagnostic and prognostic validity and to elaborate criteria for a targeted use of screening questionnaires to guide therapeutic interventions.
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Unrelieved pain is a substantial public health concern owing in part to deficits in clinical expertise among physicians. In most medical faculties worldwide, teaching on pain and pain management is either nonexistent or limited to a small number of students attending voluntary courses. In light of the fact that pain is the most frequent reason to seek medical advice, the lack of formal training of pain medicine is considered the leading reason for inadequate pain management. Therefore, the patients' unmet needs for adequate diagnosis and therapy call for action. ⋯ The introduction of pain medicine into the undergraduate curriculum in Germany is a major challenge regarding the development and implementation processes. This article describes current instruments and implementation strategies for pain medicine as a new cross-sectional subject in Germany.