Der Schmerz
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There are no data available from representative samples of the general German population on predictors of widespread pain (WP) and fibromyalgia syndrome (FMS). ⋯ WP and FMS are components of a complex of high somatic symptom intensity, low social class index and older age.
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The aim of this study was to investigate the criterion validity of the Mainz Pain Staging System (MPSS), considering the four axes of the MPSS separately. ⋯ Findings confirm the criterion validity of the MPSS for chronic low back pain. In addition, results support the significance of psychosocial factors for the further development of chronicity.
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Postherpetic neuralgia can lead to therapy-resistant neuropathic pain. We report the case of a 74-year-old woman with postherpetic perineal neuralgia resistant to opioids and antiepileptic drugs who has been successfully treated with oral ketamine for 28 months. ⋯ Significant side effects have not yet been reported. Despite "off-label" use, ketamine is an important third line option in cases of therapy-resistant neuropathic pain.
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The German Society for the Study of Pain (DGSS) commissioned a meta-analytic review of the evidence on the long-term effects of opioids, non-opioid analgesics and cognitive- behavioral procedures for chronic non-cancer pain. A multidisciplinary expert panel was established to review the evidence and formulate recommendations as far as possible on the basis of means, standard deviations and group sizes from randomized controlled trials. ⋯ Therefore, the LONTS guidelines focus on the prevention of adverse effects and misuse and a multidisciplinary approach for the treatment of chronic pain is strongly recommended. Principles of opioid prescription and on the management of risks associated with the long-term use of opioids are described.