Der Schmerz
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The objective of this study was to evaluate the clinical outcome of CT-guided radiofrequency- (RF-)thermocoagulation of cervical zygapophysial joints for chronic non radicular cervical pain syndrome using an improved posterior approach. ⋯ CT-guided radiofrequency thermocoagulation is an effective, precise and secure, minimally invasive treatment for non radicular cervical pain that is caused by zygapophysial joint arthropathy, when CT-guided, lateral drug instillation does not cause a lasting improvement.
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The term "neuralgia of the occipital nerve" in clinical work includes different kinds of pain in the occipital region. Correctly, this diagnosis should be reserved for such pain syndromes which, corresponding to the definition of neuralgia, are due to damage of the cervical roots C1-C3 or of the major occipital nerve arising from those roots. We introduce an operative method to treat chronic therapy-resistant headaches in the area of the major and minor occipital nerve. The courses of three of the first patients operated in our hospital are described. ⋯ The epifacial stimulation of the occipital nerve is an effective method to treat neuralgia of this nerve. Patients with destruction of the nerve have to be excluded, because in their cases the stimulation does not work.
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Modern pain therapy began with the discovery of morphine by Sertürner in 1803. The following continuous introduction of new analgesics promised an end of pain as a bane of mankind. Reality, however, soon proved different. ⋯ The first specialised pain clinic opened by Bonica in the USA and the founding of the International Association for the Study of Pain (IASP) have been milestones in the treatment of chronic pain. Today several associations and societies are active promoting both the needs of patients suffering from chronic pain and the needs of the professionals treating pain patients. Although recently physicians can qualify in specialised pain therapy there are still by far too few specialists to provide sufficient care for all chronic pain patients in Germany.
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Specialized pain management centres have been shown to achieve significant clinical efficacy and a relevant reduction of direct and indirect costs. Furthermore, only patients are admitted after conventional therapies failed. The results of specialized pain management might be even more impressive if patients were treated earlier. Parameters of cost efficacy in pain treatment include pain reduction, reduction of drug intake, increase of physical activity, improvement of quality of life, reduction of inability to work, avoidance of early retirement.
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Comparative Study Clinical Trial Controlled Clinical Trial
[Music therapy for chronic headaches. Evaluation of music therapeutic groups for patients suffering from chronic headaches].
This paper presents a new approach to music therapeutic treatments. We developed a short time treatment ( 8 group sessions) for patients suffering from chronic headaches. The multimodal concept of this headache treatment and particularly the effect of a sound trance on headache patients are explained and evaluated in this paper. ⋯ The results indicate that music therapy groups are more successful than a waiting group. The study's results agree with numerous other psychological evaluation studies and shows once more that music therapists working with patients suffering from chronic headaches are able to achieve successful results particularly long-dated. Thus, creative therapeutic approaches supplement the medical treatment, as they help the patients to develop an adaptive way of coping their pain. Yet, it will need further research to confirm the benefit of music therapy for patients suffering from chronic pain.