Der Schmerz
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Coenesthesia, a rarely described symptom, is classified as schizophrenia according to ICD-10 and can occur independently of psychiatric diseases as a form of pain. The prevalence in chronic pain disorders is still unknown. The present study investigates the characteristics and psychological comorbidities of painful coenesthesia. ⋯ Coenesthesia does not necessarily occur in connection or only with schizophrenia. Coenesthesia should be considered if the patient gives a bizarre description of pain, but also in common pain descriptions, such as burning, stabbing, cramping, or a feeling of pressure, if these are related to unusual locations (cramping tooth).
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Almost everyone is familiar with "tense muscles", but what is muscle tension physiologically behind? Are tense muscles more active; do they have problems relaxing? Are they harder or stiffer than asymptomatic muscles? In this work, current evidence regarding the activity and stiffness of tense neck muscles is presented. Further, measurement methods and their limitations are explained. These limitations reveal the shortcomings of the current knowledge and the need for further research. Finally, a recently funded research project on the measurement of tense muscles is presented.
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Androgen insufficiency under treatment with opioids, antidepressants and anticonvulsants in chronic pain diseases is a side effect with a high prevalence. It can lead to clinical metabolic alterations, adynamia, stress intolerance, anemia or osteoporosis and has a significant impact on the quality of life. Opioids, antidepressants and anticonvulsants affect the hypothalamic-pituitary-gonadal axis of sex hormones. ⋯ The recommendation of a differential therapeutic selection of certain substances is only indicative and does not meet evidential criteria. The indications for androgen substitution must be individualized and in consideration of the risk-benefit profile. Awareness of this side effect of an otherwise lege artis medicinal pain therapy must be sharpened and compulsory included in the differential diagnostic considerations.
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According to the current guidelines preventive treatment of migraine should consist of a combination of pharmacological and nonpharmacological forms of treatment. Physiotherapeutic modalities could be an option for nonpharmacological migraine management. ⋯ The evidence suggests that multimodal physiotherapy treatment is a good supplement to medication and should therefore be considered as a nonpharmacological treatment for patients with migraine; however, further RCTs with a low risk of bias are necessary in order to confirm the effectiveness with high quality evidence.
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The objective of the review is to map the content of intervention education in people with acute nonspecific lumbar low back pain (LBP) to make it available in a synopsis. ⋯ The teaching of pathoanatomical information can potentially trigger or increase anxiety and worry, whereas information on neurophysiological mechanisms of pain development and processing is more likely to have an anxiety-reducing effect. The results can contribute to the design of the intervention in different settings.