Articles: chronic.
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Treatment of chronic pain disease is a scientific and clinical challenge encountered in all branches of medicine. Essential trigeminal neuralgia and chronic pain situations are noted for their exceptionally marked severity and also for their psychic and social consequences. It is not rare for a primarily somatic pain syndrome to develop into a painful disease in its own right, which is highly refractory to treatment. ⋯ Vincristine iontophoresis was applied in 33 patients hitherto unsuccessfully treated with various other methods. In 78% of the cases, attenuation of the pain was achieved. This noninvasive therapy proved to be free of side effects.
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Acupuncture is increasingly being used in Western medicine. In the present study the effect of acupuncture treatment was examined in 60 patients with chronic pain. The long-term success after 6 months was evaluated in 45 patients. ⋯ It appeared that the consumption of analgesics could be reduced significantly in patients in whom the treatment was successful. All patients had been treated before by several methods. Because of the small number of side-effects and the patients' high degree of acceptance as well as the success of the treatment, we consider acupuncture an effective method in the treatment of chronic pain.
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A group study on the comparative efficacy of EMG biofeedback and progressive relaxation is presented. Sixteen children aged between 8 and 14 years with chronic tension headache and combined headache participated in the study. Six sessions of relaxation training and 12 (shorter) biofeedback sessions were held with each child. ⋯ Other variables indicate further positive effects of treatment (e.g., medication consumption, absence from school). After 6 months of follow-up the children treated by relaxation had achieved event further reductions in headache activity. Suggestions for further improvement in the clinical and economic efficiency of treatment formats are presented, and perspectives for future research are discussed.
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The chronic headache patients in our neurological outpatient department treated between 1985 and 1987 were retrospectively studied. One-third (n=44) were examined and questioned about the efficacy of treatment. Initial treatment in the outpatient department had been at least 2 years before the study, thus allowing evaluation of the long-term course of the illness. ⋯ Adequate consideration of the non-medical therapeutic elements should be ensured in such structures headache therapy. A uniform classification of headache and records of the course in the form of headache diaries are essential for comparing the results. A sufficiantly long post-therapy observation period should be allowed in order to facilitate evaluation of the therapeutic response.
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Dextropropoxyphene is a mild opioid analgesic whose analgesic potency corresponds to that of acetylsalicylic acid and paracetamol. It has a similar analgesic effect to codeine but also a considerably lower addiction and dependence potential. Dextropropoxyphene is a therapeutic alternative to other weak opioids such as codeine or dihydrocodeine. ⋯ Repeated administration of the sustained-release form at the therapeutically recommended intervals does not lead to cumulation, and the risk of accidental overdosage is extremely low. Intoxication can only occur after simultaneous ingestion of alcohol or other centrally depressant substances or in the presence of hepatic and/or renal failure. Sustained-release dextropropoxyphene is a sensible and undeniable alternative for the second stage in the analgesic ladder of chronic pain therapy.