Articles: pain-clinics.
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The aim of the study was to evaluate an educational video designed to modify the pain concept of chronic pain patients. It is commonly described that chronic pain patients foster an illness model which is dominated by purely medical assumptions about causes of pain and its modulation and treatment. Furthermore the mostly unrealistic hope for total pain relief which is expected from the pain expert guides the patients' seek for help. ⋯ The Ss participating in the study were 47 chronic pain patients of a pain ambulance and 42 patients of a pain clinic (inpatient setting). The results showed that after viewing the pain video the groups differed significantly in their pain concept as predicted. The use of an educational video, like the one evaluated, seems useful to initiate first steps in illness concept modification by expanding and enriching the patients attitude by assumptions about the influence of psychological factors on pain maintenance and management and shaping realistic attitudes towards treatment.
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Myofascial pain syndromes, fibromyalgia, and articular dysfunctions may all be contributing to our patients' ubiquitous musculoskeletal pain problems that generally are poorly understood and poorly managed. Thepectoralis minor myofascial pain syndrome, for example, results from trigger points (TrPs) activated by stress overload of the muscle. ⋯ Snapping palpation at the TrP elicits a local twitch response (LTR). The increased muscle tension of a pectoralis minor syndrome commonly entraps the lower trunk of the brachial plexus, producing symptoms of a cervical radiculopathy.
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The analgesic effectiveness of physical therapy in rheumatology is dependent on the differentiated clinical picture (joint, soft parts, spinal column, musculature) and on the differentiated therapeutic remedy (intensity, duration of single treatments, frequency, duration of therapeutic series). Physico- and kinesitherapy can be distinguished with regard to objective and subjective doses; manual therapy is between them. ⋯ The problem "rheumatism and pain" mainly exists at the level of "chronic"; diagnostics of movement function (articular and muscular functions) on one hand and dosage of therapeutic remedies (drugs and remedies of physiotherapy) on the other are the guidelines. Course (rehabilitation) as well as onset (prevention) of rheumatic clinical pictures determine the further strategy of pain therapy.
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A completely new classification system for headache disorders, cranial neuralgias and facial pain has been prepared by a headache classification committee working within the International Headache Society (IHS). The committee is made up of an international body of experts, who spent almost 3 years on the preparation of the classification, publishing it in 1988 (Cephalalgia 8 Suppl 7ratio1ff., 1988). The German translation appeared a year later (Nervenheilkunde 8ratio161-203, 1989). ⋯ The advantages and the problems encountered are discussed. On balance, the new IHS classification is proving to be a very useful basis for the diagnosis of painful conditions affecting the head and face. It is indispensable for a modern headache clinic.