Ugeskrift for laeger
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Phantom pain is experienced by about 70% of patients following limb amputation. In most patients, both the frequency and the intensity of pain attacks diminish with time, but severe pain persists in about 5-10%. ⋯ Treatment of phantom pain is not successful; a recent study on prevention of the pain with a preoperative epidural blockade showed negative results. The future may reveal new specific drugs for treatment.
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There is a therapeutic potential in the doctor-patient relationship, in the diagnostic process, and in the symbolic elements of medical therapy. This unspecific effect seems, however, to be mainly caused by the doctor-patient relationship and the diagnostic process, and superfluous investigations and treatments should therefore not be initiated due to an unfounded idea about the potential of the so-called placebo effect. ⋯ It is pointed out, that the outcome of a treatment is a sum of the effect of the relationship between the physician and the patient, plus the specific biological treatment effect, plus the incidental effect including the effect of the patients knowledge of being under treatment. The article asks for more research in the first and the last of these three components of therapy.