Der Schmerz
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The first type of facial pain is of vascular origin. Cluster headache is described as well as its subgroups and carotidodynia. Two organic lesions of the arterial wall can also cause facial pain: dissection of the internal carotid artery and giant cell arteritis. ⋯ Also, local lesions in the cranial nerves can cause facial pain, as well as organic processes of the upper cervical spine and of the occipitocervical transition. The characteristics of facial pain due to eye or ENT and dental lesions are described. So called atypical facial pain occurs quite frequently and mostly affects middle-aged women.
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The aim of this investigation has been to test in humans the reliability and validity of three painful stimuli, i.e, mechanical pressure, a modified submaximum-effort tourniquet technique, and the cold pressure test. Twenty-four untrained subjects (twelve females, twelve males) volunteered in the experiments and, after a trial session were presented with four runs of these three noxious stimuli within 36 h. They assessed the painfulness using a direct scaling technique (category subdividing procedure). ⋯ Repeated mechanical stimulation caused sensitization that did not occur with ischemia or cold. There were no significant differences whether the experiments were performed in the morning or in the evening. Experimental pain induction either by mechanical pressure or by ischemia judged in accordance with the category subdividing procedure produce reliable and valid results; the methods are easily applicable and economic.
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This epidemiological questionnaire-study of 362 patients suffering from chronic pain related to musculoskeletal disorders showed the following results: Most musculoskeletal pain syndromes are located in the head and back areas (57.3%). Patients who seek treatment in an orthopedic pain clinic suffer from at least moderate pain according to the verbal rating scale and from pain equal too or more than 50 on to the numeric rating scale. For most patients (51.9%) the duration of the pain has been between 1 and 10 years. ⋯ Most patients with chronic pain consult 2 to 6 doctors. For typical orthopedic pain syndromes most patients consult an orthopedist. Patients with chronic headaches consult an orthopedic specialist about as frequently as neurologist or internist specialist.