Der Schmerz
-
The paper reports the results of a population-based pain survey in Lübeck, a city of 210,000 inhabitants in the northern part of Germany. Data were collected from 308 respondents (systematic sample aged 26-75 years) by mailed questionnaires (response rate: 80%). Subjects indicated on a list of 11 pain conditions whether they suffered from these kinds of painever, during the past 6 months, or "today". ⋯ However, 8% of the total sample reported more than 14 pain-related disability days and were classified as being affected by pain to a sociomedically relevant degree. Approximately half of the subjects who reported pain in the past 6 months did not consult a physician. This proportion decreased considerably in subgroups with more than 6 disability days.
-
74 pop/rock/jazz musicians and 100 classical musicians were investigated by means of a specially designed questionnaire. Several social, musical, pain-, and health-related questions were asked. ⋯ Specific instruments showed specific muscolosceletal pain patterns. 55% of the musicians in the classical field were treated by an orthopedic surgeon, whereas 43% of rock-pop-jazz musicians chose no therapy, although they suffered from pain. Only 32% of the classical musicians showed good compliance; 64% believe that medical therapy is not adjusted to the needs of musicians. 98% of the classical musicians and 89% of rock-pop-jazz musicians wish to have a doctor who is specially trained to deal with the needs of musicians.
-
After the initial clinical reports of Shealy 1967 dorsal column stimulation (DCS) was first introduced in Germany by Krainick (Freiburg) and Winkelmüller (Hannover) in 1972. At first, the success rate in unselected patients was unsatisfactory. The results improved with careful patient selection and better technical equipment allowing preliminary testing procedures before definitive implantation. ⋯ The best indications and target group are cases with radicular low-back pain after failed back surgery, stump and phantom pain, pain states following partial lesions of brachial/lumbar plexus and peripheral nerves, sympathetic dystrophy and rest pain in peripheral vascular disease (PVD). Possible indications for SCS are pain after incomplete lesions of spinal cord or cauda equina, postherpetic neuralgia, sclerodermia and PVD. Failures must be expected in pain states related to progressive malignant disease and complete deafferentation after spinal lesions or root avulsion.
-
The rationale for the use of spinal cord stimulation (SCS) in the treatment of chronic pain arose from Melzack and Wall's gate theory of the control of pain (1965). Originally electrodes were placed directly on the spinal cord via open operation, while now they are placed by means of direct puncture the epidural space. ⋯ The implantation of an SCS system is a surgical procedure, which requires the highest standards in asepsis. The operation and its complications and ways of avoiding them are described.