Der Schmerz
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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.
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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.