Der Schmerz
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Acupuncture is increasingly being used in Western medicine. In the present study the effect of acupuncture treatment was examined in 60 patients with chronic pain. The long-term success after 6 months was evaluated in 45 patients. ⋯ It appeared that the consumption of analgesics could be reduced significantly in patients in whom the treatment was successful. All patients had been treated before by several methods. Because of the small number of side-effects and the patients' high degree of acceptance as well as the success of the treatment, we consider acupuncture an effective method in the treatment of chronic pain.
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Treatment of chronic pain disease is a scientific and clinical challenge encountered in all branches of medicine. Essential trigeminal neuralgia and chronic pain situations are noted for their exceptionally marked severity and also for their psychic and social consequences. It is not rare for a primarily somatic pain syndrome to develop into a painful disease in its own right, which is highly refractory to treatment. ⋯ Vincristine iontophoresis was applied in 33 patients hitherto unsuccessfully treated with various other methods. In 78% of the cases, attenuation of the pain was achieved. This noninvasive therapy proved to be free of side effects.
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Epidural steroid injections are frequently used in the conservative treatment of backache, although they are still subject to critical discussion. Relief of pain is attributed to the anti-inflammatory effect of the steroid. During a 3-year period, 53 patients with back pain or differing aetiology were treated with one or more epidural injections of 14 mg betamethasone (2 ml Celestan) in a prospective and retrospective fashion. ⋯ Patients with acute pain (up to 6 months) responded better than patients with chronic symptoms. No significant correlations were detected between response and other characteristics, e.g. age, sex, number of injections, type of pain, intensity of pain, or psychological overlay. For patients with acute pain epidural steroid injections seem to be a safe, appropriate and promising procedure.
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Neuropathic pain is one of the problem areas in the management of cancer pain. In a retrospective study, prevalence and characteristics of neuropathic pain in 1318 cancer patients attending a pain clinic were examined. Of the patients, 135 suffered from neuropathic, 285 from neuropathic and nociceptive, 890 from nociceptive and 8 from unknown pain conditions. ⋯ Of 110 clinically analysed neuropathic pain conditions, 44% were neuralgic, 31% radicular, 13% sympathically maintained, and 10% caused by deafferentiation, while in 3% the nature was unknown. To evaluate the efficacy of cancer pain treatment, nocicepetive pain has to be differentiated from neuropathic pain. In addition to this, neuropathic pain has to be divided into subgroups.
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A group study on the comparative efficacy of EMG biofeedback and progressive relaxation is presented. Sixteen children aged between 8 and 14 years with chronic tension headache and combined headache participated in the study. Six sessions of relaxation training and 12 (shorter) biofeedback sessions were held with each child. ⋯ Other variables indicate further positive effects of treatment (e.g., medication consumption, absence from school). After 6 months of follow-up the children treated by relaxation had achieved event further reductions in headache activity. Suggestions for further improvement in the clinical and economic efficiency of treatment formats are presented, and perspectives for future research are discussed.