Der Schmerz
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It has been found difficult to stimulate the primary C-fibre afferents separately from those of Adelta fibres. A necessary and sufficient condition for the investigation of the C-fibre system is the selective stimulation of C fibres without activation of Adelta fibres. The stimulation of tiny skin areas allows such a selective activation of C fibres. ⋯ The stimulation of tiny skin areas represents a simple method for selective stimulation of C fibres.
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Clinical Trial
[Multimodal therapy patients with chronic cervical and lumbar pain. Results of a comparative prospective study].
Multimodal therapy has been established for patients with chronic low back pain, but studies reporting results in patients with chronic neck pain are rare. ⋯ Multimodal therapy is also an efficient treatment strategy for patients with chronic cervical pain as has already been shown for patients with chronic lumbar pain.
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Secondary mechanical hyperalgesia has been demonstrated in postoperative patients indicating that central sensitization occurs after surgery. However, the underlying mechanisms are unknown. Here, we studied the role of spinal AMPA/kainate receptors for pain behaviors indicating secondary hyperalgesia caused by gastrocnemius incision in the rat. ⋯ This amplification process likely requires Ca(2) influx through spinal AMPA/KA (but not NMDA) receptors. Behaviors for secondary mechanical hyperalgesia after incision can be inhibited without affecting primary mechanical hyperalgesia and guarding. Mechanisms for central sensitization causing secondary hyperalgesia in postoperative patients may therefore be separated from spontaneous pain and hyperalgesia that arises adjacent to the area of the incision.
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Fear Avoidance Beliefs and physical function in elderly individuals with chronic low back pain This analysis assessed how fear avoidance beliefs (FABs) affected subjective and objective functional parameters as well as pain in elderly individuals. The study comprised 152 elderly patients with low back pain, which was attributed to spondylosis in almost half of the cases. Their average age was 70.1 years (SD=4.3, range 65-84). ⋯ High fear avoiders also show lower values in the objective measure at all three measurement points. No influence of the FABs on the pain parameters could be determined. It would be expected that the efficacy of physiotherapy could be improved if the patients' FABs are taken into consideration when planning the treatment regimen.
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Among the possible reasons for low back pain, psychological factors are getting more attention. Early assessment of the stage of chronicity is important for successful therapy. The aim of the present study was to analyse the applicability of the Mainz Pain Staging System (MPSS) for chronic back pain outpatients. ⋯ The present study confirms the significance and usefulness of the MPSS applied to outpatients with back pain. To assess completely the stage of chronicity, psychological and physical/functional parameters should also be obtained.