Der Schmerz
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Comparative Study
[Treatment for chronic back pain? : Active multimodal, interdisciplinary pain therapy vs. physiotherapy-physical therapy for chronic back pain].
In industrialized countries, chronic back pain is referred to as the "number one common disease". ⋯ Treatment with MMSTh is superior to standard physiotherapy-physical. Due to the extensive, proven positive effect on many pain-causing and pain-preserving factors, multimodal pain centers should be used more frequently in chronic back pain patients.
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A patient with long-term fibromyalgia syndrome and concomitant post-traumatic stress disorder is reported. The relocation to a so-called external safe site resulted within a very short time in a sustained remission of the fibromyalgia syndrome, due to psychotherapeutic interventions. This shows that-according to the clinical guidelines-a psychiatric examination and, if necessary, targeted therapy of the psychiatric comorbidity is indispensable in patients with fibromyalgia syndrome.
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To date only few studies have addressed the level of intelligence of children and adolescents with chronic pain. The few currently available studies suggest a cognitive performance of pediatric pain patients in the average range (IQ 85-115); however, only little is known about the relationship between pain characteristics and cognitive skills. ⋯ The results support the assumption that the intellectual performance of pediatric pain patients lies within the average range; however, the results indicate a limited competence in verbal abstraction and expressiveness of pediatric pain patients, which are negatively related to pain intensity. Further studies to examine causal relationships are needed.
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Case Reports
[Schwannoma of the inferior gluteal nerve as a rare cause of gluteal radiating chronic low back pain].
This is the first report of a schwannoma of the inferior gluteal nerve (IGN) as a cause of chronic low back pain in a 43-year-old man. The patient suffered from severe pain radiating to the gluteal region. He was treated for months without pain relief and was on long-term disability. ⋯ By tumor resection, a schwannoma was histologically confirmed. After tumor removal the patient is free of pain with all medication discontinued. He has been fully reintegrated into his professional life.
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This study examines the perspectives of patients and family caregivers on outpatient palliative care networks. It contrasts primary palliative care (AAPV) and specialized outpatient care (SAPV) services, particularly in regard to pain management. ⋯ The personal and professional composition of networks of outpatient palliative care varies individually according to care situation and form. Care networks of AAPV and SAPV differ with regard to the accessibility of health care professionals and pain therapy. Home-based palliative care is often made possible by informal care givers in the first place.