Der Schmerz
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In previous years numerous acute pain models to investigate the pathophysiological mechanisms of pain and to validate treatment procedures have been described. Due to the specific questions addressed by different trials standardized protocols are often missing. Therefore, the research results obtained are only comparable or reproducible to a limited extent. The transferability of acquired knowledge to clinical pain is limited by the mostly short test duration of already established models. ⋯ The established acute pain model in this study is characterized by the induction of thermal pain stimuli of defined intensity and variable duration. There is no danger of significant thermal tissue damage and the pain was tolerated by all study participants. The pain model can easily be established using a device for quantitative sensory testing.
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In this article we address the relevance of rare diseases and their peculiarities with respect to pain therapy. Towards this end, four rare diseases (hemophilia, Morbus Fabry, dermatomyositis, and facioscapulohumeral dystrophy (FSHD)) will be presented and fundamental aspects of their pain therapies described. The diseases were chosen to showcase a pain therapy based on the WHO-step-by-step plan (hemophilia), a complex but established pain therapy (M. Fabry), and two less well established, individually adapted pain therapies (dermatomyositis, FSHD).
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The direct comparison of day care pain patients with patients from other treatment sectors with respect to sociodemographic, pain-related and psychological characteristics has not yet been the subject of systematic analyses. The project core documentation and quality assurance in pain therapy (KEDOQ-pain) of the German Pain Society (Deutsche Schmerzgesellschaft e. V.) makes this comparison possible. ⋯ The comparison of outpatients and inpatients showed significant group differences for some variables; however, the effects were very small. The evaluations suggest that pain therapy day care facilities treat a special group of pain patients that significantly differ from patients in other treatment sectors. Cautious conclusions are drawn regarding the systematic allocation of patients to care appropriate to their treatment needs.