Der Schmerz
-
Pain caused by the sacroiliac joint (SIG) makes up a relevant proportion of lumbar back pain and can have a variety of specific and non-specific causes. The SIG represents the central link between the spine and the lower extremity. It is characterized by high stability and low mobility. ⋯ More specifically, movement and provocation tests as well as infiltrations are carried out. General information and conservative therapeutic methods represent the first-line therapies. Interventional and surgical procedures can help in the case of chronification.
-
Case Reports
[Drug-induced reversible cerebral vasoconstriction syndrome : Ustekinumab as possible trigger?]
The reversible cerebral vasoconstriction syndrome (RCVS) is a common cause of thunderclap headache. Many trigger factors, such as the intake of vasoactive and less commonly immunosuppressive medication have previously been described. This article reports the first case of the occurrence of RCVS after the intake of ustekinumab in a female patient with a history of Crohn's disease.
-
The corona pandemic has led to a number of restrictions and prohibitions, which in turn place large psychosocial or spiritual burdens on patients with COVID-19, their families and relatives and the treating personnel in the healthcare system. Patients with COVID-19 are not allowed to receive visitors and many hospitals and nursing homes have completely banned visitors. Many support services have been reduced or stopped completely. ⋯ Families should also be enabled to say goodbye to the deceased with adequate protective equipment or should be offered alternative real or virtual options for remembrance and commemoration. Health care professionals coping with the exceptional stress should be continuously supported. This requires clear communication and leadership structures, communication training, psychosocial support, but most of all optimal framework conditions for the clinical work.
-
People have the need to find explanations for the events that occur in their lives. This is especially true when it comes to experiences that impact a person's entire existence and endanger their self-esteem and sense of identity. Chronic pain is one such experience. The search for the cause behind such pain is primarily motivated by the expectation that once the cause of the pain has been identified, an effective pain-alleviating therapy should ensue. Due to the numerous advances in the last several decades towards understanding the fundamental mechanisms governing the origins and processing as well as the treatment of pain, such expectations towards medicine can frequently be met; however, in many cases the experiences of chronic pain remain difficult to explain and, above all, very difficult to manage. ⋯ The following changes in perspective are recommended: the search for the past-centered why should make way for the future-oriented quest for the what for of continuing to live a life with chronic pain.
-
The Mainz Pain Staging System (MPSS), which has been validated primarily in middle-aged and chronic low back pain patients, is designed to predict prognosis and control the use of resources at baseline. In multi-morbid and functionally impaired patients (geriatric patients) with multiple causes of pain, it is unclear whether this instrument can be implemented at all and whether it permits statements to be made on the severity of pain chronification. ⋯ MPSS can be used in multi-morbid and functionally impaired elderly patients undergoing inpatient treatment. Chronification features are more pronounced at higher stages than at lower levels. Only one category of the MPSS cannot be collected by self-assessment. The possibilities of prognosis estimation and resource control using the MPSS should be further investigated for these patients.