Der Schmerz
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Observational Study
[Acupuncture covered by statutory health insurance in Germany : An observational study based on claims data].
The coverage for acupuncture for chronic lower back or knee pain by the statutory health insurance was introduced in 2007. The aim of this study was to investigate characteristics of patients and providers of acupuncture and temporal and regional trends in the utilization of acupuncture. ⋯ Higher utilization of acupuncture by women reflects the epidemiology of back and knee pain and their preference for alternative complementary medicine. On the one hand, the large proportion of patients treated repeatedly with acupuncture suggests perceived benefits. On the other hand, provision of acupuncture services is decreasing continuously and a relevant proportion of subjects are terminating treatment prematurely.
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The characterization of subtypes of chronic pain patients based on their pain coping profiles may contribute to a better understanding of the pain syndrome, to more specific indications of established treatment options as well as to further development of therapeutic interventions. ⋯ The results revealed three distinct subgroups regarding pain coping patterns: (1) high impairment and high coping, (2) low impairment and high coping and (3) high impairment and low coping. The subgroups differed significantly in almost all characteristics, except for pain duration and pain intensity. The categorization into the abovementioned pain coping subtypes may assist clinicians in tailoring pain treatment to the needs and characteristics of the individual patients.
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Case Reports
[Unsuccessful pain treatment over 6 years of a thoracic radiculopathy caused by an unrecognized Tarlov cyst].
This article presents a case of unsuccessful pharmaceutical and invasive pain treatment for 6 years without any adequate diagnostics in a female suffering from unilateral thoracic radiculopathy (Th8, right) leading to severe disability and unemployment. The origin was an undetected Tarlov cyst. ⋯ This case underlines the necessity of adequate diagnostics ahead of long-term pain treatment. Thoracic Tarlov cysts are very uncommon but should be included in the differential diagnosis because curative treatment may be possible.