Der Schmerz
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To assess the efficacy of multimodal pain therapy for chronic pain patients it is necessary to use suitable outcome domains as well as reliable and valid measurement instruments. Using pain intensity as an example, however, it is shown that there are critical issues with respect to suitability for chronic pain patients and the quality (e.g. content validity, feasibility and interpretability) of commonly used measurement instruments. ⋯ The results of the pilot studies affirmed that the construct of pain intensity as well as the measurement instruments must be critically considered when applied to chronic pain patients and the effectiveness of multimodal pain therapy. The concept of patient focus groups proved to be a suitable method for patient participation. Integrating patients should be considered not only in discussions of existing pain scales but also in developing new measurement instruments.
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Review Meta Analysis
[Chronic low back pain and psychological comorbidity : A review].
Back pain is a common, disabling problem in Germany. Previous research has evaluated associations between low back pain (LBP), depression, and fear. ⋯ The results can improve the understanding of the complexity of LBP perception and its therapy. The generalization of the results is limited. To cover the correlation of psychosocial and lifestyle factors and pain perception of LBP, further research is required. To obtain a clearer picture of pain perception in persons with LBP, standardized pain assessment would be beneficial. In addition, we recommend that future studies follow standardized procedures to allow greater comparability.
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Randomized Controlled Trial
[Treatment of fibromyalgia syndrome with gamma-hydroxybutyrate : A randomized controlled study].
The etiology of fibromyalgia syndrome is not yet fully understood. Current hypotheses suggest a potential role of gamma-hydroxybutyrate (GHB) in influencing endocrinological abnormalities in patients with fibromyalgia. ⋯ Administration of low dose GHB did not yield clinical improvements in female outpatients with fibromyalgia. General improvement in the course of treatment may have resulted from operant behavioral pain therapy. Future studies on GHB should control hypothetical risk factors for identification of non-responders.
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The wrist and hand form a highly complex organ that is of great importance in almost all daily activities. The hand serves as a tool and an organ of sense. ⋯ Almost all structures of the hand are easily accessible for clinical examination, i. e. inspection, palpation and clinical tests, including dynamic testing. Diagnostic imaging completes the examination procedure.