Der Schmerz
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Multicenter Study
[Experience in measuring the quality of treatment in interventional pain therapy : The Activity Index on a touchscreen PC].
There is a growing interest in patient-related outcome measurement. In this field questionnaires on touch screens are becoming more common. This study was designed to identify problems in usability and feasibility of a web-based questionnaire. ⋯ This web-based questionnaire is the first of its kind to be evaluated in everyday practice of interventional pain therapy for lumbar back pain. The vast majority of the patients were able to efficiently complete the questionnaire. The questionnaire was highly acceptable to patients, nurses and doctors. We found some usability problems but mainly in the older age group.
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The medical and healthcare economic burden caused by chronic lumbar back pain (CLBP) requires the use of interdisciplinary treatment approaches. The present study aimed to evaluate whether the effectiveness of inpatient multimodal pain therapy (MPT, operations and procedures (OPS) coding 8-918.02), can be increased by implementing additional neuromuscular core stability exercises (NCSE). ⋯ Despite the use of an additional NCSE, no significant added value in individuals with CLBP could be detected, although a systematic pre-post effect in daily functions and physical well-being (one week after discharge) was observed for the IG only. Therefore, on the basis of the study results, the implementation of additional NCSE into the inpatient MPT cannot be clearly recommended. To further delineate the therapeutic relevance, studies with larger sample sizes are needed.
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Chronic low back pain is often accompanied by fear-avoidance cognitions, increased depressive symptoms and decreased quality of life. ⋯ To improve the physical quality of life, depressive symptoms should be included into the treatment of chronic low back pain.
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This article presents the case of a 33-year-old female patient with exacerbation of a pre-existing tension type headache. The exacerbation occurred within the scope of an infection and persisted after the infection had receded. The excessive diagnostic approaches went on for weeks and only finally came to an end with the diagnosis of a pregnancy. The impacts of hormonal changes on headaches caused by pregnancy are discussed as well as postinfection events.
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Review Meta Analysis
[Recommendations for treatment of fibromyalgia : Where will we stand in 10 years?]
This article elucidates changes in the recommended diagnostics and therapy of fibromyalgia (FM). The recommendations from major internationally recognized guidelines are compared with the newest recommendations of the European League Against Rheumatism (EULAR) that in contrast to the guidelines surprisingly recommend physical exercise after patient education for all FM patients. ⋯ Finally, we try to predict how patients will be treated 10 years from now, for which knowledge from the guidelines and the initial approaches that diagnosed heterogeneity in FM are included. Empirically based questions will drive mechanism-based approaches as opposed to simply reacting to symptoms, in order to meet the challenge of an individual, mechanism-oriented treatment.