Der Schmerz
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Review
[Multidisciplinary assessment for multimodal pain therapy : Indications and range of performance].
According to evidence-based German national guidelines for non-specific low back pain, a broad multidisciplinary assessment is indicated after persisting pain experience of 6 weeks in order to check the indications for an multi- and interdisciplinary pain therapy program. In this paper the necessary topics, the content and the disciplines involved as well as the extent of the multidisciplinary assessment are described as developed by the ad hoc commission on multimodal pain therapy of the German Pain Society.
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Establishing a trustful therapeutic relationship and reflecting on attitudes and behavior is essential in caring for patients with functional pain syndromes. Hope-disappointment circles are common and can be intensified by unfavorable caregiver behavior. A biopsychosocial, empathetic and coping-oriented attitude has proved to be useful. A motivating communication is recommended that carefully explores the pain and its interactions with psychosocial factors following the three typical phases of accepting complaints, establishing biopsychosocial understanding and developing coping strategies.
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Biography Historical Article
[Development of epidural spinal cord stimulation : Fortieth anniversary of the first implantation in Germany].
Spinal cord stimulation is nowadays an established therapy for various neuropathic and vasculopathic pain syndromes after more conservative measures have failed. However, 40 years ago, only 5 years after the first worldwide implantation in the US, this therapy was promoted in Germany. ⋯ Nowadays about 1700 spinal cord stimulation systems are implanted annually in Germany. The development of spinal cord stimulation from the beginnings up to now taking into special consideration the early years in Germany are presented.
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Pain sensitivity is a risk factor for postoperative pain and is usually determined by experimental pain stimulation. Ruscheweyh et al. (Pain 146:65-74, 2009) developed the pain sensitivity questionnaire (PSQ) which assesses general pain sensitivity by self-rating without using extensive and painful experimental stimulation. The objective of this study was to examine whether subjective pain sensitivity affects postoperative pain intensity and can be considered as a risk factor for postoperative pain. ⋯ Subjective pain sensitivity can easily be measured by the PSQ and is a risk factor for postoperative pain intensity.