Der Schmerz
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Elektrophysiological methods provide objective data about the function of the somatosensory system. Broadly established methods like neurography, myography, sensory evoked potentials and electrically evoked reflexes are in contrast to less well known techniques as laser-evoked potentials and microneurography. ⋯ Unlike, laser-evoked potentials and microneurography describe the functionality of nonmyelinated, small diameter nerve fibers, which transmit pain and temperatures as sensory signals. Investigation of the sympathetic sudomotoric system can provide evidence for lesions within sympathetic nerves.
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The results of conventional chronic back pain therapy are unsatisfactory. Deconditioning, psychosocial disorders and prolonged disability are common sequelae. ⋯ Patient selection by a health fund, interdisciplinary assessment and severity adapted treatment resulted in significant reduction in pain and functional improvement in disabled back pain patients.
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Practice Guideline
[Definition, classification and diagnosis of fibromyalgia syndrome].
Interdisciplinary guidelines for the definition, classification and diagnosis of chronic widespread pain (CWP) and fibromyalgia syndrome (FMS) were developed by collaboration of 10 German medical and psychological associations and 2 patient self-help organizations. ⋯ CWP is defined by the criteria of the American College of Rheumatology (ACR--strong consensus). FMS can be diagnosed for clinical purposes by symptom-based criteria (without tender point examination) as well as by the ACR criteria (strong consensus).
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The guideline was developed by 10 scientific societies and 2 patient self-help organizations and coordinated by the German Association of Pain Therapy (DIVS). The guideline was approved by the Association of the Scientific Medical Societies in Germany AWMF (AWMF number 041/004), april 17, 2008. No direct or indirect financial support by pharmaceutical companies was involved and there were no potential conflicts of interest for any of the 58 participants of the guideline group. ⋯ Standardized, formal procedures to reach a consensus on recommendations were used. The guideline was reviewed by the board of directors of the societies engaged in the development of the guideline. The guideline will be published in complete and short scientific versions, clinical practice and patient versions.