Der Schmerz
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The interest of patients with chronic pain in complementary and alternative medicine (CAM) is high. The aim of an accompanying complementary therapy is to strengthen the patient's self-efficacy, the ability to make decisions and the autonomy. The best evidence exists for physical activity and a balanced diet. ⋯ Heat applications can support multimodal pain therapy. In the case of anti-inflammatory phytotherapeutic agents, there are good rationales from basic research and reliable empirical knowledge regarding the dosage. The evidence on cannabis is low.
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In the field of headache disorders, the term "fear of attacks" refers to the fear of a headache attack occurring. Excessive fear of attacks may worsen the course of a migraine and lead to an increase in migraine activity. In the assessment of attack-related fear, a categorical (fear of attacks as a specific phobia) and a dimensional approach (measuring the extent of fear using a questionnaire) are available. ⋯ The treatment of attack-related fear includes behavioral interventions as well as pharmacological therapy. Behavioral interventions have few side effects and are based on the treatment of common anxiety disorders (e.g., agoraphobia). Although the evidence of existing treatments is sparse, attack-related fear should be considered in routine care.
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Narrative Medicine is an interdisciplinary concept that joins literary texts and theory on the one hand with medical education on the other. It suggests that specific skills can be practiced by reflecting about literature and the arts, which represent existential human experiences. These skills are narrative competence, tolerance for ambiguity, changing one's perspective, empathy, and self-care. ⋯ Literary texts in a medical classroom can be a productive resource to practice and critically discuss competences identified in the National Competency-Based Learning Objective Catalogue for Medicine 2.0.
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For a long time, biblical views of pain were used to relieve and legitimize suffering. Nowadays, however, pain is seen as an evil to be fought. Despite this difference, it is worth researching the variety of images of pain in the Old Testament in order to include them in current debates. ⋯ Social and political upheavals played a crucial role in the development of Old Testament images of pain. That is why the ultimate cause of pain is only partially attributed to the divine, but more to human violence structures. The texts focus their hope on God as a deliverer from distress because he allows himself to be affected by pain.