Der Schmerz
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Review Practice Guideline Meta Analysis
[Multicomponent therapy of fibromyalgia syndrome. Systematic review, meta-analysis and guideline].
The scheduled update to the German S3 guidelines on fibromyalgia syndrome (FMS) by the Association of the Scientific Medical Societies ("Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften", AWMF; registration number 041/004) was planned starting in March 2011. ⋯ The use of a multicomponent therapy (the combination of aerobic exercise with at least one psychological therapy) for a minimum of 24 h is strongly recommended for patients with severe FMS. The English full-text version of this article is available at SpringerLink (under "Supplemental").
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Review Comparative Study
[Efficacy, utility and cost-effectiveness of multidisciplinary treatment for chronic low back pain].
Qualitative criteria, such as efficacy, utility and cost-effectiveness are essential for insurance and reimbursement companies to meet the costs for a multidisciplinary treatment (MDT) for persons with chronic low back pain (CLBP). ⋯ The MDT of CLBP is moderately efficient, purposeful, cost-effective and demonstrate an alternative treatment form to surgical treatment.
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Review
[Development of an internet-based clinical pathway exemplified by the fibromyalgia syndrome].
Clinical pathways (CP) are considered to be a tool of clinical process management describing the optimal route for diagnostic and therapeutic medical treatment of a specified patient. Apart from economic aspects CPs can make a contribution to optimization of health quality management as well as to improvement of medical staff and both patient satisfaction and patient safety whereas the feasibility and acceptance of evidence-based medicine guidelines are often found to be low. In order to stimulate critical discussion by offering the opportunity to easily gain first practical experience, a free web-based clinical pathway system for diagnosis and treatment for patients with fibromyalgia syndrome (FMS) will be presented.
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Pain-related evoked potentials (PREPs) represent a novel method for the evaluation of peripheral and central nociceptive pathways, e.g. in the diagnosis of small fiber neuropathy (SFN) or after therapeutic interventions for headache. Compared to contact heat-evoked and laser-evoked potentials, recording of PREPs is less stressful for the subjects and technically less demanding. ⋯ They have also been evaluated after interventional methods, such as direct current stimulation (tDCS). The article reviews and discusses the advantages and pitfalls of this technique in the context of recent clinical studies as compared to other paradigms of peripheral electrical stimulation and delineates perspectives and possible indications.