Schmerz最新文献

Lumbar spinal canal stenosis primarily affects older individuals over 65 years old and is often associated with typical symptoms, such as spinal claudication. Aside from rare congenital causes, it usually develops secondarily due to age-related changes, such as disc protrusion, facet joint degeneration and ligament hypertrophy. Apart from the typical clinical symptoms, native upright X‑ray images in two planes and magnetic resonance imaging (MRI) are decisive. Patients without relevant neurological deficits should primarily undergo conservative treatment. In cases of pain that cannot be alleviated by conservative approaches, neurological deficits and ineffective conservative treatment the indications for surgical treatment can be justified. A minimally invasive decompression should be strived for whenever possible. A fusion can become necessary in the presence of a clinically relevant instability, stenosis or malalignment.

Background: Nursing home residents frequently experience pain as a result of diseases. As posited by Egle et al., the bio-psycho-social model asserts that pain can affect individuals in various ways. Nevertheless, the various dimensions of pain are often not considered in pain management, and in numerous instances, pain is not even recognized by nursing professionals. The objective of the present study is to assess the prevalence of pain and the interventions implemented to reduce pain in an Austrian nursing home.

Methods: For this descriptive cross-sectional study, convenience sampling in an Austrian nursing home was used. The focus of the data collection was to assess the prevalence, intensity, and duration of pain as well as the interventions used by the nurses to reduce pain.

Results: Of 121 nursing home residents, 67 participated in the study: 39 residents had pain, whereby the majority had chronic pain. In total, 64 interventions were implemented, whereby most were pharmacological.

Conclusion: Nonpharmacological interventions play an important role in pain management. However, they were seldom used by nursing staff. The results of the study were discussed with nursing staff at the nursing home and based on the discussion, a summary of nonpharmacological interventions was created. The so-called "toolbox" is freely available and is intended to support nursing staff in deciding with nursing home residents which interventions to use to reduce pain.

In addition to the usual evaluation approach (usually a clinical randomized trial in the sense of the question: does an intervention work), complex interventions require further systematic investigations to prove their effectiveness. The role of the context in which the intervention is delivered is essential here, as is consideration of the question of why an intervention works (or does not work). Detailed recommendations exist for the planning and implementation of effectiveness studies on complex interventions, to which interdisciplinary multimodal pain therapy undoubtedly belongs. In an effectiveness model, concrete, verifiable assumptions are formulated as to how an intervention produces changes that are reflected in the endpoint. This article provides a brief introduction to methodological approaches to effectiveness research on complex interventions and uses the PAIN 2.0 project (01NVF20023) to describe in concrete terms what an effectiveness model for interdisciplinary multimodal pain therapy for the prevention of chronic pain in an outpatient setting might look like.

Background: Pain is an omnipresent symptom in the field of musculoskeletal healthcare. Person-centred care in accordance with current scientific recommendations requires comprehensive and evidence-based knowledge about pain. However, there appears to be a lack of knowledge in this area both internationally and nationally.

Aim: This study aimed to evaluate the pain-related knowledge and postural-structural-biomechanical (PSB) beliefs regarding pain among physiotherapists practicing in Germany.

Method: An online survey, which included the German version of the revised Neurophysiology of Pain Questionnaire (rNPQ-D) and the Essential Knowledge of Pain Questionnaire (EKPQ), was answered by n = 105 physiotherapists using SoSci Survey. A satisfactory result is achieved when at least 90% of the participants answer at least eight of the 12 questions correctly. Additionally, the possible influence of the variables 'academic degree' and 'working experience' of the participants on the questionnaire scores was investigated.

Results: The average score of the rNPQ‑D was 70.8 ± 15.4% (95% CI: 67.8-73.8%). The average score of the EKPQ was 51.4 ± 26% (95% CI: 46.4-56.4%). Neither the rNPQ‑D (69.5% of participants; n = 73) nor the EKPQ (30.6% of participants; n = 32) yielded a satisfactory result. The scores of the questionnaires correlated moderately positively and statistically significantly with each other (r = 0.47; p < 0.001). The average score of the EKPQ was significantly lower than the average score of the rNPQ‑D (p < 0.01; d = 0.84). Academically trained therapists achieved higher average scores than those non-academically trained (p < 0.05; rNPQ-D: d = 0.48, EKPQ: d = 0.42). Furthermore, participants with ≤5 years of professional experience achieved significantly higher scores than participants with >5 years of professional experience (p < 0.05; rNPQ-D: d = 0.75; EKPQ: d = 0.68).

Conclusion: The knowledge among physiotherapists in Germany about pain appears to be deficient and strongly PSB-orientated. In addition, academically trained therapists seem to have a more pronounced theoretical and case-related knowledge of pain compared to graduates of vocational physiotherapy training programmes. To ensure successful and effective future treatment of individuals experiencing pain, it is imperative to systematically investigate the potential causes of such deficits. Physiotherapeutic pain care in Germany should strive for a systemic change in favour of evidence-based practice.

Background: Endometriosis (EM) is one of the most common gynecologic conditions in our society. The diagnosis takes an average of 7 to 10 years. To shorten this period, this syndrome needs more attention. The aim of this article is to show overlaps between EM and low back pain (LBP) and to describe their relevance for physiotherapeutic screening.

Objectives: What clinical signs do the syndromes EM and LBP have in common and to what extent can physiotherapeutic screening take gynecological aspects into account and be adapted accordingly?

Results: To answer this question, the two syndromes were screened for overlaps. These overlaps were then related to the existing literature and case studies. The current research situation shows overlaps of the two syndromes with regard to the etiology, the pain mechanism as well as a psychosocial aspect. The literature shows that more women than men are affected by LBP and other chronic pain syndromes. EM occurs almost exclusively in women and, like LBP, is considered a chronic pain syndrome. Thus, a common pain mechanism of the two syndromes is discussed in the literature. The most frequent overlap of the two syndromes is shown by the occurrence of LBP as a frequent symptom of EM. This connection can be justified by structural causes as well as by a reflex pain presentation.

Conclusion: In a physiotherapeutic setting, evidence of EM can be observed in the history and physical examination. Considering these factors may help shorten the diagnosis time of endometriosis by referring for further evaluation if gynecologic involvement is suspected in LBP. A comprehensive history is important and should cover urologic, gynecologic, as well as sexual history. In this article, the term woman is used to refer to the biological female sex and is not related to individual gender identity. The clinical picture mainly affects women, which is why in the following work, as far as it concerns the people suffering from the disease, it is not used in the opposite sense.