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Therapie chronischer Schmerzen

Chronic pain management

  • Arzneimitteltherapie
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Zusammenfassung

Schmerz ist eine der häufigsten Beschwerden, die den Patienten zum Arzt führen. Daher ist die Kenntnis häufiger Schmerzdiagnosen und möglicher Therapieansätze essenziell. Zahlreiche medikamentöse und interventionelle Therapieoptionen stehen in Klinik und Praxis zur Verfügung, um Schmerzerkrankungen kausal und symptomatisch zu behandeln. Chronische neuropathische Schmerzen können wirksam durch Medikamente gelindert werden. Auch interventionelle Verfahren können effektiv in der Schmerztherapie eingesetzt werden, wie die Spinal Cord Stimulation bei therapierefraktärer Angina pectoris. Bei bestimmten Krankheitsbildern (Phantomschmerz, M. Sudeck) sind ergotherapeutische Verfahren (z. B. Spiegeltherapie) sinnvoll. Die konsequente Diagnose und Therapie akuter Schmerzen ist die beste Prophylaxe chronischer Schmerzen.

Abstract

Pain is one of the major complaints leading to doctor visits. Therefore basic knowledge of frequent pain diagnoses and possible treatment approaches is essential. Numerous medical and interventional therapeutic options are available for causal or symptomatic treatment of pain. The treatment of neuropathic pain is often difficult and demands special knowledge. Antidepressants like amitriptyline and anticonvulsive drugs are the first choice in these cases. Also interventional approaches are useful, such as spinal cord stimulation for angina pectoris. For the treatment of complex regional pain syndrome and phantom pain the use of mirror feed-back is a new effective method for pain relief. The only way to prevent from development of chronic pain is the early and effective treatment of acute pain.

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Authors and Affiliations

  1. Klinik für Anaesthesiologie, Intensiv-, Palliativ- und Schmerzmedizin, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Bürkle-de-la-Camp Platz 1, 44789, Bochum, Deutschland

    D. Rothstein &  M. Zenz

  2. Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Knappschaftskrankenhaus Bochum-Langendreer, In der Schornau 23-25, 44892, Bochum, Deutschland

    M. Zenz

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Correspondence to D. Rothstein or M. Zenz.

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Rothstein, D., Zenz, M. Therapie chronischer Schmerzen. Internist 50, 1161–1168 (2009). https://doi.org/10.1007/s00108-009-2474-z

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