Rupert Conrad1, Franziska Geiser1, Martin Mücke2,3,4. 1. Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie Universitätsklinikum Bonn Sigmund-Freud-Str. 25 53127 Bonn Deutschland Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie. 2. Klinik für Palliativmedizin Universitätsklinikum Bonn Deutschland Klinik für Palliativmedizin, Universitätsklinikum Bonn. 3. Institut für Hausarztmedizin Universitätsklinikum Bonn Deutschland Institut für Hausarztmedizin, Universitätsklinikum Bonn. 4. Zentrum für Seltene Erkrankungen (ZSEB) Universitätsklinikum Bonn Deutschland Zentrum für Seltene Erkrankungen Bonn (ZSEB).
Abstract
Pain and fatigue - a systematic review Introduction: Chronic pain and fatigue are symptoms that often occur together and characterize the symptom picture of various diseases. Nevertheless, integrative explanatory approaches have so far received little attention in medical practice. METHODS: Based on a systematic literature search in the Embase, Medline, PsychInfo, and CENTRAL databases, we searched for high-quality intervention studies for the simultaneous treatment of pain and fatigue. RESULTS: From 1,496 total hits, 158 studies were included in the evaluation. The most commonly studied clinical pictures of the symptomcomplex were tumor catabolism, fibromyalgia, chronic fatigue, rheumatoid arthritis, and osteoarthritis.Current explanations of the symptom complex focus on the activation of proinflammatory microglia in centralized pain syndrome with multiple effects on neurotransmission, neuroendocrinology, neuroplasticity, and the autonomic nervous system. In this model, fatigue can be understood as an evolutionary, meaningful symptom protective of the organism. CONCLUSIONS: A deeper understanding of the relationship between centralized pain syndrome and fatigue allows for new explanatory and treatment approaches.
Pain and fatigue - a systematic review Introduction: Chronic pain and fatigue are symptoms that often occur together and characterize the symptom picture of various diseases. Nevertheless, integrative explanatory approaches have so far received little attention in medical practice. METHODS: Based on a systematic literature search in the Embase, Medline, PsychInfo, and CENTRAL databases, we searched for high-quality intervention studies for the simultaneous treatment of pain and fatigue. RESULTS: From 1,496 total hits, 158 studies were included in the evaluation. The most commonly studied clinical pictures of the symptomcomplex were tumor catabolism, fibromyalgia, chronic fatigue, rheumatoid arthritis, and osteoarthritis.Current explanations of the symptom complex focus on the activation of proinflammatory microglia in centralized pain syndrome with multiple effects on neurotransmission, neuroendocrinology, neuroplasticity, and the autonomic nervous system. In this model, fatigue can be understood as an evolutionary, meaningful symptom protective of the organism. CONCLUSIONS: A deeper understanding of the relationship between centralized pain syndrome and fatigue allows for new explanatory and treatment approaches.