A postal survey was carried out on every 71st person aged between 18 and 80 in the population registers in County Regierungsbezirk Karlsruhe in the State of Baden-Würtemberg. It asked 2127 persons whether they had, in the previous 6 months, experienced any form of unduly prolonged pain (as distinct from brief intercurrent self-limiting episodes related to injury inflammation etc.) and, if so, to specify its location, duration, severity and persistence. It also sought information on the resulting calls on healthcare professionals and the degree of satisfaction with treatments received. The age and gender distributions of the sample selected for survey matched those in the population from which it was drawn. Of the 1420 respondents, only 1304 declared their age and gender--a condition for inclusion in the analysis. Of these, 610 reported some form of unduly prolonged pain, which had lasted more than a year in 530. For all pain lasting longer than a year, the estimated prevalence of mild pain was 11%, severe 25% and intolerable 3.5%: the corresponding estimates for persistent as opposed to episodic pain were 2% for mild, 10% for sever and 1% for intolerable. Pain was present in more than one anatomical location in most of those who reported it. Musculoskeletal pain was overwhelmingly the most common. Increasing age, obesity and being female pre-disposed to the reporting of pain, with women being more liable to report headache and pain in the neck and shoulder. One hundred and thirty-six pain reporters either gave no information on consultation or sought no help from healthcare professionals: a third of the remainder consulted more than one professional, with general practitioners and specialists in physical medicine (niedergelassener Orthopäde) being the most common. A wide variety of treatments were used, with oral medications, massage, exercises, mud pack and heat treatment being the most popular; two-thirds of sufferers used more than one type of treatment. The most popular types of treatment tended also to be the most successful, except for oral medication (which was also the most heterogeneous). Multiple logistic regression analyses identified consistent associations between duration and severity of pain, the number of sites where it was reported, the numbers of healthcare professionals consulted and the number of treatments tried, and the same groupings of features were associated with decreased likelihood of overall satisfaction with treatment received.

No abstract

Two daily doses of oral Harpagophytum extract WS 1531 (600 and 1200, respectively, containing 50 and 100 mg of the marker harpagoside) were compared with placebo over 4 weeks in a randomized, double-blind study in 197 patients with chronic susceptibility to back pain and current exacerbations that were producing pain worse than 5 on a 0-10 visual analogue scale. The principal outcome measure, based on pilot studies, was the number of patients who were pain free without the permitted rescue medication (tramadol) for 5 days out of the last week. The treatment and placebo groups were well matched in physical characteristics, in the severity of pain, duration, nature and accompaniments of their pain, the Arhus low back pain index and in laboratory indices of organ system function. A total of 183 patients completed the study. The numbers of pain-free patients were three, six and 10 in the placebo group (P), the Harpagophytum 600 group (H600) and the Harpagophytum 1200 group (H1200) respectively (P = 0.027, one-tailed Cochrane-Armitage test). The majority of responders' were patients who had suffered less than 42 days of pain, and subgroup analyses suggested that the effect was confined to patients with more severe and radiating pain accompanied by neurological deficit. However, subsidiary analyses, concentrating on the current pain component of the Arhus index, painted a slightly different picture, with the benefits seeming, if anything, to be greatest in the H600 group and in patients without more severe pain, radiation or neurological deficit. Patients with more pain tended to use more tramadol, but even severe and unbearable pain would not guarantee that tramadol would be used at all, and certainly not to the maximum permitted dose. There was no evidence for Harpagophytum-related side-effects, except possibly for mild and infrequent gastrointestinal symptoms.

Musculoskeletal pain was overwhelmingly the most common. Increasing age, obesity and being female pre-A postal survey was carried out on every 71st person disposed to the reporting of pain, with women being aged between 18 and 80 in the population registers more liable to report headache and pain in the neck in County Regierungsbezirk Karlsruhe in the State of and shoulder. One hundred and thirty-six pain reporters Baden-Wü rtemberg. It asked 2127 persons whether either gave no information on consultation or sought they had, in the previous 6 months, experienced any no help from healthcare professionals: a third of the form of unduly prolonged pain (as distinct from brief remainder consulted more than one professional, with intercurrent self-limiting episodes related to injury general practitioners and specialists in physical mediinflammation etc.) and, if so, to specify its location, cine (niedergelassener Orthopä de) being the most duration, severity and persistence. It also sought common. A wide variety of treatments were used, with information on the resulting calls on healthcare oral medications, massage, exercises, mud pack and professionals and the degree of satisfaction with treatheat treatment being the most popular; two-thirds of ments received. The age and gender distributions of sufferers used more than one type of treatment. The the sample selected for survey matched those in the most popular types of treatment tended also to be the population from which it was drawn. Of the 1420 remost successful, except for oral medication (which was spondents, only 1304 declared their age and genderalso the most heterogeneous). Multiple logistic rea condition for inclusion in the analysis. Of these, 610 gression analyses identified consistent associations reported some form of unduly prolonged pain, which between duration and severity of pain, the number of had lasted more than a year in 530. For all pain lasting sites where it was reported, the numbers of healthcare longer than a year, the estimated prevalence of mild professionals consulted and the number of treatments pain was 11%, severe 25% and intolerable 3.5%: the tried, and the same groupings of features were ascorresponding estimates for persistent as opposed to sociated with decreased likelihood of overall satepisodic pain were 2% for mild, 10% for severe and isfaction with treatment received. 1% for intolerable. Pain was present in more than one anatomical location in most of those who reported it.

The effects of an oral preparation containing an extract of thyme and primula (Bronchipret; Bionorica) on the lung function of five horses suffering heaves were determined in a longitudinal study. The horses accepted the product well. The plasma concentrations of the marker substance, thymol, indicated that at least one of the substances in the extract had been absorbed from the gastrointestinal tract. The compliance, pulmonary pressure and airway resistance of the horses' lungs were all significantly improved after one month of treatment However, the severity of their clinical signs and their arterial oxygen partial pressure had not improved significantly.