Marcus Schiltenwolf

Marcus Schiltenwolf
Universität Heidelberg · Center of Orthopaedics, Traumatology and Paraplegiology

Head of Conservative Orthopaed

About

526
Publications
115,542
Reads
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6,171
Citations
Introduction
Marcus Schiltenwolf is the head of conservative orthopaedics at the University Hospital Heidelberg. His main fields are pain medicine, psychosomatics and legal assessment. Main topics of his scientific work are psychosocial factors in musculoskeletal pain, multiprofessional pain therapy, attachment and pain, cytokines in pain, quantitative sensory testing.
Additional affiliations
January 2009 - present
Universität Heidelberg
Position
  • Head of Conservative Orthopedics, Pain Management, Legal Assessment
January 2000 - present
Zentrum für Orthopädie, Unfallchirurgie und Paraplegiologie
Position
  • Coordinator Medical Teaching in Musculoskeletal Diseases
Description
  • Coordinating teaching in musculoskeletal diseases and rehabilitation in the Heidelberg Curriculum Medicinale (HeiCuMed)
May 1987 - present
Universität Heidelberg
Position
  • Head of Conservative Orthopaedics

Publications

Publications (526)
Article
Full-text available
Attachment insecurity relates to the onset and course of chronic pain via dysfunctional reactions to pain. However, few studies have investigated the proportion of insecure attachment styles in different pain conditions, and results regarding associations between attachment, pain severity, and disability in chronic pain are inconsistent. This study...
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There is a growing number of patients worldwide being treated with long-term opioids for chronic non-cancer pain, although there is limited evidence for their effectiveness in improving pain and function. Opioid-use related adverse effects, especially in cognitive functioning in these patients, are rarely evaluated. The present study investigated t...
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Long-term opioid treatment has been used extensively in treatment of chronic low back pain (cLBP) in the last decades. However, there are serious limitations to the long-term efficacy of opioids and related side effects. In this study we investigated whether long-term opioid treatment changes pain sensitivity of patients with cLBP. A prospective, n...
Article
  Several studies have shown that exposure to opioids for short or long periods alters pain sensitivity. Little is known about changes in pain sensitivity during and after tapering of long-term prescribed opioid treatment in chronic low-back pain (cLBP) patients.   The goal of this prospective longitudinal study was to investigate pain sensitivity...
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Objective 10% of all individuals in Germany develop persistent symptoms due to nonspecific back pain (NSBP) causing up to 90% of direct and indirect expenses for health care systems. Evidence indicates a strong relationship between chronic nonspecific back pain and psychosocial risk factors. The Örebro Musculoskeletal Pain Screening Questionnaire (...
Article
Objective: To investigate the impact of varus malalignment of the knee on pain reduction achieved by an ankle-foot orthosis and a laterally wedged insole in patients with medial knee osteoarthritis. Design: Secondary analysis of a randomized, clinically prospective cross-over study. Patients: Twenty-eight participants with medial knee osteoart...
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Osteoarthritis (OA) is no longer considered a purely degenerative disease. OA is defined as a disease of the entire joint, in which inflammation occurs in various joint tissues. The overall aim of this study was to analyze the presence and polarization of CD8+ T cell subsets in OA knee joints, in relation to the OA stage and compartment (synovial f...
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Background: Long-term clinical and radiographic outcome data after standard cemented long-stem reverse shoulder arthroplasty (RSA) remain underreported. The aim of this study is to report on medium- to long-term data of patients over 60 years of age. Methods: The same type of RSA (Aequalis Reverse II, Memphis, TN, USA) was implanted in 27 patien...
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Problem: Worldwide, at least one in four adults do not exercise sufficiently. Inactivity is associated with an increase in disease burden and mortality, whereas exercise can contribute to a longer, healthier life. Chronic musculoskeletal pain is a significant public health concern; in Germany, approximately 15% of the adult population suffers from...
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The effects of exercise interventions on unspecific chronic low back pain (CLBP) have been investigated in many studies, but the results are inconclusive regarding exercise types, efficiency, and sustainability. This may be because the influence of psychosocial factors on exercise induced adaptation regarding CLBP is neglected. Therefore, this stud...
Article
Background Back pain in the pediatric population is common. History and a thorough physical examination and a systematic work-up approach are key components to guide the physician in evaluating the possible causes of pain and providing appropriate treatment.Objective The main aim of this review was to develop an algorithmic approach to assist physi...
Article
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Intervertebral disc-related diseases of the cervical and lumbar spine are considered to be occupational diseases, if the occupational and medical prerequisites are fulfilled and the causal connection between the prerequisites is likely. The working conditions include occupational burdens with long-term lifting and carrying of heavy loads or long-te...
Article
Full-text available
The effects of exercise interventions on unspecific chronic low back pain (CLBP) have been investigated in many studies, but the results are inconclusive regarding exercise types, efficiency, and sustainability. This may be because the influence of psychosocial factors on exercise induced adaptation regarding CLBP is neglected. Therefore, this stud...
Article
Full-text available
Objective To compare biomechanical and clinical outcome of laterally wedged insoles (LWI) and an ankle-foot orthosis (AFO) in patients with medial knee osteoarthritis. Design Single-centre, block-randomized, cross-over controlled trial. Setting Outpatient clinic. Subjects About 39 patients with symptomatic medial knee osteoarthritis. Interventi...
Article
Study Design: Prospective 2-year factor-, cluster-, and reliability-multicentre analysis. Summary of Background Data: A very high number of functional outcomes that can be utilized as variables in low back pain (LBP) trials exists. Objective: To provide evidence on the uniqueness and usefulness of a set of potential relevant outcomes. Methods: Par...
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Background: The back pain screening tool Risk-Prevention-Index Social (RPI-S) identifies the individual psychosocial risk for low back pain chronification and supports the allocation of patients at risk in additional multidisciplinary treatments. The study objectives were to evaluate (1) the prognostic validity of the RPI-S for a 6-month time frame...
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Background: Spinal infections represent a therapeutic challenge. The often protracted course of the disease is accompanied by pain, which can lead to a chronic pain experience even after the infectious disease has been treated successfully. The aim of this study was to investigate possible risk factors of pain chronification. Methods: In a prosp...
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Chronic pain is one of the major causes of disability in the general population. Even though there are effective treatment options available for reducing symptoms, these treatments often do not have consistent lasting effects. As the usage of mobile devices has increased enormously during the last few years, mobile application-based treatment optio...
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Low-to-moderate quality meta-analytic evidence shows that motor control stabilisation exercise (MCE) is an effective treatment of non-specific low back pain. A possible approach to overcome the weaknesses of traditional meta-analyses would be that of a prospective meta-analyses. The aim of the present analysis was to generate high-quality evidence...
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The opioid epidemic in North America challenges national guidelines worldwide to define the importance of opioids for the management of chronic noncancer pain (CNCP). Methods: The second update of the German guidelines on long-term opioid therapy for CNCP was developed by 26 scientific associations and 2 patient self-help organizations. A systema...
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Despite the growing body of literature demonstrating a crucial role of T helper cell (Th) responses in the pathogenesis of osteoarthritis (OA), only few clinical studies have assessed interactions between Th cells and OA—related symptoms. Yet, the inclusion of clinical data in the interpretation of cellular analyses of Th cell infiltration is essen...
Article
Beitrag aus: Der niedergelassene Arzt; 7(69):40-44 20.07.2020 Ziel dieses Beitrages ist es, einen Überblick über die aktuellen Empfehlungen zu Diagnostik und Therapie des nicht-spezifischen Rückenschmerzes zu geben. Die Arbeit beruht in ihren zentralen Inhalten auf den Empfehlungen der Nationalen VersorgungsLeitlinie Nicht-spezifischer Kreuzschmerz...
Article
Pain caused by the sacroiliac joint (SIG) makes up a relevant proportion of lumbar back pain and can have a variety of specific and non-specific causes. The SIG represents the central link between the spine and the lower extremity. It is characterized by high stability and low mobility. There are significant inter-individual differences. In additio...
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(1) Background: Studies show several advantages of unicompartmental knee replacement (UKR) over total knee replacements (TKR), whereas registry based revision rates of UKR are significantly higher than for TKA. Registry data report lower revision rates for cementless UKR compared to cemented UKR. The aim of this study was to assess clinical and rad...
Article
On behalf of the Medical Advisory Committee for occupational diseases at the German Federal Ministry for Work and Social an interdisciplinary working group with medical experts in the field of casualty surgery, occupational health, orthopaedics, and radiology discussed the description of meniscopathy in the sense of the German occupational disease...
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Background The second scheduled update of the German S3 guidelines on long-term opioid therapy for chronic noncancer pain (CNCP), the LONTS (AWMF registration number 145/003), was started in December 2018.Methods The guidelines were developed by 28 scientific societies and 2 patient self-help organizations under the coordination of the German Pain...
Article
Full-text available
Background: The back pain screening tool Risk-Prevention-Index Social (RPI-S) identifies the individual psychosocial risk for low back pain chronification and supports the allocation of patients at risk in additional multidisciplinary treatments. The study objectives were to evaluate (1) the prognostic validity of the RPI-S for a 6-month time frame...
Article
Full-text available
Purpose: Psychosocial variables are known risk factors for the development and chronification of low back pain (LBP). Psychosocial stress is one of these risk factors. Therefore, this study aims to identify the most important types of stress predicting LBP. Self-efficacy was included as a potential protective factor related to both, stress and pain...
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Résumé Les douleurs musculosquelettiques chroniques font référence aux douleurs osseuses, articulaires et tissulaires qui persistent depuis plus de 3 mois. Dans ces affections, il est communément admis que les dysfonctions secondaires ou les conséquences de la douleur persistante–peur du mouvement, catastrophisme, anxiété ou sensibilisation du syst...
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Bei Schmerzen im unteren Rücken (Kreuzschmerzen) finden häufig diagnostische und therapeutische Prozeduren statt, die nicht evidenzbasiert sind. In diesem narrativen Übersichtsbeitrag werden Mythos und Evidenz dieser Verfahren vorgestellt und diskutiert. In den meisten Fällen handelt es sich um nichtspezifische Schmerzen, bei denen keine Grunderkr...
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Purpose: Psychosocial variables are known risk factors for the development and chronification of low back pain (LBP). Psychosocial stress is one of these risk factors. Therefore, this study aims to identify the most important types of stress predicting LBP. Self-efficacy was included as a potential protective factor related to both, stress and pai...
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Zus amme nfassung Schon vor oder bald nach der Entbindung eines Kindes mit an geborene r Querschnittlähmung (Myelomen ingozele oder Spina bifida ap erta) muß durch Beratung des Geburtshelfers geklärt we rden , welche Ha-bilitationsm öglichkeiten und somit welche Lebenschan-cen sich nach der neurochirurgischen Intervention-Verschluß der Zele und Ver...
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Multidisciplinary pain management programs (MPMP) for patients suffering from chronic back pain include a variety of treatment modalities. The patients’ perceived helpfulness of these treatment modalities remains unclear. The aims of this prospective observational cohort study were to assess (i) the patients’ perceived helpfulness of different trea...
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Low-back pain is a major health problem exacerbated by the fact that most treatments are not suitable for self-management in everyday life. Particularly, interdisciplinary programs consist of intensive therapy lasting several weeks. Additionally, therapy components are rarely coordinated regarding reinforcing effects, which would improve complaints...
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Spondylodiscitis accounts for 2–7% of osteomyelitis cases and is characterized by pain, systemic inflammation, and permanent neurological deficits. We aimed to identify imaging characteristics and clinical parameters to successfully predict microbiological pathogens by computed tomography (CT)-guided biopsy in suspected spondylodiscitis cases. Fort...
Article
Background The sacroiliac joint is a common cause of low back pain. Due to variable symptoms, the diagnosis is often very difficult. For diagnosis, systemic disease, as well as pathologies in the hips and lumbar spine must be excluded. Objectives To describe anatomy and function of the joint and underlying pathologies. To present the evidence of a...
Article
Due to its high prevalence und sometimes serious medical consequences, osteoporosis is of highest socio-economic importance. Medical experts are confronted with it in a wide variety of fields of law. In order to be able to correctly classify the disease in the respective legal framework, current knowledge about it is required. Important classificat...
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Osteoarthritis (OA) is a progressive joint disease driven by a blend of inflammatory and biomechanical processes. Studies using human samples to understand inflammatory mechanisms in OA frequently recruit OA patients with different affected joints, even though recent evidence indicates that OA is a heterogeneous disease which only culminates in a c...
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The aim of this study was to identify inflammatory mediators of potential clinical relevance in synovial fluid (SF) samples of patients with knee osteoarthritis (OA). Therefore, radiographic OA severity, knee pain and function of 34 OA patients undergoing unicompartmental (UC) and bicompartmental (BC) knee arthroplasty were assessed prior to surger...
Article
Wenngleich die Anzahl an Majoramputationen bundesweit rückläufig ist, finden weiterhin mehr als 57.000 amputationschirurgische Eingriffe statt. Auch aufgrund hoher prothetischer Versorgungskosten resultieren daher weiterhin eine Vielzahl sozialgerichtlicher Auseinandersetzungen, in denen medizinische Sachverständigengutachten angefordert werden. Un...
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Die interdisziplinäre multimodale Schmerztherapie (IMST) ist eine wichtige Therapiekomponente in der Behandlung von Patienten mit chronischen Schmerzen, die auf der grundlegenden Philosophie des biopsychosozialen Modells aufbaut. In den letzten Jahren wird diese Behandlungsform in Deutschland zunehmend angeboten; die Rahmenbedingungen, die u. a. du...
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Background Use of the arm above shoulder level has been described as a risk factor for developing rotator cuff tears (RCT). There is a lack of information regarding the frequency and distribution of RCT in a population using their arms above shoulder level during daily work. The aim of this study was to analyze clinical and radiographic findings in...