Current pain and headache reports
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Curr Pain Headache Rep · Oct 2001
ReviewInterventional approaches to the management of myofascial pain syndrome.
Interventional therapies are a valuable addition to our armamentarium when treating myofascial pain syndromes. When combined with other therapies, interventional techniques can be an effective adjunct in the multidisciplinary management of pain. ⋯ More recent advances, such as the use of botulinum toxin, are also discussed. In addition, other techniques such as acupuncture and the use of laser therapy are mentioned.
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This article discusses the neurophysiology of myofascial pain syndrome. The local twitch response is a characteristic finding of this condition; it is activated by snapping palpation, pressure, or needle insertion at the trigger point. It is manifested by a burst of activity in the muscle band that contains the activated trigger point. ⋯ While this theory may explain the effects of alpha-adrenergic antagonists at the trigger point, it does not fully explain the electromyographic (EMG) findings recorded at the trigger point. The second theory is that trigger points represent hyperactive end-plate regions, as the EMG activity recorded at trigger points resembles that described at the end-plate region. Other theories that either deny the existence of myofascial pain syndrome or believe it represents a focal dystonia are also discussed.
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Curr Pain Headache Rep · Oct 2001
Randomized Controlled Trial Multicenter Study Clinical TrialThe use of ibuprofen plus caffeine to treat tension-type headache.
Simple analgesics such as ibuprofen, aspirin, and acetaminophen have long been used in the treatment of tension-type headache. Studies of combination agents of aspirin with caffeine or acetaminophen with caffeine have also demonstrated efficacy as analgesic agents. ⋯ We undertook the direction of a multicenter, double-blind, placebo-controlled, parallel trial to assess the efficacy and safety of ibuprofen combined with caffeine in the treatment of tension-type headache. The study was designed to also verify the analgesic efficacy of caffeine and further assess the role of tension-type headache as a model for the study of pain.
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Curr Pain Headache Rep · Oct 2001
ReviewThe role of psychometric testing and psychological treatment in tension-type headache.
Tension-type headaches are a common occurrence for many people. Psychological issues such as stress, depression, and anxiety have been shown to coexist with tension-type headaches. ⋯ In this article, the role of psychometric testing and the application of psychological interventions for use on patients with tension-type headaches are reviewed. Recommendations are made about approaches that are designed to improve physical and psychological health.
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Curr Pain Headache Rep · Oct 2001
ReviewClassification, epidemiology, and natural history of myofascial pain syndrome.
Myofascial pain syndrome is a disease of muscle that produces local and referred pain. It is characterized by a motor abnormality (a taut or hard band within the muscle) and by sensory abnormalities (tenderness and referred pain). ⋯ When it becomes chronic, it tends to generalize, but it does not change to fibromyalgia. It is a treatable condition that can respond well to manual and injection techniques, but requires attention to postural, ergonomic, and structural factors, and toxic or metabolic factors that impair muscle function.