Current pain and headache reports
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Curr Pain Headache Rep · Feb 2006
ReviewNeuropsychologic aspects of post-traumatic headache and chronic daily headache.
The management of patients with chronic refractory head pain remains a treatment challenge. Treatment focus should be multidisciplinary as patients evolve into a deteriorated status with psychologic, social, vocational, and cognitive dysfunction. ⋯ The patient with post-traumatic head pain copes with head injury sequelae. Issues related to worker's compensation, insurance, disability decisions, and litigation are intrinsic to these patient groups.
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Curr Pain Headache Rep · Feb 2006
ReviewIntravenous treatment of chronic daily headaches in the outpatient headache clinic.
The most likely future of aggressive headache treatment will reside in the sphere of the specialist's clinic. This is a far more cost- and time-effective mode of treating intractable chronic daily headaches (CDH), including chronic migraines. We have used this technique successfully in our clinic for many years. ⋯ Patients can be offered a maximum degree of success for control of their intractable headaches. In this article, approaches to aggressive treatment of ongoing CDH using intravenous methods of therapy are discussed. All of these can be performed in the clinic setting, avoiding some of the costly aspects of treatment that are present in an emergency room setting.
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Curr Pain Headache Rep · Feb 2006
ReviewThe importance of incorporating faith and spirituality issues in the care of patients with chronic daily headache.
Patients with chronic daily headache are difficult and often frustrating to treat. They are in many ways similar to chronic pain patients and patients with other chronic serious illnesses that have come to alter many aspects of their life, affecting their physical and emotional well-being, their ability to work, and their family and social relationships. ⋯ Numerous studies have demonstrated a positive association between being religious or spiritual and improved health, both in response to acute events and in chronic disease. Because religion is so positively associated with improved outcomes, it is important for physicians to recognize this aspect of a patient's life and try to encourage positive use of the patient's belief system as an adjunct in treatment.
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Curr Pain Headache Rep · Feb 2006
ReviewMedication-overuse headache: description, treatment, and relapse prevention.
Medication-overuse headache (MOH) has increasingly become a focus within the field of headache. The biologic and physiopathologic origin for MOH likely resides in receptor physiology, but it also is probable that the initiation and sustaining dynamics of this pathologic condition involve several other factors. ⋯ The problem regarding the diagnosis, the classification, and clinical aspects of MOH is reviewed in this article. The different therapeutic approaches, initial outcomes, and long-term durability of treatment also are discussed.
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Curr Pain Headache Rep · Feb 2006
Review Case ReportsTopical agents for the treatment of chronic pain.
Unlike systemic analgesics, topical analgesics exert their analgesic activity locally and without significant systemic absorption. This is in contrast to transdermal analgesics, which require systemic absorption for clinical benefit. ⋯ Topical analgesics have been studied in an increasing number of painful clinical conditions, and the results of some of these studies are summarized in this article. The potential role of topical analgesics acting peripherally in affecting the central processing of pain as well as painful states considered to be "central," not "peripheral," also are reviewed.