Current pain and headache reports
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Curr Pain Headache Rep · Apr 2008
ReviewStem cell regeneration of degenerated intervertebral discs: current status.
Low back pain (LBP) is one of the most common musculoskeletal conditions, and intervertebral disc (IVD) degeneration is associated with most cases. Although many treatment options are available, they focus on the removal of symptoms rather than repair of the degenerate tissue. ⋯ A number of problems must be overcome for MSC-based IVD regeneration to be successful, including determining a method for the differentiation of stem cells into nucleus pulposus-like cells. Although this is still a relatively new field, it offers huge potential for the clinical treatment of IVD degeneration and LBP in the future.
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Burn injuries and their subsequent treatment cause one of the most excruciating forms of pain imaginable. Practitioners in the field have been concerned about the suboptimal management of acute pain in this population. ⋯ The concept of allostatic load is presented as a potential explanation for the relationship between acute pain and subsequent psychologic and physiologic outcomes. A biopsychosocial model is also presented as a means of obtaining better inpatient pain management and helping to mediate this relationship.
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Curr Pain Headache Rep · Apr 2008
Review Case ReportsMedication-overuse headache in patients with cluster headache.
Cluster headache (CH) is associated with the most severe pain of the primary headache disorders. Barriers to optimal care include misdiagnosis, diagnostic delay, undertreatment, and mismanagement. ⋯ A personal or familial history of migraine appears to be strongly associated with the development of MOH in CH, at least with the phenotype of background headache. Patients with CH, especially those with a personal and/or family history of migraine, must be carefully monitored for MOH, and medication withdrawal should be considered if a CH patient presents with features of MOH.
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Empathy is a provider attribute that has been a topic of increased clinical interest, particularly as it relates to pain. This article examines various dimensions of the pain and empathy literature: definitions of empathy, research regarding the psychophysiology of empathy for pain, and research related to empathy in psychological and medical care. ⋯ Although this literature supports the clinical value of provider empathy and/or behaviors likely to reflect empathy, little research has explicitly examined empathy in the treatment of pain. Nonetheless, when considered in the broader context, the evidence is sufficient to draw some conclusions regarding approaches to pain care that are likely to reflect and/or elicit provider empathy and are central to effective pain management.
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Cluster headache (CH) has traditionally been associated with certain anthropometric features, personality traits, and lifestyle features. This article focuses on lifestyle features in patients with CH. Especially excessive smoking and alcohol consumption have been ascribed to patients with CH. ⋯ On the contrary, patients with CH seem to avoid alcohol, particularly during active phases, likely due to its ability to trigger attacks. Present studies are purely descriptive. Thus, the associations sketched give no information about the long-term effects of smoking or alcohol consumption on the course of CH.