Current pain and headache reports
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Myofascial pain is a common cause of regional chronic pain. Myofascial trigger points can refer pain to the head and face in the cervical region, thus contributing to cervicogenic headache. When identified properly, cervical myofascial pain is a treatable component of headache management. This article reviews current literature on the pathophysiology, diagnosis, and management of cervical myofascial pain.
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Treatment for patients who are dying from cancer and are suffering with physiologic and existential symptoms is an important and valuable skill for health care providers. However, the treatment for suffering at the end of life and the use of sedation for comfort often are misunderstood. The following is a discussion of the clinical skills and ethical considerations that health care providers should have when treating terminal patients with cancer.
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Idiopathic intracranial hypertension (IIH) is a disorder of increased intracranial pressure that may have papilledema with normal imaging study results. Headache is the most frequent symptom. Although the headache characteristics are indistinguishable from the symptoms of migraine headache, accompanying symptoms of increased intracranial pressure, such as pulsatile tinnitus, transient visual obscurations, and radicular neck pain, may aid in the diagnosis. ⋯ Medical treatment for the headache includes weight loss for obese patients, diuretic therapy, and migraine preventive medications. If medical therapy does not abolish the headache, surgical options should be considered. Because patients with IIH have a poor quality of life, patient education and supportive materials are important.
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Cancer pain is a significant problem despite the advent of the World Health Organization's cancer pain guidelines, the US government's cancer pain guidelines, and the Joint Commission's mandate for hospital pain evaluation and treatment. Ninety percent of patients with cancer pain can be effectively treated with oral conservative medications. The remaining 10% need more invasive treatments to control their pain. This article reviews current methods of controlling cancer pain using intrathecal catheters, nerve blocks, and neurosurgical procedures.
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It is estimated that 40% to 50% of patients with metastatic disease and 90% of patients with terminal cancer experience unrelieved pain. Furthermore, inadequate treatment of cancer pain is a greater possibility if the patient is a substance abuser. In this paper, we will explore pertinent conceptual and clinical aspects of addiction that can assist in improving the identification and treatment of patients with substance use disorders.