Current pain and headache reports
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The view that fibromyalgia syndrome (FMS) is a psychiatric disorder or can be caused by stress or abuse is unproven. The construct of posttraumatic FMS has not been adequately validated. ⋯ More research examining specific psychological processes in FMS is desirable. Because of the potential for harm to patients, clinicians should be cognizant of possible undue influences on medical opinion by agencies providing health care and research funding.
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Curr Pain Headache Rep · Aug 2001
ReviewCervicogenic headache: clinical presentation, diagnostic criteria, and differential diagnosis.
Since the first attempt at setting down diagnostic criteria was made in 1990, there has been considerable progress in the field of cervicogenic headache (CEH). CEH makes up a "final common pathway" for several neck disorders that may originate at different levels of the cervical spine. CEH has been defined as being mainly a unilateral headache without sideshift; it may accordingly also be bilateral. ⋯ Pain stemming from the neck usually spreads to the oculofrontotemporal area. The most characteristic features are symptoms and signs of neck involvement (such as mechanical precipitation of attack, and so forth). Migraine without aura and tension-type headache are the most difficult differential diagnosis problems.
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Fibromyalgia is a multisystem illness. One of its defining features, generalized pain, may also be present in other rheumatic entities. ⋯ This article discusses the different rheumatic and nonrheumatic diseases that overlap or are prone to be confused with fibromyalgia. It emphasizes the key points in the differential diagnosis.
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Curr Pain Headache Rep · Jun 2001
ReviewEffective management of ice pick pains, SUNCT, and episodic and chronic paroxysmal hemicrania.
Idiopathic stabbing headaches, the SUNCT syndrome, and the paroxysmal hemicranias are a group of primary headache disorders that are characterized by brief, short-lived attacks of head pain, which recur multiple times throughout the day. These syndromes are much less prevalent than other types of primary headaches such as migraine and tension-type headaches but are significantly more disabling. Recognition of these uncommon disorders is important because their management differs from standard headache therapies.
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Control of malignant pain and related symptoms is paramount to clinical success in caring for cancer patients. To achieve the best quality of life for patients and families, oncologists and palliative care clinicians must work together to understand problems related to psychologic, social, and spiritual pain. ⋯ We discuss clinical experience with several classes of drugs that are currently used to treat cancer pain: 1) nonsteroidal anti-inflammatory drugs, with emphasis on cyclooxygenase-2 inhibitors; 2) opioid analgesics, with specific emphasis on methadone and its newly recognized value in cancer pain; 3) ketamine, an antagonist at N-methyl-d-aspartate receptors; and 4) bisphosphonates, used for pain resulting from bone metastases. New concepts that compare molecular actions of morphine at excitatory opioid receptors, and methadone at nonopioid receptor systems, are presented to underscore the importance of balancing central nervous system excitatory (anti-analgesic) versus inhibitory (analgesic) influences.