Current pain and headache reports
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Curr Pain Headache Rep · Jan 2025
ReviewDiagnosis and Management of Mild Traumatic Brain Injury (mTBI): A Comprehensive, Patient-centered Approach.
The purpose of this review is to provide an update regarding recent research and recommendations in the care of mild traumatic brain injury (mTBI). ⋯ New diagnostic criteria for mTBI have recently been developed by the American Congress of Rehabilitation Medicine through the Delphi method and this will help to standardize assessment, diagnosis, and treatment. Symptoms of mTBI are diverse and can sometimes become persistent. Treatment of mTBI should be patient-centered and may require subspeciality referral and coordinated, inter-disciplinary, or multi-disciplinary treatment.
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Curr Pain Headache Rep · Jan 2025
ReviewPain and Perception: Exploring Psychedelics as Novel Therapeutic Agents in Chronic Pain Management.
Chronic pain affects approximately 1.5 billion people worldwide, representing the leading cause of disability and a significant financial burden on healthcare systems. Conventional treatments, such as opioids and non-steroidal anti-inflammatory drugs, are frequently linked to adverse effects, including dependency and gastrointestinal issues, and often offer limited long-term relief. This review explores the potential of psychedelics, including psilocybin, LSD, and ketamine, as alternative therapeutic agents in chronic pain management. ⋯ These substances modulate pain perception through actions on serotonergic and glutamatergic systems and may promote neuroplasticity, offering novel pathways for pain relief. Specifically, the review details the pharmacologic actions of psychedelics, their effects on chronic pain syndromes such as cancer pain, migraines, and neuropathic pain, and their clinical implications. The safety profiles, patient responses, and analgesic properties of these compounds are examined, highlighting the need for further research to validate their efficacy and optimize their therapeutic use in pain management.
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Management of primary headache disorders during pregnancy is limited due to known teratogenicity or unknown safety of many currently available pharmaceutical therapies. Here, we explore the safety and efficacy of non-invasive neuromodulatory devices as another treatment modality for pregnant patients. ⋯ There are six FDA-cleared, non-invasive neuromodulatory devices currently available for the management of headache that include remote electrical neuromodulation (REN), noninvasive vagal nerve stimulation (nVNS), external trigeminal nerve stimulation (eTNS), single-pulse transcranial magnetic stimulation (sTMS), and external concurrent occipital and trigeminal neurostimulation (eCOT-NS). Neuromodulatory devices are a safe, effective, and well tolerated non-pharmacological option for migraine and other primary headache disorders. Although evidence of safety and tolerability use in pregnancy is limited, they may serve as a therapeutic alternative or adjunct to improve the care of our pregnant patients.
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Curr Pain Headache Rep · Jan 2025
Review Meta AnalysisEfficacy of Intra-Articular Platelet-Rich Plasma Injections in Treatment of Knee Osteoarthritis: A Systematic Review and Meta-Analysis.
Knee osteoarthritis (OA) is a gradual deterioration of articular cartilage characterized by pain and physical dysfunction. Although analgesic pharmacological agents are the first-line treatment for knee OA, they are not effective for all patients. In this study, we evaluate the efficacy of an intra-articular injection treatment using platelet-rich plasma (PRP) in reducing pain and improving functional ability. ⋯ Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this systematic review and meta-analysis (SR/MA) provides an updated overview for the role of PRP in knee OA treatment. Ten articles, published between 2016 and 2023, met the inclusion criteria and compared PRP treatment to a placebo control at six-month follow-up. A total of 9,409 potential studies were identified from a review of four different databases: PubMed (n = 4595), Cochrane (n = 4252), VHL (n = 112), and OpenSigle (n = 450). After the titles and abstracts and inclusion and exclusion criteria were considered, a total of 10 studies were analyzed. Although a significant improvement among PRP-treated groups in some studies was found, there was variability such as where the aforementioned scores appeared to worsen and some only demonstrated trends. Overall, PRP may be a promising treatment for symptomatic knee OA. However, further research is necessary to determine the efficacy of PRP in treating knee OA, with specific considerations for times at follow-up, frequency and dosage of injections, and comorbidities, which were unaccounted for in this SR/MA.
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Curr Pain Headache Rep · Jan 2025
ReviewEthical Considerations in the Use of Artificial Intelligence in Pain Medicine.
Although the integration of artificial intelligence (AI) into medicine and healthcare holds transformative potential, significant challenges must be necessarily addressed. This technological innovation requires a commitment to ethical principles. Key issues concern autonomy, reliability, and bias. ⋯ S. executive orders, provide essential guidelines for the responsible use of AI. This step is crucial for balancing innovation with rigorous ethical standards, ultimately leveraging the incredible AI's benefits. As the field evolves rapidly and concepts like algorethics and data ethics become more widespread, the scientific community is increasingly recognizing the need for specialists in this area, such as AI Ethics Specialists.