Gender Minority Stress, Psychiatric Comorbidities, and the Experience of Migraine in Transgender and Gender-Diverse Individuals: a Narrative Review
AbstractPurpose of ReviewThis review aims to discuss the experience of migraine in transgender and gender-diverse individuals as it relates to other psychiatric comorbidities such as anxiety, depression, PTSD, and others. As this population faces stigma and discrimination, literature posits that gender minority stress can also contribute to the experience of pain in these individuals.Recent FindingsThough there is little explicit data on these topics, more recent studies have explored the concept of gender minority stress and how stigma and discrimination can affect health outcomes and overall perception of health. These f...
Source: Current Pain and Headache Reports - December 15, 2021 Category: Neurology Source Type: research

Neurostimulation Treatment in Chronic Cluster Headache —a Narrative Review
AbstractPurpose of ReviewIn this narrative review, the current literature on neurostimulation methods in the treatment of chronic cluster headache is evaluated. These neurostimulation methods include deep brain stimulation, vagus nerve stimulation, greater occipital nerve stimulation, sphenopalatine ganglion stimulation, transcranial magnetic stimulation, transcranial direct current stimulation, supraorbital nerve stimulation, and cervical spinal cord stimulation.Recent FindingsAltogether, only nVNS and SPG stimulation are supported by at least one positive sham-controlled clinical trial for preventive and acute attack (on...
Source: Current Pain and Headache Reports - December 11, 2021 Category: Neurology Source Type: research

Non-pharmacologic and Mindful-Based Approaches for Pediatric Headache Disorders: a Review
AbstractPurpose of ReviewHeadache disorders in children and adolescents are common. Among the different headache disorders, migraine and tension headache are highly prevalent and often debilitating. Pharmacological treatments for pediatric patients are often not approved or effective. Practice guidelines for prevention of pediatric headache and migraine are now incorporating information and recommendations regarding non-pharmacologic therapeutic options. Understanding the mechanism of action, safety, and efficacy of the non-pharmacologic as well as mindful-based therapeutic alternatives currently available for the manageme...
Source: Current Pain and Headache Reports - December 11, 2021 Category: Neurology Source Type: research

Updates in the Diagnostic Approach of Headache
AbstractPurpose of ReviewIn this review, we summarize updates in the diagnostic approach of headaches with the aim of facilitating the distinction between primary and secondary etiology in headaches.Recent FindingsIn the USA, headache is the fifth most common complaint in the emergency department, but only a minority will have a secondary etiology. Initial suspicion and diagnostic workup of secondary headache relies on a patient ’s medical history due to a scarcity of validated biomarkers. A special interest group under theInternational Headache Society recently synthesized information on red flags (information that ...
Source: Current Pain and Headache Reports - December 11, 2021 Category: Neurology Source Type: research

Beyond the Raskin Protocol: Ketamine, Lidocaine, and Other Therapies for Refractory Chronic  Migraine
AbstractPurpose of ReviewThe purpose of this review is to discuss the available evidence and therapeutic considerations for intravenous drug therapy for refractory chronic migraine.Recent FindingsIn carefully monitored settings, the inpatient administration of intravenous lidocaine and ketamine can be successful in treating refractory chronic migraine.SummaryMany patients with refractory chronic migraine have experienced treatment failure with the Raskin protocol. The use of aggressive inpatient infusion therapy consisting of intravenous lidocaine or ketamine, along with other adjunctive medications, has become increasingl...
Source: Current Pain and Headache Reports - December 11, 2021 Category: Neurology Source Type: research

Intrathecal Baclofen Monotherapy and Polyanalgesia for Treating Chronic Pain in Patients with Severe Spasticity
AbstractPurpose of ReviewIntrathecal drug delivery is a well evidenced strategy for the treatment of many chronic pain syndromes. While opioids, anesthetics, and ziconotide are the most commonly used agents, intrathecal baclofen (ITB), which is indicated to treat spasticity, is also thought to have some analgesic properties that are poorly understood. These analgesic benefits have been reported with ITB use in treating patients with central neurological disorders who suffer from severe spasticity and chronic pain. Our review aims to characterize ITB ’s effects on pain, function, and quality of life in patients with s...
Source: Current Pain and Headache Reports - December 11, 2021 Category: Neurology Source Type: research

Effect of Guided Imagery on Pain and Health-Related Quality of Life in Musculoskeletal Medicine: a Comprehensive Narrative Review
AbstractPurpose of ReviewGuided imagery (GI) is a non-pharmacological method used to reduce pain, stress, and anxiety. No comprehensive review has yet investigated the application of GI in musculoskeletal medicine, its various types, and potential mechanisms. The aim of this comprehensive narrative review was to examine the types of GI used in musculoskeletal medicine and GI effect on pain and health-related quality of life.Recent FindingsA comprehensive narrative review of the English language scientific literature. PubMed, Google Scholar, ProQuest, and PEDro databases were searched from inception until August 2020 using ...
Source: Current Pain and Headache Reports - December 11, 2021 Category: Neurology Source Type: research

Stigma and Migraine: Developing Effective Interventions
AbstractPurpose of ReviewMigraine and other primary headache disorders do not receive adequate research funding, medical resources, or other forms of structural support relative to their prevalence and the disability they cause. In recent research, scholars have argued that stigma associated with headache disorders explains some of this discrepancy.This review will discuss (1) the factors contributing to stigma toward migraine and other primary headache disorders, (2) how structural and enacted stigma may perpetuate individual disability, (3) the impact of internalized stigma, and (4) interventions to mitigate stigma towar...
Source: Current Pain and Headache Reports - December 6, 2021 Category: Neurology Source Type: research

Correction to: A Review of Techniques of Intercostal Nerve Blocks
(Source: Current Pain and Headache Reports)
Source: Current Pain and Headache Reports - November 27, 2021 Category: Neurology Source Type: research

Co-Occurring Trauma and Non-Suicidal Self-Injury Among People With Chronic Pain: A Systematic Review
AbstractPurpose of ReviewTrauma and posttraumatic stress are common among individuals with chronic pain and contribute to increased morbidity and impairment. Individuals with trauma and chronic pain may be prone to non-suicidal self-injury, a relatively common yet risky self-regulatory behavior. There is a dearth of research on the intersection of trauma, chronic pain, and non-suicidal self-injury (NSSI). We conducted a systematic review of the extant literature.Recent FindingsFive quantitative and eight case reports were identified. Only one quantitative study reported specifically on NSSI. Self-harm rates varied across s...
Source: Current Pain and Headache Reports - November 11, 2021 Category: Neurology Source Type: research

Update of Neuromodulation in Chronic Migraine
AbstractPurpose of ReviewNeuromodulation devices have become an attractive alternative to traditional pharmacotherapy for migraine, especially for patients intolerant to medication or who prefer non-pharmacological options. In the past decades, many studies demonstrated the efficacy of neuromodulation devices in patients with episodic migraine (EM). However, the benefit of these devices on chronic migraine (CM), which is typically more debilitating and refractory than EM, remains not well studied.Recent FindingsWe reviewed the literature within the last five  years on using FDA-cleared and investigational devices for ...
Source: Current Pain and Headache Reports - November 11, 2021 Category: Neurology Source Type: research

The Psychiatric Comorbidities of Migraine in Children and Adolescents
AbstractPurpose of ReviewUnderstanding comorbidities in migraine is important because it can help us understand disease pathophysiology while also aiding the development of more effective treatment strategies. Additionally, it can provide greater awareness about appropriate diagnosis, the need for additional disease screening, and the natural history of migraine. Psychiatric comorbidities have been independently studied in both adults and children with migraine because their presentations can be distinct, and the physiology in these two groups can be different.Recent FindingsWhile symptoms of anxiety and depression seem to...
Source: Current Pain and Headache Reports - November 11, 2021 Category: Neurology Source Type: research

Headache as a Symptom of COVID-19: Narrative Review of 1-Year Research
AbstractPurpose of ReviewHeadache is a common symptom of COVID-19 with emerging literature being published on the subject. Although it may seem unspecific, scientific evidence has allowed a better definition of this headache type, revealing relevant associations with other COVID-19 symptoms and prognoses. We therefore sought to highlight the most remarkable findings concerning headache secondary to COVID-19, specifically focusing on epidemiology, characteristics, pathophysiology, and treatments.Recent FindingsThe real prevalence of headache as a symptom of COVID-19 is still unclear ranging from 10 to 70%. Headache mainly h...
Source: Current Pain and Headache Reports - November 11, 2021 Category: Neurology Source Type: research

Indomethacin-Induced Headache: Causing the Problem You Are Trying to Solve
AbstractPurpose of ReviewIndomethacin is an important medication in the headache medicine toolbox given its utility for both of the diagnosis and treatment of several primary headache disorders. Despite its prevalence in earlier rheumatologic studies, the possibility of drug-induced headache is a not commonly discussed in headache literature.Recent FindingsHerein, we describe a case of drug-induced headache after indomethacin trial for the treatment of an undifferentiated trigeminal autonomic cephalgia.SummaryRecognition of indomethacin-induced headache has important implications for patient education and interpreting the ...
Source: Current Pain and Headache Reports - November 11, 2021 Category: Neurology Source Type: research

Correction to: Reducing New Persistent Opioid Use After Surgery: a Review of Interventions
(Source: Current Pain and Headache Reports)
Source: Current Pain and Headache Reports - November 5, 2021 Category: Neurology Source Type: research

A Review of Techniques of Intercostal Nerve Blocks
AbstractPurpose of ReviewIntercostal nerve blocks are indicated for multiple chronic pain and acute pain conditions including rib fractures, herpes zoster, post-thoracotomy pain syndrome, and intercostal neuralgia. Intercostal neuralgia is a type of neuropathic pain that is in the distribution of intercostal nerves. The purpose of this review is to evaluate the different techniques used to perform intercostal nerve blocks and review their efficacy and safety including blind technique using anatomical landmarks, and fluoroscopically guided and ultrasound-guided intercostal nerve blocks.Recent FindingsLiterature search was p...
Source: Current Pain and Headache Reports - November 4, 2021 Category: Neurology Source Type: research

Cluster Headache: Clinical Characteristics and Opportunities to Enhance Quality of Life
We present the existing body of literature on psychological factors associated with cluster headache and recommendations to address gaps in current clinical care with regards to psychological treatments for cluster headache.Recent FindingsPeople with cluster headache often endorse depressive symptoms, are more likely than the general population to report suicidal ideation and behaviors, and experience significantly decreased quality of life. Psychological treatments such as Acceptance and Commitment Therapy may be particularly valuable for patients with cluster headache given that they are transdiagnostic in nature and can...
Source: Current Pain and Headache Reports - October 19, 2021 Category: Neurology Source Type: research

The Use of Behavioral Modalities for Headache During Pregnancy and Breastfeeding
AbstractPurpose of ReviewMigraine is primary headache which commonly affects women of childbearing age. Migraine and other primary headache disorders are also common during pregnancy.  Understanding which treatments are effective and can be safely given to patients with primary headache during pregnancy and lactation is essential in supporting these patients before, during, and after childbirth. Behavioral modalities have the potential to improve the health of both mother and ba by, while empowering patients to make informed decisions in family planning and creating future treatment plans.Recent FindingsResearch shows...
Source: Current Pain and Headache Reports - October 19, 2021 Category: Neurology Source Type: research

Medical Cannabis for Headache Pain: a Primer for Clinicians
AbstractPurpose of ReviewPublic acceptance ofCannabis sativa L. (cannabis) as a therapeutic option grows despite lags in both research and clinician familiarity. Cannabis —whether as a medical, recreational, or illicit substance—is and has been commonly used by patients. With ongoing decriminalization efforts, decreased perception of harms, and increased use of cannabis in the treatment of symptoms and disease, it is critical for clinicians to understand the rati onale for specific therapies and their medical and practical implications for patients. In view of the opioid crisis, overall patient dissatisfaction,...
Source: Current Pain and Headache Reports - October 9, 2021 Category: Neurology Source Type: research

Review of Radiofrequency Ablation for Peripheral Nerves
AbstractPurpose of ReviewRadiofrequency ablation (RFA) has become an increasingly widespread treatment tool for various chronic pain syndromes within the last two decades with the majority of publications on the topic coming after 2006. Not only are clinicians using RFA to treat more peripheral nerve pain syndromes but the technology itself is evolving quickly to the point that it is nearly impossible to stay abreast on the complexity of such a diversely utilized instrument. This review summarizes studies that focus on the use of RFA for peripheral nerve neurotomy and anatomical studies regarding RFA published between 2015...
Source: Current Pain and Headache Reports - October 7, 2021 Category: Neurology Source Type: research

Correction to: Ketamine in the Past, Present, and Future: Mechanisms, Metabolites, and Toxicity
(Source: Current Pain and Headache Reports)
Source: Current Pain and Headache Reports - September 18, 2021 Category: Neurology Source Type: research

Occipital Neuralgia
This article reviews the anatomy, pathophysiology, clinical presentation, differential diagnosis, diagnostic testing, and management approaches for occipital neuralgia.Recent FindingsNon-pharmacological treatments aim to alleviate muscle tension and improve posture. Acupuncture shows some promise. The occipital nerve block is considered the first line in a minimally invasive intervention, but the duration of relief may be short term. An onabotulinum toxin A injection may improve the sharp but not the dull component of the pain of occipital neuralgia. Radiofrequency ablation and occipital nerve stimulation may provide effec...
Source: Current Pain and Headache Reports - July 21, 2021 Category: Neurology Source Type: research

Ketamine in the Past, Present, and Future: Mechanisms, Metabolites, and Toxicity
AbstractPurpose of ReviewWhile ketamine ’s analgesia has mostly been attributed to antagonism of N-methyl-d-aspartate receptors, evidence suggests multiple other pathways are involved in its antidepressant and possibly analgesic activity. These mechanisms and ketamine ’s role in the nociplastic pain paradigm are discussed. Animal studies demonstrating ketamine’s neurotoxicity have unclear human translatability and findings from key rodent and human studies are presented.Recent FindingsKetamine ’s metabolites, and (2R,6R)-hydroxynorketamine in particular, may play a greater role in its clinical activ...
Source: Current Pain and Headache Reports - July 16, 2021 Category: Neurology Source Type: research

Hypertension and Migraine: Time to Revisit the Evidence
AbstractPurpose of ReviewIt was reported that migraine was associated with increased vascular risks, and the association between high blood pressure (BP) and migraine was believed by some to be the missing link. The current review focused on the associations between migraine and hypertension and BP per se, and evidence on the directionality of the associations was also reviewed.Recent FindingsIn cross-sectional studies, the findings regarding whether migraine was associated with hypertension were inconsistent, and positive, neutral, or even inverse associations were reported. When individual BP parameters were examined sep...
Source: Current Pain and Headache Reports - July 16, 2021 Category: Neurology Source Type: research

Temperature-Mediated Nerve Blocks in the Treatment of Pain
AbstractPurpose of ReviewAnalgesic hot and cold temperatures have been used for both conservative and ablative therapies for millennia. There are well-known locoregional neurovascular changes associated with the application of heat or ice in the literature and in practice. The oscillation between heat and cold has recently been identified as a synergistic mechanism of action with early translational results in humans.Recent FindingsRecent mechanistic work in the feline model has demonstrated that a reliable, reversible nerve block can be achieved within a temperature range that is non-destructive (15 –45°C). The ...
Source: Current Pain and Headache Reports - July 16, 2021 Category: Neurology Source Type: research

Chronic Pain in Patients with Rheumatoid Arthritis
AbstractPurpose of ReviewChronic pain is highly prevalent in patients with rheumatoid arthritis (RA) and can cause various physical and psychological impairments. Unfortunately, the appropriate diagnosis of chronic pain syndromes in this population can be challenging because pain may be primary to RA-specific inflammation and/or secondary to other conditions, typically osteoarthritis (OA) and fibromyalgia (FM). This disparity further poses a clinical challenge, given that chronic pain can often be discordant or undetected with standard RA-specific surveillance strategies, including serological markers and imaging studies. ...
Source: Current Pain and Headache Reports - July 16, 2021 Category: Neurology Source Type: research

Dehydration and Headache
AbstractPurpose of ReviewWe define dehydration and its relationship to pain physiology including both primary and secondary headache disorders.Recent FindingsIntravenous fluids administered for acute migraine attacks in an emergency department setting have not been shown to improve pain outcomes. However, increased intravascular volume before diagnostic lumbar puncture may reduce the frequency of post-lumbar puncture headache from iatrogenic spinal fluid leak. Maintenance of euhydration can help treat orthostatic and “coat-hanger” headache due to autonomic disorders. Similarly, prevention of fluid losses can mi...
Source: Current Pain and Headache Reports - July 15, 2021 Category: Neurology Source Type: research

HIV Neuropathy —a Review of Mechanisms, Diagnosis, and Treatment of Pain
This article is a systematic review of data from 2018 to 2020 regarding information from publications on epidemiologic, diagnostic, and therapeutic advancements in human immunodeficiency virus –associated peripheral neuropathy.Recent FindingsThe epidemiology/pathology of HIV neuropathy is discussed. Diagnostics includes skin wrinkling-eutectic mixture of local anesthetic test and neurologic examinations. Therapeutic interventions include pharmacologic and nonpharmacologic management as well as self-management strategies.SummaryPeripheral neuropathy continues to affect the lives of persons living with HIV. First-line ...
Source: Current Pain and Headache Reports - July 8, 2021 Category: Neurology Source Type: research

The Diagnosis and Management of Posttraumatic Headache with Associated Painful Cranial Neuralgias: a Review and Case Series
This article is a brief review of the literature and a retrospective report of 2 cases of posttraumatic headache with associated painful cranial neuralgias.Recent FindingsTwo patients presented with headaches that met criteria for posttraumatic headache, but their history and physical examination suggested the presence of a focal painful cranial neuralgia. One patient was diagnosed with auriculotemporal neuralgia, which was exquisitely responsive to an auriculotemporal nerve block. The second patient was diagnosed with supratrochlear neuralgia, which was effectively treated with a supratrochlear nerve block. In both cases,...
Source: Current Pain and Headache Reports - June 23, 2021 Category: Neurology Source Type: research

Headache Related to PPE Use during the COVID-19 Pandemic
AbstractPurpose of ReviewPersonal protection equipment (PPE) –associated headache is an unusual secondary headache disorder that predominantly occurs in healthcare workers as a consequence of the donning of protective respirators, face masks and/or eyewear. The appreciation of this entity is important given the significant ramifications upon the occupationa l health of healthcare workers and could additionally have an impact on persons living with pre-existing headache disorder(s).Recent FindingsThere has been a renewed interest and recognition of PPE-associated headaches amongst healthcare professionals, largely bro...
Source: Current Pain and Headache Reports - June 15, 2021 Category: Neurology Source Type: research

Models for Treating Post-traumatic Headache
AbstractPurpose of ReviewTo discuss the treatment of post-traumatic headache (PTH) and how to choose pharmacotherapy based upon known pathophysiology.Recent FindingsPreclinical models of traumatic brain injury are finally revealing some of the mechanisms of PTH, including the significant role that inflammatory neuropeptides like calcitonin gene-related peptide (CGRP) play in the initiation and persistence of symptoms.SummaryTo effectively treat post-traumatic headache (PTH), one needs to understand the pathophysiology behind the initiation and persistence of symptoms. Recent animal models are starting to elucidate these me...
Source: Current Pain and Headache Reports - June 14, 2021 Category: Neurology Source Type: research

Monckeberg ’s Medial Sclerosis as a Cause for Headache and Facial Pain
AbstractPurpose of ReviewM önckeberg’s medial sclerosis (MMS) is a chronic, non-inflammatory degenerative condition affecting primarily the tunica media of muscular arteries resulting in their calcification. The purpose of this comprehensive review is to describe MMS as it appears in the literature, in the context of heada che and facial pain. Understanding the etiopathology, the associated conditions, and the differential diagnoses is important in managing MMS.Recent FindingsManagement of MMS primarily depends upon identification of its associated conditions and their treatment. Due to the rare incidence and in...
Source: Current Pain and Headache Reports - June 4, 2021 Category: Neurology Source Type: research

Post-traumatic Headache in Children and Adolescents
AbstractPurpose of ReviewPost-traumatic headache is a common disorder in the pediatric age group, seen both by child neurologists and by non-neurologists. The current review of post-traumatic headache in children and adolescents aims to review the pathophysiology, risk factors, clinical features, neuroimaging, and both acute and preventive treatment options.Recent FindingsRecent literature provides insight into specific risk factors in the pediatric age group for developing post-traumatic headache as well as unique pathophysiologic changes seen in neuroimaging and neurometabolic pathways. It also elucidates common treatmen...
Source: Current Pain and Headache Reports - June 4, 2021 Category: Neurology Source Type: research

Evidence of Potential Mechanisms of Acupuncture from Functional MRI Data for Migraine Prophylaxis
AbstractPurpose of ReviewTo summarize the clinical neuroimaging evidence pertaining to the potential mechanisms of acupuncture for migraine prophylaxis.Recent FindingsFrom a descriptive perspective, converging evidence from recent neuroimaging studies, mainly from functional MRI (fMRI) studies, has demonstrated that when compared with sham acupuncture, verum acupuncture could normalize the decrease of the functional connectivity of the rostral ventromedial medulla-trigeminocervical complex (RVM/TCC) network, frontal-parietal network, cingulo-opercular networks, and default mode network and could normalize sensorimotor netw...
Source: Current Pain and Headache Reports - May 26, 2021 Category: Neurology Source Type: research

Repetitive Transcranial Magnetic Stimulation for Treating Chronic Neuropathic Pain: a Systematic Review
AbstractGiven pharmacological interventions ’ limited efficacy and abundance of its adverse effects, the repetitive transcranial magnetic stimulation (rTMS) is considered a viable non-invasive option for managing chronic neuropathic pain of different origins with promising outcomes.Purpose of ReviewThe provision of a systematic review of current literature on rTMS for managing chronic neuropathic pain of different origins, and assess its efficacy and outcomes, highlighting the need for standard protocols for utilizing rTMS.Recent FindingsVariable stimulation modalities were trialed targeting the M1, DLPFC, and somato...
Source: Current Pain and Headache Reports - May 12, 2021 Category: Neurology Source Type: research

Mechanism of Action of Peripheral Nerve Stimulation
AbstractPurpose of ReviewThe number of applications for peripheral nerve stimulation (PNS) in the pain management field is ever-growing. With the increasing number of clinical applications for peripheral nerve stimulation, the purpose of this article is to review the mechanism of action surrounding PNS, the recent literature from January 2018 to January 2021, and pertinent clinical outcomes.Recent FindingsThe authors searched articles identified from PubMed (January 2018 –January 2021), Cochrane Central Register of Controlled Trials databases (January 2018–January 2021), and Scopus (January 2018–January 2...
Source: Current Pain and Headache Reports - May 11, 2021 Category: Neurology Source Type: research

Recent Advances in Peripheral Opioid Receptor Therapeutics
AbstractPurpose of ReviewAlthough opioids are excellent analgesics, they are associated with severe short- and long-term side effects that are especially concerning for the treatment of chronic pain. Peripherally acting opioid receptor agonists promise to mitigate the more serious centrally mediated side effects of opioids, and the goal of this paper is to identify and elaborate on recent advances in these peripheral opioid receptor therapeutics.Recent FindingsPeripheral opioid receptor agonists are effective analgesics that at the same time circumvent the problem of centrally mediated opioid side effects by (1) preferenti...
Source: Current Pain and Headache Reports - May 10, 2021 Category: Neurology Source Type: research

Incidence, Diagnosis, and Management of Neuromas Following Radiofrequency Ablation Treatment: a Narrative Review
ConclusionsNeuroma formation following radiofrequency ablation procedures is exceedingly rare and could be a hypothetical concern in clinical practice. However, the true incidence may be inaccurate given the asymptomatic nature of neuromas. (Source: Current Pain and Headache Reports)
Source: Current Pain and Headache Reports - May 7, 2021 Category: Neurology Source Type: research

Flavonoids in the Treatment of Neuropathic Pain
AbstractPurpose of ReviewChronic pain continues to present a large burden to the US healthcare system. Neuropathic pain, a common class of chronic pain, remains particularly difficult to treat despite extensive research efforts. Current pharmacologic regimens exert limited efficacy and wide, potentially dangerous side effect profiles. This review provides a comprehensive, preclinical evaluation of the literature regarding the role of flavonoids in the treatment of neuropathic pain.Recent FindingsFlavonoids are naturally occurring compounds, found in plants and various dietary sources, which may have potential benefit in ne...
Source: Current Pain and Headache Reports - May 7, 2021 Category: Neurology Source Type: research

Interventional Therapies for Pain in Cancer Patients: a Narrative Review
This article reviews the interventional techniques available to mitigate the debilitating effects that untreated or poorly treated pain have in this population.Recent FindingsA range of interventional therapies and technical approaches are available for the treatment of cancer-related pain. Many of the techniques described may offer effective analgesia with less systemic toxicity and dependency than first- and second-line oral and parenteral agents. Neuromodulatory techniques including dorsal root ganglion stimulation and peripheral nerve stimulation are increasingly finding roles in the management of oncologic pain.Summar...
Source: Current Pain and Headache Reports - May 7, 2021 Category: Neurology Source Type: research

Management of Refractory Pain After Total Joint Replacement
AbstractPurpose of ReviewChronic pain after total joint replacement (TJA), specifically total knee replacement (TKA), is becoming more of a burden on patients, physicians, and the healthcare system as the number of joint replacements performed increases year after year. The management of this type of pain is critical, and therefore, understanding the various modalities physicians can use to help patients with refractory pain after TJA is essential.Recent FindingsThe modalities by which chronic pain can be successfully managed include genicular nerve radioablation therapy (GN-RFA), neuromuscular electrical stimulation (NMES...
Source: Current Pain and Headache Reports - April 17, 2021 Category: Neurology Source Type: research

Bruxism in Acute Neurologic Illness
AbstractPurpose of ReviewWhile traditionally encountered in ambulatory settings, bruxism occurs in patients with a variety of acute neurologic illnesses including encephalitis, intracerebral hemorrhage, traumatic brain injury, hypoxic-ischemic encephalopathy, and acute ischemic stroke. Untreated bruxism in acute neurologic illness can lead to tooth loss, difficulty in mouth care resulting in recurrent aspiration pneumonia, endotracheal tube dislodgement, and even tongue laceration or amputation. Inpatient clinicians should be aware of the etiologies and management strategies for bruxism secondary to acute neurologic illnes...
Source: Current Pain and Headache Reports - April 10, 2021 Category: Neurology Source Type: research

Neurology of Preeclampsia and Related Disorders: an Update in Neuro-obstetrics
AbstractPurpose of ReviewPreeclampsia and related hypertensive disorders of pregnancy affect up to 10% of pregnancies. Neurological complications are common and neurologists often become involved in the care of obstetric patients with preeclampsia. Here, we review the definition(s), epidemiology, clinical features, and pathophysiology of preeclampsia, focusing on maternal neurological complications and headache as a common presenting symptom of preeclampsia.Recent FindingsNeurological symptoms are early and disease-defining features of preeclampsia. Neurological complications of preeclampsia may include headaches, visual s...
Source: Current Pain and Headache Reports - April 7, 2021 Category: Neurology Source Type: research

Pain Control in Dermatologic Conditions
AbstractPurpose of ReviewPain management in dermatologic conditions can be complicated by the primary disease burden and associated decreased quality of life, disability, and psychosocial issues. This review focuses on pain management strategies in some of the more painful dermatologic conditions.Recent FindingsPain management in painful dermatologic conditions such as pyoderma gangrenosum, postherpetic neuralgia, lower limb ulcers, and hidradenitis suppurativa revolves around treatment of the underlying disease process. Topical agents such as topical steroids and systemic immunosuppressants with over-the-counter analgesic...
Source: Current Pain and Headache Reports - April 6, 2021 Category: Neurology Source Type: research

Pain Management in Painful Psoriasis and Psoriatic Arthropathy: Challenging and Intricately Intertwined Issues Involving Several Systems
AbstractPurpose of ReviewPsoriasis and psoriatic arthropathy are inflammatory autoimmune conditions that can lead to profound emotional distress, social stigmatization, isolation, disfigurement, pain, disability, unemployment, and decreased quality of life. Thus, this disease has immense psychological, social, and economic implications as the pain experienced is closely associated with the primary disease burden. This review focuses on discussing the primary disease burden of psoriasis and psoriatic arthropathy, as well as management of different types of pain in these patients.Recent FindingsPain affects over 40% of patie...
Source: Current Pain and Headache Reports - April 6, 2021 Category: Neurology Source Type: research

Recent Advances of Magnetic Resonance Neuroimaging in Trigeminal Neuralgia
This article reviews the recent advances in magnetic resonance neuroimaging of the trigeminal nerve. (Source: Current Pain and Headache Reports)
Source: Current Pain and Headache Reports - April 6, 2021 Category: Neurology Source Type: research

The Litigation Complexity of Posttraumatic Headaches
AbstractPurpose of ReviewThis review explores the workings of the legal process in posttraumatic headache (PTH) claims by discussing representative court cases, the approaches taken by both plaintiff and defense attorneys in evaluating a client with PTH, and the role of the expert witness. This discussion also examines the question of whether or not litigation prolongs the symptoms of PTH and concussion, looking at the issues of malingering and the psychological effect of litigation.Recent FindingsLitigation prolongs recovery of PTH, primarily not from malingering but rather due to the psychological mindset of the plaintif...
Source: Current Pain and Headache Reports - April 6, 2021 Category: Neurology Source Type: research

CBT and CFT for Chronic Pain
AbstractPurpose of ReviewChronic pain is a widespread public and physical health crisis, as it is one of the most common reasons adults seek medical care and accounts for the largest medical reason for disability in the USA (Glombiewski et al., J Consult Clin Psychol. 86(6):533-545, 2018; Schemer et al., Eur J Pain. 23(3):526-538, 2019). Chronic pain is associated with decreased functional status, opioid dependence and substance abuse disorders, mental health crises, and overall lower perceived quality of life (Korff et al., J Pain. 17(10):1068-1080, 2016). For example, the leading cause of chronic pain and the leading cau...
Source: Current Pain and Headache Reports - April 1, 2021 Category: Neurology Source Type: research

Stroke-Like Migraine Attacks After Radiation Therapy (SMART) Syndrome: A Comprehensive Review
AbstractPurpose of ReviewSMART syndrome is a delayed complication of cranial irradiation that can be misconstrued as tumor recurrence or some other intracranial neurological disease. Recognition of this clinical syndrome is imperative as it can obviate the need for invasive diagnostic testing and can provide reassurance to both the patient and their loved ones.Recent FindingsSMART syndrome is generally considered a reversible clinical syndrome; however, neurological deficits may become permanent. Pathophysiology of SMART syndrome may involve cerebrovascular autoregulation impairment, neuronal dysfunction leading to trigemi...
Source: Current Pain and Headache Reports - March 24, 2021 Category: Neurology Source Type: research

Biologic Therapy in Chronic Pain Management: a Review of the Clinical Data and Future Investigations
This article aims to distill the most recent, available data from both laboratory research and clinical trials to better illuminate the potentials for these therapies in the treatment of chronic pain.Recent FindingsThere are numerous investigations underway using mesenchymal stem cells (MSCs) to treat painful, largely degenerative conditions. A large majority of these investigations focus on osteoarthritis of the knee and have demonstrated significantly improved pain scores. Some of these investigations have demonstrated significantly increased articular cartilage and meniscus growth as well as improved function. These stu...
Source: Current Pain and Headache Reports - March 24, 2021 Category: Neurology Source Type: research