Patient Satisfaction in Academic Pain Management Centers: How Do We Compare?
AbstractPurpose of ReviewThe aim of the study was to investigate patient satisfaction amongst academic pain management centers and associated factors.Recent FindingsApproximately 25% of pain management centers perform better than other practices on Press Ganey surveys. The majority of respondents (96%) indicated that pain management practices were uniquely positioned to receive poorer scores on patient satisfaction surveys. The majority of respondents (20/26), who reported a reason, indicated that limiting opioid prescribing led to poor patient satisfaction scores. Eighty-three percent of respondents indicated that they re...
Source: Current Pain and Headache Reports - November 18, 2020 Category: Neurology Source Type: research

Interventional Procedures in Episodic Migraine
AbstractPurpose of ReviewMigraine is a common disorder which in many cases can be adequately treated with medications. However, there are some patients who may either not respond to medications or have contraindications to their use. In this review, we will evaluate the available literature on the interventional procedures available to treat patients with episodic migraine. We will review the technical details of performing the procedures, the potential mechanisms of action, and available data on their effectiveness.Recent FindingsRecent studies conducted on the subject of interventional procedures including peripheral ner...
Source: Current Pain and Headache Reports - November 12, 2020 Category: Neurology Source Type: research

Narrative Review: Headaches After Reversible Cerebral Vasoconstriction Syndrome
AbstractPurpose of ReviewReversible cerebral vasoconstriction syndrome (RCVS) is a disorder with distinct features: recurrent thunderclap headaches with reversible vasoconstriction of intracranial arteries. Substantial studies regarding outcomes after RCVS were conducted, showing favorable functional outcomes in most patients despite the potentially life-threatening complications of RCVS, including ischemic stroke, intracranial hemorrhage, or convexity subarachnoid hemorrhage. However, patients may report headaches after the resolution of RCVS while relative studies were scarce.Recent FindingsTwo prospective studies from d...
Source: Current Pain and Headache Reports - November 8, 2020 Category: Neurology Source Type: research

Exparel for Postoperative Pain Management: a Comprehensive Review
AbstractPurpose of ReviewMultimodal pain management is the most effective way to treat postsurgical pain. However,  the use of opioids for acute pain management has unfortunately been a significant contributor to the current opioid epidemic. The use of opioids should be limited and only considered a “rescue” pain medication after other modalities of pain management have been utilized.Recent FindingsIt may be difficult to curtail the use of opioids in the treatment of chronic pain; however, in the postsurgical setting, there is compelling evidence that an  opioid-centric analgesic approach is...
Source: Current Pain and Headache Reports - October 23, 2020 Category: Neurology Source Type: research

The Impact of the Quantity and Quality of Social Support on Patients with Chronic Pain
AbstractPurpose of ReviewSocial support is an important yet often overlooked aspect of chronic pain management. Understanding the impact of social support on patients with chronic pain and determining if a relationship exists between a patient ’s perceived social support and their perceived quality of life is a crucial component to completely treating a pain patient. We sought to develop an intervention for patients with chronic pain that addresses the different types of social support, barriers to using social support, and ways to impr ove the quality of their social support.Recent FindingsA retrospective review of ...
Source: Current Pain and Headache Reports - October 15, 2020 Category: Neurology Source Type: research

Nummular Headache - a Case Report of a Rare Entity
AbstractPurpose of ReviewThe purpose of this manuscript is to shed light on systematic work-up of a diagnostic challenge such as nummular headache (NH), and to summarize the relevant literature on NH.Recent FindingsThe specific nature of the shape of the pain site is usually characteristic of NH. Multiple modalities of investigation including succinct imaging are necessary to successfully rule out other similar conditions.SummaryA 26-year-old female patient of Asian-Indian origin presented to the clinic with the chief complaint of chronic persistent left parietal headache for more than 10 years, which has been worsening ov...
Source: Current Pain and Headache Reports - October 12, 2020 Category: Neurology Source Type: research

Clinical Effectiveness and Mechanism of Action of Spinal Cord Stimulation for Treating Chronic Low Back and Lower Extremity Pain: a Systematic Review
AbstractPurpose of ReviewThe purpose of the present systematic review is to provide a current understanding of the mechanism of action and the evidence available to support clinical decision-making. The focus is to summarize randomized controlled trials (RCTs) and nonrandomized or observational studies of spinal cord stimulation in chronic pain to understand clinical effectiveness and the mechanism of action.Recent FindingsSeveral recent studies have demonstrated the benefit of spinal cord stimulation in managing chronic pain. Until recently, the mechanism of action was founded on a central paradigm derived from gate contr...
Source: Current Pain and Headache Reports - September 29, 2020 Category: Neurology Source Type: research

Brain Metabolism and Structure in Chronic Migraine
AbstractPurpose of ReviewThe purpose of this paper is to review and synthesize current literature in which neurochemical and structural brain imaging were used to investigate chronic migraine (CM) pathophysiology and to further discuss the clinical implications.Recent FindingsSpectroscopic and structural MRI studies have shown the presence of both impaired metabolism and structural alterations in the brain of CM patients. Metabolic changes in key brain regions support the notion of altered energetics and homeostasis as part of CM pathophysiology. Furthermore, CM, like other chronic pain disorders, may undergo structural re...
Source: Current Pain and Headache Reports - September 28, 2020 Category: Neurology Source Type: research

Complications Associated with Lumbar Transforaminal Epidural Steroid Injections
AbstractPurpose of ReviewLow back pain with radicular symptoms is a common cause of disability in the adult population in the USA. Lumbar transforaminal epidural steroid injection (TFESI) is one of the most frequently used intervention for lumbar radiculitis. The purpose of this review is to evaluate complications associated with lumbar TFESI.Recent FindingsBased on the literature review, the reported rate of minor complications was between 2.4 and 9.6%. The major complications including spinal abscess, spinal cord infarct, and epidural hematoma were documented as case reports. Some patients with spinal cord infarct had pe...
Source: Current Pain and Headache Reports - September 28, 2020 Category: Neurology Source Type: research

Chronic Cluster Headache Update and East –West Comparisons: Focusing on Clinical Features, Pathophysiology, and Management
AbstractPurpose of ReviewThis review provides an update on chronic cluster headache (CH) focusing on clinical features, pathophysiology, and management as well as comparisons between Eastern and Western populations.Recent FindingsChronic CH in Eastern populations was relatively rare, compared to that in Western populations. Lacrimation and/or conjunctival injection is the most frequently reported cranial autonomic symptom, and visual aura is predominant in chronic CH patients. Neuroimaging evidence in both ethnic groups suggests that CH pathophysiology involves the hypothalamus and pain-modulatory areas, with dynamic alter...
Source: Current Pain and Headache Reports - September 28, 2020 Category: Neurology Source Type: research

Efficacy and Feasibility of Behavioral Treatments for Migraine, Headache, and Pain in the Acute Care Setting
AbstractPurpose of ReviewThis narrative review examines the use of behavioral interventions for acute treatment of headache and pain in the emergency department (ED)/urgent care (UC) and inpatient settings.Recent FindingsBehavioral interventions demonstrate reductions of pain and associated disability in headache, migraine, and other conditions in the outpatient setting. Behavioral treatments may be a useful addition for patients presenting with acute pain to hospitals and emergency departments.SummaryWe review challenges and limitations and offer suggestions for implementation of behavioral interventions in the acute sett...
Source: Current Pain and Headache Reports - September 25, 2020 Category: Neurology Source Type: research

Post Traumatic Headache: Clinical care of athletes vs non athletes with Persistent Post Traumatic Headache after Concussion: Sports Neurologist and Headache Specialist Perspective
AbstractPurposeThe purpose of this paper is to review and outline the similarities and differences in the treatment of athletes compared with that of other populations with a persistent post-traumatic headache after a concussion.Recent FindingsAfter an extensive review of the literature and despite well over 2 million Americans experiencing post-traumatic headache (PTH) each year, a number of which will continue to experience persistent post-traumatic headache (PPTH). There is little evidence on the management of the disorder and essentially no evidence-based research when it comes to the management of athletes.SummaryWith...
Source: Current Pain and Headache Reports - September 2, 2020 Category: Neurology Source Type: research

Low-Dose Naltrexone for Chronic Pain: Update and Systemic Review
AbstractPurpose of ReviewThe purpose of this review is to evaluate and explain our current understanding of the clinical use of low-dose naltrexone in the treatment of chronic pain.Recent FindingsRecent pre-clinical uses and clinical studies further elucidate the use of low-dose naltrexone in the treatment of chronic pain.SummaryLow-dose naltrexone (LDN) has shown promise to reduce symptoms related to chronic pain conditions such as fibromyalgia, inflammatory bowel conditions, and multiple sclerosis. The mechanism of LDN appears to be modulation of neuro-inflammation, specifically, the modulation of the glial cells and rel...
Source: Current Pain and Headache Reports - August 25, 2020 Category: Neurology Source Type: research

Complications of Fluoroscopically Guided Cervical Interlaminar Epidural Steroid Injections
AbstractPurpose of ReviewCervical interlaminar epidural steroid injection is a common intervention in the management of cervical radiculitis. Given the large number of injections done annually, it is important to assess the potential complications associated with this procedure.Recent FindingsBased on current published studies, the overall complication rate varies. The vast majority are minor complications. However, this review also identified potentially catastrophic complications following cervical interlaminar epidural steroid injections.SummaryBased upon our review, cervical epidural steroid injection is considered a s...
Source: Current Pain and Headache Reports - August 25, 2020 Category: Neurology Source Type: research

Epidemiology of Headache in Children and Adolescents —Another Type of Pandemia
AbstractPurpose of ReviewHeadaches are not only responsible for restrictions in everyday life in adults. In children and adolescents, regular headaches lead also to reduced life quality and limitations in the social sphere, in school education, and in professional careers. Here, we provide an overview on the frequency of headache in children and adolescents with the aim of increasing awareness about this particular health issue.Recent FindingsOverall, headache prevalence in children and adolescents has been increasing in recent years. From various regions worldwide, data describing headache, its forms, and consequences are...
Source: Current Pain and Headache Reports - August 24, 2020 Category: Neurology Source Type: research

Pain Syndromes Secondary to Cluneal Nerve Entrapment
AbstractPurpose of ReviewThe purpose of this review is to provide an overview of the cluneal nerves, present a summary of pain syndromes secondary to clunealgia, and evaluate current literature for diagnostic and treatment modalities.Recent FindingsMultiple trials and studies have reported success with numerous modalities ranging from nerve blocks, neuroablation, and even peripheral neuromodulation with varying degrees of clinical benefit.SummaryCluneal nerve entrapment or chronic impingement can cause buttock pain or referred pain to nearby areas including the lower back, pelvic area, or even the lower extremities. Clunea...
Source: Current Pain and Headache Reports - August 20, 2020 Category: Neurology Source Type: research

Surgical Flow Disruptions, a Pilot Survey with Significant Clinical Outcome Implications
This study, therefore, attempted to better understand SFDs and their impact from the perspective of operating room team members.Recent FindingsAfter Institutional Review Board approval, a survey was sent to operating room team members including surgeons, anesthesia providers, nurses, and surgical technologists. The survey was developed to assess the perceived frequency and consequences of SFDs, and the ability to report and perceive the efficacy of reporting to management. Among 111 survey participants, 65% reported that surgical flow disruptions happen either “several times a day” or “every procedure.&rd...
Source: Current Pain and Headache Reports - August 17, 2020 Category: Neurology Source Type: research

Ultrasound-Guided Neuraxial Anesthesia
AbstractPurpose of ReviewThere has been a recent surge of interest in clinical applications of ultrasound, which has revolutionized acute pain management. This review is to summarize the current status of ultrasound utilization in neuraxial anesthesia, the most common type of regional anesthesia.Recent FindingsUltrasound-assisted and ultrasound-guided neuraxial anesthesia has improved clinical accuracy and patient safety through landmark identification including proper vertebral level and midline, as well as via measurements on neuraxial space. Direct needle or catheter visualization during the entire procedure has not yet...
Source: Current Pain and Headache Reports - August 17, 2020 Category: Neurology Source Type: research

An Update on Idiopathic Hypertrophic Cranial Pachymeningitis for the Headache Practitioner
AbstractPurpose of ReviewWe aim to review idiopathic hypertrophic cranial pachymeninigitis (IHCP), describe common head pain patterns and features associated with the disorder, suggest potential classification of head pain syndromes based on the recently published International Classification of Headache Disorders-3, explore pathophysiology found to be associated with cases of IHCP, and indicate common treatment for the disorder.Recent FindingsIt is suggested that a subset of IHCP is an IgG4-related autoimmune disorder. Patients with IHCP were found to have elevated cerebrospinal fluid (CSF) protein and lymphocytic pleocyt...
Source: Current Pain and Headache Reports - August 16, 2020 Category: Neurology Source Type: research

Neurophysiological Mechanisms Supporting Mindfulness Meditation –Based Pain Relief: an Updated Review
AbstractPurpose of ReviewThis review examines recent (2016 onwards) neuroscientific findings on the mechanisms supporting mindfulness-associated pain relief. To date, its clear that mindfulness lowers pain by engaging brain processes that are distinct from placebo and vary across meditative training level. Due to rapid developments in the field of contemplative neuroscience, an update review on the neuroimaging studies focused on mindfulness, and pain is merited.Recent FindingsMindfulness-based therapies produce reliably reductions in a spectrum of chronic pain conditions through psychological, physiological, and neural me...
Source: Current Pain and Headache Reports - August 16, 2020 Category: Neurology Source Type: research

Neurosurgical Evaluation for Patients with Chronic Lower Back Pain
AbstractPurpose of ReviewChronic low back pain (CLBP) is a major cause of disability in the USA, and it affects approximately 1 in 4 Americans. CLBP patients are commonly referred to or seek out neurosurgical evaluations and opinions for treatment and management.Recent FindingsLiterature shows that only a minority of patients with CLBP may benefit from a surgical procedure. These patients that present to clinic often have been ailing for a considerable amount of time and are eager for effective treatment to alleviate pain. However, determining if a patient with CLBP is a surgical candidate is predicated upon having no succ...
Source: Current Pain and Headache Reports - August 16, 2020 Category: Neurology Source Type: research

Current Concepts of Minimally Invasive Treatment Options for Plantar Fasciitis: a Comprehensive Review
ConclusionWhile conservative management continues to be the mainstay of treatment for plantar fasciitis, multiple minimally invasive treatment options are emerging with potential effectiveness in reducing pain and improving the function. (Source: Current Pain and Headache Reports)
Source: Current Pain and Headache Reports - August 11, 2020 Category: Neurology Source Type: research

Correction to: Intravenous Migraine Treatment in Children and Adolescents
The original publication of this article unfortunately contained the incorrect version of the manuscript. The original article has been corrected. (Source: Current Pain and Headache Reports)
Source: Current Pain and Headache Reports - August 10, 2020 Category: Neurology Source Type: research

Novel Agents in Neuropathic Pain, the Role of Capsaicin: Pharmacology, Efficacy, Side Effects, Different Preparations
AbstractPurpose of ReviewCapsaicin is a natural substance used to treat neuropathic pain because of its ability to be used in a more direct form on patients and efficiently treat their pain without the amount of side effects seen in the use of oral medications.Recent FindingsCurrently, the treatments for neuropathic pain are, control of the underlying disease process, then focused on symptomatic relief with pharmacotherapy, topical analgesics, or other interventions. When all pharmacological agents fail to relieve the pain, interventional strategies can be considered, such as neural blocks, spinal cord stimulation, and int...
Source: Current Pain and Headache Reports - August 5, 2020 Category: Neurology Source Type: research

Neuropathic Pain and Sickle Cell Disease: a Review of Pharmacologic Management
AbstractPurpose of ReviewSickle cell disease (SCD) remains among the most common and severe monogenic disorders present in the world today. Although sickle cell pain has been traditionally characterized as nociceptive, a significant portion of sickle cell patients has reported neuropathic pain symptoms. Our review article will discuss clinical aspects of SCD-related neuropathic pain, epidemiology of neuropathic pain among individuals with SCD, pain mechanisms, and current and future potential pharmacological interventions.Recent FindingsNeuropathic pain in SCD is a complicated condition that often has a lifelong and signif...
Source: Current Pain and Headache Reports - July 23, 2020 Category: Neurology Source Type: research

Unusual Brain MRI Findings in Patients Imaged for Headache: a Case Series
We describe a series of cases with unusual brain MRI findings in patients who present with headache disorders.Recent FindingsIncidental findings in patients imaged for headache include the following: aneurysm, arachnoid cyst, cerebral vascular malformations, Arnold-Chiari malformations, empty sella turcica, gray matter heterotopias, mastoiditis, mega cisterna magna, meningioma, normal variants of cerebral circulation, paranasal sinus disease, pineal cyst, pituitary tumor, Rathke ’s cleft cyst, skull hyperostosis, and vestibular schwannoma. The most common abnormal MRI findings encountered in migraine are nonspecific ...
Source: Current Pain and Headache Reports - July 19, 2020 Category: Neurology Source Type: research

Diagnosis, Treatment, and Management of Dejerine –Roussy Syndrome: a Comprehensive Review
AbstractPurpose of ReviewPost-stroke pain represents a complex condition with few standardized diagnostic criteria. As such, the array of symptoms is often difficult to categorize and diagnose. Central post-stroke pain (CPSP), also known as Dejerine –Roussy syndrome, presents as painful paresthesia in any part of the body that is usually coupled with sensory abnormalities.Recent FindingsIn patients who had experienced a cerebrovascular accident, CPSP typically affects the same areas of the body that are also impacted by the general motor and sensory deficits that result from stroke. Though it is generally debated, CP...
Source: Current Pain and Headache Reports - July 14, 2020 Category: Neurology Source Type: research

Endometriosis Pain Management: a Review
AbstractPurpose of ReviewThe purpose of this review is to summarize the up-to-date pain management options and recommendations for the challenging disease, endometriosis.Recent FindingsThe mainstays of endometriosis advances of both surgical and medical management continue to evolve. Experimental pharmaceuticals include Gestirone, and aromatase inhibitors have shown promise but are still under scrutiny. Surgical techniques include laparoscopic uterosacral nerve ablation/resection and presacral neurectomy.SummaryNo studies have directly compared medical versus surgical management, and as such, no one treatment modality can ...
Source: Current Pain and Headache Reports - July 14, 2020 Category: Neurology Source Type: research

Pediatric Migraine Phenomena and Variants: Don ’t Let Them Go Over Your Head
AbstractPurpose of ReviewPrimary care providers, general pediatric neurologists, and other related subspecialty providers require a clear understanding of pediatric migraine with typical aura and its variants.Recent FindingsWe highlight some of the genetic mutations known to contribute to specific types of migraine with aura, discuss the ophthalmologic phenomena of migraine and call attention to some of the earliest manifestations of migraine in children, many of which have correlates in adulthood.SummaryWhile the majority of headaches in children are migraine with or without aura or tension type, many migraine and aura va...
Source: Current Pain and Headache Reports - July 14, 2020 Category: Neurology Source Type: research

Headache in Beh çet’s Disease
AbstractPurpose of ReviewOur objective is to describe the various neurologic manifestations of Behcet ’s syndrome with special attention to headache syndromes.Recent FindingsMost recent studies have focused on data collection to better characterize the relatively rare disorder of neuro-Behcets (NBD). In patients with Behcet ’s disease (BD) who are experiencing headache, most are primary headache disorders, specifically tension type or migraines. Worsening headache can, however, be a sign of increased Behcets disease activity.SummaryBehcet ’s disease is a chronic, systemic, inflammatory disorder of unknown...
Source: Current Pain and Headache Reports - July 14, 2020 Category: Neurology Source Type: research

Cephalgia Alopecia
AbstractPurpose of ReviewIn this review, we examine reported cases of cephalgia alopecia including the initial case report from 2006. The goal is to review the clinical description, pathophysiology, diagnosis, and treatment of cephalgia alopecia.Recent FindingsThe pathophysiology of the headache and hair loss in cephalgia alopecia is believed to be related to neuroregulation of skin and nerve. It is hypothesized that the headache causes recurrent activation of trigeminal and upper cervical branches that innervate the hair cells. The repetitive activation of C fibers results in depletion of substance P and calcitonin gene-r...
Source: Current Pain and Headache Reports - July 14, 2020 Category: Neurology Source Type: research

Intravenous Migraine Treatment in Children and Adolescents
AbstractPurpose of ReviewPediatric migraine is a common, chronic, and disabling neurological disorder in children and adolescents. Outpatient management is not always effective, and intravenous migraine management may be necessary for headache treatment in the pediatric emergency department. Most current treatment is based on retrospective evidence and there is a lack of well-designed randomized double-blinded controlled pediatric studies. Intravenous drug treatment agents including intravenous fluids, prochlorperazine, diphenhydramine, metoclopramide, dexamethasone, magnesium, valproate and propofol, and dihydroergotamine...
Source: Current Pain and Headache Reports - July 7, 2020 Category: Neurology Source Type: research

Utilizing the Biopsychosocial Model in Concussion Treatment: Post-Traumatic Headache and beyond
AbstractPurpose of ReviewTo discuss recent literature concerning the application of the biopsychosocial model in the management of concussion and post-concussion headache.Recent FindingsCurrent research suggests that the biopsychosocial model is applicable to the concussion management process, particularly management of post-concussion headache. Such application is best illustrated by current active treatment strategies such as exercise, multifaceted rehabilitation, and psychosocial interventions targeting improved patient outcomes.SummaryOverall, the biopsychosocial model has significant applications to the management of ...
Source: Current Pain and Headache Reports - June 26, 2020 Category: Neurology Source Type: research

A Comprehensive Review of the Treatment and Management of Myofascial Pain Syndrome
AbstractPurpose of ReviewMyofascial pain syndrome (MPS) is a musculoskeletal pain condition that stems from localized, taut regions of skeletal muscle and fascia, termed trigger points. The purpose of this comprehensive review is to provide updated information on prevalence, pathophysiology, and treatment modalities with a focus on interventional modalities in managing MPS.Recent FindingsThough MPS can present acutely, it frequently presents as a chronic condition, affecting up to 85% of adults during their lifetime. MPS is an often-overlooked component of pain with overarching effects on society, including patient quality...
Source: Current Pain and Headache Reports - June 26, 2020 Category: Neurology Source Type: research

Exercise and Migraine Prevention: a Review of the Literature
AbstractPurpose of ReviewThis review intends to characterize the recent literature pertaining to the role of aerobic exercise in the prevention of migraine. Areas of consensus within that literature may be used to guide clinical practice, allowing for the promulgation of evidence-based practice recommendations.Recent FindingsThe past decade has seen the publication of numerous high-quality studies that explore aspects of exercise ’s effects on migraine prevention, including its success as a stand-alone prevention strategy, as well as its non-inferiority to some pharmacologic preventive measures.SummaryExercise often ...
Source: Current Pain and Headache Reports - June 10, 2020 Category: Neurology Source Type: research

A Comprehensive Review of the Diagnosis, Treatment, and Management of Postmastectomy Pain Syndrome
AbstractPurpose of ReviewPostmastectomy pain syndrome (PMPS) remains poorly defined, although it is applied to chronic neuropathic pain following surgical procedures of the breast, including mastectomy and lumpectomy in breast-conserving surgery. It is characterized by persistent pain affecting the anterior thorax, axilla, and/or medial upper arm following mastectomy or lumpectomy. Though the onset of pain is most likely to occur after surgery, there may also be a new onset of symptoms following adjuvant therapy, including chemotherapy or radiation therapy.Recent FindingsThe underlying pathophysiology is likely multifactor...
Source: Current Pain and Headache Reports - June 10, 2020 Category: Neurology Source Type: research

Pediatric Migraine and Academics
AbstractPurpose of ReviewThe purpose of this review is to examine the multitude of factors which may impact learning and academic performance in patients with pediatric migraine.Recent FindingsA range of associations of varying degree were noted between pediatric migraine and conditions such as ADHD, learning disabilities, sleep disorders, and psychiatric comorbidities with regard to headache pain and school functioning. Recent literature highlights the importance of sleep in relation to headache, mood disorders, and learning in youth and the emerging role of perfectionism.SummaryChildren with migraine remain at risk for s...
Source: Current Pain and Headache Reports - June 10, 2020 Category: Neurology Source Type: research

A Comprehensive Review of the Celiac Plexus Block for the Management of Chronic Abdominal Pain
The objective of this manuscript is to provide a comp rehensive review of the CPB as it pertains to CAP with a focus on the associated anatomy, indications, techniques, neurolysis/blocking agents, and complications observed in patients who undergo CPB for the treatment of CAP.Recent FindingsThe CAP is difficult to manage due to lack of precision in diagnosis and limited evidence from available treatments. CAP can arise from both benign and malignant causes. Treatment options include pharmacologic, interventional, and biopsychosocial treatments. Opioid therapy is typically utilized for the treatment of CAP; however, opioid ...
Source: Current Pain and Headache Reports - June 10, 2020 Category: Neurology Source Type: research

Considerations and Implications of Cannabidiol Use During Pregnancy
AbstractPurpose of ReviewCannabis is a naturally occurring plant that is composed of over sixty phytocannabinoids, of which cannabidiol (CBD) has been recently identified as having therapeutic potential.Recent FindingsAlthough not clearly understood in its mechanism of action, CBD contains potent anti-inflammatory, anti-hyperalgesia, and analgesic qualities now being further analyzed for its use in the treatment of a plethora of diseases. Related to its large safety profile and lack of psychoactive effects typically associated with cannabis and tetrahydrocannabinol (THC), CBD is being used more frequently for self-treatmen...
Source: Current Pain and Headache Reports - June 9, 2020 Category: Neurology Source Type: research

Minimally Invasive Therapies for Osteoarthritic Hip Pain: a Comprehensive Review
The objective of this review is to provide an update of current minimally invasive therapies for the treatment of pain stemming from hip osteoarthritis; these include intra-articular injection of medication, regenerative therapies, and radiofrequency ablation. (Source: Current Pain and Headache Reports)
Source: Current Pain and Headache Reports - June 5, 2020 Category: Neurology Source Type: research

Gut Microbiome Dysbiosis and Depression: a Comprehensive Review
AbstractPurpose of ReviewThe human gut microbiome is involved in a bi-directional communication pathway with the central nervous system (CNS), termed the microbiota –gut–brain axis. The microbiota–gut–brain axis is believed to mediate or modulate various central processes through the vagus nerve. The microbiota–gut–brain axis is involved with the production of microbial metabolites and immune mediators which trigger changes in neurotransmission, neu roinflammation, and behavior. Little is understood about the utilization of microbiome manipulation to treat disease.Recent FindingsThough s...
Source: Current Pain and Headache Reports - June 5, 2020 Category: Neurology Source Type: research

The Role of the Cannabinoid System in Pain Control: Basic and Clinical Implications
AbstractPurpose of ReviewThe purpose of this review is to provide a comprehensive update of the different known components of the endogenous cannabinoid system and the mechanisms of action, as it applies to analgesia.Recent FindingsFollowing the discovery of the endogenous cannabinoid system in the early 1990s and the subsequent characterization of the cannabinoid receptor, there has been a renewed interest in cannabinoid research. Recent work has demonstrated its efficacy as a pharmacologic agent. There is limited evidence in the literature about the understanding of the endocannabinoid system and its role in the treatmen...
Source: Current Pain and Headache Reports - June 5, 2020 Category: Neurology Source Type: research

Fear, Avoidance, and Disability in Headache Disorders
AbstractPurpose of ReviewThe purpose of this review is to summarize the role of avoidance behavior in headache-related disability and overview relevant clinical implications.Recent FindingsAvoidance occupies a central role in contemporary psychological perspectives on headache disorders and other chronic pain conditions. Several cognitive constructs of relevance to headache are influenced and maintained by avoidance behavior. A growing body of literature attests to the notion that avoidance of headache triggers, of stimuli that exacerbate headache, and of broader life domains can negatively affect headache progression, dis...
Source: Current Pain and Headache Reports - May 28, 2020 Category: Neurology Source Type: research

Acupuncture for Migraine: a Review of the Data and Clinical Insights
AbstractPurpose of ReviewThe purpose of this review is to discuss the current evidence for acupuncture in migraine and to provide insight into which patients may benefit most from acupuncture.Recent FindingsMultiple studies support acupuncture as a validated modality for the prevention of episodic migraine. While small studies on acupuncture for the prevention of chronic migraine are encouraging, evidence for its benefit is limited. Likewise, the existing studies on acupuncture for acute migraine treatment are insufficient.SummaryAcupuncture is commonly used to treat migraine and has gained popularity as a validated non-ph...
Source: Current Pain and Headache Reports - May 28, 2020 Category: Neurology Source Type: research

Headache in the Older Population: Causes, Diagnoses, and Treatments
AbstractPurpose of ReviewPrimary headaches are less common and differ in presentation in older versus younger individuals. Secondary headaches become more common among older patients.Recent FindingsDiagnosis and management of headaches in those>  65 years are discussed. Migraine and tension-type headaches are rarely new onset in this age group and should be a diagnosis of exclusion. In older individuals, migraine is more likely to be bilateral with less sensory sensitivities. Migraine aura may present without headache; careful assessment is needed to exclude stroke. Other primary headaches discussed include ...
Source: Current Pain and Headache Reports - May 28, 2020 Category: Neurology Source Type: research

Headache in Ruptured Intracranial Dermoid Cysts
AbstractPurpose of ReviewIntracranial dermoid cysts are benign, rare mass-occupying lesions of the central nervous system arising from the neuroectodermal cell lines. While rupture of intracranial dermoid cysts is rare, it can present with a variety of clinical manifestations. To explore the headache manifestations among patients with ruptured intracranial dermoid cysts. To our knowledge, limited studies focusing on headache due to the intracranial dermoid cysts rupture have been published to date. A literature review was done through PubMed/Medline. Articles within the past 10  years were reviewed. Articles in langua...
Source: Current Pain and Headache Reports - May 28, 2020 Category: Neurology Source Type: research

Is Percutaneous Adhesiolysis Effective in Managing Chronic Low Back and Lower Extremity Pain in Post-surgery Syndrome: a Systematic Review and Meta-analysis
AbstractPurpose of ReviewThe growing prevalence of spinal pain in the USA continues to produce substantial economic impact and strain on health-related quality of life. Percutaneous adhesiolysis is utilized for recalcitrant, resistant conditions involving spinal pain when epidural injections have failed to provide adequate improvement, especially low back and lower extremity pain, specifically in post-lumbar surgery syndrome. Despite multiple publications and systematic reviews, the debate continues in reference to effectiveness, safety, appropriate utilization, and medical necessity of percutaneous adhesiolysis in chronic...
Source: Current Pain and Headache Reports - May 27, 2020 Category: Neurology Source Type: research

The AL blation Technique for Treating Migraine Headache
AbstractPurposeThis work aims at describing a technique “The ALblation technique” for treating migraine headache. This technique describes radiofrequency ablation for supraorbital, supratrochlear, lesser occipital and greater occipital nerves bilaterally for treating migraine headache. This is a novel procedure that was not described before.Recent findingsAuthor published some articles on radiofrequency ablation for the pericranial nerves for treating different types of headache with consistent positive outcomes. Success of this procedure depends on identifying the appropriate nerves to treat the headache and a...
Source: Current Pain and Headache Reports - May 12, 2020 Category: Neurology Source Type: research

Recommendations for Managing Opioid-Tolerant Surgical Patients within Enhanced Recovery Pathways
AbstractPurpose of ReviewOne of the consequences of the opioid epidemic is an increase in the number of opioid-tolerant patients. These patients are at higher risk for readmission and longer hospital stays following surgery. Enhanced recovery after surgery (ERAS) pathways can be used as a framework for providing high-quality comprehensive care to patient population. It is estimated that as many as 15% of all surgery patients in the USA are receiving opioids going into surgery. The number of patients on medication maintenance therapy with long-acting opioids such as methadone or partial mu receptor agonists like buprenorphi...
Source: Current Pain and Headache Reports - May 7, 2020 Category: Neurology Source Type: research

A Comprehensive Review of the Diagnosis, Treatment, and Management of Urologic Chronic Pelvic Pain Syndrome
AbstractPurpose of ReviewUrologic chronic pelvic pain syndrome (UCPPS) is a chronic, noncyclic pain condition which can lead to significant patient morbidity and disability. It is defined by pain in the pelvic region, lasting for greater than 3 to 6  months, with no readily identifiable disease process. The aim of this review is to provide a comprehensive update of diagnosis and treatment of UCPPS.Recent FindingsUCPPS encompasses chronic pelvic pain syndrome or chronic prostatitis (CP/CPPS) in men and interstitial cystitis or painful bladder syndrome (IC/PBS) in women. Underlying inflammatory, immunologic, and neuropa...
Source: Current Pain and Headache Reports - May 5, 2020 Category: Neurology Source Type: research