Post Dural Puncture Headache, Managed with Epidural Blood Patch, Is Associated with Subsequent Chronic Low Back Pain in Patients: a Pilot Study
AbstractPurpose of ReviewPost dural puncture headache (PDPH) is a relatively common complication which may occur in the setting of inadvertent dural puncture (DP) during labor epidural analgesia and during intentional DP during spinal anesthetic placement or diagnostic lumbar puncture. Few publications have established the long-term safety of an epidural blood patch (EBP) for the treatment of a PDPH.Recent FindingsThe aim of this pilot study was to examine the association of chronic low back pain (LBP) in patients who experienced a PDPH following labor analgesia and were treated with an EBP. A total of 146 patients were co...
Source: Current Pain and Headache Reports - January 8, 2020 Category: Neurology Source Type: research

The Interaction Between Chronic Pain and PTSD
AbstractPurpose of ReviewPost-traumatic stress disorder (PTSD) and chronic pain often co-occur. Understanding the shared mechanisms, signs to identify PTSD, and treatment options is integral in allowing providers to better serve their patients.Recent FindingsIndividuals with comorbid PTSD and chronic pain report greater PTSD symptoms, pain, anxiety, depression, disability, and opioid use than those with only one of these conditions. There are several empirically supported therapies for chronic pain, and for PTSD, as well as pilot data for a treatment of comorbid pain and PTSD.SummaryThe purpose of this paper is to review a...
Source: Current Pain and Headache Reports - November 28, 2019 Category: Neurology Source Type: research

Can Anything Good Ever Come From Bearing Migraine Attacks? Suggestions for a Comprehensive Concept of Gain in Migraine
AbstractPurpose of ReviewThe purpose of this review is to summarise the current state of knowledge concerning known types of gain, the reasons why patients might seek it, as well as implications for headache disorders.Recent FindingsEven though the subject has been studied in the past, it received less attention in recent years.SummaryThere is no doubt that migraine is a highly disabling disorder. However, attacks sometimes may be beneficial for the migraine brain as a time-out from the daily routine. On the other hand, patients are often stigmatised as trying to satisfy other needs through their disease. These “othe...
Source: Current Pain and Headache Reports - November 16, 2019 Category: Neurology Source Type: research

Pain: Is It All in the Brain or the Heart?
AbstractPurpose of ReviewScientists have reported that pain is always created by the brain. This may not be entirely true. Pain is not only a sensory experience, but also can be associated with emotional, cognitive, and social components. The heart is considered the source of emotions, desire, and wisdom. Therefore, the aim of this article was to review the available evidence about the role of the heart in pain modulation.Recent FindingsDr. Armour, in 1991, discovered that the heart has its “little brain” or “intrinsic cardiac nervous system.” This “heart brain” is composed of approximat...
Source: Current Pain and Headache Reports - November 14, 2019 Category: Neurology Source Type: research

Transdermal Lidocaine for Perioperative Pain: a Systematic Review of the Literature
AbstractPurpose of ReviewThe purpose of this review is to provide a summary of the perioperative studies that have examined transdermal lidocaine (lidocaine patch) as an analgesic and put the evidence in context of the likely overall benefit of transdermal lidocaine in the perioperative period.Recent FindingsSeveral randomized controlled trials have been published in the past 4 years that concluded transdermal lidocaine can reduce acute pain associated with laparoscopic trocar or cannula insertion.SummaryTransdermal lidocaine may reduce short-term pain after surgery in selected surgery types and has a low risk of toxicity ...
Source: Current Pain and Headache Reports - November 14, 2019 Category: Neurology Source Type: research

Treatment of Discogenic Low Back Pain: Current Treatment Strategies and Future Options —a Literature Review
AbstractPurpose of ReviewMany studies have demonstrated that discogenic low back pain is the most common type of chronic low back pain (CLBP), one of the major causes of disability, and has a major socioeconomic impact. Our aim is to review present therapeutic interventions for discogenic low back pain.Recent FindingsThere are a multitude of treatments used in clinical practice to treat CLBP, but there is continued debate and lack of consensus among clinicians and the policy makers as to which modality is the best approach. Based on controlled evaluations, lumbar intervertebral discs have been shown to be the source of chr...
Source: Current Pain and Headache Reports - November 9, 2019 Category: Neurology Source Type: research

Headache and Barometric Pressure: a Narrative Review
AbstractPurpose of ReviewAlterations in atmospheric pressure have been long associated with headaches. The purpose of this review article is to investigate the association of barometric pressure with headache, classifying into two broad categories primary headache disorders (barometric pressure triggering migraine or tension-type headache) and secondary headache disorders (barometric pressure triggering high-altitude headache and headache attributed to airplane travel), discussing the pathophysiology and possible treatments.Recent FindingsMultiple studies have been performed with inconsistent results regarding the directio...
Source: Current Pain and Headache Reports - November 9, 2019 Category: Neurology Source Type: research

Efficacy of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in the Preventative Treatment of Episodic Migraine in Adults
AbstractPurpose of ReviewSystematic review of angiotensin-converting enzyme inhibitors (ACE inhibitors) and angiotensin receptor blockers (ARB) in the prophylactic treatment of adults with migraine. To identify gaps in research and provide guidance for future clinical trials.Recent FindingsA search was completed using PubMed, MEDLINE, Embase, and the Cochrane Library January 1, 1990 through December 31, 2017. The following are keywords used in the search: migraine, migraine prophylaxis/prevention, renin-angiotensin-aldosterone system, RAAS, ACE inhibitors, angiotensin-converting enzyme inhibitors: quinapril, perindopril, r...
Source: Current Pain and Headache Reports - September 12, 2019 Category: Neurology Source Type: research

Cognition and Cognitive Impairment in Migraine
AbstractBackgroundMigraine is a complex neurological disorder that affects a significant percentage of the human species, from all geographic areas and cultures. Cognitive symptoms and dysfunctions are interim and disabling components of this disorder and may be related to the brain processes underlying the pathophysiology. Yet they are often undervalued by clinicians. In this review, we present the different types of cognitive dysfunctions associated with migraine and the mechanisms that are potentially causing them.FindingsWhile reversible attack-related cognitive dysfunction seems extremely consistent and likely related...
Source: Current Pain and Headache Reports - September 11, 2019 Category: Neurology Source Type: research

Painful Seizures: a Review of Epileptic Ictal Pain
AbstractPurpose of ReviewTo summarize the literature regarding the prevalence, pathophysiology, and anatomic networks involved with painful seizures, which are a rare but striking clinical presentation of epilepsy.Recent FindingsSeveral recent large case series have explored the prevalence of the main cephalgic, somatosensory, and abdominal variants of this rare disorder. Research studies including the use of electrical stimulation and functional neuroimaging have demonstrated the networks underlying painful somatosensory or visceral seizures. Improved understanding of some of the overlapping mechanisms between migraines a...
Source: Current Pain and Headache Reports - September 10, 2019 Category: Neurology Source Type: research

Role of Alpha-2-Microglobulin in the Treatment of Osteoarthritic Knee Pain: a Brief Review of the Literature
AbstractPurpose of ReviewChronic knee pain remains a debilitating condition that remains difficult to manage. The purpose of this review, therefore, is to summarize current understanding of alpha-2-microglobulin in the treatment of osteoarthritic knee pain. Furthermore, we investigate its role in the anti-inflammatory properties of platelet-rich plasma (PRP).Recent FindingsAlpha-2-microglobulin, a 720-kD protein complex, is an active protease inhibitor with tremendous anti-inflammatory properties in animal models. A growing body of evidence suggests that this complex is the most instrumental factor for cartilage preservati...
Source: Current Pain and Headache Reports - September 9, 2019 Category: Neurology Source Type: research

Headache Attributed to Autonomic Dysreflexia: Clinical Presentation, Pathophysiology, and Treatment
AbstractA patient presenting with marked elevation in blood pressure and concurrent headache often presents a diagnostic challenge for even the most seasoned clinician. When marked hypertension and headache occur in a patient with a history of upper spinal cord injury, the patient should be presumed to have autonomic dysreflexia until proven otherwise. Autonomic dysreflexia can at times trigger headaches, hypertension, and variations in pulse, as well other autonomic signs and symptoms. Autonomic dysreflexia is a medical emergency for which appropriate treatment may be life-saving. In this review, we address the historical...
Source: Current Pain and Headache Reports - August 27, 2019 Category: Neurology Source Type: research

Patients with Chronic Musculoskeletal Pain of 3 –6-Month Duration Already Have Low Levels of Health-Related Quality of Life and Physical Activity
This study assessed the levels of quality of life and physical activity at the beginning stage of chronic musculuskeletal pain.Summary:Prospective cross-sectional study carried out at a musculoskeletal and sports medicine clinic. Eighty-five consecutive patients with muskuloskeletal (i.e., spine, peripheral joint, muscle, tendon) pain of 3 –6-month duration, not diagnosed before, age 14 and older, and from either gender were recruited. Short Form-36 Health Survey and International Physical Activity Questionnaire long were administered during assessments. Scores on subscales of Short Form-36 Health Survey and total sc...
Source: Current Pain and Headache Reports - August 27, 2019 Category: Neurology Source Type: research

The Clinical Use of IgG Food Sensitivity Testing with Migraine Headache Patients: a Literature Review
AbstractPurpose of ReviewThis literature review describes the relationship between IgG food sensitivities and their relation to migraine headaches.Recent FindingsIgG food sensitivities have been linked to various symptoms and disorders. While food sensitivities and intolerances are recognized within the clinical medicine community, diagnosing these sensitivities and intolerances can be challenging because symptoms are usually delayed hours to days and may not occur after every exposure to the allergen. Some reports indicate that foods such as chocolate, cheese, cow ’s milk, eggs, and red wine may be triggers for migr...
Source: Current Pain and Headache Reports - August 27, 2019 Category: Neurology Source Type: research

Manual Therapy and Quality of Life in People with Headache: Systematic Review and Meta-analysis of Randomized Controlled Trials
AbstractPurpose of ReviewPeople with headache usually experienced significantly lower health-related quality of life (HRQoL) than the healthy subjects. The goal of this systematic review was to evaluate the effectiveness of manual therapy on HRQoL in patients with tension-type headache (TTH), migraine (MH) or cervicogenic headache (CGH).Recent FindingsWe searched randomized controlled trials (RCTs) on MEDLINE, COCHRANE and PEDro databases. Treatment was manual therapy compared to usual care or placebo. The outcome was the HRQoL that could be measured by Headache Impact Test (HIT-6), Headache Disability Inventory (HDI), Mig...
Source: Current Pain and Headache Reports - August 10, 2019 Category: Neurology Source Type: research

Correction to: Diving Headache
The original version of this article incorrectly listed the second author ’s name. It should be Stephanie J. Nahas, not Stephanie J. Nahas-Geiger. The author name is corrected in this erratum. (Source: Current Pain and Headache Reports)
Source: Current Pain and Headache Reports - August 10, 2019 Category: Neurology Source Type: research

Enhancing Motivation for Change in the Management of Chronic Painful Conditions: a Review of Recent Literature
AbstractPurpose of ReviewThe purpose of this review is to evaluate and summarize recent empirical research investigating motivational factors for management of chronic pain and headache disorders.Recent FindingsResearch on motivation for non-pharmacological treatment of chronic pain and headache disorders has identified factors that influence initiation of and adherence to treatment. To address common factors that inhibit initiation of treatment (i.e., cost, time commitment), several electronic treatments have been developed. Self-efficacy is the most commonly studied psychosocial influence on treatment adherence, with evi...
Source: Current Pain and Headache Reports - August 6, 2019 Category: Neurology Source Type: research

A Comprehensive Review of Analgesia and Pain Modalities in Hip Fracture Pathogenesis
AbstractPurpose of ReviewHip fracture is common in the elderly population, painful and costly. The present investigation was undertaken to review epidemiology, socio-economic and medical implications, relevant anatomy, and anesthetic and pain modalities of hip fracture.Recent FindingsA literature search of PubMed, Ovid Medline, and Cochrane databases was conducted in December 2018 to identify relevant published clinical trials, review articles, and meta-analyses studies related to anesthetic and pain modalities of hip fracture. The acute pain management in these situations is often challenging. Common issues associated wit...
Source: Current Pain and Headache Reports - August 6, 2019 Category: Neurology Source Type: research

Utilization Patterns of Facet Joint Interventions in Managing Spinal Pain: a Retrospective Cohort Study in the US Fee-for-Service Medicare Population
AbstractPurpose of ReviewTo assess patterns of utilization and variables of facet joint interventions in managing chronic spinal pain in a fee-for-service (FFS) Medicare population from 2009 to 2016, with a comparative analysis from 2000 to 2009 and 2009 to 2016.Recent FindingsFrom 2009 to 2016, facet joint interventions increased at an annual rate of 2% per 100,000 Medicare population compared to 10.2% annual rate of increase from 2000 to 2009. Lumbosacral facet joint nerve block episodes decreased at an annual rate of 0.1% from 2009 to 2016, with an increase of 16.2% from 2000 to 2009. In contrast, lumbosacral facet join...
Source: Current Pain and Headache Reports - August 6, 2019 Category: Neurology Source Type: research

A Comprehensive Review of Trigeminal Neuralgia
AbstractPurpose of ReviewTrigeminal neuralgia (TN) is characterized by recurrent attacks of lancinating facial pain in the dermatomal distribution of the trigeminal nerve. TN is rare, affecting 4 to 13 people per 100,000.Recent FindingsAlthough there remains a debate surrounding the pathogenesis of TN, neurovascular compromise is the most currently accepted theory. Minimal stimulation caused by light touch, talking, or chewing can lead to debilitating pain and incapacitation of the patient. Pain may occur sporadically, though is primarily unilateral in onset. The diagnosis is typically determined clinically. Treatment opti...
Source: Current Pain and Headache Reports - August 6, 2019 Category: Neurology Source Type: research

Tramadol Prescription over a 4-Year Period in the USA
AbstractPurpose of ReviewDeaths associated to tramadol, a synthetic opioid, are rising globally. Herein, we characterize prescription patterns of tramadol relative to other opioids in the USA from 2012 to 2015, by geographic region and physician specialty.Recent FindingsData on opioid was obtained using Truven Health Analytics MarketScan for the years 2012 –2015. Inclusion criteria included subjects living in the USA with ages from 12 to 64 years. Patterns of prescription of tramadol were contrasted with other prescription opioids including hydrocodone, codeine, oxycodone, oxymorphone, methadone, and fentanyl. B...
Source: Current Pain and Headache Reports - August 6, 2019 Category: Neurology Source Type: research

Novel Regional Anesthesia for Outpatient Surgery
AbstractPurpose of ReviewPeripheral nerve blocks are effective and safe modalities for perioperative analgesia. But it remains unclear what blocks are adequate for ambulatory surgeries, as well as the proper patient management before and after discharge.Recent FindingsEmerging nerve blocks have sparked interests due to ease to perform under ultrasound guidance and lower risks of adverse events. Some of these novel blocks are particularly suitable for ambulatory procedures, including but not limited to motor-sparing lower extremity nerve blocks and phrenic-sparing nerve blocks for shoulder surgeries.SummaryThe adoption of p...
Source: Current Pain and Headache Reports - August 1, 2019 Category: Neurology Source Type: research

Recent Advances in the Understanding and Management of Carpal Tunnel Syndrome: a Comprehensive Review
AbstractPurpose of ReviewCarpal tunnel syndrome (CTS) is an entrapment neuropathy that involves the compression of the median nerve at the wrist and is considered the most common of all focal entrapment mononeuropathies. CTS makes up 90% of all entrapment neuropathies diagnosed in the USA and affects millions of Americans.Recent FindingsAge and gender likely play a role in the development of CTS, but additional studies may further elucidate these associations. Of known associated risk factors, diabetes mellitus seems to have the greatest association with CTS. One of the most commonly reported symptoms in CTS is a “pi...
Source: Current Pain and Headache Reports - August 1, 2019 Category: Neurology Source Type: research

Expanding Role of the Erector Spinae Plane Block for Postoperative and Chronic Pain Management
AbstractPurpose of ReviewThe erector spinae plane block (ESPB), first described in 2016, offers the promise of becoming a safe, less invasive, and technically less demanding alternative to conventional thoracic regional anesthetic techniques including thoracic epidurals and traditional paravertebral blocks. Clinical and cadaveric studies suggest that ESPB acts on the ventral rami of spinal nerves in the paravertebral space via penetration of the intertransverse connection tissues and moreover achieves visceral analgesia via the rami communicantes and sympathetic chain.Recent FindingsThe block has garnered considerable appe...
Source: Current Pain and Headache Reports - August 1, 2019 Category: Neurology Source Type: research

Chronic Headache: a Review of Interventional Treatment Strategies in Headache Management
AbstractPurpose of the ReviewTo provide an overview of current interventional pain management techniques for primary headaches with a focus on peripheral nerve stimulation and nerve blocks.Recent FindingsDespite a plethora of treatment modalities, some forms of headaches remain intractable to conservative therapies. Interventional pain modalities have found a niche in treating headaches. Individuals resistant to common regimens, intolerant to pharmaceutical agents, or those with co-morbid factors that cause interactions with their therapies are some instances where interventions could be considered in the therapeutic algor...
Source: Current Pain and Headache Reports - July 29, 2019 Category: Neurology Source Type: research

Stem Cell Therapies for Treatment of Discogenic Low Back Pain: a Comprehensive Review
AbstractPurpose of ReviewDiscogenic low back pain (DLBP) stems from pathology in one or more intervertebral discs identified as the root cause of the pain. It is the most common type of chronic low back pain (LBP), representing 26 –42% of attributable cases.Recent FindingsThe clinical presentation of DLBP includes increased pain when sitting, coughing, or sneezing, and experiencing relief when standing or ambulating. Dermatomal radiation of pain to the lower extremity and neurological symptoms including numbness, motor weakness, and urinary or fecal incontinence are signs of advanced disease with disc prolapse, nerve...
Source: Current Pain and Headache Reports - July 29, 2019 Category: Neurology Source Type: research

Migraine as a Stroke Mimic and as a Stroke Chameleon
AbstractPurpose of ReviewThis review details the frequency of and ways in which migraine can be both an ischemic stroke/transient ischemic attack mimic (false positive) and chameleon (false negative). We additionally seek to clarify the complex relationships between migraine and cerebrovascular diseases with regard to diagnostic error.Recent FindingsNearly 2% of all patients evaluated emergently for possible stroke have an ultimate diagnosis of migraine; approximately 18% of all stroke mimic patients treated with intravenous thrombolysis have a final diagnosis of migraine. Though the treatment of a patient with migraine wi...
Source: Current Pain and Headache Reports - July 29, 2019 Category: Neurology Source Type: research

Linking Traumatic Brain Injury, Sleep Disruption and Post-Traumatic Headache: a Potential Role for Glymphatic Pathway Dysfunction
AbstractPurpose of the ReviewTraumatic brain injury (TBI) is a major public health concern in the USA and worldwide. Sleep disruption and headaches are two of the most common problems reported by patients after TBI. In this manuscript, we review the current knowledge regarding the relation between post-traumatic sleep disruption and headaches. We also describe the role of the glymphatic system as a potential link between TBI, sleep, and headaches.Recent FindingsRecent studies show a reciprocal relation between post-traumatic sleep disruption and headaches: patients with sleep disruption after TBI report more headaches, and...
Source: Current Pain and Headache Reports - July 29, 2019 Category: Neurology Source Type: research

Off-label Antidepressant Use for Treatment and Management of Chronic Pain: Evolving Understanding and Comprehensive Review
AbstractPurpose of ReviewWhile clinicians have been using antidepressants for off-label indications in the treatment of chronic pain in recent years, newer studies have proven effectiveness and provided additional mechanistic understanding and defined potential adverse effects. As depression and chronic pain are frequently comorbid conditions, the use of antidepressants has allowed for treatment of both conditions concomitantly in the same patient population.Recent FindingsThe most commonly used antidepressants for chronic pain are tricyclic antidepressants (TCAs), though selective serotonin or noradrenaline reuptake inhib...
Source: Current Pain and Headache Reports - July 29, 2019 Category: Neurology Source Type: research

Regional Anesthesia in Patients on Anticoagulation Therapies —Evidence-Based Recommendations
AbstractPurpose of ReviewAnticoagulant use among patients is prevalent and increasing. It is important for anesthesiologists to be aware of patients on anticoagulants while performing regional anesthesia.Recent FindingsIn recent years, the FDA has approved many new anticoagulants. With new drugs coming to the market, new side effect profiles should be considered when treating patients, especially when using regional anesthesia. Both ASRA and European agencies have laid out recommendations regarding anticoagulant use and neuraxial/regional techniques. Regarding newer anticoagulants, the guidelines for discontinuation prior ...
Source: Current Pain and Headache Reports - July 29, 2019 Category: Neurology Source Type: research

Presentation and Management of Headache in Pituitary Apoplexy
AbstractPurpose of ReviewPituitary apoplexy (PA) occurs in the setting of an infarction and/or hemorrhage of a pre-existing adenoma. The most common presenting symptom is a severe, sudden onset headache. However, the characteristics of headache in the setting of PA are varied and can sometimes mimic primary headache disorders. The purpose of this article is to review the various presentations of headache in PA. We also outline treatment options for persistent headaches following PA.Recent FindingsA recent retrospective review of patients undergoing transsphenoidal resection of sellar lesions, including PA, found that gross...
Source: Current Pain and Headache Reports - July 29, 2019 Category: Neurology Source Type: research

Treatment Strategies and Effective Management of Phantom Limb –Associated Pain
AbstractPurpose of ReviewPhantom sensations are incompletely understood phenomena which take place following an amputation or deafferentation of a limb. They can present as kinetic, kinesthetic, or exteroceptive perceptions. It is estimated that phantom limb pain (PLP) affects anywhere from 40 to 80% of amputees.Recent FindingsPsychiatric illnesses such as depression, anxiety, and mood disorders have higher prevalence in amputees than in the general population. Pharmacologic treatment has been used as first-line therapy for amputees suffering from PLP with agents including gabapentinoids, amitriptyline, and other tricyclic...
Source: Current Pain and Headache Reports - July 29, 2019 Category: Neurology Source Type: research

Medication Overuse and Medication Overuse Headache: Risk Factors, Comorbidities, Associated Burdens and Nonpharmacologic and Pharmacologic Treatment Approaches
AbstractPurpose of ReviewWith a worldwide high disease burden, medication overuse headache (MOH) is an endemic and disabling neurological disorder. Because of the limitations of previous study designs, there are still debates and questions regarding the disease ’s nature and treatment strategy. This review will discuss the following concepts; (1) recent progress in association between medication overuse (MO) and MOH; (2) the burden, risk factors and comorbidities of MOH; (3) evidence of treatment in patients with MOH.Recent FindingsThe causal relationship between MO and MOH has not been identified. Currently, the tre...
Source: Current Pain and Headache Reports - July 26, 2019 Category: Neurology Source Type: research

Advances in the Understanding and Management of Chronic Pain in Multiple Sclerosis: a Comprehensive Review
AbstractPurpose of ReviewMultiple sclerosis (MS) is an autoimmune disorder of the central nervous system that can lead to severe physical, cognitive, and neurological deficits that often manifest in young adults. Central neuropathic pain is a common presenting symptom, often prompting patients to seek treatment with opioids, NSAIDS, antiepileptics, and antidepressants despite minimal effectiveness and alarming side-effect profiles. Additionally, spasticity occurs in more than 80% of MS patients and is an important consideration for further study in treatment.Recent FindingsRelated to inconsistencies in pain presentation an...
Source: Current Pain and Headache Reports - July 25, 2019 Category: Neurology Source Type: research

Pseudotumor Cerebri Syndrome in Children
AbstractPurpose of ReviewPseudotumor cerebri syndrome (PTCS) may affect both children and adults; however, the risk factors and clinical presentation vary greatly between these populations. This review aims to highlight the entity of PTCS in children and the unique considerations in this population; review the epidemiology and demographics; discuss the clinical presentation, revised diagnostic criteria, and approach to evaluation; review management strategies; and discuss the prognosis and long-term outcomes in children with PTCS.Recent FindingsClinical presentation can be variable in children and may be less obvious than ...
Source: Current Pain and Headache Reports - July 10, 2019 Category: Neurology Source Type: research

Radiofrequency Ablation for Management of Shoulder Pain
AbstractPurpose of ReviewThe treatment options for the management of shoulder pain are broad but evolving process. Modalities for controlling shoulder pain have commonly focused on pharmacotherapy, physical therapy, rehabilitation, and invasive procedures (surgical procedures, surgical, intra-articular steroid injections, many times, being sub-optimal). The use of radiofrequency ablation (RFA) for managing shoulder pain is on the rise. Our review investigated the evidence for the use of RFA in the management of shoulder pain.Recent FindingsIn our investigation, a review of the literature was conducted using Medline, PubMed...
Source: Current Pain and Headache Reports - July 10, 2019 Category: Neurology Source Type: research

An Update on Cognitive Therapy for the Management of Chronic Pain: a Comprehensive Review
AbstractPurpose of ReviewPsychological approaches to the management of chronic pain have proven to be very effective in allowing patients to better manage their symptoms and with overall functioning.Recent FindingsCognitive functional therapy (CFT) is centered on a three-step process, beginning with cognitive training, then progressing to functional movement training and exposure with control, and ending with physical activity and lifestyle changes. Cognitive behavioral therapy (CBT) as a technique focuses on identifying and changing maladaptive behaviors, thought patterns, and situations that contribute to psychiatric dys...
Source: Current Pain and Headache Reports - July 10, 2019 Category: Neurology Source Type: research

Systematic Review of Radiofrequency Ablation for Management of Knee Pain
AbstractPurpose of ReviewChronic pain of the lower extremity remains challenging to manage. Radiofrequency ablation procedure applies heat to nerve fibers with the goal of mitigating chronic pain conditions of the knee. However, the clinical efficacy has not yet been adequately established. The goal of this review paper is to report the use of radiofrequency ablations in the treatment of osteoarthritis of the knee.Recent FindingsPubMed and the Cochrane Controlled Trials Register were searched (final search 28 February 2018) using the MeSH terms “radiofrequency ablation,” “neurolysis,” “radiofr...
Source: Current Pain and Headache Reports - July 8, 2019 Category: Neurology Source Type: research

A Multimodal Approach to Pain Management for Patients with Chronic Back Pain: Outcome Measures at 1  Year
AbstractPurpose of ReviewThe purpose of this study is to evaluate the effectiveness of a multimodal approach to treating chronic low back pain.Recent FindingsChronic non-cancer-related back pain is often a frustrating and poorly managed problem for patients. It poses a significant public health issue worsened by the widespread use of narcotics. In 2016, the CDC released guidelines with noticeably more strict recommendations on prescription of narcotics for pain.SummaryVeterans at an interventional pain clinic presenting with chronic back pain refractory to medical and to surgical care were enrolled in an 8-week interdiscip...
Source: Current Pain and Headache Reports - July 8, 2019 Category: Neurology Source Type: research

Emerging Novel Pharmacological Non-opioid Therapies in Headache Management: a Comprehensive Review
AbstractPurpose of ReviewChronic headache is a significant worldwide problem despite advances in treatment options. Chronic headaches can have significant a detrimental impact on the activities of daily living.Recent FindingsPatients who do not obtain relief from chronic head and neck pain from conservative treatments are commonly being managed with interventional treatments. These interventional treatment options include botulinum toxin A, injections, local occipital nerve anesthetic and corticosteroid infiltration, occipital nerve subcutaneous stimulation and occipital nerve pulsed radiofrequency (PRF), sphenopalatine ga...
Source: Current Pain and Headache Reports - July 8, 2019 Category: Neurology Source Type: research

Platelet-Rich Plasma for the Treatment of Low Back Pain: a Comprehensive Review
AbstractPurpose of ReviewBack pain is a growing problem worldwide, incurring enormous economic costs and disability. Current treatment modalities often provide adequate relief but fail to address underlying conditions. Regenerative cellular modalities aim to restore anatomical function in degenerative conditions which may cause low back pain. Platelet-rich plasma (PRP) consists of an increased concentration of autologous platelets suspended in a small amount of plasma. PRP can be administered via injection or topically and is prepared using various techniques.Recent FindingsWhile a unifying mechanism of action is not well ...
Source: Current Pain and Headache Reports - July 3, 2019 Category: Neurology Source Type: research

Challenges of Robotic Gynecologic Surgery in Morbidly Obese Patients and How to Optimize Success
This article reviews the benefits of a minimally invasive approach in obese patients and provides a thorough guide to perioperative management of obese patients undergoing robotic gynecologic surgery. A useful set of tips and tricks to overcome many of the technical challenges in performing robotic surgery in the obese patients is included.Recent FindingsIn the USA, obesity has risen to affect 39.8% of the population, which leads to increased incidence of mortality, hypertension, diabetes, heart disease, and stroke. Moreover, obese patients are at greater risk of perioperative complications during gynecologic surgery. With...
Source: Current Pain and Headache Reports - July 1, 2019 Category: Neurology Source Type: research

Consensus Perioperative Management Best Practices for Patients on Transdermal Fentanyl Patches Undergoing Surgery
AbstractPurpose of ReviewThe administration of a transdermal fentanyl patch can be complicated with different pharmacokinetics than other fentanyl preparations.Recent FindingsThe medical condition and baseline opioid requirements must all be carefully considered when dosing a fentanyl patch. An advantage of the fentanyl patch is its ability to bypass the gastrointestinal tract and in many patients, provide effective analgesia with minimal side effects. Fentanyl patches must be carefully administered since morbidity and/or mortality can result from the following: Giving higher doses than a patient needs, combining the medic...
Source: Current Pain and Headache Reports - June 21, 2019 Category: Neurology Source Type: research

Comprehensive Perioperative Management Considerations in Patients Taking Methadone
AbstractPurpose of ReviewWell-informed staff can help decrease risks and common misconceptions regarding opioid-tolerant patients, especially those taking methadone.Recent FindingsIn 2015, opioid pain relievers were the second most used drug at 3.8 million. Overdose death was three times greater in 2015 than in 2000. Medication-assisted treatment was sought by more than 2 million individuals with substance use disorder, one of which is methadone.SummaryChronic pain affects millions of adults in the USA. Opioid therapy is widely used among these adults. Related to the risk of abuse and dependence, guidelines suggest that op...
Source: Current Pain and Headache Reports - June 17, 2019 Category: Neurology Source Type: research

Postoperative Management of Corneal Abrasions and Clinical Implications: a Comprehensive Review
AbstractPurpose of ReviewTotal patient care is of extreme importance during the administration of anesthesia. Proper care of the eye is necessary during all anesthetic administrations, especially during the administration of general anesthesia or monitored anesthesia care. By paying attention to details, the likelihood of an occurrence of eye injuries is reduced.Recent FindingsThough perioperative eye injuries are rare during general anesthesia, they do account for 2 –3% of claims against anesthesiologists. Ocular injuries may occur during general anesthesia even when tape has been utilized for eye closure. Corneal a...
Source: Current Pain and Headache Reports - May 30, 2019 Category: Neurology Source Type: research

Cerebral Venous Thrombosis Headache
AbstractPurpose of ReviewCerebral venous thrombosis (CVT) is a neurovascular disease caused by a thrombotic occlusion of either a dural sinus or cerebral vein. CVT results in a variety of neurological symptoms with the most common being headache. The purpose of this review is to characterize CVT, describe the headache pattern, and, finally, provide an update to date review of diagnostic and treatment options for this condition.Recent FindingsCVT is a very difficult disease to diagnose due to the variability in both patient presentation and imaging findings. Recent literature has attempted to standardize its risk factors, d...
Source: Current Pain and Headache Reports - May 30, 2019 Category: Neurology Source Type: research

Diving Headache
AbstractThis review will focus on the most recent information regarding the ICHD-3 definition of diving headache as well as other important causes of diving headache that are not listed in the ICHD-3 classification system. The paper will discuss etiology, diagnosis, and management of these disorders, focusing, when possible, on the newest research available. ICHD-3 diving headache is due to hypercapnia and is treated accordingly with oxygen. Other causes of diving headache range from decompression sickness to external compression headache to primary headache disorders, such as migraine. Correctly determining the underlying...
Source: Current Pain and Headache Reports - May 30, 2019 Category: Neurology Source Type: research

Correction to: A Review of Current Denervation Techniques for Chronic Hip Pain: Anatomical and Technical Considerations
In the original publication, the legend in the Figure  1 caption were missing and Table 2 was not presented correctly. (Source: Current Pain and Headache Reports)
Source: Current Pain and Headache Reports - May 28, 2019 Category: Neurology Source Type: research

Regional Nerve Blocks —Best Practice Strategies for Reduction in Complications and Comprehensive Review
AbstractPurpose of ReviewUnderstanding the etiologies of the complications associated with regional anesthesia and implementing methods to reduce their occurrence provides an opportunity to foster safer practices in the delivery of regional anesthesia.Recent FindingsNeurologic injuries following peripheral nerve block (PNB) and neuraxial blocks are rare, with most being transient. However, long-lasting and devastating sequelae can occur with regional anesthesia. Risk factors for neurologic injury following PNB include type of block, injection in the presence of deep sedation or general anesthesia, presence of existing neur...
Source: Current Pain and Headache Reports - May 23, 2019 Category: Neurology Source Type: research

Subarachnoid Hemorrhage and Headache
AbstractPurpose for ReviewSubarachnoid hemorrhage is a serious and life-threatening medical condition which commonly presents with an acute headache. Unfortunately, it remains frequently misdiagnosed at initial presentation with dire consequences in terms of patient morbidity and mortality. The goal of this paper is to review salient features in the clinical history, as well as recently developed clinical decision rules, which can help determine which patients warrant further investigation for subarachnoid hemorrhage when the initial presentation is that of an acute headache.Recent FindingsA recent prospective observationa...
Source: Current Pain and Headache Reports - May 23, 2019 Category: Neurology Source Type: research