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 24, 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 20, 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 15, 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 15, 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 15, 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 15, 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 15, 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 8, 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 27, 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 27, 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 11, 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 11, 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 11, 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 11, 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 10, 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 6, 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 6, 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 6, 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 29, 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 29, 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 29, 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 29, 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 28, 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 13, 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 8, 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 6, 2020 Category: Neurology Source Type: research

Does Epidural Bupivacaine with or Without Steroids Provide Long-Term Relief? A Systematic Review and Meta-analysis
AbstractPurpose of ReviewLow back and lower extremity pain have been treated since 1901 with local anesthetics alone and since 1952 in combination with steroids. Over the years, multiple randomized controlled trials, systematic reviews with or without meta-analysis have been reaching discordant conclusions regarding the effectiveness of sodium chloride solution, local anesthetics, and steroids in managing spinal pain. Further, related to lack of understanding, multiple reviewers have considered local anesthetics including lidocaine and bupivacaine as equivalent to placebo based on theory that steroid is the only drug effec...
Source: Current Pain and Headache Reports - April 25, 2020 Category: Neurology Source Type: research

Is a One Prognostic Block Sufficient to Proceed with Radiofrequency Ablation? A Single Center Experience
AbstractPurpose of ReviewWe performed this study and associated review to examine whether a one prognostic block is sufficient to proceed with radiofrequency ablation.Recent FindingsTo perform one or two prognostic blocks before performing radiofrequency ablation is a very controversial issue. The practice is inconsistent and insurance companies even do not follow same regulations.SummaryWe found in our research that majority of patients who receive a successful first prognostic block also receive a successful second prognostic block. We think one prognostic block can be sufficient to move forward with radiofrequency ablat...
Source: Current Pain and Headache Reports - April 22, 2020 Category: Neurology Source Type: research

A Comprehensive Update on the Treatment and Management of Postdural Puncture Headache
AbstractPurpose of ReviewThe purpose of this manuscript is to provide a comprehensive review of postdural puncture headache (PDPH) with a focus on epidemiology, pathophysiology, treatment, and prophylaxis.Recent FindingsPDPH is an adverse iatrogenic complication of neuraxial anesthesia that occurs following inadvertent puncture of the dura after epidural or spinal anesthesia. The overall incidence of PDPH after neuraxial procedures varies from 6 to 36%. The occurrence of PDPH can lead to increased patient morbidity, delayed discharge, and increased readmission. PDPH is a self-limiting postural headache that most often will...
Source: Current Pain and Headache Reports - April 22, 2020 Category: Neurology Source Type: research

Effects of Tourniquets in the Development of Pain States: a Novel Clinical Pilot Study and Review of Utilization of Tissue Oximetry to Measure Neural Ischemia
AbstractPurpose of ReviewApproximately 20% of patients undergoing surgery develop persistent lower extremity pain following total knee arthroplasty. Animal studies have confirmed that prolonged tourniquet time increases the risk of endoneural ischemia and can mediate or modulate the development of chronic pain. The use of Near InfraRed Spectroscopy (NIRS) adjacent to nerve tissue, previously described as ONG has been shown to detect early neural compromise and has demonstrated clinical utility in carpal tunnel diagnosis.Recent FindingsIn this pilot study, we recruited 10 healthy adult volunteers to undergo oxyneurography (...
Source: Current Pain and Headache Reports - April 22, 2020 Category: Neurology Source Type: research

Utilization of Vertebral Augmentation Procedures in the USA: a Comparative Analysis in Medicare Fee-for-Service Population Pre- and Post-2009 Trials
AbstractPurpose of ReviewTo review the utilization patterns of vertebral augmentation procedures in the US Medicare population from 2004 to 2017 surrounding concurrent developments in the literature and the enactment of the Affordable Care Act (ACA).Recent FindingsThe analysis of vertebroplasty and kyphoplasty utilization patterns was carried out using specialty utilization data from the Centers for Medicare and Medicaid Services Database. Of note, over the period of time between 2009 and 2017, the number of people aged 65 or older showed a 3.2% rate of annual increase, and the number of Medicare beneficiaries increased by...
Source: Current Pain and Headache Reports - April 14, 2020 Category: Neurology Source Type: research

Dexmedetomidine in Enhanced Recovery After Surgery (ERAS) Protocols for Postoperative Pain
AbstractPurpose of ReviewEffective acute pain management has evolved considerably in recent years and is a primary area of focus in attempts to defend against the opioid epidemic. Persistent postsurgical pain (PPP) has an incidence of up to 30 –50% and has negative outcome of quality of life and negative burden on individuals, family, and society. The 2016 American Society of Anesthesiologists (ASA) guidelines states that enhanced recovery after surgery (ERAS) forms an integral part of Perioperative Surgical Home (PSH) and is now recomm ended to use a multimodal opioid-sparing approach for management of postoperative...
Source: Current Pain and Headache Reports - April 2, 2020 Category: Neurology Source Type: research

Perioperative Point of Care Ultrasound (POCUS) for Anesthesiologists: an Overview
This article provides a brief overview of the indications, techniques for image acquisition, and general principles in interpreting basic images.Recent FindingsWhole-body POCUS can provide quick diagnoses and impact clinical management across relevant pre-, intra-, and post-operative settings. Anesthesia providers need to understand different applications for POCUS, including focused cardiac ultrasound (FoCUS), lung ultrasound (LUS), gastric ultrasound, abdominopelvic ultrasound, and the use of ultrasound for airway management. Currently, there is no standard ultrasound curriculum for anesthesiology residents, and teaching...
Source: Current Pain and Headache Reports - March 21, 2020 Category: Neurology Source Type: research

Temporal tendinosis: A cause of chronic orofacial pain
AbstractPurpose of ReviewDiverse musculoskeletal disorders and neuropathic symptoms of the face pose significant diagnostic challenges. In particular, temporal tendinosis is generally overlooked in the medical and dental literature and is therefore a poorly understood topic and often problematic cause of chronic orofacial pain. In this article, we explore temporal tendinosis as a cause of unresolved orofacial pain by reviewing the complex anatomy of the temporalis muscle, common presentations of temporal tendinosis, possible etiologies for injury and place a strong emphasis on required diagnostic evaluation and clinical ma...
Source: Current Pain and Headache Reports - March 21, 2020 Category: Neurology Source Type: research

A Comprehensive Review of Over-the-counter Treatment for Chronic Migraine Headaches
AbstractPurpose of ReviewMigraine headaches are a neurologic disorder characterized by attacks of moderate to severe throbbing headache that are typically unilateral, exacerbated by physical activity, and associated with phonophobia, photophobia, nausea, and vomiting. In the USA, the overall age-adjusted prevalence of migraine in female and male adults is 22.3% and 10.8%, respectively.Recent FindingsMigraine is a disabling disease that ranks as the 8th most burdensome disease in the world and the 4th most in women. The overarching hypothesis of migraine pathophysiology describes migraine as a disorder of the pain modulatin...
Source: Current Pain and Headache Reports - March 21, 2020 Category: Neurology Source Type: research

A Comprehensive Review of the Treatment and Management of Pain in Sickle Cell Disease
AbstractPurpose of ReviewSickle cell disease (SCD) is a hematological disorder which leads to serious complications in multiple organ systems. While significant research has addressed many of the effects of acute pain episodes and end-organ damage connected to this disease, little has approached the chronic pain state associated with this condition.Recent FindingsAssociated chronic pain represents a significant detractor from the quality of life experienced by these patients, affecting over half of those with SCD on more days than not. Current treatment typically is centered upon preventing and responding to acute vasooccl...
Source: Current Pain and Headache Reports - March 21, 2020 Category: Neurology Source Type: research

Current Concepts in the Management of Vertebral Compression Fractures
The objective of this review is to compare outcomes between multiple augmentation techniques and ongoing discussions of effectiveness of vertebral augmentation procedures.Recent FindingsVertebral compression fractures (VCFs) are a prevalent disease affecting approximately 1.5 million US adults annually. VCFs can cause severe physical limitations, including back pain, functional disability, and progressive kyphosis of the thoracic spine that ultimately results in decreased appetite, poor nutrition, impaired pulmonary function, and spinal cord compression with motor and sensory deficits. The deconditioning that affects patie...
Source: Current Pain and Headache Reports - March 20, 2020 Category: Neurology Source Type: research

Radiofrequency Ablation for Treating Headache: a Follow-up Study
AbstractPurpose of ReviewTo identify the efficacy of radiofrequency ablation of pericranial nerves in treating headache.Recent FindingsRecent studies by the same group showed promising results in treating headache using radiofrequency ablation.SummaryPericranial nerves can be a therapeutic target for treating headache. Our results showed efficacy of radiofrequency ablation. More studies using other modalities as neuromodulation are needed and may show efficacy as well. (Source: Current Pain and Headache Reports)
Source: Current Pain and Headache Reports - March 12, 2020 Category: Neurology Source Type: research

Patient and Surgery-Related Predictors of Acute Postoperative Pain
AbstractPurpose of ReviewThe purpose of the present investigation is to provide a comprehensive review of both patient and procedure specific predictors of acute postoperative pain.Recent FindingsAs the global number of surgeries continues to increase, as well as evidence of worse patient outcomes in those who suffer from poorly controlled postoperative pain, it is becoming more critical for perioperative physicians to have a deep understanding of the risks which might lead to increased pain in the immediate postoperative settings. It is also important to recognize potential tools to prevent the development and intensity o...
Source: Current Pain and Headache Reports - February 18, 2020 Category: Neurology Source Type: research

Transcutaneous Electrical Nerve Stimulation in Relieving Neuropathic Pain: Basic Mechanisms and Clinical Applications
AbstractPurpose of ReviewTranscutaneous electrical nerve stimulation (TENS) is widely used as a non-pharmacological approach for pain relief in a variety of clinical conditions. This manuscript aimed to review the basic mechanisms and clinical applications regarding the use of TENS for alleviating the peripheral (PNP) and central neuropathic pain (CNP).Recent FindingsBasic studies on animal models showed that TENS could alleviate pain by modulating neurotransmitters and receptors in the stimulation site and its upper levels, including the spinal cord, brainstem, and brain. Besides, many clinical studies have investigated t...
Source: Current Pain and Headache Reports - February 18, 2020 Category: Neurology Source Type: research

Minimally Invasive Lumbar Decompression and Interspinous Process Device for the Management of Symptomatic Lumbar Spinal Stenosis: a Literature Review
AbstractPurpose of ReviewSymptomatic lumbar spinal stenosis (LSS) is a condition affecting a growing number of individuals resulting in significant disability and pain. Traditionally, treatment options have consisted of conservative measures such as physical therapy, medication management, epidural injections and percutaneous adhesiolysis, or surgery. There exists a treatment gap for patients failing conservative measures who are not candidates for surgery. Minimally invasive lumbar decompression (MILD ®) and interspinous process device (IPD) with Superion® represent minimally invasive novel treatment options that ...
Source: Current Pain and Headache Reports - February 18, 2020 Category: Neurology Source Type: research

An Analysis of Predictors of Persistent Postoperative Pain in Spine Surgery
AbstractPurpose of ReviewThis review aims to identify perioperative patient-related factors that are associated with the development of persistent postoperative pain (PPP) in patients undergoing spine surgery.Recent FindingsTwenty-one studies published between 2000 and 2019 were included in this literature review. The following five patient-related factors were identified to be associated with the development of PPP after spine surgery: anxiety, depression, pain catastrophizing, pain sensitivity, and preoperative opioid consumption.SummaryThe existing literature suggests that the risk factors for developing chronic pain af...
Source: Current Pain and Headache Reports - February 18, 2020 Category: Neurology Source Type: research

Sacral Insufficiency Fractures: a Review of Risk Factors, Clinical Presentation, and Management
AbstractPurpose of the ReviewSacral insufficiency fractures (SIF) are a common and often underdiagnosed source of low back pain. In patients with SIF, there is both a compromised sacroiliac joint and weakened sacrum, resulting in decreased resistance to torsional stress, leading to fracture. While conservative medical management is a safe option, minimally invasive intervention may provide improved short and long-term relief of low back pain in patients presenting with SIF. This comprehensive review is undertaken to provide an update to the current understanding of SIF with description of risk factors, clinical presentatio...
Source: Current Pain and Headache Reports - February 17, 2020 Category: Neurology Source Type: research

Correction to: Role of Alpha-2-Microglobulin in the Treatment of Osteoarthritic Knee Pain: a Brief Review of the Literature
The original publication listed author Alan Kaye as “A. Kaye,” but his name should read “A.D. Kaye.” The correct author name is presented in this article. (Source: Current Pain and Headache Reports)
Source: Current Pain and Headache Reports - February 8, 2020 Category: Neurology Source Type: research

Minimally Invasive Treatment of Chronic Ankle Instability: a Comprehensive Review
The objective of this manuscript is to provide a comprehensive review of CAI diagnosis and our current understanding of minimally invasive treatment options.Recent FindingsFirst-line treatment is conservative management, some of which includes neuromuscular rehabilitation, balance training, nonsteroidal anti-inflammatory drugs (NSAIDs), manual mobilization, ice therapy, and compression. While conservative management is effective, additional treatments for those who fail conservative management, or who seek alternative options also have been explored.SummaryRecent advances and modern techniques have expanded available treat...
Source: Current Pain and Headache Reports - February 4, 2020 Category: Neurology Source Type: research

Evaluation of Cost-Utility of Thoracic Interlaminar Epidural Injections
AbstractPurpose of ReviewChronic thoracic pain, even though not as prevalent as low back and neck pain, appears in approximately 30% of the general population. The severity of thoracic pain and degree of disability seems to be similar to other painful conditions. Despite this severity, interventions in managing chronic thoracic pain are less frequent, and there is a paucity of literature regarding epidural injections and facet joint interventions.Recent FindingsAs with lumbar and cervical spine, a multitude of interventions are offered in managing chronic thoracic pain, including interventional techniques with epidural inj...
Source: Current Pain and Headache Reports - January 30, 2020 Category: Neurology Source Type: research

The Role of Exparel Plus Meloxicam for Postoperative Pain Management
AbstractPurpose of ReviewAcute postoperative pain reduction is a major target against the opioid crisis. While opioids have traditionally been the mainstay for postoperative analgesia, current practice has focused on a multimodal approach to pain control, including ultrasound-guided blocks with longer acting local anesthetic agents.Recent FindingsNon-steroidal anti-inflammatory drugs (NSAIDs), such as meloxicam, are an important class of medications utilized to manage pain in the perioperative period. An additional treatment used in perioperative or postoperative pain relief is Exparel, a bupivacaine (sodium channel blocke...
Source: Current Pain and Headache Reports - January 30, 2020 Category: Neurology Source Type: research

Rhinogenic Headache in Children and Adolescents
AbstractPurpose of ReviewThe purpose of this review is to evaluate and explain our current understanding of rhinogenic headache in the pediatric population.Recent FindingsOne study showed that 40 % of pediatric patients with migraine had previously received an incorrect diagnosis of sinus headache. Two studies found that over 50% of pediatric patients with migraines have associated cranial autonomic symptoms, possibly elucidating the reasons for misdiagnosis. Some case reports demonstrate successful treatment of rhinogenic contact point headache with the surgical resection of mucosal contact points, although this diagnosis...
Source: Current Pain and Headache Reports - January 30, 2020 Category: Neurology Source Type: research

The Role of Cannabidiol (CBD) in Chronic Pain Management: An Assessment of Current Evidence
AbstractPurpose of ReviewGiven the growing challenges in chronic pain management coupled with the ongoing consequences of the opioid epidemic, pain management practitioners are looking into more effective, innovative, and safer alternatives to treat pain. Cannabis-based medicine had been described for hundreds of years but only recently have we seen the more scientific, evidence-based approach to its use, and ongoing investigations continue to explore its potential medical benefits. While historically more attention has been paid to the psychoactive component of the cannabis plant Δ9-tetrahydrocannabinol (THC), there...
Source: Current Pain and Headache Reports - January 24, 2020 Category: Neurology Source Type: research

Dysphasia and Other Higher Cortical Dysfunctions During the Migraine Aura —a Systematic Review of Literature
AbstractPurpose of the ReviewAlthough visual and somatosensory disturbances are the most common migraine aura (MA) symptoms, patients can also experience other symptoms during their MA. The aim of this review is to provide an overview of studies that report symptoms of dysphasia and other higher cortical dysfunctions (HCDs) during MA, as well as to determine the frequency of HCDs.Recent FindingsFive studies met the inclusion criteria, corresponding to 697 patients overall. The most frequently reported HCDs were those of the language group (range 10 –53%). The occurrence of visual HCDs was noted in 12–40 patient...
Source: Current Pain and Headache Reports - January 24, 2020 Category: Neurology Source Type: research