Medical Cannabis for Chronic Nonmalignant Pain Management
AbstractPurpose of ReviewCannabis has been used since ancient times for medical and recreational research. This review article will document the validity of how medical cannabis can be utilized for chronic nonmalignant pain management.Recent FindingsCurrent cannabis research has shown that medical cannabis is indicated for symptom management for many conditions not limited to cancer, chronic pain, headaches, migraines, and psychological disorders (anxiety and post-traumatic stress disorder). Δ9‐Tetrahydrocannabinol (THC) and cannabidiol (CBD) are active ingredients in cannabis that modulate a patient’s symptoms. These...
Source: Current Pain and Headache Reports - March 10, 2023 Category: Neurology Source Type: research
Quality Improvement in the Management of Subarachnoid Hemorrhage: Current State and Future Directions
AbstractPurpose of ReviewAneurysmal subarachnoid hemorrhage carries high mortality and morbidity. Quality improvement (QI) efforts in the management of this disease process are growing as the field of neurocritical care matures. This review provides updates in QI in subarachnoid hemorrhage (SAH) and discusses gaps and future directions.Recent FindingsLiterature published on the topic over the past 3 years were evaluated. An assessment of current QI practices pertaining to the acute care of SAH was conducted. These include processes surrounding acute pain management, inter-hospital coordination of care, complications duri...
Source: Current Pain and Headache Reports - March 7, 2023 Category: Neurology Source Type: research
Role of Integrative Health on Neuropathic Pain
AbstractPurpose of ReviewPatients diagnosed with neuropathic pain experience continuous or intermittent spontaneous pain throughout their lives. Pharmacological treatments often provide limited relief; therefore, a multidisciplinary approach should be utilized to manage neuropathic pain. This review examines the current literature on integrative health modalities (anti-inflammatory diets, functional movement, acupuncture, meditation, and transcutaneous therapy) for treating patients with neuropathic pain.Recent FindingsThe use of an anti-inflammatory diet, functional movement, acupuncture, meditation, and transcutaneous th...
Source: Current Pain and Headache Reports - March 2, 2023 Category: Neurology Source Type: research
Insomnia and Migraine: A Review of Evidence-Based, Biobehavioral Interventions
AbstractPurpose of ReviewThe purpose of this review is to discuss the current evidence for Cognitive Behavioral Therapy for Insomnia (CBT-I) for patients with migraine and comorbid insomnia. In this article, we provide a narrative review of the literature on CBT-I and migraine, highlighting recent advances in research into this topic. Finally, we propose a way for clinicians to integrate CBT-I into clinical practice.Recent FindingsMultiple studies support CBT-I as a validated modality for the treatment of insomnia in migraine.SummaryCBT-I is used to treat insomnia and should be offered as first line therapy. Clinicians sho...
Source: Current Pain and Headache Reports - January 26, 2023 Category: Neurology Source Type: research
Treating Chronic Pain with Deep Brain Stimulation
AbstractPurpose of ReviewDeep brain stimulation (DBS) for chronic pain has been controversial. Despite the discouraging outcomes from multicenter clinical trial in the twentieth century, there is sustained interest in optimizing its use to improve patient outcomes. Here we provide a concise overview of DBS for chronic pain as a reference for clinicians.Recent FindingsRecently published data lends tentative support for DBS as a means of treating chronic pain. Still, high level-of-evidence data remain elusive. There are a handful of ongoing and prospective clinical trials exploring DBS for pain in the context of closed-loop ...
Source: Current Pain and Headache Reports - December 26, 2022 Category: Neurology Source Type: research
The Experience of BIPOC Living with Chronic Pain in the USA: Biopsychosocial Factors that Underlie Racial Disparities in Pain Outcomes, Comorbidities, Inequities, and Barriers to Treatment
AbstractPurpose of ReviewThis review synthesizes recent findings related to the biopsychosocial processes that underlie racial disparities in chronic pain, while highlighting opportunities for interventions to reduce disparities in pain treatment among BIPOC.Recent FindingsChronic pain is a prevalent and costly public health concern that disproportionately burdens Black, Indigenous, and people of color (BIPOC). This unequal burden arises from an interplay among biological, psychological, and social factors.SummarySocial determinants of health (e.g., income, education level, and lack of access or inability to utilize health...
Source: Current Pain and Headache Reports - December 17, 2022 Category: Neurology Source Type: research
Pill Counting as an Intervention to Enhance Compliance and Reduce Adverse Outcomes with Analgesics Prescribed for Chronic Pain Conditions: A Systematic Review
AbstractPurpose of ReviewAppropriate use of opioid analgesics is a key concern within the field of pain medicine. Several methods exist to discourage abuse and facilitate effective treatment regimens. Pill counting is often cited as one such method and frequently employed in varying fashions within clinical practice. However, to date, there is no published review of the evidence to support this practice. This was a comprehensive review of the available literature that was conducted with analysis of the efficacy and practical application of pill counting during treatment of chronic pain conditions.Recent FindingsThere is pa...
Source: Current Pain and Headache Reports - December 2, 2022 Category: Neurology Source Type: research
A Comprehensive Review of Spinal Cord Stimulator Infections
AbstractSpinal cord stimulator (SCS) is approved to treat various pain conditions and is commonly seen in the chronic pain patient population. Due to the nature of the device and its location, infections associated with SCS have a particularly high morbidity. According to post-market data and medical device reports, 87% of patients receiving SCS implants were given perioperative antibiotics as the implantable neurostimulator or receiver pocket serve as the most common sites of infection. The most common antibiotics for surgical prophylaxis given are first-generation cephalosporins (cefalexin, cefazolin) at the time of i...
Source: Current Pain and Headache Reports - December 1, 2022 Category: Neurology Source Type: research
A Comprehensive Review: Chronic Pain Sequelae in the Presence of Ehlers –Danlos Syndrome
AbstractPurpose of ReviewPatients diagnosed with Ehlers –Danlos syndromes (EDS), and especially those with the hypermobility subtype, often experience a diverse range of acute and chronic pain conditions throughout their lifetime. These can present in a variety of different phenotypes and comorbidities, making it difficult to develop structured treatme nt protocols. This review seeks to summarize the current literature to address old and novel treatments for EDS.Recent FindingsHistorically, medications and surgery have been used to treat patients with EDS but with low efficacy. Newer therapies that have shown promising e...
Source: Current Pain and Headache Reports - November 25, 2022 Category: Neurology Source Type: research
Behavioral Health, Telemedicine, and Opportunities for Improving Access
AbstractPurpose of ReviewThe purpose of this review is to summarize advances in behavioral treatments for pain and headache disorders, as well as recent innovations in telemedicine for behavioral treatments.Recent FindingsResearch for behavioral treatments continues to support their use as part of a multidisciplinary approach to comprehensive management for pain and headache conditions. Behavioral treatments incorporate both behavioral change and cognitive interventions and have been shown to improve outcomes beyond that of medical management alone. The onset of the COVID-19 public health emergency necessitated the rapid u...
Source: Current Pain and Headache Reports - November 23, 2022 Category: Neurology Source Type: research
Headache After Vaccination: An Update on Recent Clinical Trials and Real-World Reporting
AbstractPurpose of ReviewThe aim of this review is to characterize headache as a vaccine adverse event (VAE) in clinical trials.Recent FindingsOf the recent phase III vaccine RCTs (non-COVID-19), 53 studies reported on headache (13 infectious agents). The median rate (interquartile range) of headache was 15.6% (IQR: 9.6 –37.6%). Of these, 24.5% of the RCTs reported headache greater in the vaccine group compared to the placebo/control group. In the herpes zoster vaccination trials, headache was more common in all active groups: median rate 33.9% (IQR: 29.7 –40.5%) as compared to placebo: median rate 17.7% (IQR: 15.4 –...
Source: Current Pain and Headache Reports - November 23, 2022 Category: Neurology Source Type: research
Legal Aspects of Migraine in the Workplace
This study explores legal aspects of migraine in the workplace. While the high prevalence of migraine is well-documented, its effects on the livelihoods of those living with the disease are less understood. Because migraine symptoms are often invisible, discussions concerning migraine in the workplace can be challenging. What are the rights of persons with migraine in the workplace? Time off may provide a brief respite, but it is not a long-term solution. Claiming disability for migraine has challenges, including barriers to doing so and required paperwork. How can persons with migraine remain employed and productive? How ...
Source: Current Pain and Headache Reports - November 18, 2022 Category: Neurology Source Type: research
Pulsed Radiofrequency for the Treatment of Trigeminal Neuralgia
This article examines pulsed radiofrequency (PRF) ablation (RFA) of the trigeminal nerve as a minimally invasive procedure that offers a promising alternative to invasive procedures for relief of trigeminal neuralgia while minimizing tissue damage.Recent FindingsEfficacy of PRF and RFA in treating trigeminal neuralgia has been studied before, but literature lacks large size studies.SummaryThe results of this retrospective study indicate that PRF can be used as a safe and effective treatment for patients suffering from trigeminal neuralgia that is refractory to conservative measures. (Source: Current Pain and Headache Reports)
Source: Current Pain and Headache Reports - November 15, 2022 Category: Neurology Source Type: research
Headache Disorders: Does Pain Affect Blood Pressure?
AbstractPurpose of ReviewThe perspective that pain corresponds to elevated blood pressure is overly simplistic. Our objective is to investigate and debunk misconceptions regarding the effect of pain on blood pressure.Recent FindingsWhile pain can increase blood pressure in the acute setting, prolonged pain and migraine ’s effect on blood pressure varies and can result in lower-than-expected blood pressure. Therefore, attributing pain as a sole source of elevation of blood pressure may lead to delays in diagnosing hypertension. Based on limited studies available, comorbid pain and chronic hypertension have a high er concu...
Source: Current Pain and Headache Reports - October 17, 2022 Category: Neurology Source Type: research
Pathophysiology of Chronic Migraine: Insights from Recent Neuroimaging Research
AbstractPurpose of ReviewChronic migraine (CM) is a highly disabling primary headache disorder with a substantial impact on patients ’ quality of life. Episodic migraine (EM) and CM are dynamic states; CM usually evolves from EM alongside increased headache frequency, comorbidities, and medication overuse, supporting the notion that migraine is a spectrum disorder. This narrative review aims to summarize neuroimaging studies to better understand the pathophysiology of CM.Recent FindingsPositron emission tomography studies have revealed abnormal energy metabolism and metabolic changes in the dorsal rostral pons in individ...
Source: Current Pain and Headache Reports - October 7, 2022 Category: Neurology Source Type: research
