A Review of Techniques of Intercostal Nerve Blocks
AbstractPurpose of ReviewIntercostal nerve blocks are indicated for multiple chronic pain and acute pain conditions including rib fractures, herpes zoster, post-thoracotomy pain syndrome, and intercostal neuralgia. Intercostal neuralgia is a type of neuropathic pain that is in the distribution of intercostal nerves. The purpose of this review is to evaluate the different techniques used to perform intercostal nerve blocks and review their efficacy and safety including blind technique using anatomical landmarks, and fluoroscopically guided and ultrasound-guided intercostal nerve blocks.Recent FindingsLiterature search was p...
Source: Current Pain and Headache Reports - November 4, 2021 Category: Neurology Source Type: research
Cluster Headache: Clinical Characteristics and Opportunities to Enhance Quality of Life
We present the existing body of literature on psychological factors associated with cluster headache and recommendations to address gaps in current clinical care with regards to psychological treatments for cluster headache.Recent FindingsPeople with cluster headache often endorse depressive symptoms, are more likely than the general population to report suicidal ideation and behaviors, and experience significantly decreased quality of life. Psychological treatments such as Acceptance and Commitment Therapy may be particularly valuable for patients with cluster headache given that they are transdiagnostic in nature and can...
Source: Current Pain and Headache Reports - October 19, 2021 Category: Neurology Source Type: research
The Use of Behavioral Modalities for Headache During Pregnancy and Breastfeeding
AbstractPurpose of ReviewMigraine is primary headache which commonly affects women of childbearing age. Migraine and other primary headache disorders are also common during pregnancy. Understanding which treatments are effective and can be safely given to patients with primary headache during pregnancy and lactation is essential in supporting these patients before, during, and after childbirth. Behavioral modalities have the potential to improve the health of both mother and ba by, while empowering patients to make informed decisions in family planning and creating future treatment plans.Recent FindingsResearch shows tha...
Source: Current Pain and Headache Reports - October 19, 2021 Category: Neurology Source Type: research
Medical Cannabis for Headache Pain: a Primer for Clinicians
AbstractPurpose of ReviewPublic acceptance ofCannabis sativa L. (cannabis) as a therapeutic option grows despite lags in both research and clinician familiarity. Cannabis —whether as a medical, recreational, or illicit substance—is and has been commonly used by patients. With ongoing decriminalization efforts, decreased perception of harms, and increased use of cannabis in the treatment of symptoms and disease, it is critical for clinicians to understand the rati onale for specific therapies and their medical and practical implications for patients. In view of the opioid crisis, overall patient dissatisfaction, and lac...
Source: Current Pain and Headache Reports - October 9, 2021 Category: Neurology Source Type: research
Review of Radiofrequency Ablation for Peripheral Nerves
AbstractPurpose of ReviewRadiofrequency ablation (RFA) has become an increasingly widespread treatment tool for various chronic pain syndromes within the last two decades with the majority of publications on the topic coming after 2006. Not only are clinicians using RFA to treat more peripheral nerve pain syndromes but the technology itself is evolving quickly to the point that it is nearly impossible to stay abreast on the complexity of such a diversely utilized instrument. This review summarizes studies that focus on the use of RFA for peripheral nerve neurotomy and anatomical studies regarding RFA published between 2015...
Source: Current Pain and Headache Reports - October 7, 2021 Category: Neurology Source Type: research
Correction to: Ketamine in the Past, Present, and Future: Mechanisms, Metabolites, and Toxicity
(Source: Current Pain and Headache Reports)
Source: Current Pain and Headache Reports - September 18, 2021 Category: Neurology Source Type: research
Occipital Neuralgia
This article reviews the anatomy, pathophysiology, clinical presentation, differential diagnosis, diagnostic testing, and management approaches for occipital neuralgia.Recent FindingsNon-pharmacological treatments aim to alleviate muscle tension and improve posture. Acupuncture shows some promise. The occipital nerve block is considered the first line in a minimally invasive intervention, but the duration of relief may be short term. An onabotulinum toxin A injection may improve the sharp but not the dull component of the pain of occipital neuralgia. Radiofrequency ablation and occipital nerve stimulation may provide effec...
Source: Current Pain and Headache Reports - July 21, 2021 Category: Neurology Source Type: research
Ketamine in the Past, Present, and Future: Mechanisms, Metabolites, and Toxicity
AbstractPurpose of ReviewWhile ketamine ’s analgesia has mostly been attributed to antagonism of N-methyl-d-aspartate receptors, evidence suggests multiple other pathways are involved in its antidepressant and possibly analgesic activity. These mechanisms and ketamine ’s role in the nociplastic pain paradigm are discussed. Animal studies demonstrating ketamine’s neurotoxicity have unclear human translatability and findings from key rodent and human studies are presented.Recent FindingsKetamine ’s metabolites, and (2R,6R)-hydroxynorketamine in particular, may play a greater role in its clinical activity than previou...
Source: Current Pain and Headache Reports - July 16, 2021 Category: Neurology Source Type: research
Hypertension and Migraine: Time to Revisit the Evidence
AbstractPurpose of ReviewIt was reported that migraine was associated with increased vascular risks, and the association between high blood pressure (BP) and migraine was believed by some to be the missing link. The current review focused on the associations between migraine and hypertension and BP per se, and evidence on the directionality of the associations was also reviewed.Recent FindingsIn cross-sectional studies, the findings regarding whether migraine was associated with hypertension were inconsistent, and positive, neutral, or even inverse associations were reported. When individual BP parameters were examined sep...
Source: Current Pain and Headache Reports - July 16, 2021 Category: Neurology Source Type: research
Temperature-Mediated Nerve Blocks in the Treatment of Pain
AbstractPurpose of ReviewAnalgesic hot and cold temperatures have been used for both conservative and ablative therapies for millennia. There are well-known locoregional neurovascular changes associated with the application of heat or ice in the literature and in practice. The oscillation between heat and cold has recently been identified as a synergistic mechanism of action with early translational results in humans.Recent FindingsRecent mechanistic work in the feline model has demonstrated that a reliable, reversible nerve block can be achieved within a temperature range that is non-destructive (15 –45°C). The underly...
Source: Current Pain and Headache Reports - July 16, 2021 Category: Neurology Source Type: research
Chronic Pain in Patients with Rheumatoid Arthritis
AbstractPurpose of ReviewChronic pain is highly prevalent in patients with rheumatoid arthritis (RA) and can cause various physical and psychological impairments. Unfortunately, the appropriate diagnosis of chronic pain syndromes in this population can be challenging because pain may be primary to RA-specific inflammation and/or secondary to other conditions, typically osteoarthritis (OA) and fibromyalgia (FM). This disparity further poses a clinical challenge, given that chronic pain can often be discordant or undetected with standard RA-specific surveillance strategies, including serological markers and imaging studies. ...
Source: Current Pain and Headache Reports - July 16, 2021 Category: Neurology Source Type: research
Dehydration and Headache
AbstractPurpose of ReviewWe define dehydration and its relationship to pain physiology including both primary and secondary headache disorders.Recent FindingsIntravenous fluids administered for acute migraine attacks in an emergency department setting have not been shown to improve pain outcomes. However, increased intravascular volume before diagnostic lumbar puncture may reduce the frequency of post-lumbar puncture headache from iatrogenic spinal fluid leak. Maintenance of euhydration can help treat orthostatic and “coat-hanger” headache due to autonomic disorders. Similarly, prevention of fluid losses can mitigate s...
Source: Current Pain and Headache Reports - July 15, 2021 Category: Neurology Source Type: research
HIV Neuropathy —a Review of Mechanisms, Diagnosis, and Treatment of Pain
This article is a systematic review of data from 2018 to 2020 regarding information from publications on epidemiologic, diagnostic, and therapeutic advancements in human immunodeficiency virus –associated peripheral neuropathy.Recent FindingsThe epidemiology/pathology of HIV neuropathy is discussed. Diagnostics includes skin wrinkling-eutectic mixture of local anesthetic test and neurologic examinations. Therapeutic interventions include pharmacologic and nonpharmacologic management as well as self-management strategies.SummaryPeripheral neuropathy continues to affect the lives of persons living with HIV. First-line trea...
Source: Current Pain and Headache Reports - July 8, 2021 Category: Neurology Source Type: research
The Diagnosis and Management of Posttraumatic Headache with Associated Painful Cranial Neuralgias: a Review and Case Series
This article is a brief review of the literature and a retrospective report of 2 cases of posttraumatic headache with associated painful cranial neuralgias.Recent FindingsTwo patients presented with headaches that met criteria for posttraumatic headache, but their history and physical examination suggested the presence of a focal painful cranial neuralgia. One patient was diagnosed with auriculotemporal neuralgia, which was exquisitely responsive to an auriculotemporal nerve block. The second patient was diagnosed with supratrochlear neuralgia, which was effectively treated with a supratrochlear nerve block. In both cases,...
Source: Current Pain and Headache Reports - June 23, 2021 Category: Neurology Source Type: research
Headache Related to PPE Use during the COVID-19 Pandemic
AbstractPurpose of ReviewPersonal protection equipment (PPE) –associated headache is an unusual secondary headache disorder that predominantly occurs in healthcare workers as a consequence of the donning of protective respirators, face masks and/or eyewear. The appreciation of this entity is important given the significant ramifications upon the occupationa l health of healthcare workers and could additionally have an impact on persons living with pre-existing headache disorder(s).Recent FindingsThere has been a renewed interest and recognition of PPE-associated headaches amongst healthcare professionals, largely brought...
Source: Current Pain and Headache Reports - June 15, 2021 Category: Neurology Source Type: research
