Current pain and headache reports
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Chronic widespread pain, the cardinal symptom of fibromyalgia (FM), is common in the general population, with comparable prevalence rates of 7.3% to 12.9% across different countries. The prevalence of FM in the general population was reported to range from 0.5% to 5% and up to 15.7% in the clinic. The common association of FM with other rheumatic disorders, chronic viral infections, and systemic illnesses has been well documented in several studies. ⋯ FM is considered a member of the family of functional somatic syndromes. These syndromes are very common and share a similar phenomenology, epidemiologic characteristics, high rates of occurrence, a common pathogenesis, and similar management strategies. A high prevalence of FM was demonstrated among relatives of patients with FM and it may be attributed to genetic and environmental factors.
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Fibromyalgia, chronic fatigue syndrome, and related illnesses fall under the spectrum of chronic multisymptom illnesses (CMI). This constellation of syndromes often is defined by chronic pain, unremitting fatigue, cognitive difficulties, and various other symptoms. ⋯ However, research has shown that exercise is quite beneficial in reducing pain and fatigue in this population and should be included as part of a multimodal therapy regimen. This article reviews the exercise and CMI literature and provides a model for applying these evidence-based guidelines to a clinical population.
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Cervicogenic headache (CEH) with pain radiating from the neck to the forehead is a common finding after whiplash injury. In most whiplash studies, the whiplash headaches are not defined. Post-whiplash CEH typically is a moderate headache with a benign, but often prolonged course. ⋯ Post-whiplash CEH is accompanied by great disability and high use of medication. Although the natural course seems favorable for unilateral CEH during the first postinjury years, some patients will need specific treatment for their headaches. There is a lack of controlled studies to guide practitioners to choose investigations and treatment for chronic CEH.
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Curr Pain Headache Rep · Oct 2003
Comparative StudyDo the proposed cervicogenic headache diagnostic criteria demonstrate specificity in terms of separating cervicogenic headache from migraine?
Diagnostic criteria for cervicogenic headache (CH) have been proposed. These criteria are controversial in that they appear to overlap or include characteristics that usually are attributed to migraine headache (MH). Whether these criteria are specific enough to separate CH patients from MH patients remains to be controversial. ⋯ In addition, the authors report the results of a study attempting to build a model of variables typically associated with CH or MH, which would identify patients with CH. A significant model could not be built that did not include MH symptoms. As such, it has been concluded that it is unlikely that the criteria for CH will have the specificity required to separate CH patients from MH patients.
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Curr Pain Headache Rep · Oct 2003
ReviewFibromyalgia, hepatitis C infection, and the cytokine connection.
Fibromyalgia and chronic hepatitis C infection share many clinical features including prominent somatic complaints such as musculoskeletal pain and fatigue. There is a growing body of evidence supporting a link between cytokines and somatic complaints. ⋯ The association between chronic hepatitis C infection and fibromyalgia is discussed, including a description of key cytokine changes in chronic hepatitis C infection. Future studies are encouraged to further characterize these immunologic alterations with potential pathophysiologic and therapeutic implications.