Current pain and headache reports
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Curr Pain Headache Rep · Apr 2004
ReviewIs childhood abuse a risk factor for chronic pain in adulthood?
Childhood sexual and physical abuse often are viewed as important factors in the development and persistence of chronic pain syndromes in adulthood. Nevertheless, earlier reviews on this issue have reached conflicting conclusions regarding the veracity of the relationship. In this critical review of existing research on childhood abuse and pain in adulthood, surprisingly mixed evidence is found, with significant effects found most consistently in very large cross-sectional studies that rely on self-reported abuse status. ⋯ When examining the literature from the perspective of epidemiological standards for inferring causation, the authors conclude that the evidence does not demonstrate a causal relationship. It appears that any overall relationship between childhood abuse and pain in adulthood probably is modest in magnitude, if it exists at all. Clinical implications and suggestions for future research directions are discussed.
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This article discusses cluster headache and a variety of cluster mimics, with the intention of aiding the practitioner in differentiating between primary cluster headache and secondary forms of cluster. Secondary causes of cluster headache include infections, tumors, vascular abnormalities, and head trauma. In addition, other trigeminal autonomic cephalgias occasionally can be difficult to distinguish from primary cluster headache.
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Curr Pain Headache Rep · Apr 2004
ReviewA review of nonvalidated and complementary therapies for cluster headache.
Cluster headache is arguably the most disabling form of primary headache. There is a great deal of information available about alternative therapy for migraine, but very little regarding alternative therapy for cluster headaches. This article reviews the popular and scientific print and electronic sources of information about alternative and complementary treatments for cluster headache dietary supplements, herbal modalities, folk remedies, physical and manual therapies, and unlabeled use of prescription drugs such as botulinum toxin, baclofen, and methylphenidate.
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Curr Pain Headache Rep · Apr 2004
ReviewHypothalamo-pituitary-adrenal axis dysfunction as a contributory factor to chronic pain and depression.
Chronic pain and depressive illness are variably resistant to treatment with current pharmacologic therapies. Pain as a reflex sensory response is accompanied by a fast autonomic and delayed neuroendocrine response mediated by the sympathoadrenal and hypothalamo-pituitary-adrenal (HPA) axis, respectively. The emotional aspect of the pain response is encoded by corticolimbic systems (including the HPA axis) to encapsulate the relationship between pain, memory, and mood. ⋯ Conversely, many chronic pain patients may suffer from depressive illness, which appears to develop as a consequence of chronic pain. A comparison of key changes in HPA function after chronic stress in animals with clinical depression in humans, reveals some striking similarities. In this article, the role of the HPA axis in the etiology of chronic pain and depression is discussed.
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Curr Pain Headache Rep · Apr 2004
ReviewThe prevalence of post-traumatic stress disorder in chronic pain patients.
Several of the more common causes of chronic pain include traumatic events such as motor vehicle accidents and work-related incidents. Therefore, it is not unusual for patients presenting with chronic pain to also describe significant levels of distress including post-traumatic symptomatology and, in the more severe cases, post-traumatic stress disorder (PTSD). Throughout the past few decades, the literature relating to chronic pain and PTSD has become progressively more sophisticated, resulting in well-supported theories and treatments for sufferers. ⋯ This review presents a summary of the literature relating to the two disorders in terms of symptoms, prevalence, and comorbidity. It also briefly describes the main empirically supported psychologic theories of chronic pain and PTSD and briefly reviews the evidence regarding what factors maintain the disorders. Treatment implications and issues for future research are considered.