Current pain and headache reports
-
Low back pain is a common complaint in the primary care setting. Although most patients with acute low back pain will improve with conservative treatment, back pain often recurs, and a subset of patients will progress to chronic and sometimes disabling symptoms. ⋯ The benefit of medications, including nonsteroidal anti-inflammatory drugs, analgesics, and possibly antidepressants or muscle relaxants, must be weighed against potential adverse effects. There is insufficient evidence regarding the effectiveness of many of the available therapies for chronic low back pain, and well-designed, randomized controlled trials are needed to clarify the role of these treatments.
-
Curr Pain Headache Rep · Dec 2006
ReviewTension-type headache: why does this condition have to fight for its recognition?
Tension-type headache is the most prevalent type of primary headache but is frequently forgotten by the patient and doctor. This article summarizes the present knowledge about tension-type headache and discusses some of the problematic aspects. Most patients in specialized headache clinics suffer from several different primary and secondary headaches at the same time and deserve a careful characterization before a rational therapy can be initiated. In particular, it is of utmost importance to increase focus on clinical and basic research in order to develop effective treatment strategies for the most neglected and most costly type of headache.
-
Pain caused by temporomandibular disorders originates from either muscular or articular conditions, or both. Distinguishing the precise source of the pain is a significant diagnostic challenge to clinicians, and effective management hinges on establishing a correct diagnosis. ⋯ A review of the pathophysiology of the most common disorders is provided. Trends in evaluation, diagnosis, treatment, and research are presented.
-
Although many Americans suffer from undertreated pain, the regulatory and legal environment for the use of opioids in pain relief is currently in a state of flux. The federal government's efforts to curb drug abuse have complicated the use of opioids for pain relief. ⋯ Despite a disturbing shift in regulatory authority over opioid analgesics away from health agencies and toward law enforcement agencies, recent state policies and guidelines from national medical organizations are playing an important role in promoting the use of opioids for pain treatment and helping to reduce practitioners' concerns over regulatory oversight. Current and future trends concerning the legal and regulatory aspects of chronic opioid treatment are discussed in this article.
-
Headache is common in childhood; recurrent headaches include both migraine and tension-type headache (TTH). Although much of the attention recently has been focused on migraine, TTH can also be problematic for children and needs further study. Standardized criteria have been developed and used for epidemiology and treatment studies, but they are yet to be validated for children. The pathophysiology, selective treatment, impact, and outcome of TTH in children need to be studied further.