Current pain and headache reports
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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.
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Tension-type headache is the most common primary headache disorder seen in adults. Although the prevalence peaks in the fourth and fifth decades of life, significant fractions of the elderly continue to experience either episodic or chronic tension-type headaches. Many secondary headache disorders may present with headaches symptomatically compatible with the diagnosis of tension-type headache. ⋯ Once the diagnosis of tension-type headache is made, numerous nonpharmacologic and pharmacologic management options are available to reduce the frequency and severity of episodes. Special dosing considerations must be considered in the elderly. Advancing age is a positive prognostic factor in the remission of episodic and chronic tension-type headaches.
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Curr Pain Headache Rep · Dec 2006
ReviewAt the crossroads between tension-type headache and fibromyalgia.
Fibromyalgia syndrome and tension-type headache have multiple clinical features in common, and pathogenic mechanisms partly overlap. Significant differences need to be recognized as well. Studying the correlations of these often comorbid conditions represents a unique opportunity to gain insight into their pathophysiology and that of other chronic pain syndromes, to increase the accuracy of their diagnosis, and to improve the therapeutic armamentarium.
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Much of the contemporary literature on headache disorders focuses on migraine headaches, despite the fact that tension-type headache (TTH) is highly prevalent and can be as debilitating as migraines. This article reviews the current literature on prevalence rates of psychiatric disorders in TTH populations, psychologic factors associated with TTH, and psychiatric disorders and their relationships with treatment outcomes in TTH. Key conclusions of this review include 1) prevalence rates of TTH vary across clinical and population-based samples; 2) greater TTH chronicity is associated with increased affective distress; 3) Axis II personality disorders may play an important role in TTH prevalence rates and psychologic functioning but have been understudied to date; and 4) maladaptive coping is common in persons with TTH.
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Low back pain (LBP) is one of the most prevalent medical problems in society today. In addition to the profound effect LBP can have on patients, it has an exceedingly high societal cost. Although most acute episodes of back pain will ultimately resolve, this condition will become chronic for many. ⋯ Fusion is the most established treatment option for this condition. Disc arthroplasty is being increasingly considered. Class I studies critically evaluating established and evolving technologies continue to help shape our understanding of the surgical options for this condition.