Current pain and headache reports
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Opioid analgesics are effective for treating many pain conditions. Opioid analgesic tolerance is a pharmacologic phenomenon that could affect the clinical use of opioid analgesics. ⋯ Thus, exposure to opioids could lead to two seemingly unrelated cellular processes (ie, the development of opioid tolerance and opioid-induced pain sensitivity). Their converging effects may be part of the mechanisms leading to the reduced opioid analgesic efficacy in chronic opioid therapy.
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Curr Pain Headache Rep · Feb 2006
ReviewMedication-overuse headache: description, treatment, and relapse prevention.
Medication-overuse headache (MOH) has increasingly become a focus within the field of headache. The biologic and physiopathologic origin for MOH likely resides in receptor physiology, but it also is probable that the initiation and sustaining dynamics of this pathologic condition involve several other factors. ⋯ The problem regarding the diagnosis, the classification, and clinical aspects of MOH is reviewed in this article. The different therapeutic approaches, initial outcomes, and long-term durability of treatment also are discussed.
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Curr Pain Headache Rep · Feb 2006
Review Case ReportsTopical agents for the treatment of chronic pain.
Unlike systemic analgesics, topical analgesics exert their analgesic activity locally and without significant systemic absorption. This is in contrast to transdermal analgesics, which require systemic absorption for clinical benefit. ⋯ Topical analgesics have been studied in an increasing number of painful clinical conditions, and the results of some of these studies are summarized in this article. The potential role of topical analgesics acting peripherally in affecting the central processing of pain as well as painful states considered to be "central," not "peripheral," also are reviewed.
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Curr Pain Headache Rep · Feb 2006
ReviewThe importance of incorporating faith and spirituality issues in the care of patients with chronic daily headache.
Patients with chronic daily headache are difficult and often frustrating to treat. They are in many ways similar to chronic pain patients and patients with other chronic serious illnesses that have come to alter many aspects of their life, affecting their physical and emotional well-being, their ability to work, and their family and social relationships. ⋯ Numerous studies have demonstrated a positive association between being religious or spiritual and improved health, both in response to acute events and in chronic disease. Because religion is so positively associated with improved outcomes, it is important for physicians to recognize this aspect of a patient's life and try to encourage positive use of the patient's belief system as an adjunct in treatment.
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Celiac plexus block has long been used to provide analgesia for upper abdominal pain. In particular, neurolytic celiac plexus block has been advocated for pancreatic cancer pain. ⋯ In addition, neurolytic celiac plexus block may prolong survival, but the data supporting this remain controversial. The optimal technique for accomplishing neurolytic celiac plexus block remains undetermined.