Current pain and headache reports
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Curr Pain Headache Rep · Apr 2006
Review Case ReportsCluster headache: a case-based review of diagnostic and treatment approaches.
Cluster headache is one of the worst pain syndromes known to mankind. Medical treatment is highly effective in most cases, but because cluster headache is rare, many physicians are not familiar with the details of its management. This article reviews three common presentations of cluster headache to illustrate standard approaches to its treatment. Algorithms for acute, preventive, and transitional (bridge) therapy are provided.
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Chronic pain is one of the frequently encountered clinical problems that is difficult to cure. Hyperbaric oxygen (HBO) therapy has been reported in chronic pain syndromes with promising results. In this review, we focus on the effectiveness of HBO in fibromyalgia syndrome, complex regional pain syndrome, myofascial pain syndrome, migraine, and cluster headaches. ⋯ However, physicians performing HBO must be aware of oxygen toxicity. Another problem regarding HBO is the scarcity of centers administering it. Further research is required focusing on the optimal treatment protocol, the cost/benefit ratio, and the safety of HBO in chronic pain management.
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Cluster headache is a rare but debilitating recurrent headache disorder. It is most common in middle-aged and older men, a group with a high prevalence of cardiovascular disease. This article reviews available information regarding the association of cluster headache and the heart in three selected areas: 1) the known effects of cluster headache on cardiovascular parameters such as heart rate and rhythm and blood pressure; 2) the prevalence of cardiac risk factors in subjects with cluster headache; and 3) the connection between patent foramen ovale and cluster headache. ⋯ There also is evidence that disturbances of autonomic function or certain structural cardiac anomalies may be more common in cluster headache sufferers. In addition, a number of important treatment options for cluster headache have effects on cardiovascular function that must be considered in planning therapy. The implications of these findings for clinical practice are discussed.
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The experience of chronic pain can be associated with significant distress and disability; however, this is not always the case. Although attempts to control or reduce pain can be helpful for many pain sufferers, on some occasions this is not an effective option and a different response is required. ⋯ At least 15 laboratory and clinical studies make the growing case for the role of acceptance in the functioning of people with chronic pain, and evidence from treatment outcome studies is promising. It appears that acceptance-related processes will at least expand our range of psychologic treatment methods for chronic pain sufferers and, at best, significantly improve them.
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Curr Pain Headache Rep · Apr 2006
ReviewChronic widespread pain and psychiatric disorders in veterans of the first Gulf War.
More than 10% of the 700,000 American troops who served during the first Gulf War (GW) are receiving treatment for a constellation of diffuse and frequently poorly defined medical and psychiatric symptoms that have been designated the GW syndrome by both clinicians and the popular media. The current clinical consensus is that the symptoms reported in GW veterans are the sequela of combat and other stressful events that have been identified in the veterans of other wars and armed conflicts. ⋯ Research has confirmed a close bimodal relationship between chronic pain and psychiatric symptoms. Investigators are now exploring the efficacy of treatment approaches that address the close relationship between chronic pain and mental illness in this challenging patient population.