Current pain and headache reports
-
Cancer pain management is a major element of successful cancer survivorship. Regardless of where someone is along the cancer experience, from a newly diagnosed patient to long-term survivor, pain is a potential treatment-related effect that can have a significant impact on a survivor's life. Quality pain management for cancer survivors is complicated by the fact that cancer-related pain can be due to the tumor, surgery, radiation, and/or chemotherapy. ⋯ Despite almost 40 years of attention devoted to improving cancer pain management, many cancer survivors are less than optimally treated, often owing to survivor and healthcare provider knowledge barriers. This article reviews some of the latest research related to cancer pain management treatment options, measurement/assessment, and interventions. Progress has been made in understanding new aspects of the pain experience, but more work is yet to be done.
-
Curr Pain Headache Rep · Jan 2014
ReviewTrigeminal autonomic cephalalgias: beyond the conventional treatments.
The trigeminal autonomic cephalalgias include cluster headache, paroxysmal hemicrania, short-lasting unilateral neuralgiform headache attacks, and hemicrania continua. While the majority responds to conventional pharmacological treatments, a small but significant proportion of patients are intractable to these treatments. ⋯ The evidence base for conventional treatments is limited, and the evidence for those used beyond convention is more so. At present, the most evidence exists for nerve blocks, deep brain stimulation, occipital nerve stimulation, sphenopalatine ganglion stimulation in chronic cluster headache, and microvascular decompression of the trigeminal nerve in short-lasting unilateral neuralgiform headache attacks.
-
Chronic pain conditions are associated with an elevated risk for suicide. Of particular importance is the question of why pain conditions might be linked to increased suicide risk. ⋯ Bridging across research areas and drawing on the interpersonal-psychological theory of suicide, we suggest that chronic pain may facilitate the development of a key risk factor for suicide: fearlessness about death. Given that chronic pain can lead to (and be exacerbated by) depression, engender hopelessness, facilitate a desire for escape through death, and erode the natural fear of dying, clinicians must be aware of psychological processes that can combine to create elevated suicide risk in patients with chronic pain, and they should also assess and treat suicide risk factors in these patients.
-
Chronic migraine (CM) is a subtype of migraine broadly defined by the presence of headache at least 15 days per month. Emerging evidence suggests that CM and episodic migraine (EM) differ not only in headache frequency, but that they are distinct clinical entities. Because individuals with CM are more disabled, they demonstrate higher societal burden than those with EM. ⋯ The second, the International Burden Migraine Study (IBMS), is a Web-based survey conducted in North America, Western Europe, Asia/Pacific, and Brazil. The third is a clinic-based survey performed in Taiwan. This review discusses results of these studies with regard to healthcare resource use (and related direct costs) and loss of productivity (and related indirect costs) from the perspective of cost-effectiveness of new therapeutic approaches to CM.
-
Curr Pain Headache Rep · Jan 2014
ReviewIntrathecal therapy for chronic pain: current trends and future needs.
The management of chronic pain continues to pose many challenges to healthcare providers. Intrathecal drug delivery systems (IDDS) provide an effective therapy for patients suffering from chronic pain intractable to medical management. ⋯ In addition, there remains a need to enhance physician knowledge on the pharmacodynamics and pharmacokinetics of intrathecal drug delivery and promote further research into this field and drug delivery modalities. The purpose of this article is to provide a comprehensive review of the determinants of successful intrathecal drug delivery with an emphasis on its use in noncancer pain.