Current pain and headache reports
-
Fabry disease is characterized by burning or shooting pains in hands and feet, which have a severe impact on the quality of life of patients. It is therefore of importance that Fabry patients receive adequate diagnosis, counseling, treatment and follow up. This review describes neuropathic pain in classical Fabry disease with the aim to help clinicians to recognize Fabry patients among patients presenting with chronic extremity pain. The diagnostic dilemmas in patients with neuropathic pain and a non-classical disease course are discussed, together with the available diagnostic modalities, pain medication options and the effect of enzyme replacement therapy on small fiber neuropathy.
-
The influence of environmental factors on the clinical manifestation of migraine has been a matter of extensive debate over the past decades. Migraineurs commonly report foods, alcohol, meteorologic or atmospheric changes, exposure to light, sounds, or odors, as factors that trigger or aggravate their migraine attacks. ⋯ The aim of the review is to critically analyze clinical and pathophysiological facts that support or refute a correlation between certain environmental stimuli and the occurrence of migraine attacks. Given the substantial discrepancy between patients' reports and objective clinical data, the methodological difficulties of investigating the link between environmental factors and migraine are highlighted.
-
Curr Pain Headache Rep · Oct 2013
ReviewVaccination against and treatment of acute herpes zoster for prevention of post-herpetic neuralgia.
Zostavax (zoster vaccine) is a 1-dose, high-potency, live, attenuated varicella zoster virus (VZV) vaccine that boosts VZV-specific cell-mediated immunity (CMI), and this is its presumed mechanism of action. Other strategies focus on preventing the major complication of HZ, post-herpetic neuralgia (PHN). Evidence that the vaccine is effective in older patients comes from the pivotal Shingles Prevention Study. ⋯ However, the duration of efficacy beyond 5 years after vaccination remains unclear. The Long-Term Persistence Substudy, currently under analysis, may provide additional data on the duration of efficacy for zoster vaccine. This review discusses vaccination against HZ, and further reviews recent pharmacotherapy for prevention of PHN.
-
Curr Pain Headache Rep · Sep 2013
ReviewMyofascial trigger point therapy: laser therapy and dry needling.
The aim of the present review is to discuss two forms of treatment for myofascial pain: laser therapy and dry needling. Although studies have reported the deactivation of myofascial trigger points with these two methods, clinical trials demonstrating their efficacy are scarce. ⋯ It has been suggested that improvements in microcirculation through the administration of laser therapy may favor the supply of oxygen to the cells under conditions of hypoxia and help remove the waste products of cell metabolism, thereby breaking the vicious cycle of pain, muscle spasm and further pain. While laser therapy is the method of choice for patients with a fear of needles and healthcare professionals inexperienced with the dry needling technique, further controlled studies are still needed to prove the greater efficacy of this method.
-
Chronic pain due to injury to or diseases of the nervous system, known as neuropathic pain (NP), is a common debilitating medication condition for which there are currently several symptomatically effective therapies. Therefore, early identification of NP in the primary and specialty care setting will avoid unnecessary delays in amelioration of symptoms. ⋯ This focused review will describe the primary NP assessment tools that are currently available, and discuss their suitability for screening patients and for research applications. Wider use of NP assessment tools will facilitate the development of new therapies, further clarify the epidemiology of this condition, and improve the treatment of NP.