Current pain and headache reports
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Curr Pain Headache Rep · Dec 2010
ReviewTension-type headache and women: do sex hormones influence tension-type headache?
Most of the world's population has suffered from a tension-type headache (TTH) at some point in their lives. The pathophysiology of this disease is not well understood, but TTH shares many features with migraine, leading to the belief that TTH and migraine may be on different ends of the same disease spectrum. There are many shared triggers between migraine and TTH, menstruation being one of them. Does menses being a trigger for TTH make TTH more like migraine, or does the role of sex hormones in TTH give us insight into the unique pathophysiology of this disease? This article will review TTH, concentrating on the role of sex hormones as a trigger for TTH.
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Curr Pain Headache Rep · Dec 2010
Patient-derived determinants for participation in placebo-controlled clinical trials for fibromyalgia.
Perspectives of patients with fibromyalgia influence their likelihood of participating in randomized placebo-controlled trials and potentially clash with current, well-established methodology of randomized controlled trial design. Mandates to use only acetaminophen for breakthrough pain and that require discontinuation of concomitant medications, especially in studies lacking an active comparator arm, could bias a trial cohort to thereby reduce the generalizability of study findings and conclusions. This study evaluates factors affecting willingness to participate in such clinical trials, including the impact of altruism, payment, study duration, forced discontinuation of specific medications, and subject demographics for patients seen by rheumatologists proficient and avidly interested in treating fibromyalgia.
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Tension-type headache (TTH) is the most prevalent type of headache across all age groups worldwide. TTH is common, disabling, and associated with medical and psychiatric comorbidities. This review will focus on the epidemiologies of episodic and chronic TTH in various age groups, factors associated with progression and remission, comorbidities, and the burden of TTH.
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Curr Pain Headache Rep · Dec 2010
ReviewManaging pain in the elderly population: pearls and pitfalls.
While pain is a common symptom among older adults, it often is underdiagnosed and undertreated. Aging-related physiological changes, misperceptions about the use of pain medications by both patients and providers, and the lack of evidence-based clinical research on pain management in older adults are some of the reasons why pain in older adults is mismanaged. Using extrapolated evidence from pain research in younger patients, consensus statements, and best practice guidelines, this article summarizes and highlights areas of geriatric pain assessment and management that need special consideration. Some highlighted areas include 1) pain assessment in cognitively impaired patients; 2) medication choice and initiation doses; 3) duration of adequate medication trials; and 4) common medication side effects and suggested management.
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Curr Pain Headache Rep · Oct 2010
ReviewGenetics of menstrual migraine: the epidemiological evidence.
Approximately one of every three to five women with migraine without aura experience migraine attacks in relation to menstruation. The International Classification of Headache Disorders, 2nd Edition provides appendix diagnoses for pure and menstrually related migraine without aura that need further validation. Probands with menstrual migraine might have more affected relatives than probands with nonmenstrual migraine. However, precise epidemiological, family, and twin data still are lacking.