Current pain and headache reports
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Tension-type headache is the most common headache type worldwide. Chronic tension-type headache (CTTH) affects 2% to 3% of patients, yet it represents the least talked about subtype of chronic daily headache. There is much debate in the headache community on whether CTTH exists as its own entity or is a milder form of chronic migraine (CM), because there are similarities and differences between the two headache forms. This article reviews CTTH, as well as the current pathophysiology and treatment, and discusses controversial issues in the diagnosis of CTTH and CM.
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Curr Pain Headache Rep · Dec 2009
ReviewUpdate on the management of pain in arthritis and the use of cyclooxygenase-2 inhibitors.
Chronic pain from arthritis continues to be one of the biggest causes of disability and loss of function in the United States today. This is still the case despite many new insights into the pathophysiology of pain, effective treatment approaches, and new, safer medications that can be used long-term. There are many different types of arthritic problems. ⋯ To complicate treatment for this condition, the most widely used group of medications is under new scrutiny because of concerns regarding long-term detrimental side effects. A complete understanding of the risk factors for NSAIDs, specifically cyclooxygenase-2 inhibitors, is still not available. But published data and new clinical guidelines still suggest that treatment for this large category of diseases can be effective and safe.
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Curr Pain Headache Rep · Dec 2009
ReviewMechanisms by which sleep disturbance contributes to osteoarthritis pain: a conceptual model.
Sleep disturbance is prevalent in aging and painful rheumatologic populations, but it has largely been a neglected dimension of the routine clinical care of arthritis patients. Pain associated with osteoarthritis (OA) is a leading cause of disability worldwide, and factors that contribute to pain in OA are poorly understood. Sleep disturbance is not only a consequence of pain, it is also likely to play an integral role in pain expression. ⋯ This article reviews the extant literature on sleep disturbance and hyperalgesia in patients with OA. We propose a conceptual working model describing pathways by which sleep disturbance interacts directly with central pain processing mechanisms and inflammatory processes, and indirectly with mood and physical functioning to augment clinical OA pain. The clinical and research implications of the model are discussed.
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Tension-type headache (TTH) is the most common type of headache in the general population, including individuals over the age of 65 years. Although the prevalence of migraine decreases markedly with age, TTH has a greater tendency to persist later in life. ⋯ Special considerations in this population include the higher prevalence of secondary causes and multiple medical comorbidities. This article presents an update on the epidemiology and prognosis of TTH in the elderly.