Current pain and headache reports
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Low back pain (LBP) is one of the most prevalent medical problems in society today. In addition to the profound effect LBP can have on patients, it has an exceedingly high societal cost. Although most acute episodes of back pain will ultimately resolve, this condition will become chronic for many. ⋯ Fusion is the most established treatment option for this condition. Disc arthroplasty is being increasingly considered. Class I studies critically evaluating established and evolving technologies continue to help shape our understanding of the surgical options for this condition.
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Low back pain is a common complaint in the primary care setting. Although most patients with acute low back pain will improve with conservative treatment, back pain often recurs, and a subset of patients will progress to chronic and sometimes disabling symptoms. ⋯ The benefit of medications, including nonsteroidal anti-inflammatory drugs, analgesics, and possibly antidepressants or muscle relaxants, must be weighed against potential adverse effects. There is insufficient evidence regarding the effectiveness of many of the available therapies for chronic low back pain, and well-designed, randomized controlled trials are needed to clarify the role of these treatments.
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Curr Pain Headache Rep · Dec 2006
ReviewTension-type headache: why does this condition have to fight for its recognition?
Tension-type headache is the most prevalent type of primary headache but is frequently forgotten by the patient and doctor. This article summarizes the present knowledge about tension-type headache and discusses some of the problematic aspects. Most patients in specialized headache clinics suffer from several different primary and secondary headaches at the same time and deserve a careful characterization before a rational therapy can be initiated. In particular, it is of utmost importance to increase focus on clinical and basic research in order to develop effective treatment strategies for the most neglected and most costly type of headache.
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Patients and physicians are frequently unaware that pain coming from the muscles of the head and neck is probably the cause of the most frequent forms of migraine. Identifying the extracranial origins of the patient's headache by physical examination should reassure patient and examiner that the headache is benign and treatable. The results of the examination should lead to physical treatment, reducing headache frequency and severity. This paper describes techniques of the physical examination to identify the extracranial causes of migraine headache.
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Low back pain is one of the complaints most commonly seen in the clinical setting. Correctly or incorrectly, these patients are often given the diagnosis of fibromyalgia, myofascial pain syndrome, disk herniation, or some other label. ⋯ Therefore, in order to fully evaluate and treat a patient with low back pain, it is necessary to consider and address these soft tissue conditions. This paper reviews soft tissue causes of low back pain and discusses how they are most appropriately diagnosed and managed.