Current pain and headache reports
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Treatment of pain of urogenital origin, chronic pelvic pain syndrome, can be frustrating for patients and physicians. The usual approaches do not always produce the desired results. ⋯ Referred pain from myofascial trigger points can mimic visceral pain syndromes and visceral pain syndromes can induce trigger point development and myofascial pain and dysfunction. The referred pain syndrome can long outlast the initial event, making diagnosis difficult.
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Clinical understanding and management of myofascial pain is overlooked frequently when dealing with pain. Myofascial pain is defined as pain or autonomic phenomena referred from active trigger points, with associated dysfunction. The trigger point is a focus of hyperirritability in the muscle that, when compressed, is locally tender and, if sensitized, gives rise to referred pain and tenderness. ⋯ Myofascial pain is poorly understood, which results too often in underdiagnosis and poor management. The pathogenesis likely has a central mechanism with peripheral clinical manifestations. The therapy for myofascial pain requires enhancing central inhibition through pharmacology or behavioral techniques and simultaneously reducing peripheral inputs through physical therapies including exercises and trigger point-specific therapy.
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Curr Pain Headache Rep · Dec 2004
ReviewAn expansion of Simons' integrated hypothesis of trigger point formation.
Simons' integrated hypothesis proposed a model of trigger point (TrP) activation to explain known TrP phenomena, particularly endplate noise. We propose an expansion of this hypothesis to account for new experimental data and established muscle pathophysiology.
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Pain therapies from natural sources date back thousands of years to the use of plant and animal extracts for a variety of painful conditions and injuries. We certainly are all familiar with modern uses of plant-derived analgesic compounds such as opium derivatives from papaverum somniferum and salicylates from willow bark (Salix species). ⋯ Sarapin, derived from carnivorous pitcher plants, has been injected for regional analgesia in human and veterinary medicine, but efficacy is controversial. Biologic organisms can play important roles in developing an understanding of pain mechanisms, either from isolation of compounds that are analgesic or of compounds that produce pain, hyperalgesia, and allodynia.
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Although tension-type headache is at least as prevalent as migraine in children and adolescents, in contrast to migraine, childhood tension-type headache has received limited research attention. Follow-up studies have shown that migraine may reverse in tension-type headache and vice versa. ⋯ It is very important to recognize these children and to intervene. Further studies are needed to clarify the pathophysiology of pediatric tension-type headache.