Current pain and headache reports
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Careful evaluation of the chronic headache patient can reveal the presence or absence of musculoskeletal factors to be causative or contributory to the headache condition. This article presents a review of the literature surrounding physical findings in patients with cervicogenic and musculoskeletal sources of pain and specific treatment with physical therapy. Included in the discussion is the identification of muscular and joint involvement in a given headache, the relevance of postural, range of motion, and strength deficits, and appropriate individualized treatment strategies with a review of relevant outcome studies. Possible mechanisms for treatment effects also are considered.
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Curr Pain Headache Rep · Dec 2003
ReviewPsychologic and behavioral management of tension-type headache: treatment procedures.
Used as an adjunct or alternative to medication treatment, psychologic and behavioral approaches to tension-type headache decrease headache frequency, affective distress, and headache-related disability. These approaches directly address the psychologic and behavioral factors that contribute to the disorder and to the individual headache episodes. ⋯ Recent attempts to make treatment more accessible to a wider range of tension-type headache sufferers include using medical personnel to deliver treatment from physician practices and using existing and emerging technologies to provide care in a purely self-administered format without face-to-face contact with therapists. These attempts are promising, but remain preliminary; therefore, there is a need for further development and testing.
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Nociceptive nerve endings in muscles and other tissues are equipped with a multitude of receptor molecules for endogenous pain-producing and sensitizing agents. Particularly interesting molecules are the purinergic receptors, which can be activated by adenosine triphosphate (ATP), and the vanilloid receptor, which is sensitive to protons (low pH). The purinergic receptors are activated by tissue damage because cell necrosis is associated with the release of ATP. ⋯ This central sensitization is the basis for the spontaneous pain and hyperalgesia of patients. The transition from acute to chronic muscle pain is complete when the initially functional changes are transformed into structural ones. Patients with morphologic alterations in their nociceptive system are difficult to treat because the changes need time to normalize.
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Curr Pain Headache Rep · Oct 2003
Review Comparative StudyCytokines in parvovirus B19 infection as an aid to understanding chronic fatigue syndrome.
Human parvovirus B19 infection has been associated with various clinical manifestations of a rheumatic nature such as arthritis, fatigue, and chronic fatigue syndrome (CFS), which can persist for years after the acute phase. The authors have demonstrated recently that acute B19 infection is accompanied by raised circulating levels of IL-1b, IL-6, TNF-a, and IFN-g and that raised circulating levels of TNF-a and IFN-g persist and are accompanied by MCP-1 in those patients who develop CFS. A resolution of clinical symptoms and cytokine dysregulation after intravenous immunoglobulin (IVIG) therapy, which is the only specific treatment for parvovirus B19 infection, also has been reported. Although CFS may be caused by various microbial and other triggers, that triggered by B19 virus is clinically indistinguishable from idiopathic CFS and exhibits similar cytokine abnormalities and may represent an accessible model for the study of CFS.
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Curr Pain Headache Rep · Oct 2003
ReviewAcupuncture in the management of myofascial pain and headache.
Acupuncture encompasses a host of healing techniques that have been practiced for more than 2000 years. Many different techniques and styles are in use in the West. ⋯ However, acupuncture, unlike many indigent medical practices in the world, has withstood the test of time in China and in the West, with many practitioners and patients reporting real benefits for the conditions of headache and myofascial pain when treated by acupuncture. This review provides a brief overview of acupuncture and what is known of its effectiveness in treating headache and myofascial pain.