Current pain and headache reports
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Despite no clear explanation of the mechanism underlying chronic daily headache, sensitization of central nociceptive neurons is one possibility. Either prolonged activation of peripheral nociceptors or any factors that can alter the endogenous pain control system can trigger this process. ⋯ It was also shown that chronic analgesic exposure led to changes in the serotonin content and the density of the 5-HT(2A) receptor in the cerebral cortex. The plasticity of the serotonin-dependent pain control system may facilitate the process of sensitization and results in the development of chronic daily headache.
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Chronic daily headache (CDH), an almost continual headache in the absence of organic pathology, is an exceptionally challenging type of headache to treat in children and adolescents. CDH has different expressions in children and adults; the different expressions may reflect several different etiologies or a developmental continuum. Although a positive family history predisposes children to develop headache, many environmental, biological, and psychological processes may share a role in the etiology. ⋯ Although many drug and nondrug therapies are available for treating children's headache, we lack data about which therapies are best for children with CDH or its subtypes. The current principles guiding our management of CDH in children and adolescents are extrapolated from the existing literature on childhood headache, CDH in adults, and our clinical experience. A child-centered focus is particularly important in the treatment of CDH because it is not caused by an underlying disease or disorder.
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Curr Pain Headache Rep · Oct 2001
Randomized Controlled Trial Multicenter Study Clinical TrialThe use of ibuprofen plus caffeine to treat tension-type headache.
Simple analgesics such as ibuprofen, aspirin, and acetaminophen have long been used in the treatment of tension-type headache. Studies of combination agents of aspirin with caffeine or acetaminophen with caffeine have also demonstrated efficacy as analgesic agents. ⋯ We undertook the direction of a multicenter, double-blind, placebo-controlled, parallel trial to assess the efficacy and safety of ibuprofen combined with caffeine in the treatment of tension-type headache. The study was designed to also verify the analgesic efficacy of caffeine and further assess the role of tension-type headache as a model for the study of pain.
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Curr Pain Headache Rep · Oct 2001
ReviewThe role of psychometric testing and psychological treatment in tension-type headache.
Tension-type headaches are a common occurrence for many people. Psychological issues such as stress, depression, and anxiety have been shown to coexist with tension-type headaches. ⋯ In this article, the role of psychometric testing and the application of psychological interventions for use on patients with tension-type headaches are reviewed. Recommendations are made about approaches that are designed to improve physical and psychological health.
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Curr Pain Headache Rep · Oct 2001
ReviewInterventional approaches to the management of myofascial pain syndrome.
Interventional therapies are a valuable addition to our armamentarium when treating myofascial pain syndromes. When combined with other therapies, interventional techniques can be an effective adjunct in the multidisciplinary management of pain. ⋯ More recent advances, such as the use of botulinum toxin, are also discussed. In addition, other techniques such as acupuncture and the use of laser therapy are mentioned.