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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Inspired by the work of Bonica (Seattle, USA), the university clinic of Mainz has formed a study-group (existing since 5 years) which deals not only with the problems but also with the interpretation and treatment of chronic pain. Through the interdisciplinary co-work between collegues from different branches, 618 patients afflicted with chronic headache were examined and therapeutic plans were developed. These therapeutic plans have in general proved to be very successful compared to single, limited treatments by the different branches of medicine. Important experiences for the otolaryngologist as well as the general work to the organisation are discovered in detail.
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PMID:[Chronic headache: experiences of 5 years interdisciplinary work]. 13 79

A course of 10 daily acupuncture treatments was given to 200 patients who suffered from chronic pain syndromes of at least one year duration and the result assessed at the end of the course of treatment and after an interval of at least 2 months. Treatments were individualized using needling of body loci distally and near the site of pain, and ear acupuncture. In 38 patients suffering from chronic headaches, including 13 cases of migraine-type headache, 81% reported an improvement in their condition, but only one patient was pain free for the 2-month observation period. In 162 patients with other chronic pain problems, 99 or 61% were improved or pain free at the end of treatment; in 69 of these a worthwhile degree of improvement persisted over the observation period of 2 months. Thirteen percent of all patients did not respond to acupuncture and in 26% the response was considered as transient only. Daily treatments are not more effective than weekly or biweekly treatments. Pain in the neck and shoulder region, in the knee and low back pain responded to acupuncture with prolonged improvement in over 50% of the patients treated. Facial pain syndromes and pain in the region of the trunk were least responsive and only 3 of 11 patients with post-herpetic neuralgia reported still having less pain after 2 months. Needling of effective loci and particularly ear needling often causes an instantaneous reduction or disappearance of pain; the speed of this response can only be explained by a mechanism within the nervous system. Based on our experience acupuncture represents a useful therapeutic modality in the management of pain.
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PMID:Acupuncture in chronic pain. 13 11

Compared self-concepts of three groups, medical patients, chronic low back pain patients and chronic head pain patients (N = 60) to determine (1) whether chronic pain patients have self-perceptions that differ from other medical patients; (2) whether changes in self-perception are limited to physical attributes and capacities; and finally (3) whether persons who suffer different types of chronic pain would have differing self-concepts. Significantly lower self-concepts were obtained from groups of head pain and low back pain patients. Self-concept patterns for the two pain groups were quite similar with the exception of two self-concept components that were significantly lower for the head pain group. Differences were explained in terms of loss of many normal functions and disruption of normal life-styles. Implications for treatment of pain patients and for training of health professionals were discussed.
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PMID:The impact of chronic pain on the self-concept. 15 2

A group of moderately to severely depressed individuals with moderate anxiety were studied to determine the frequency and nature of pain complaints and their response to doxepin. It was discovered that 100% of these subjects had chronic pain complaints, most of which paralleled the course of depression. Headache was most commonly noted. Doxepin's analgesic effects were intimately associated with its antidepressant effects. There was a highly significant relationship between improvement of depression and reduction of pain on doxepin (P less than 0.005). Conversely, patients who obtained minimal antidepressant effect also obtained minimal analgesic effect. Psychophysiologic and biochemical hypotheses of this association of pain and depression are discussed.
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PMID:The effectiveness of tricyclic antidepressants in the treatment of coexisting pain and depression. 53 Jul 39

Acupuncture has been used to treat various conditions of chronic pain in a pain clinic. Six hundred and six acupuncture treatments were administered within the space of 12 months to 72 patients who had not responded well to conventional treatment. At completion of the acupuncture treatments 19 patients showed marked improvement, 20 showed improvement and 21 transient improvement. Long-term results were also investigated at a mean of four months after the final treatment. The results of this follow-up study showed marked improvement in 11 patients and improvement in 20 others. In terms of conditions treated, best responses were obtained in patients with musculo-skeletal disorders, degenerative or osteoarthritis and headache.
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PMID:The results of therapeutic acupuncture in a pain clinic. 125 76

We investigated the role of fear of pain in headache sufferers using the Fear of Pain Questionnaire (FPQ). Seventy-six headache sufferers and 58 controls completed the FPQ and measures of depression, anxiety, and anger. Headache sufferers also completed measures of stress-related physical symptoms and coping with pain. We found that the FPQ has excellent internal consistency as well as good concurrent and construct validity indicated by the high correlations between the FPQ subscales and both anxiety and depression but low correlations with anger. There were marked differences between headache sufferers and controls on the FPQ; headache sufferers showed much greater fear of severe and medical pain and lower fear of minor pain. Fear of pain was generally not related to headache characteristics such as frequency, severity, or duration. On the other hand, it was related to headache impact such as disruption of pleasurable activities. These results are consistent with models of chronic pain disorders which emphasize the role of fear of pain over the nociceptive intensity of the pain stimulus.
Headache 1992 Jun
PMID:Fear of pain in recurrent headache sufferers. 139 48

This research develops and evaluates a simple method of grading the severity of chronic pain for use in general population surveys and studies of primary care pain patients. Measures of pain intensity, disability, persistence and recency of onset were tested for their ability to grade chronic pain severity in a longitudinal study of primary care back pain (n = 1213), headache (n = 779) and temporomandibular disorder pain (n = 397) patients. A Guttman scale analysis showed that pain intensity and disability measures formed a reliable hierarchical scale. Pain intensity measures appeared to scale the lower range of global severity while disability measures appeared to scale the upper range of global severity. Recency of onset and days in pain in the prior 6 months did not scale with pain intensity or disability. Using simple scoring rules, pain severity was graded into 4 hierarchical classes: Grade I, low disability--low intensity; Grade II, low disability--high intensity; Grade III, high disability--moderately limiting; and Grade IV, high disability--severely limiting. For each pain site, Chronic Pain Grade measured at baseline showed a highly statistically significant and monotonically increasing relationship with unemployment rate, pain-related functional limitations, depression, fair to poor self-rated health, frequent use of opioid analgesics, and frequent pain-related doctor visits both at baseline and at 1-year follow-up. Days in Pain was related to these variables, but not as strongly as Chronic Pain Grade. Recent onset cases (first onset within the prior 3 months) did not show differences in psychological and behavioral dysfunction when compared to persons with less recent onset. Using longitudinal data from a population-based study (n = 803), Chronic Pain Grade at baseline predicted the presence of pain in the prior 2 weeks. Chronic Pain Grade and pain-related functional limitations at 3-year follow-up. Grading chronic pain as a function of pain intensity and pain-related disability may be useful when a brief ordinal measure of global pain severity is required. Pain persistence, measured by days in pain in a fixed time period, provides useful additional information.
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PMID:Grading the severity of chronic pain. 140 9

Based on obligatory notifications from pharmacies to the National Board of Health about prescription of strong analgesics as well as questionnaires to the prescribing doctors, the occurrence and causes of pain requiring strong analgesics outside hospitals were analysed over a period of one month in Denmark in a limited population (480,000), corresponding to nearly 10% of the Danish population. During one month, strong analgesics were prescribed to 0.2 per cent of the population. The commonest acute conditions were back pain (23%) and trauma (17%). The commonest recurrent acute conditions were headache (25%) and angina pectoris (17%). The commonest chronic non-malignant conditions were back pain (29%) and pancreatitis (7%). The commonest malignant conditions were lung cancer (20%) and colorectal cancer (14%). The commonest conditions indicated under the chronic pain syndrome were headache (33%) and back pain (13%). Conditions requiring strong analgesics reflect to some extent the distribution of painful conditions in the general population.
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PMID:Epidemiology of pain requiring strong analgesics outside hospital in a geographically defined population in Denmark. 142 20

Twenty consecutive patients with recurrent Tolosa-Hunt syndrome were studied. One had a parent who suffered from recurrent Tolosa-Hunt syndrome. Thirty-three percent of the patients had also recurrent periods of weeks to months of unilateral periorbital pain without ophthalmoplegia. One patient had cluster headache before the Tolosa-Hunt syndrome started. Some patients had involvement of cranial nerves outside the cavernous sinus region during Tolosa-Hunt syndrome and also between episodes. The same systemic symptoms, i.e. back pain, cold feet, arthralgia, gut problems, varices, vertigo, chronic fatigue, thrombophlebitis, memory deficiency and signs of inflammation in serum, occurred in Tolosa-Hunt syndrome as earlier found in patients with orbital venous vasculitis. Seventy-three percent of the patients had pathologic orbital phlebograms. All patients treated with steroids reacted promptly; four who developed chronic pain syndromes were treated satisfactorily with azathioprine.
Cephalalgia 1992 Feb
PMID:Recurrent Tolosa-Hunt syndrome. 155 57

Our purpose was to examine the MMPI profiles of 157 patients with chronic headache or facial pain. The following diagnostic groups were considered: tension-type headache (n = 44); migraine + cluster headache + chronic paroxysmal hemicrania (20); trigeminal neuralgia (7); atypical facial pain (AFP) (33); temporomandibular joint dysfunction (TMJ) (53). There were two control groups: C1 of 27 healthy individuals and C2 of 18 patients with chronic pain located elsewhere. A "Pain Index" was calculated (0-10) which quantified pattern, duration and frequency of pain. The Italian MMPI abbreviated version was administered to all subjects. One-way Anova, the Duncan test and correlation analysis were performed. Of the diagnostic groups, AFP scored highest and TMJ lowest in all except three scales. In the AFP group, all neurotic scales scored above 70. The Pain Index correlated with higher scores on most scales. Chronic pain may lead to personality alterations, but some features of craniofacial pain correlate with specific personality disturbances.
Cephalalgia 1992 Apr
PMID:MMPI profiles in patients with headache or craniofacial pain: a comparative study. 157 44


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