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

Nociceptive flexion reflexes, RIII reflex in particular, have been demonstrated to be a useful tool for pain research in humans, since the threshold of RIII reflex is that of pain. In this study a reduction of RIII reflex threshold, strictly related to the severity of the disease, is described in migraine with interval headache (MIH), that is considered a severe and evolutive form of common migraine (CM). These abnormalities were not found in CM or in other chronic pain conditions, i.e. chronic tensive headache (CTH), suggesting that this electrophysiological parameter may be useful in the clinical assessment of primary headache. Moreover, the administration of amitriptyline, a drug producing analgesia mainly by blocking serotonin uptake, was able to markedly increase the RIII reflex threshold in MIH. This fact supports the hypothesis that an impairment of serotoninergic antinociceptive system may exist in this type of headache. A significant correlation between percentage increase in RIII reflex threshold and reduction of PTI was also observed after amitriptyline treatment, indicating that pain reflex may be used for predicting treatment response in migraine.
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PMID:Pain reflexes in the clinical assessment of migraine syndromes. 360 72

Although it is clear that health care utilization rates differ among individuals, what is not so obvious is the explanation for the variation in illness responses, nor is it known whether responses to illness are consistent or predictable. This pilot study compared responses to common symptoms and health maintenance activities in 1) healthy subjects with no medical visits in the previous year, 2) patients with chronic headaches with high medical utilization who remained functional at work and home, and 3) patients with nonmalignant chronic pain who were seriously dysfunctional in work and home responsibilities. The chronic pain samples differed primarily in level of functioning with similar outpatient utilization levels; they reported greatly differing response tendencies to common symptoms, with the more functional group endorsing numerous self-help strategies along with medical care seeking. The dysfunctional pain patients responded consistently with only one illness behavior: they went to the doctor. Among all three groups, the severely impaired individuals were most likely to say that they made special efforts to maintain their health; however, there was no single pro-health activity they engaged in more than the other groups. There appear to be attitudinal as well as behavioral differences in response to health and illness issues between these groups of high and low utilizers and, within the high utilizer group, between those who are more or less impaired by their pain.
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PMID:Responses to illness and health in chronic pain patients and healthy adults. 367 36

In 1983 26 general practitioners in a Danish provincial town made a week's survey of pain as the main cause of patient-doctor contact during the day time. The population served was 45 000-50 000 persons of all ages. Coexistent pain which was not the cause of actual contact was not recorded. Out of 2 886 contacts of all causes 641 were due to pain (22% or 222/1 000 contacts). Percentages for acute and chronic pain were 61 and 39 respectively. The commonest causes of pain were musculo-skeletal (50%), visceral including cardio-vascular (20%), infectious (15%), and headaches (8%). The overall female: male ratio was 1.5: 1, but with considerable variation within the different pain categories. The ratios for acute and chronic pain were 1.4: 1 and 1.8: 1 respectively. About one hundred contacts were recorded as "problem cases" whose predominant complaints were low back pain, headaches, and visceral pain. Pain--especially chronic pain with a non-malignant cause--is a major problem in general practice. Essentially, pain is a primary health care problem and research in this field should be encouraged.
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PMID:Pain in general practice. Pain as a cause of patient-doctor contact. 372 34

The dexamethasone suppression test (DST) was administered in 48 daily chronic headache (DCH) sufferers, 37 of whom also suffered from mild to severe depression. In 14 of 48 subjects (29.2%), cortisol values at 1600h were greater than 50 ng/ml, despite normal suppression at 0800h. The escapers showed basal cortisol values and (Depression scale) scores on the Minnesota Multiphasic Personality Inventory higher than suppressors. Thus, a group of DCH sufferers appeared to share a biochemical defect often seen in endogenous depression. The escape from dexamethasone suppression could be a psychobiological indicator of vulnerability to develop depressive disorder and/or chronic pain complaints.
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PMID:Abnormal dexamethasone suppression test in daily chronic headache sufferers. 378 99

A survey of the psychological characteristics of a large sample of chronic headache cases (n = 360), including classical and common migraine and tension headache sufferers, was carried out. Comparing groups defined in terms of the chronicity of their headache problems, it was found that those with a longer history of headache had a higher level of behavioural disruption and a stronger bond between pain experience, and both complaint levels and behavioural avoidance patterns. Despite the common somatic components (sleep disturbance, fatigue, irritability, etc.), depression was not found to be elevated in this chronic pain group. In addition, there was no evidence of depression levels being higher in the populations who had had a longer history of headache problems. Higher levels of complaint were found in those with higher depression and higher extroversion and neuroticism scores. Behavioural avoidance was significantly related to the emotional reaction component of pain. The implications of these findings with respect to the development of chronic headache are discussed.
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PMID:The effects of persistent pain: the chronic headache sufferer. 398 40

Seven chronic pain patients (six with abdominal pain and one with headache pain) were detoxified from analgesic medications, taught relaxation techniques, and given an average of 3 supportive therapy sessions. The effects of these procedures at posttreatment and at 6 months follow-up were analyzed by means of self-report diaries of pain, mood, activity and medication usage. There was a significant reduction in pain from posthospital in 5 of 7 patients and a significant reduction in pain at 6-month follow-up for all patients. There was a significant reduction in medication use for all subjects. Mood ratings tended to improve when pain was reduced, and some patients reported increased activity levels. Detoxification combined with relaxation and supportive therapy appears to produce significant relief from pain for these 7 patients.
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PMID:The effects of detoxification, relaxation, and brief supportive therapy on chronic pain. 610 38

We reviewed 317 patients with multiple sclerosis (MS) and found that the incidence of clinically significant pain, excluding headache and paresthesia, was 28.8%. Successful treatment requires recognition of the pathophysiology of the pain syndromes encountered in MS. Antidepressant drugs have been of particular value in the treatment of chronic pain in these patients.
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PMID:Pain in multiple sclerosis. 620 84

This follow-up study 1 to 5 years after biofeedback therapy, involving 58 patients in six diagnostic groups (migraine headache, tension headache, mixed headache, chronic pain, anxiety, and essential hypertension), revealed that 86% of the patients who continued to practice relaxation techniques improved, while only 50% of those who had stopped practice improved (p = .04). Among the patients who improved, 91% had continued to practice and only 9% had stopped practice, while among the patients who did not improve, 63% had continued to practice and 36% had stopped practice. Patients who were practicing only "occasionally," "as needed," or "when stressed" improved as much as or more than those who practiced regularly and frequently (i.e., at least weekly): 89% versus 77% improved, respectively (p = n.s). There was no difference in the occurrence or frequency of relaxation practice between patients who have been out of therapy 3 to 5 years and those who completed therapy more recently, or between those who were in brief versus longer-term therapy. Although continued relaxation practice is significantly related to the maintenance of long-term improvement, a few patients manage to improve without it, or continue to practice yet relapse. Furthermore, it appears that only occasional relaxation practice after therapy is sufficient to maintain long-term therapeutic gains.
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PMID:Relaxation practice after biofeedback therapy: a long-term follow-up study of utilization and effectiveness. 635 87

This article focuses on the basic premises underlying the behavioral assessment and treatment of chronic pain, particularly as they apply to the less distinct pain disorders of childhood, such as obscure headache and abdominal pain. Pain behavior management procedures, relaxation techniques, and biofeedback training are discussed in detail in reviewing recent research developments in this area.
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PMID:Behavioral approaches to the management of chronic pain in children. 638 2

The incidence of headache after dural puncture in patients being treated for chronic pain was studied prospectively. Dural punctures were performed in 142 patients and headache developed in 13 (9.2%). Four of 32 patients (12.5%) who underwent diagnostic differential spinal and nine of 110 patients (8.2%) given intrathecal steroid injection developed headache. There was a 10.7% incidence of headache when a 22-gauge needle was used as compared to 5% with a 25-gauge needle. This difference was not statistically significant. The incidence decreased with increasing age. The incidence of postdural puncture headache in chronic pain patients does not differ significantly from that previously reported for surgical patients. All patients who developed headache responded to treatment which consisted of intravenous and oral fluids, analgesics, bed rest, and, if necessary, epidural blood patch.
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PMID:Postdural puncture headache in patients with chronic pain. 644 53


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