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

This presentation summarises the opinions concerning chronic pain after mild cervical trauma without neurological and radiological findings. Clinicians are often surprised by the disabling character of the pain, despite the lack of severe lesions. The initial lesions lead in some cases to chronic headache having different features associated with cervical pain, but in our opinion this pain does not have a disabling nature. When the disabling character is present, we postulated that it is associated with other psychological, social and professional factors. In fact, the pathogenesis of this chronic disorder is multifactorial. Its treatment doesn't lead to healing but to better management of patient life with chronic pain.
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PMID:[Chronic pain sequelae after trauma of the cervical spine]. 798 42

The belief that having household pets promotes good health is ubiquitous among Americans. Recent studies support this belief where certain medical conditions are concerned. To investigate the advantages of pet ownership in the prophylaxis of headache and other chronic pain conditions, we queried 62 patients suffering from such diseases about whether they owned pets and whether children and other adults shared their households. We similarly queried a control group of 38 patients with various conditions not involving headache or chronic pain. We found that statistically, the experimental group and the control group were not significantly different in their household compositions. In fact, those with headaches and chronic pain, on average, owned slightly more pets and had slightly more children and other adults sharing their households than did those without headache or chronic pain conditions. Thus, contrary to our expectations, pet ownership apparently conferred no analgesic benefits, nor did the presence of children or of other adults in the household confer any benefit to headache and other chronic pain sufferers.
Headache 1994 Oct
PMID:Pet ownership and prophylaxis of headache and chronic pain. 800 31

Headache is a heterogeneous condition that varies widely in global severity and in severity of individual attacks. Whereas recent efforts have focused on improving the diagnostic criteria for classifying headache, less effort has been directed toward developing reliable, valid, and clinically useful methods of assessing the impact or severity of headache. Existing measures of severity include one or more of the following weaknesses: (1) only pain intensity is assessed or the measure is incomplete in other ways, (2) measures have little or no prognostic value for relevant outcomes, (3) the reliability or the validity of the measure has not been assessed, or (4) the measure is too cumbersome for clinical practice or field research. We describe a brief, simple method for grading the severity of headache, the Chronic Pain Index, which assumes that a continuum of pain intensity and disability is the underlying dimension of severity. Along this continuum, lower levels of severity are differentiated by pain intensity and higher levels by interference with function. The prognostic value of the results from a seven-item questionnaire for grading headache severity is compared with that of alternative measures. The Chronic Pain Index showed the strongest independent cross-sectional and prospective correlation with measures of headache impact, depression, and use of healthcare services. These results support the potential utility of brief methods of assessing headache severity and exemplify the importance of including measures of interference with function when assessing severity.
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PMID:Assessing headache severity. New directions. 800 24

The occurrence of headache as a sequela of low back pain was examined in a sample of chronic pain patients. All patients had low back pain without history of head, neck, or upper back injury or headache onset simultaneous with the low back pain. Consistent with prior research, headache was found to be a common concomitant of back pain. In many patients, headache was found to have begun or exacerbated markedly after onset of low back pain. Prevalence of migraine in female patients was significantly higher than the population prevalence for females in the United States; this was not true for male patients. Potential mechanisms for explaining the high prevalence of migraine following low back pain are discussed, including increased muscle tension, psychosocial factors, and analgesic overuse.
Headache 1994 May
PMID:Migraine as a sequela to chronic low back pain. 802 46

In this study, the psychological functioning of patients with chronic post-traumatic headache (PTH), chronic combination headache and chronic low back pain without headache, whose time of onset was similar, and a matched group of controls was investigated. The Symptom Checklist 90-Revised (SCL-90-R), State-Trait Anger Expression Inventory (STAXI), State-Trait Anxiety Inventory, Form Y (STAI-Y), and Beck Depression Inventory (BDI) were used to assess the degree of psychopathology. A MANOVA test indicated highly significant differences between groups. In general, the pain groups fell along a continuum with PTH subjects demonstrating the highest elevations, back pain subjects demonstrating the next highest elevations, and combination subjects demonstrating fewer elevations. A cluster analysis indicated that findings were best classified into four clusters, but no one pain diagnosis predominated in any cluster. Eighty-nine percent of controls were assigned to clusters 1 or 2, which revealed essentially normal scores on all tests. It is suggested that while chronic pain patients demonstrate more psychopathology than non-pain controls, a variety of coping styles exists within each pain group independent of diagnostic categorization.
Cephalalgia 1994 Apr
PMID:Psychopathology in individuals with post-traumatic headaches and other pain types. 806 49

Drug dependence in "pain patients" usually involves primary headache syndromes with chronicity resulting from the use of analgesic-psychotropic or ergotamine-containing combination preparations. Since, during the withdrawal phase, enhancement of pain intensity together with other abstinence phenomena are to be expected, hospitalization is usually indicated. Psychosomatic pain syndromes with dependence on benzodiazepine derivatives represent the second largest group. In these patients, withdrawal is effected stepwise, usually on an outpatient basis. Opioid analgesics administered to patients to treat chronic pain do not necessarily lead to the development of tolerance. Occasionally, dependency is observed in organic or psychosomatic pain states. In all three groups, typical addition behavior is rare.
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PMID:[Drug dependence and withdrawal in chronic pain patients]. 807 Jul 45

This study compares the effectiveness of guided imagery, (psychosynthetic approach), and biofeedback in the treatment of migraine headache. Specifically, the volunteer's subjective perception of the efficacy of the treatments is assessed. The subjects were 40 male and female volunteers presenting with migraine headache diagnosis at Sunnybrook Health Sciences Centre in Toronto, Canada. Subjects were randomly assigned to one of the three treatment conditions or to a control group. All subjects attended six sessions of training. Measures were completed pre- and post-treatment. The results did not reveal significant reduction in migraine activity in any of the treatment groups. There were no differences among the groups regarding the intake of medication. Nevertheless the implementation of guided imagery training resulted in subjective reports of improved capacity to cope with the pain and in subjective reports of a reduced perception of the pain itself, although objective measures did not indicate an appreciable change in migraine activity. Findings from the present study do not support either feedback or guided imagery training as more effective in counteracting migraines although subjective reports do favor guided imagery as having a positive influence on the perception of migraine pain. These findings are discussed from the perspective of empowering the sufferers by providing them with a more active role in dealing with the migraine triggering physiology, abandoning the "learned helplessness" typical of chronic pain syndromes. The issue of cost effectiveness is raised and it supports the use of guided imagery versus biofeedback training given the lack of theoretical agreement in the current literature.
Headache 1994 Feb
PMID:Migraine headaches: coping efficacy of guided imagery training. 816 75

Based primarily on anecdotal evidence, patients with reflex sympathetic dystrophy (RSD) have often been suspected of having a high degree of psychosocial disturbance prior to the onset of symptoms as well as in reaction to the disorder. In the present study, patients presenting to a pain center with RSD were compared to patients with low back (LBP) and headache pain (HAP) on a variety of self-reported demographic, behavioral, pain, and mood measures. Typical of most patients experiencing chronic pain, all three groups demonstrated elevations indicative of pain, emotional distress, and behavioral disturbance. However, although the RSD patient group reported the highest level of pain intensity, the most employment disruption, and contained the highest percentage of patients receiving financial compensation, this same group paradoxically reported less emotional distress on the Symptom Checklist-90R than did LBP and HAP patients. This paradox may be due to the lesser chronicity of the RSD patients as well as to their apparently experiencing a more sympathetic response from doctors, employers, and insurance carriers than their LBP and HAP counterparts. On balance, the present data do not support the hypothesis the RSD patients, relative to other pain patients, are uniquely disturbed in psychosocial functioning.
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PMID:A psychosocial and behavioral comparison of reflex sympathetic dystrophy, low back pain, and headache patients. 823 46

This report examined first onset rates of 5 common pain symptoms and assessed, on a prospective basis, whether depressive symptoms at baseline were associated with onset risks. Adult Health Maintenance Organization (HMO) enrollees (n = 1016) were interviewed in 1986 about their history of each of 5 pain conditions (back pain, severe headache, chest pain, abdominal pain and temporomandibular disorder (TMD) pain). Three years later, this sample was re-interviewed (n = 803) to measure site-specific first onset rates. The Symptom Checklist 90-Revised (SCL-90-R) Depression scale was administered at baseline and at 3 year follow-up. Over the three year follow-up interval, rates of first onset were: 17.7% for back pain; 4.2% for severe headache; 3.0% for chest pain; 3.1% for abdominal pain; and 6.5% for TMD pain. Onset rates of persistent pain and of chronic pain dysfunction were substantially lower, but over 1% experienced onset of chronic pain dysfunction for back pain and for headache. There were not significant differences in onset rates of back pain, abdominal pain or TMD pain by severity or chronicity of depressive symptoms. Relative to the non-depressed, persons with moderate-to-severe depressive symptoms were more likely to develop headache and chest pain (adjusted odds ratios of 1.7 to 5.0). For headache and chest pain, onset risks were highest among the chronically depressed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:First onset of common pain symptoms: a prospective study of depression as a risk factor. 830 12

Headache, upper torso and upper limb pain can all originate in lesions of the cervical spine. The pain distribution is similar whether the cause is traumatic or degenerative. Nociceptive fibres are present in many cervical spine structures including the disc annulus, facet joint capsules, muscles, meninges, arteries, nerve roots and dorsal root ganglia. Such nerves are not present in the disc nucleus, facet articular cartilages and the ligamentum flavum. Central nervous connections between the trigeminal nucleus and upper cervical sensory input provide an explanation for some forms of headache and facial pain. This paper focuses on neck sprain from road traffic accidents as a cause of pain. Similar lesions are seen in the cervical spines of those who die immediately and survivors who die some years after a neck injury, from unrelated causes. Both discs and facet joints are injured. The common disc injury is a "rim lesion" or transverse tear near the anterior vertebral rim. It is caused by distraction and shearing in sudden extension. Both the posterior disc and the facets are compressed, causing disc contusion or herniation, facet haemarthroses, bruising around the C2 nerve, or fractures of articular processes. Suboccipital vascular congestion and annulus calcification are also seen in the "survivors". Chronic pain develops in 20-40% of the "survivors". The reasons include altered spinal mechanics, neural damage and vascular changes. Management must always start with an accurate diagnosis based on a history and physical examination. Simple investigations such as extension X-rays may reveal vacuum clefts in the same anatomical position as rim lesions. Nuclear scans detect increased uptake at damaged end plates or facet fractures.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Acute injury of the neck: anatomical and pathological basis of pain. 836 30


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