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Query: UMLS:C0344307 (analgesia)
 28,200 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Tension headaches can form a chronic (very long duration) condition. EMG biofeedback, relaxation training and analgesia by hypnotic suggestion can reduce the pain. So far, no differences have been demonstrated between the effects of various psychological treatments. In a constructively designed study, we firstly compared an abbreviated form of autogenic training to a form of hypnotherapy (future oriented hypnotic imagery) which was not presented as hypnosis and secondly we compared both treatments to the same future oriented hypnotic imagery, but this time explicitly presented as hypnosis. The three treatments were equally effective at post-treatment, but after a 6-month follow-up period, the future oriented hypnotic imagery which had been explicitly presented as hypnosis was superior to autogenic training. Contrary to common belief, it could be demonstrated that the therapists were as effective with the treatment modality they preferred as with the treatment modality they felt to be less remedial.
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PMID:Hypnosis and autogenic training in the treatment of tension headaches: a two-phase constructive design study with follow-up. 156 74

Naloxone per se causes no pain in normal man, indicating that opioidergic antinociceptive systems are not tonically active, but this might not be the case in chronic pain conditions. The present investigation tested the hypothesis that pain in chronic headache is the result of insufficiently attenuated nociceptive impulses. Forty-seven patients suffering from chronic tension headache entered the present double-blind cross-over trial of naloxone 4 mg i.v. versus saline. Adverse effects were negligible. Patients scored headache pain on a 100 mm visual analog scale and change in headache on a 5-point verbal rating scale after 5, 15, 30, 60 and 90 min. Mean arterial blood pressure decreased 4.2 mm Hg (P less than 0.05) after naloxone compared to saline, but naloxone had no effect on headache (P = 0.96). A bimodal distribution of acute pain patients into placebo responders and non-responders has been reported, but our chronic pain patients showed a homogeneous placebo response. Review of the literature indicates that acute clinical pain and stimulation-induced analgesia in experimental pain has a naloxone-responsive component. Chronic pain does not appear to be influenced by naloxone in moderate doses.
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PMID:Naloxone in moderate dose does not aggravate chronic tension headache. 268 74

Antidepressant drugs are now an important component of the analgesic pharmacopeia. Their ability to relieve pain is independent of the presence of clinical depression, and their efficacy has been documented in the treatment of migraine and tension headaches, neuropathic pain and chronic pain syndromes, including those associated with cancer. The tricyclic antidepressants are safe for use in patients with prolonged pain. The low doses required for analgesia are well tolerated and do not produce the side effects associated with the classic analgesic drugs.
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PMID:Treatment of pain with antidepressants. 298 20

Acupuncture is a valuable method of complementary medicine with broad application in neurology. It is based on the experiences of traditional Chinese medicine as well as on experimentally proven biological (biochemical and neurophysiological) effects. Acupuncture-induced analgesia is mediated by inhibition of pain transmission at a spinal level and activation of central pain-modulating centers by release of opioids and other peptides that can be prevented by opioid antagonists (naloxone). Modern neuroimaging methods (functional MRI) confirmed the activation of subcortical and cortical centers, while transcranial Doppler sonography and SPECT showed an increase of cerebral blood flow and cerebral oxygen supply in normal subjects. Clinical experience and controlled studies confirmed the efficacy of acupuncture in various pain syndromes (tension headache, migraine, trigeminal neuralgia, posttraumatic pain, lumbar syndrome, ischialgia, etc.) and suggest favorable effects in the rehabilitation of peripheral facial nerve palsy and after stroke. Appropriate techniques, hygiene safeguards and knowledge of contraindications will minimize the risks of rare side effects of acupuncture which represents a valuable adjunction to the treatment repertoire in modern neurology. There is sufficient evidence of acupuncture to expand its use into conventional medicine and to encourage further studies of its pathophysiology and clinical value.
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PMID:[Principles and application of acupuncture in neurology]. 1107 28

Seven hundred three subjects completed a randomized, double-blind, parallel-group, single-center study comparing the single-dose efficacy of ketoprofen 12.5 mg, ketoprofen 25 mg, acetaminophen 1000 mg, and placebo in the treatment of tension headache. For the primary efficacy variable, 4-hour sum of pain relief intensity differences, ketoprofen 25 mg was significantly superior to placebo. Ketoprofen 25 mg also demonstrated superior pain relief in the first hour after dosing, and the time to meaningful pain relief was significantly shorter for the ketoprofen 25-mg group. Ketoprofen 12.5 mg proved to be significantly superior to placebo for pain relief intensity difference and pain relief at 3 hours, global assessment of medication at 4 hours, and for time to onset of meaningful pain relief. The data suggest a dose response for ketoprofen 12.5 mg and 25 mg. Acetaminophen 1000 mg proved to be numerically more favorable than placebo in most variables, but could not be separated from placebo with statistical significance. In spite of possible inflation of the placebo response due to sensitivity limits of the study, ketoprofen 25 mg demonstrated a more rapid onset of analgesia compared to acetaminophen 1000 mg, and patients' global assessment rated ketoprofen 25 mg higher than acetaminophen 1000 mg.
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PMID:Ketoprofen, acetaminophen, and placebo in the treatment of tension headache. 1139

There is a clear relationship between single doses of ibuprofen over the range 50-400 mg and the peak analgesic effect and the duration of analgesia. The smallest clinically useful dose of ibuprofen is 200 mg. Ibuprofen 400 mg has been shown to be as effective as aspirin 600 or 900 mg/day in models of moderate pain but superior to aspirin or paracetamol in more sensitive models such as dental pain. The duration of action of ibuprofen 400 mg is at least 6 hours compared with 4-6 hours for ibuprofen 200 mg or paracetamol. In patients undergoing oral surgery, ibuprofen 200 mg was broadly comparable with naproxen 220 mg and ibuprofen 400 mg comparable with ketoprofen 25 mg. The combination of ibuprofen and hydrocodone is more effective than either drug alone in patients undergoing abdominal and gynaecological surgery. The absorption of ibuprofen acid is influenced by formulation, and certain salts of ibuprofen (lysine, arginine, potassium) and solubilised formulations have an enhanced onset of activity. These differences are clinically important, offering a shorter time to onset of relief of tension headache compared with paracetamol.
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PMID:Review of the analgesic efficacy of ibuprofen. 1272 41

Between 1986 and 2003, research efforts on complementary and alternative medicine (CAM) were subsidized by the Dutch government. This led to 12 academic theses and a considerable number of papers in medical journals. In our review, we have summarized the results of this research, grouped by therapeutic category (that is, acupuncture, paranormal therapies, naturopathy, manual therapies, homeopathy and anthroposophical medicine.) Of the 12 theses, four were written in Dutch, three of which were not subsequently published in peer-reviewed journals, while the fourth, on enzyme therapy, led to a number of papers in Dutch medical journals. In three instances, mildly positive findings were reported: on the efficacy of manual therapies, the use of acupuncture analgesia in surgery, and an elimination diet against migraine and tension headaches. These positive conclusions can easily be explained by methodological shortcomings (e.g., not using credible placebo-control groups); in the other nine theses, the researchers themselves had drawn negative conclusions. The Dutch government ended its financial support for CAM research in 2006.
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PMID:A Dutch view of the ''science'' of CAM 1986--2003. 1992 6

Intractable headaches can be debilitating, often leading to significant distress, prolonged medical treatment, and unanticipated hospital admissions. There have been significant advances in the treatment of primary intractable headaches such as migraines, tension headaches, and cluster headaches beyond medical management. Treatments may now include interventional strategies such as trigger-point injections, peripheral nerve stimulators, or peripheral nerve and ganglion blocks. There are few studies, however, describing the use of interventional techniques for the management of intractable secondary headaches, including those attributed to injury or infection. A new regional anesthetic technique, the erector spinae plane (ESP) block, was initially used for neuropathic thoracic pain. ESP block has since been reported to provide acute and chronic pain relief of the shoulder, spine, abdomen, pelvis, thorax, and lower extremity. Additionally, there has been one case report to describe the use of the ESP block in the treatment of refractory tension headache. We report four cases of effective analgesia for intractable secondary headache resistant to medical management with high thoracic ESP blocks. In each case, the ESP block provided instant pain relief. We suggest that the findings of this case series indicate that the ESP block may be a useful intervention in patients with severe secondary headache or posterior cervical pain where conventional therapies have limited success, though more studies are necessary.
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PMID:Relief of Secondary Headaches with High Thoracic Erector Spinae Plane Block. 3260 18