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In migraine or primary headache in children, parents play a fundamental role in pain management. For this narrative review, PubMed, Google Scholar, and Psych Info were searched using the terms "parent headache", "mother/father headache", "parental impact headache", "alexithymia parents headache", "catastrophizing parent headache", "family headache", "children parent headache", and "quality of life family headache". Articles were chosen for inclusion based on their relevance in to the topic.
Sleep disturbance may limit improvement in pain outcomes if not directly addressed in treatment. Moreover, sleep problems may be exacerbated by opioid therapy. This study examined the effects of baseline sleep disturbance on improvement in pain outcomes using data from the Strategies for Prescribing Analgesics Comparative Effectiveness (SPACE) trial, a pragmatic 12-month randomized trial of opioid vs nonopioid medication therapy.
Pruritus, a common symptom of psoriasis, negatively impacts quality of life; however, treatment of lesional skin does not consistently alleviate psoriatic itch.
Astrocytes are essential contributors to neuronal function. As a consequence, disturbed astrocyte-neuron interactions are involved in the pathophysiology of several neurological disorders, with a strong impact on brain circuits and behavior. Here, we describe altered cortical physiology in a genetic mouse model of familial hemiplegic migraine type 2 (FHM2), with reduced expression of astrocytic Na,K-ATPases. We used whole-cell electrophysiology, two-photon microscopy, and astrocyte gene rescue to demonstrate that an impairment in astrocytic glutamate uptake promotes NMDA spike generation in dendrites of cingulate cortex pyramidal neurons and enhances output firing of these neurons. Astrocyte compensation of the defective ATPase in the cingulate cortex rescued glutamate uptake, prevented abnormal NMDA spikes, and reduced sensitivity to cranial pain triggers. Together, our results demonstrate that impaired astrocyte function alters neuronal activity in the cingulate cortex and facilitates migraine-like cranial pain states in a mouse model of migraine.
Chronic pain is common in children and increases their risk for developing a chronic pain condition in adulthood, yet relatively little is known about early parental psychosocial factors that predict the development of chronic pain in childhood. We examined the extent to which chronic pain frequency in a community sample of 6-year-old children was related to frequency of chronic pain in their parents, and was prospectively predicted by early maternal risk (i.e., depressive symptoms) and promotive (i.e., hope) factors. Fifty primary caregivers (94% mothers) of 6-year-old twin children who were enrolled in a larger study during children's infancy were randomly selected to complete a telephone interview regarding their own, their partner's, and their children's pain symptoms and functioning. Pain symptom scores were derived by summing the number of seven possible body areas that were painful at least monthly during the prior 6 months. Pain symptoms at three or more sites were coded as multisite pain. Prior maternal depressive symptoms and hope were assessed when children were aged 12-months. Pain symptom scores were positively correlated within families, and risk of child pain increased in a dose-response fashion according to whether neither, one, or both parents experienced multisite pain. Maternal hope but not depressive symptoms prospectively predicted fewer painful body regions in children five years later. Findings suggest that pain runs in families and pain in childhood may be influenced by early maternal psychosocial factors. Future research should focus on how parents' own health and psychological attributes influence risk for children's chronic pain.
Low back pain (LBP) is prevalent and may transition into chronic LBP (cLBP) with associated reduced quality of life, pain, and disability. Because cLBP affects a heterogenous population, rehabilitation efforts must be individualized to meet the needs of various patient populations as well as individuals. This narrative review evaluated the many approaches to LBP rehabilitation including treatment-based classifications and specific types of rehabilitation efforts from exercise and physical therapy to spinal manipulation and bracing. Clinicians caring for patients with LBP or cLBP must be aware of the various options to find the right treatment course for each patient. In many cases, with proper patient expectations and care, nonpharmacological options may suffice to manage cLBP. While there is a rightful role for analgesics in the management of LBP, nonpharmacological options should be seriously considered, as they can play an important and health-sustaining role in patient management.
Postherpetic neuralgia (PHN) is one of the most common complications of herpes zoster (HZ). Heritable factors have been found to play a role in various clinical pain symptoms. However, the effect of gene variability on the susceptibility of PHN remains poorly understood.
Patients undergoing cancer treatment often experience chemotherapy-induced neuropathic pain at their extremities, for which there is no U.S. Food and Drug Administration-approved drug. The authors hypothesized that local sympathetic blockade, which is used in the clinic to treat various pain conditions, can also be effective to treat chemotherapy-induced neuropathic pain.