The health care professions are all facing an aging and rising tide of baby boomers, and many of these patients are going to be suffering from chronic pain , for a variety of reasons. Unfortunately, the elderly are often untreated or under-treated for pain. Patient and physician should each begin to ask themselves how can this situation might be improved. Pain is a common complaint of the older patient, and as the population ages, frailty and chronic diseases associated with pain will increase. However, it does not get as much attention as older patients are more likely to suffer from arthritis , cancer, and other musculoskeletal disorders. Studies have shown up to 50% of the elderly have significant pain problems; that number rises as high as 80% in the nursing home population. Unfortunately, the elderly do not in general have adequate pain treatment, resulting in depression , anxiety , social isolation, cognitive impairment, immobility, a...
Recently I wrote about the anti-seizure medication, Topamax, for chronic headache pain. Today, I would like to discuss another medication which has also been used to treat seizures: Lyrica. This has been on the market for less than a year, but I have found it a very helpful drug in patients with chronic pain syndromes, such as fibromyalgia. Fibromyalgia occurs predominantly in women of child-bearing age, and is seen commonly in the offices of most rheumatologists in the United States. Afflicted patients usually complain of diffuse musculoskeletal pain, poor sleep, and fatigue. Often, the amount of pain is related to the amount of sleep—the less sleep, the more pain. Many patients feel their pain is worsened by stress, cold weather, or overexertion. Conversely, patients will feel better in warm weather, while on vacation and away from the usual worries of day to day living, and with improved sleep hygiene. Patients will often suffer from chronic headaches and an irritable bowel.
Hemicrania continua is not a form of migraine . It's an entirely separate primary headache disorder . The International Headache Society's International Classification of Headache Disorders, 3rd edition (ICHD-3) describes hemicrania as:
"Persistent, strictly unilateral headache, associated with ipsilateral conjunctival injection (forcing of fluid into the conjuctiva, the mucous membrane that lines the eyelids), lacrimation , nasal congestion, rhinorrhea , forehead and facial sweating, miosis , ptosis and/or eyelid edema, and/or with restlessness or agitation. The headache is absolutely sensitive to indomethacin." 2
The Research Poster
"To find safe and comparable alternative treatments for HC in patients intolerant to indomethacin." 1
"Hemicrania continua (HC) is a primary headache disorder which responds absolutely to therapeutic doses of indomethacin. Unfortunately, approximately a fourth of patients develop adverse effects leading to ...
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