Diagnosis and treatment of persistent pain after trauma to the head and neck.
OBJECTIVE
A retrospective and prospective study on 22 cases of persistent pain after trauma to the head and neck is presented. According to the predominant symptoms and signs, pain patterns could be divided into musculoskeletal, vascular, and neuropathic, facilitating treatment decisions. Most cases were musculoskeletal in origin, with many demonstrating a combination of two or three pain states.


RESULTS
The variety of pain complaints and their underlying pathophysiology are discussed and treatments for specific pain states are examined.


CONCLUSIONS
Amitriptyline was the most useful drug in that it provided pain relief in musculoskeletal, vascular, and some neuropathic pain conditions. Multidrug therapy may be indicated in some recalcitrant cases, and drug alternatives are discussed.
Department of Oral Diagnosis, Oral Medicine, and Oral Radiology, Hebrew University, Hadassah School of Dental Medicine, Jerusalem, Israel.
R
R
Benoliel
E
E
Eliav
H
H
Elishoov
Y
Y
Sharav
D000328:Adult; D000639:Amitriptyline / Q000627:therapeutic use*; D002220:Carbamazepine / Q000627:therapeutic use; D002908:Chronic Disease; D006259:Craniocerebral Trauma / Q000150:complications*; D005157:Facial Pain / Q000188:drug therapy / Q000209:etiology; D005260:Female; D006261:Headache / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D008297:Male; D008410:Masticatory Muscles / Q000503:physiopathology; D008875:Middle Aged; D009209:Myofascial Pain Syndromes / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D019838:Neck Injuries; D009334:Neck Muscles / Q000503:physiopathology; D009437:Neuralgia / Q000188:drug therapy / Q000209:etiology; D010146:Pain / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D018710:Pain Clinics; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D012189:Retrospective Studies; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000188:drug therapy / Q000209:etiology; D016896:Treatment Outcome; D014653:Vascular Headaches / Q000188:drug therapy / Q000209:etiology; D014947:Wounds and Injuries / Q000150:complications
D000639:Amitriptyline; D002220:Carbamazepine