Chronic pain rehabilitation in chronic headache disorders.
This article reviews the treatment goals and efficacy of comprehensive pain rehabilitation programs for the treatment of chronic headache. Substantial data demonstrate improved outcomes from rehabilitative treatment for chronic noncancer pain. We present a discussion of the most relevant recent publications on pain rehabilitation in chronic headache disorders. This article describes pain rehabilitation, reviews outcome data for chronic pain patients treated in this setting, and describes the unique applicability of this treatment approach for patients with chronic headache. Particular attention is directed to the rationale for and the results of the withdrawal, in a pain rehabilitation setting, of opioids and simple analgesics, ergots, and triptans that contribute to medication overuse headaches. Additionally, a case example is reviewed that illustrates the structure and function of a pain rehabilitation program in the treatment of a patient with intractable headache.
Bruce
Barbara K
BK
Mayo Clinic Department of Psychiatry and Psychology, Pain Rehabilitation Center, Mayo Clinic, Generose 2W, 200 First Street SW, Rochester, MN 55905, USA. bruce.barbara@mayo.edu
Townsend
Cynthia O
CO
Hooten
W Michael
WM
Rome
Jeffrey D
JD
Moon
Justin S
JS
Swanson
Jerry W
JW
D000700:Analgesics / Q000627:therapeutic use; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy / Q000379:methods; D005260:Female; D020773:Headache Disorders / Q000150:complications / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000150:complications / Q000523:psychology / Q000534:rehabilitation*
D000700:Analgesics