APS Press Room
News Highlights from The Journal of Pain • July 2005
The Peer Review Journal of the American Pain Society
| For immediate release | Contact: Chuck Weber (847) 705-1802 |
ARE SOME PRESUMED MIGRAINE HEADACHES MISDIAGNOSED?
GLENVIEW, IL, July 6, 2005 -- Some of the more than 28 million US patients diagnosed with migraine headaches every year may suffer from chronic facial nerve pain that is treatable with local anesthetics and nerve blocks, according to researchers at Washington University and the University of Virginia.
Writing in the July issue of The Journal of Pain, published by the American Pain Society, lead author Xiaobin Yi, MD, an anesthesiologist at Washington University School of Medicine, said that the migraine headache is one of the most common and challenging neurological disorders to diagnose properly, as headache symptoms similar to migraines can be caused by sinusitis, brain tumors, arthritis and facial nerve disorders.
It is estimated that migraines account for more than $1 billion in health care expenditures a year and $13 billion in lost worker productivity. Most migraine suffers are women and there are no diagnostic tests for the disorder.
Migraine symptoms often overlap other types of headaches, especially those caused by facial neuralgia. The researchers reported four cases in which patients with long histories of migraines were evaluated for possible facial neuralgia. Because their headaches were not responsive to migraine treatments, diagnosis of facial neuralgia was considered and nerve-block treatments with local anesthetics were administered. All of the patients reported good pain relief that lasted up to 60 days.
Facial neuralgia can be differentiated from migraines, according to the authors, with a thorough patient history, a physical exam, facial nerve evaluations and diagnostic nerve- block injections. Accurate diagnosis of facial neuralgia also can avoid the need for prolonged use of narcotic pain medications, the authors concluded.
LIDOCAINE SHOWN EFFECTIVE FOR IRRITABLE BOWEL SYNDROME
GLENVIEW, July 6, 2005 – Irritable bowel syndrome (IBS) is one of the most common gastroenterological disorders and can cause severe, chronic abdominal pain. However, a new study in The Journal of Pain shows that rectal application of a lidocaine jelly preparation can significantly decrease abdominal pain from IBS for up to four hours.
Colonic and rectal hypersensitivity that characterizes IBS arises partly from abnormal functioning of the peripheral nervous system, with pain carried to the central nervous system by peripheral nerves that innervate the rectum and lower colon. Ten women with IBS were evaluated in the study conducted at the University of Florida. Each subject was given placebo and lidocaine treatments to assess the potential efficacy of lidocaine for relieving IBS abdominal pain. The results showed that rectal application of lidocaine jelly significantly reduced abdominal pain without adverse reactions.
Co-author Donald Price, PhD, said a possible explanation for the pain relief is that the rectum may have the greatest hypersensitivity in IBS patients. So, if most ongoing abdominal pain is derived nerves supply the rectum, lidocaine treatment at the site can provide substantial pain relief.