Archive for May, 2010

Acupuncture and Tension Headaches

By Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP student and PREP-AIRED blog moderator
Thank you to 2010 MS-PREP alumna, Nancy Mitchell, for sending along a recent update to the Cochrane Library and the Cochrane Database of Systemic Reviews addressing acupuncture and tension-type headaches. In a previous Cochrane Review (2001), acupuncture was found to be inconclusive as a treatment for tension-type headaches. However an updated 2009 Cochrane Review on acupuncture and tension-type headaches, which included 11 randomly controlled trials, concluded that acupuncture may be a valuable treatment option for patients suffering from frequent tension-type headaches.
The Cochrane Review stated: “We reviewed 11 trials which investigated whether acupuncture is effective in the prophylaxis of tension-type headache. Two large trials investigating whether adding acupuncture to basic care (which usually involves only treating unbearable pain with pain killers) found that those patients who received acupuncture had fewer headaches. Forty-seven percent of patients receiving acupuncture reported a decrease in the number of headache days by at least 50%, compared to 16% of patients in the control groups. Six trials compared true acupuncture with inadequate or ‘fake’ acupuncture interventions in which needles were either inserted at incorrect points or did not penetrate the skin. Overall, these trials found slightly better effects in the patients receiving the true acupuncture intervention. Fifty percent of patients receiving true acupuncture reported a decrease of the number of headache days by at least 50%, compared to 41% of patients in the groups receiving inadequate or ‘fake’ acupuncture. Three of the four trials in which acupuncture was compared to physiotherapy, massage or relaxation had important methodological shortcomings. Their findings are difficult to interpret, but collectively suggest slightly better results for some outcomes with the latter therapies. In conclusion, the available evidence suggests that acupuncture could be a valuable option for patients suffering from frequent tension-type headache.”
Cochrane Reviews are an integral part of evidence based medicine. It is important to include both allopathic and integrative medicine studies in the rigorous review process to further our knowledge of effective strategies to treat and manage chronic pain conditions.

Add comment May 23rd, 2010

Massachuetts Pain Initiative Survey Finds Chronic Pain Affects 1 in 4 Adults in Massachusetts

by Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP student, PREP-AIRED blog moderator
Thanks to Cyndie Rodman, MS-PREP ’09, for sending along the press release from the recent Massachusetts Pain Initiative Survey. Cyndie writes that “the survey not only quantified the incidence of chronic pain among the Massachusetts general population, but also the differences and disparities experienced by minorities versus non-minorities. This is the first Massachusetts study we are aware of to look at how pain is experienced by minorities compared to non-minorities.” Tufts University School of Medicine’s Pain Research, Education and Policy (PREP) faculty member, Carol Curtiss, RN, MSN, as well as PREP guest lecturer, Paul Arnstein, PhD, APRN-BC, played instrumental roles in the survey. Click here to read the Massachusetts Pain Initiative’s press release about the survey. For more information about the Massachusetts Pain Initative, click here.

2 comments May 10th, 2010

Chiari Malformation and Pain

by Anne Colyn, MS-PREP, MAc, Dipl Ac (USA)
An episode of “House MD” on Fox on May 3 will be presenting a girl with Chiari Malformation, for many experienced as chronic unrelenting headaches.
The syndrome is complicated to explain because each individual has different symptoms. The symptoms mostly stem from a congenital problem with the lobes of the cerebellum (the very back of the brain) “sinking” into the opening at the bottom of the skull where spine meets the brain. This structural problem causes pressure on the brain stem and congestion in the opening where the spinal fluid flows in and out of the brain from the spine. The symptoms manifest themselves in each person differently, depending on how much pressure is being caused on which nerves. Most commonly a person will find out about their Chiari diagnosis after years of “unknown causes” of headaches in the back of their head, and doctors telling them it’s only an emotional problem.
Due to the structural nature of Chiari, medications typically are not beneficial. The common treatment is to repair the structural imbalance by opening that part of the skull and shrinking the lobes that are causing undue pressure on the brain stem and interrupting the spinal fluid from flowing in a direct path in and out of the brain. In fact, statistically this syndrome is just as common as Multiple Sclerosis. It’s crucial for doctors to begin educating themselves on this syndrome for those patients struggling with pain and yielding no benefit from conventional headache treatment.
Go to for information if you’d like to read more about Chiari.

Add comment May 3rd, 2010


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