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Erschienen in: Journal of Neurology 12/2019

04.11.2019 | Short Commentary

Eighty years of Medication-Overuse Headache: what about Medication-Overuse Backpain?

verfasst von: Benjamin Luchting, Jens Heyn

Erschienen in: Journal of Neurology | Ausgabe 12/2019

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Abstract

Introduction

Although chronic low back pain (CLBP) is one of the most common pain syndromes, up to now, clear pathophysiological causes or specific treatment options are missing. Medication-overuse has been associated with chronic headache, but never with CLBP.

Hypothesis

Based on several similarities between CLBP and Medication-Overuse Headache (MOH), we hypothesized that medication-overuse might contribute to CLBP as well, maybe even as an own entity. Might there be something like Medication-Overuse Backpain (MOB)?

Methods

We substantiate our hypothesis with a preliminary case-series analyzing five patients suffering from CLBP with a marked medication-overuse. In these patients, a stepwise analgesic withdrawal was recommended.

Results

Within 6 months of recruitment, five patients fulfilled the inclusion criteria and successfully completed discontinuation of their medication. All patients reported noticeable pain relief, despite the discontinuation of their analgesics. Withdrawal was well tolerated in all cases.

Conclusions

Considering our results, the described withdrawal method seems to be a simple and safe method to achieve pain reduction while simultaneously preventing organ damage. Despite the preliminary character of our results, our hypothesis might stimulate a new understanding of CLBP’s pathophysiology.
Literatur
1.
Zurück zum Zitat Boes CJ, Capobianco DJ (2005) Chronic migraine and medication-overuse headache through the ages. Cephalalgia 25(5):378–390CrossRef Boes CJ, Capobianco DJ (2005) Chronic migraine and medication-overuse headache through the ages. Cephalalgia 25(5):378–390CrossRef
3.
Zurück zum Zitat Diener HC, Holle D, Solbach K, Gaul C (2016) Medication-overuse headache: risk factors, pathophysiology and management. Nat Rev Neurol 12(10):575–583CrossRef Diener HC, Holle D, Solbach K, Gaul C (2016) Medication-overuse headache: risk factors, pathophysiology and management. Nat Rev Neurol 12(10):575–583CrossRef
2.
Zurück zum Zitat Scher AI, Rizzoli PB, Loder EW (2017) Medication overuse headache: an entrenched idea in need of scrutiny. Neurology 89(12):1296–1304CrossRef Scher AI, Rizzoli PB, Loder EW (2017) Medication overuse headache: an entrenched idea in need of scrutiny. Neurology 89(12):1296–1304CrossRef
4.
Zurück zum Zitat de Goffau MJ, Klaver ARE, Willemsen MG et al (2017) The effectiveness of treatments for patients with medication overuse headache: a systematic review and meta-analysis. J Pain 18(6):615–627CrossRef de Goffau MJ, Klaver ARE, Willemsen MG et al (2017) The effectiveness of treatments for patients with medication overuse headache: a systematic review and meta-analysis. J Pain 18(6):615–627CrossRef
5.
Zurück zum Zitat Balague F, Mannion AF, Pellise F, Cedraschi C (2012) Non-specific low back pain. Lancet 379(9814):482–491CrossRef Balague F, Mannion AF, Pellise F, Cedraschi C (2012) Non-specific low back pain. Lancet 379(9814):482–491CrossRef
6.
Zurück zum Zitat Becker A, Held H, Redaelli M et al (2010) Low back pain in primary care: costs of care and prediction of future health care utilization. Spine (Phila Pa 1976) 35(18):1714–1720CrossRef Becker A, Held H, Redaelli M et al (2010) Low back pain in primary care: costs of care and prediction of future health care utilization. Spine (Phila Pa 1976) 35(18):1714–1720CrossRef
7.
Zurück zum Zitat Luchting B, Rachinger-Adam B, Zeitler J, Egenberger L, Möhnle P, Kreth S, Azad SC (2014) Disrupted TH17/Treg balance in patients with chronic low back pain. PLoS ONE 9(8):e104883CrossRef Luchting B, Rachinger-Adam B, Zeitler J, Egenberger L, Möhnle P, Kreth S, Azad SC (2014) Disrupted TH17/Treg balance in patients with chronic low back pain. PLoS ONE 9(8):e104883CrossRef
8.
Zurück zum Zitat Airaksinen O, Brox JI, Cedraschi C, et al. (2006) Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J 15 Suppl 2:S192–S300.CrossRef Airaksinen O, Brox JI, Cedraschi C, et al. (2006) Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J 15 Suppl 2:S192–S300.CrossRef
9.
Zurück zum Zitat Straube A, Pfaffenrath V, Ladwig KH et al (2010) Prevalence of chronic migraine and medication overuse headache in Germany–the German DMKG headache study. Cephalalgia 30(2):207–213CrossRef Straube A, Pfaffenrath V, Ladwig KH et al (2010) Prevalence of chronic migraine and medication overuse headache in Germany–the German DMKG headache study. Cephalalgia 30(2):207–213CrossRef
10.
Zurück zum Zitat Schramm SH, Moebus S, Lehmann N et al (2015) The association between stress and headache: a longitudinal population-based study. Cephalalgia 35(10):853–863CrossRef Schramm SH, Moebus S, Lehmann N et al (2015) The association between stress and headache: a longitudinal population-based study. Cephalalgia 35(10):853–863CrossRef
11.
Zurück zum Zitat Westergaard ML, Munksgaard SB, Bendtsen L, Jensen RH (2016) Medication-overuse headache: a perspective review. Ther Adv Drug Saf 7(4):147–158CrossRef Westergaard ML, Munksgaard SB, Bendtsen L, Jensen RH (2016) Medication-overuse headache: a perspective review. Ther Adv Drug Saf 7(4):147–158CrossRef
12.
Zurück zum Zitat Koushede V, Hansen EH, Andersen A, Holstein BE (2012) Young adults' medicine use for headache: the combined effect of socioeconomic position and perceived stress, and the contribution of sense of coherence. Res Social Adm Pharm 8(6):533–541CrossRef Koushede V, Hansen EH, Andersen A, Holstein BE (2012) Young adults' medicine use for headache: the combined effect of socioeconomic position and perceived stress, and the contribution of sense of coherence. Res Social Adm Pharm 8(6):533–541CrossRef
13.
Zurück zum Zitat Tetsunaga T, Tetsunaga T, Nishida K et al (2018) Drug dependence in patients with chronic pain: a retrospective study. Medicine (Baltimore) 97(40):e12748CrossRef Tetsunaga T, Tetsunaga T, Nishida K et al (2018) Drug dependence in patients with chronic pain: a retrospective study. Medicine (Baltimore) 97(40):e12748CrossRef
14.
Zurück zum Zitat Vereckei E, Susanszky E, Kopp M et al (2013) Psychosocial, educational, and somatic factors in chronic nonspecific low back pain. Rheumatol Int 33(3):587–592CrossRef Vereckei E, Susanszky E, Kopp M et al (2013) Psychosocial, educational, and somatic factors in chronic nonspecific low back pain. Rheumatol Int 33(3):587–592CrossRef
15.
Zurück zum Zitat Vandenbussche N, Laterza D, Lisicki M et al (2018) Medication-overuse headache: a widely recognized entity amidst ongoing debate. J Headache Pain 19(1):50CrossRef Vandenbussche N, Laterza D, Lisicki M et al (2018) Medication-overuse headache: a widely recognized entity amidst ongoing debate. J Headache Pain 19(1):50CrossRef
16.
Zurück zum Zitat Evers S, Jensen R, European Federation of Neurological S. Treatment of medication overuse headache--guideline of the EFNS headache panel. Eur J Neurol 2011;18(9):1115–1121. Evers S, Jensen R, European Federation of Neurological S. Treatment of medication overuse headache--guideline of the EFNS headache panel. Eur J Neurol 2011;18(9):1115–1121.
17.
Zurück zum Zitat Evers S, Marziniak M (2010) Clinical features, pathophysiology, and treatment of medication-overuse headache. Lancet Neurol 9(4):391–401CrossRef Evers S, Marziniak M (2010) Clinical features, pathophysiology, and treatment of medication-overuse headache. Lancet Neurol 9(4):391–401CrossRef
18.
Zurück zum Zitat Cargnin S, Viana M, Sances G, Tassorelli C, Terrazzino S (2018) A systematic review and critical appraisal of gene polymorphism association studies in medication-overuse headache. Cephalalgia 38(7):1361–1373CrossRef Cargnin S, Viana M, Sances G, Tassorelli C, Terrazzino S (2018) A systematic review and critical appraisal of gene polymorphism association studies in medication-overuse headache. Cephalalgia 38(7):1361–1373CrossRef
19.
Zurück zum Zitat Cevoli S, Mochi M, Scapoli C, Marzocchi N, Pierangeli G, Pini LA, Cortelli P, Montagna P (2006) A genetic association study of dopamine metabolism-related genes and chronic headache with drug abuse. Eur J Neurol 13(9):1009–1013CrossRef Cevoli S, Mochi M, Scapoli C, Marzocchi N, Pierangeli G, Pini LA, Cortelli P, Montagna P (2006) A genetic association study of dopamine metabolism-related genes and chronic headache with drug abuse. Eur J Neurol 13(9):1009–1013CrossRef
20.
Zurück zum Zitat Belanger S, Ma W, Chabot JG, Quirion R (2002) Expression of calcitonin gene-related peptide, substance P and protein kinase C in cultured dorsal root ganglion neurons following chronic exposure to mu, delta and kappa opiates. Neuroscience 115(2):441–453CrossRef Belanger S, Ma W, Chabot JG, Quirion R (2002) Expression of calcitonin gene-related peptide, substance P and protein kinase C in cultured dorsal root ganglion neurons following chronic exposure to mu, delta and kappa opiates. Neuroscience 115(2):441–453CrossRef
21.
Zurück zum Zitat Lai TH1, Wang SJ. Neuroimaging Findings in Patients with Medication Overuse Headache. Curr Pain Headache Rep 2018;22(1):1. Lai TH1, Wang SJ. Neuroimaging Findings in Patients with Medication Overuse Headache. Curr Pain Headache Rep 2018;22(1):1.
22.
Zurück zum Zitat Schwedt TJ, Chong CD (2017) Medication Overuse Headache: Pathophysiological Insights from Structural and Functional Brain MRI Research. Headache 57(7):1173–1178CrossRef Schwedt TJ, Chong CD (2017) Medication Overuse Headache: Pathophysiological Insights from Structural and Functional Brain MRI Research. Headache 57(7):1173–1178CrossRef
23.
Zurück zum Zitat Vandenbussche N, Laterza D, Lisicki M, Lloyd J, Lupi C, Tischler H, Toom K, Vandervorst F, Quintana S, Paemeleire K, Katsarava Z (2018) Medication-overuse headache: a widely recognized entity amidst ongoing debate. J Headache Pain 19(1):50CrossRef Vandenbussche N, Laterza D, Lisicki M, Lloyd J, Lupi C, Tischler H, Toom K, Vandervorst F, Quintana S, Paemeleire K, Katsarava Z (2018) Medication-overuse headache: a widely recognized entity amidst ongoing debate. J Headache Pain 19(1):50CrossRef
24.
Zurück zum Zitat Riederer F, Marti M, Luechinger R, Lanzenberger R, von Meyenburg J, Gantenbein AR, Pirrotta R, Gaul C, Kollias S, Sándor PS (2012) Grey matter changes associated with medication-overuse headache: correlations with disease related disability and anxiety. World J Biol Psychiatry 13(7):517–525CrossRef Riederer F, Marti M, Luechinger R, Lanzenberger R, von Meyenburg J, Gantenbein AR, Pirrotta R, Gaul C, Kollias S, Sándor PS (2012) Grey matter changes associated with medication-overuse headache: correlations with disease related disability and anxiety. World J Biol Psychiatry 13(7):517–525CrossRef
Metadaten
Titel
Eighty years of Medication-Overuse Headache: what about Medication-Overuse Backpain?
verfasst von
Benjamin Luchting
Jens Heyn
Publikationsdatum
04.11.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Journal of Neurology / Ausgabe 12/2019
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-019-09611-7

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