Cronen M C, Waldman S D
J Pain Symptom Manage. 1990 Dec;5(6):379-81. doi: 10.1016/0885-3924(90)90034-h.
Headaches are among the most common pain syndromes encountered in clinical practice. Of these headaches, 70%-80% are ultimately diagnosed as tension type headaches (TTH). Most patients suffering from TTH will experience improvement when treated with traditional modalities, including tricyclic antidepressants, nonsteroidal antiinflammatory agents, and cognitive therapies. Unfortunately, not all patients respond to the traditional modalities. We wish to report 48 patients suffering from pain secondary to intractable TTH who failed to respond to traditional treatment modalities and were treated with cervical steroid epidural nerve blocks (CSENB). The average number of CSENB performed per patient was four. Average pain score prior to CSENB was 4.8. Six weeks following CSENB, the average pain score was 0.95. At 3 months follow-up, the VAS score was 0.35. These results suggest that CSENB may appear to provide effective relief of pain to some patients with intractable TTH.
头痛是临床实践中最常见的疼痛综合征之一。在这些头痛中，70%-80%最终被诊断为紧张型头痛（TTH）。大多数患有TTH的患者在接受包括三环类抗抑郁药、非甾体抗炎药和认知疗法在内的传统治疗方式时会有所改善。不幸的是，并非所有患者都对传统治疗方式有反应。我们希望报告48例因顽固性TTH继发疼痛且对传统治疗方式无反应而接受颈椎类固醇硬膜外神经阻滞（CSENB）治疗的患者。每位患者平均接受CSENB的次数为4次。CSENB前的平均疼痛评分为4.8。CSENB后6周，平均疼痛评分为0.95。在3个月的随访中，视觉模拟评分（VAS）为0.35。这些结果表明，CSENB似乎可为一些顽固性TTH患者提供有效的疼痛缓解。
