Recent advances in pain research: implications for chronic headache

Within the last 2 decades there has been an explosion in new information on mechanisms underlying pain. Unfortunately this information has not resulte d in a similar improvement of our handling of patients with chronic pain in cluding chronic musculoskeletal pain. Neuronal hyperexcitability, which app arently is a key phenomenon in many (if not all) types of chronic pain resu lts in changes in the nervous system from the level of the peripheral nocic eptor to the highest cortical centers in the brain. The neuronal plastic ch anges in chronic pain conditions makes the nociceptive system amenable for treatment with several traditional as well as untraditional types of interv entions. Two treatment areas that seem worth exploring within chronic pain including headache concerns preventive measures and endogenous pain modulat ion.