Memory for the intensity of past physical pain depends critically on the intensity of present pain. When their present pain intensity was high, patients with chronic headaches of myofascial origin rated their maximum, usual, and minimum levels of prior pain as being more severe than their hourly pain diaries indicated. When their present pain intensity was low, the same patients remembered all 3 levels of prior pain as being less severe than they actually had been. The results show that pain produces systematic distortions of memory similar to those associated with alterations of affect or mood, and suggest a resolution to a conspicuous conflict in the current pain literature.

Three studies are presented demonstrating the reliability of the pressure algometer as an index of myofascial trigger point sensitivity. The first study showed high reliability between and within experimenters when measuring marked trigger point locations. In study 2, significant between experimenter reliability in locating and measuring the same unmarked trigger point locations was shown, while study 3 supported the idea that trigger points are discrete points of focal tenderness within the muscle. The ability to quantify and reliably measure trigger point sensitivity opens the door to a range of clinical and research possibilities for myofascial and related musculoskeletal pain problems.

These data support the effectiveness of amitriptyline in treatment of PHN, but do not support the addition of fluphenazine.

These studies suggest that ET has promise in aiding the formation of a differential diagnosis of orofacial pain and may help in understanding mechanisms of pain as well as directing therapies.

The data closely approximate those of Chervin et al, where 80% had RDI > 5. The relationship sleep apnea has in the perpetuation or precipitation of cluster headache is still to be determined. There are some reports that treatment stops the cluster but there is no prospective study. The high incidence (80.64%) seen in this population suggests the cluster patient should receive a sleep evaluation and perhaps intervention with continuous positive airway pressure (CPAP) or an appropriate dental device.