Two types of non-adherence can be identified: underuse and overuse of pain medication.
Key-messages were: overuse of pain-medication can worsen headaches; pain-medication should be used rationally; and MOH is treatable.
The scourges of early 21st-century white working America tend to be self-inflicted: suicide, overuse of pain-killing opioid prescription drugs and excessive use of drugs and alcohol.
All patients overused acute pain medications during the one-month baseline period.
The pooled data publication do not include this information in Table 1, but the result section mention that most patients overused acute pain medication at baseline and 1.7% had opioid overuse [5].
Within the PREEMPT patient population two-thirds overused acute pain medication during the 28-day baseline period [5, 6] and OnabotA was also effective in CM patients with MO [14].
Our data confirm and support previous clinical trial findings obtained in patients with chronic migraine in which only two-thirds overused acute pain medication during the baseline period [15 17].
However, patients included in this analysis had failed other traditional treatment options (at least one), were suffering from a considerable number of headache and migraine days and were heavily overusing acute pain medications.
Incorrect transfer skills may predispose wheelchair users to developing upper limb pain and overuse related injuries, such as rotator cuff tears, elbow pain, and carpal tunnel syndrome [ 7– 11].
Subject enrollment criteria included (i) headaches occurring on 15 or more days per month for more than three months in the absence of medication overuse, (ii) pain involving the occipital or suboccipital region and (iii) pain refractory to preventive medications.
