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All Other Types of Pain Articles

The shoulder is one of the most complex joints in the human body. The humerus and scapula form the shoulder joint, supported by rotator cuff muscles and tendons.
Ehlers-Danlos Syndrome (EDS) consists of a spectrum of distinct disorders primarily driven by genetic and molecular defects that has been increasingly investigated over the past decade. The subtypes of disorders that fall within EDS have been reclassified several times.
Imagine you check your patient schedule for tomorrow and see three females lined up for the afternoon – all with pelvic pain as their chief complaint. Unusual for you? What thoughts cross your mind… I better block out some extra time; Oh no… I won’t make my evening appointment; or, Pelvic pain truly is a common problem.
PID Causes and Prevalence Pelvic inflammatory disease (PID) is a clinical syndrome of the female reproductive tract characterized by inflammation of the endometrium, fallopian tubes, and/or the peritoneum. PID occurs when micro-organisms ascend from the vagina or cervix to the fallopian tubes and other genital tract structures.
Chronic fatigue syndrome, also known as myalgic encephalomyelitis, is a long-term complicated illness with unknown causes that is characterized by at least six months of pain and fatigue. There is currently no cure for the illness and diagnosis can be difficult due to lack of testing with adequate sensitivity and specificity.
While there have been advances in pain research and pain management in the pediatric patient population, many infants and children continue to suffer due to inadequate identification and relief of their pain.
Dr. Sawsan As Sanie of the Society for Women’s Health Research (SWHR) provides insight into a recent report showcasing barriers to diagnosing and treating endometriosis.
Pelvic floor physical therapy is used to treat chronic pelvic pain in a male patient. Plus: how a thorough MSK exam and a multidisciplinary approach can improve outcome.
UCPPS patients may have a higher risk for dyspareunia and other sexual dysfunctions.
Too much imaging: a perspective on what needs to change regarding the assessment of musculoskeletal pain conditions, using back pain as an example.
A first-look case report demonstrates that RFA, compared to standard care approaches, may relieve long-term pain for patients with xiphodynia.
A look at two novel approaches: continuous femoral nerve blocks and cryoneurolysis.
Patients with chronic pain affecting the face and/or limbs may have impaired motor imagery but findings are not as clear-cut for spine and neck pain.
This genetic connective tissue disorder is featured by loose joints and stretchy skin, among other symptoms.
In pain patients with high levels of LDL cholesterol, findings could lead to better choice of statins.
The Ehlers-Danlos Society announces research efforts into hEDS biomarkers.
Expert panel showcases barriers to both diagnosing and treating the painful, chronic pelvic condition of endometriosis.
Carnett’s sign may be a useful diagnostic tool.
Ultrasound-guided hydrodissection provided relief of painful abdominal adhesions that appeared after multiple breast surgeries.
A look at the minimum clinically important differences of the 6MWT, 1MSCT, and JAM for assessing musculoskeletal conditions.
Results could lead to better targeted medications and positive outcomes.
A look at a few non-pharmacological options for the treatment of men with chronic pelvic pain.
Sexual trauma in particular was of major concern for the risks of chronic pain conditions.
Athletes can often fight through their pain to compete, which makes their pain control so unique. Tips for PM&R and other pain practitioners.
Imvexxy 4 mcg dose is now commercially available in the United States.
ITB Therapy with Lioresal Intrathecal (baclofen injection) reduces spasticity-related pain and improves quality of life.
The challenges of treating women with vulvodynia and chronic vulvar pain.
Post-menopausal women are prone to experience musculoskeletal pain and sleep disturbance. Researchers examine why.
Chronic pelvic pain from endometriosis is often misunderstood and presents many clinical challenges.
Injection techniques for targeting chronic neuropathic pelvic pain caused by endometriosis.
ORILISSA is the first FDA-approved treatment for moderate to severe pain associated with endometriosis in over a decade.
Oxidative stress contributes to the complex pathophysiology of sickle cell disease, influencing sickle cell-related pain.
Researchers find that women with endometriosis are twice as likely to have fatigue than those without endometriosis.
Common dryness and other symptoms associated with vaginal atrophy may be alleviated with topical oxytocin gel
Rise in diagnoses and costs point to need for more research, treatment methods for Amplified Musculoskeletal Pain Syndrome (AMPS) in pediatric population
An expansion of treatment means more options for migraine and musculoskeletal pain sufferers.
A search for the underlying genetics and gene expression abnormalities may improve diagnostics and treatment of Ehlers-Danlos Syndromes.
Patients with comorbid chronic pain and dementia are best managed with a collaborative multidisciplinary team.
Ehlers-Danlos Syndrome is an emerging pain disorder that requires attentiveness to diagnose and treat.
Sleep disorders and chronic pain are bidirectional and interactive and often co-exist.
Examining the interrelationship between childhood obesity and chronic pain, and the impact these comorbidities play in pain conditions.
Patients with schizophrenia do feel pain. The notion of pain insensitivity is not accurate--rather patient with schizophrenia may experience disturbed or distorted, rather than, an absence of pain.
Dr. Jori Fleisher, assistant professor of neurology at NYU Langone Medical Center, discusses the way women with Parkinson's disease experience pain.
A newly conceptualize diagnosis of somatic symptom disorder, removing the mind-body separation, in the DSM-5; this updated terminology is the focus of this month's A to Z Mental Health Series.
Letters to the Editor: Elvis Presley may have had Ehlers-Danlos syndrome, and Howard Hughes may have had Marfan's syndrome, but diagnosis is difficult. Adhesive arachnoiditis is an inflammation of the central nervous system.
Learn more about how to diagnose and treat comorbid bipolar disorders and pain.
Gaining a better understanding of the association between depression and chronic pain; the first column in a monthly series on mental health and chronic pain.
African American soldiers with sick cell trait are at higher risk of developing exertional rhabdomyolysis.
Fibromyalgia is associated with many somatic symptoms, including fatigue, gastrointestinal complaints, and headaches.
Q: What are the most common chronic overuse sports injuries? Dr. Pinzon: The majority of the injuries are, at least in my practice, primarily running and endurance sports injuries.
Learn more about the diagnosis and management of Achilles tendon injuries. The authors review conservative therapy options to reduce pain and improve function.
Learn how sports-related brain trauma from repeated concussions can produce long-term pain and dysfunctions, including insomnia, anxiety, and depression.
Forest Tennant, MD, DrPH explores the original writings of Thomas Addison, MD, (Addison's Disease) to detail stories of chronic pain and adrenal failure.
Pharmaceutical Medications There are four types of drugs that have been approved by the Food and Drug Administration (FDA) to help treat insomnia: benzodiazepines, nonbenzodiazepines, melatonin receptor agonist, and antidepressants.
Insomnia and depression often are considered comorbidities of chronic pain. However, insomnia should be considered its own entity. Learn more about differentiating pain, insomnia, and depression.
One-third of women without a known pelvic condition reported high degree of pain. Researchers suggest physicians consider asking about pain, even during routine visits.
Chronic pelvic pain is a prevalent disorder that is often underdiagnosed and inadequately treated. Learn more about tips to aid in the differential diagnosis of chronic pelvic pain and the role of pelvic floor physical therapy in treating the many types of chronic pelvic pain.
People with chronic pain are prone to frequent falls. Learn more about what is the incidence, who is at risk, and why do they occur?
Most clinicians are unfamiliar with the term pain catastrophizing. Without treatment, patients who catastrophize about their pain are at higher risk for developing chronic pain and disability. Learn more about this important psychological component of pain.
In the Diagnostic and Statistical Manual of Mental Disorders 5, sleep-wake disorders encompass 10 conditions manifested by disturbed sleep, distress, and impairment in daytime functioning.1 Sleep disorders include insomnia, narcolepsy, restless leg syndrome, and breathing-related disorders (obstructive sleep apnea).
Traumatic brain injury, or concussion, can leave a person with lifelong symptoms. In this segment, specialists in 3 areas discuss TBI-induced cellular damage to the brain and the management of its sequalae.
There is a growing awareness that sound restorative sleep is important to allow the pain patient to cope with persistent discomfort on a daily basis. Recent evidence indicates that pain and sleep have a reciprocal, interdependent relationship. In addition, recent research has established that poor sleep can predict pain in certain conditions and that poor sleep compounds the pain experience.
Glial cell activation and neuroinflammation are the underlying causes of centralized pain and its associated comorbidities, including depression, fatigue, and insomnia.
Delirium in the elderly, use of opioids following surgery, improved prosthetics, and epigentics
Shoulder pain represents a significant portion of musculoskeletal injuries. Rotator cuff injuries, in particular, can be painful and debilitating, leading to chronic disability and job loss.
This series of cases illustrates the authors’ experiences of using intercostal nerve blocks and local infiltration of anesthetics to diagnose and treat this obscure syndrome.
Dr. John Claude Krusz discusses the biomechanics and pathophysiology of traumatic brain injuries, as well as their symptoms: post-concussion syndrome, post-traumatic headache, and migraine.
Dr. Forest Tennant delves into Elvis Presley's medical records to uncover underlying head trauma, autoimmune disease, and pain that may have contributed to his untimely death.
In essence, doctors of podiatric medicine are pain management specialists, albeit in a very different way.
The science of ergonomics is an approach that aims to fit the workplace conditions and requirements to the worker--instead of the other way around.
This article discusses how to assess and measure chronic pain in pediatric patients and examines the various complementary therapies used in treatment.
Article explores a range of causes and treatments of prenatal low back pain.
PPM Editor in Chief Dr. Forest Tennant discusses suffering and suicide attempts in elderly pain patients.
Case challenge on how to manage perioperative pain in an opioid-tolerant elderly patient. How would you treat this patient who is going to have total knee arthroplasty?
PPM Editor in Chief-authored article about sudden, unexpected death in patients with chronic pain.
Editor's memo from Practical Pain Management: Should we be using the phrase "centralized pain" in the pain field?
One of the most successful treatment models for comorbid pain and mental health disorders is a program based on the biopsychosocial model, which takes into account physical, mental health, and social issues. Learn more about how this model works and if you should use it with your chronic pain patients.
Many pain management practitioners realize there is a critical connection between pain and sleep. But how best to treat these pain patients?
The prevalence of chronic pain and the presence of a sleep disorder depend on a number of factors, including the type of pain, the age of the patient, gender, and the existence of comorbid conditions such as depression.
Educate, Then Let Patient Choose C. Norman Shealy, MD, PhD Fair Grove, MO As with all medical problems, I list the best options I see and then let the patient choose. Here are some of the measures typically discussed:
Chronic pain is associated with high rates of mental health disorders. The comorbid relationship between chronic pain and these disorders has been identified in patients with chronic low back pain (LBP), chronic work-related musculoskeletal pain disability, chronic arthritis, headache/migraine, temporomandibular joint disorder (TMD), upper extremity disorders such as carpal tunnel syndrome, fibromyalgia, and a heterogeneous chronic pain group.
Sleep is a vital physiologic process, and notable reductions in sleep can have negative physiologic, cognitive, and emotional effects. Article covers treating chronic pain-related insomnia.
Along with anxiety and depression, attention deficit hyperactivity disorder (ADHD) is a common comorbidity among patients with chronic pain. Review from a pain specialist of handling this pain comorbidity.
The editor of Practical Pain Management discuses dealing with chronic pain patients who also suffer from insomnia, a common pain co-morbidity.
Case presented of a teenage boy and his mother who has mild factitious disorder by proxy (FDP). Pain management specialist discusses how to treat this psychological condition.
Practical Pain Management spoke with the authors of the Army's Pain Management Task Force Reprt to discuss some of the lessons learned from the current conflicts in Afghanistan and Iraq, as well as why pain management is an important military issue.
Dr. Forest Tennant discusses the case of a 60-year-old woman who developed chronic pain after a hip replacement surgery. What should be done for her? What can we learn from her case?
Of the most common foot conditions treated by clinicians today, none is probably more misunderstood than Morton’s entrapment. Article discusses treatments for Morton's entrapment.
Sickle cell disease can cause significant pain. Article covers pain mechanism and possible treatments for pain caused by sickle cell disease.
Research over the past decade clearly shows that severe or chronic pain leads to abnormal changes in the brain and spinal cord. Central neurologic mechanisms may prolong the experience of pain, even after the inciting factor resolves. Author suggest maldynia as the name for this pain.
The extensive mobility of the glenohumeral joint lends itself to frequent injury, particularly anterior shoulder dislocations. Many reduction techniques are available, including the Milch, Kocher, Stimson, and Bosley techniques. If one technique fails, physicians can switch to another technique without having to reposition the patient, thus avoiding additional pain.
Read what a pain patient experiences following an aircraft accident -- and what she calls "bizarre sensations." Important patient perspective for any pain management specialist to read.
Following epidural analgesia in a chronic pain patient, an occurrence of thoracic epidural abscess led to a finding of Munchausen Syndrome.
A discussion of non-pharmacologic treatments for chronic opioid-dependent patients who have sickle cell pain.
The evaluation and management of chronic overuse sports/athletic injuries is one of the most pervasive concerns in sports medicine today. Learn more about treating sports/overuse injuries.
This article discusses treatment of neuropathic pain in multiple sclerosis and explains how patients demonstrated improvement using the oral synthetic cannabinoid nabilone.
Severe, chronic, under-treated pain may produce cardiac and adrenal complications that, in some pain patients, can lead to premature death.
New research suggests interstitial cystitis (IC), a painful bladder disorder, is quite prevalent in the general population. Learn about this type of chronic pelvic pain in this article.
Article highlights treatment modalities for pelvic floor dysfunction and chronic pelvic pain. Discussion of electric neuromodulation is included.
An introductory view of surface electromyography methodology in the investigation and rehabilitation of dysfunctional and painful axial skeleton muscles.
This article discusses treatment of muscular dysfunction of upper limbs and provides an overview of the surface electromyography (SEMG) approach to the investigation of muscular dysfunction and rehabilitation of upper limb muscles.
Understanding and treating the causes and symptoms of tiredness among chronic pain sufferers helps clinicians restore alertness and vitality, increase mental and physical activity, minimize depression and apathy, and optimize pain management.
Persistent, unremitting pain may adversely affect the body's endocrine, cardiovascular, immune, neurologic and musculo-skeletal systems and require aggressive treatment of the pain as well as the resulting complications.
Vulvodynia has been historically under-recognized by the medical community. More on how clinicians can diagnose and treat this chronic pelvic pain disorder.
Insufficiently-treated severe acute pain has been observed to have multifactorial, deleterious effects — direct and indirect — on the cardiovascular system.
To optimize the outcome following sympathetic blockade, accurate diagnosis of sympathetically maintained pain (SMP) should be made.
Transcutaneous electrical nerve stimulation (TENS)—as a treatment modality for primary dysmenorrhea—can act as a pain relief mechanism for women with painful menstrual cramps.
Under-reported and under-treated, chronic insomnia coexists with and perpetuates chronic pain. Article describes treatment of this pain comorbidity.
Characterized by hand and wrist pain, carpal tunnel syndrome is a symptomatic distal median nerve neuropathy at the wrist and is the most commonly encountered entrapment neuropathy.
Medication reviews of drugs used to treat musculoskeletal pain.
There is widespread recognition that musculoskeletal and chronic pain conditions are poorly diagnosed and treated, leading to chronic disability, risk for drug dependence and depression, dissatisfaction with the medical profession and epidemic costs.
Part three of a series discussing clinical presentation, exam, and treatment options for a variety of chronic conditions, including CRPS/RSD and migraines.
Source-of-pain physical examinations, diagnoses, and treatment options are reviewed in part two of a series on chronic pain.
Insomnia is a common comorbidity with chronic pain. How do you help your pain patients get a good night's sleep?
Part four of a series reviews fibromyalgia and somatoform pain disorder tests and treatment options.
This article discusses the pain and sleep relationship as well as how CPAP and oral appliances offer hope for many pain patients who have sleep disorders.
Gynecological pain can impose physical limitations on new mothers, making child-care, sitting, walking, and other activities extremely difficult and painful.
Although severe pain can have profound and negative impacts on the cardiovascular (CV) system, this complication has received scant attention. Pain may affect the CV system by multiple mechanisms, and sudden CV death may occur in chronic pain patients who experience a severe pain flare.
Pyoderma gangrenosum (PG) is an uncommon ulcerative cutaneous condition. Article covers treatment strategies, especially pain management, as well as giving case reports.
Article discusses treatment of painful cutaneous wounds. Comprehensive management and pain control are critical for patients with chronic wounds in order to improve outcomes and speed healing.
The primary focus when helping traumatic brain injury pain patients should be understanding the diagnoses, recognizing pain, assisting with pain relief, and providing the opportunity to improve function.
The sphenopalatine ganglion has been infrequently implicated in vague symptoms of the head, face, gums, teeth, neck and back since the early 1900s. Testing of the ganglion may be necessary when there is headache or dental pain that is otherwise undiagnosed.
In this retrospective observational study of chronic unresolved ankle pain, Hackett-Hemwall dextrose prolotherapy helped promote a measurable decrease in the pain and stiffness of the treated joints and improvement in clinically-relevant parameters.
This article explains how chronic pain can cause brain atrophy, and altered neurochemistry and sensory function of the central nervous system.
A biopsychosocial approach is best suited for assessment and treatment of traumatic musculoskeletal pain with concomitant post-traumatic stress disorder (PTSD).
Most, if not all, post-concussion symptoms are quite treatable and can often make a dramatic difference in the quality of life for a chronic pain patient recovering from traumatic brain injury.
Using exclusive laser treatment, a foot neuroma case (for a patient that was not effectively treated by conventional medicine) was resolved to a pain-free state over the course of six weeks. Article covers this complementary treatment option for chronic pain patients.
A clinical history and physical examination with judicious use of appropriate diagnostic modalities are mandatory in identifying what is the likely pain in stroke survivors.
This retrospective observational study of patients with unresolved wrist pain noted improvements in many quality of life parameters after Hackett-Hemwall dextrose prolotherapy.
Depression, anxiety, coping, somatization, sleeplessness, and hypochondriasis are prevalent in the chronic pain population and, left untreated, are associated with greater risk for poor outcomes.
Case report of a male patient whose death was hastened by chronic pain.
Considerations of muscular relationships in pain management based on Surface Electromyographic (SEMG) Studies. Focuses on shoulder pain/shoulder dysfunction.
Case presentation of a US veteran of Operation Iraqi Freedom following injuries from two consecutive Improvised Explosive Devices (IEDs).
A primer for pain management physicians on the mechanism of action and indications for use.
Expert opinion is an important source of information for clinicians hoping to treat this condition efficiently and effectively.
An SEMG view of investigation of muscular dysfunction and rehabilitation of the lower limb muscles.
As part of a differential diagnosis of pain associated with tooth, gum, tongue, palate, or face, the potential presence of neuropathies should also be considered before performing irreversible procedures.
A clinical case examination of behavioral treatment using a relaxation model of biofeedback in treating this rare painful disorder.
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