dystrophy (RSD) is a condition that follows injury
to an arm or leg. RSD is also known as causalgia and
sympathetic dystrophy. The extremity is painful, diffusely
swollen, tender to the touch, and weak. Often trophic
skin changes (for example, hyperhidrosis) accompany
the pain and swelling, and the extremity may be excessively
hot or cold. The syndrome is caused by abnormal nerve
impulses after injury arising in the network of nerves
known as the sympathetic nerve system. The sympathetic
nerve system regulates blood flow and temperature sensation.
In addition, special sympathetic nerves carry pain signals.
After some injuries, the sympathetic nerve system may
be activated inappropriately and cause decreased blood
flow with increased pain. This pain is typically burning
Myofascial pain syndrome (MPS)
describes a chronic nondegenerative, noninflammatory
musculoskeletal pain condition. Distinct areas within
muscles or their delicate connective tissue coverings
(fascia) become abnormally thickened and tight. When
the myofascial tissues tighten and lose their elasticity,
neurotransmitter ability to send and receive messages
between the brain and body is damaged. These areas of
thick, ropelike bands of fascia are called trigger points,
and they can cause pain long after a muscle injury should
have healed. Trigger points refer pain both locally
and distantly. Each trigger point can develop satellite
and secondary trigger points. Tender trigger points
cause symptoms that vary from mild discomfort to incapacitating
pain. Symptoms include muscle stiffness and aching and
sharp shooting pains or tingling and numbness in areas
distant from the trigger point. The discomfort may cause
sleep disturbance, fatigue, and depression. Most commonly
trigger points are in the neck, back or buttocks.
Fibromyalgia syndrome (FMS) is a chronic central nervous
system, neuroendocrine, non-degenerative, non-inflammatory,
pain amplification disorder. It is systemic and biochemical
in nature. It is responsible for diffuse body-wide pain,
tender points that hurt but don't refer pain, and sleep
disturbances. Lab tests for FMS are valid only to rule
out other conditions. No blood test can accurately identify
FMS. Fibromyalgia syndrome was first described by William
Balfour, a surgeon at the University of Edinburgh, in
1816. Since then, the medical profession has called
it many different names, including chronic rheumatism,
myalgia, pressure point syndrome, and fibrositis.
The official definition requires that tender points
must be present in all four quadrants of the body accompanied
by widespread, continuous pain for at least three months.
Tender points occur in pairs on various parts of the
body. Because they occur in pairs, the pain is usually
distributed equally on both sides of the body.
In traumatic FMS, tender points are often clustered
around an injury. These clusters can also occur around
a repetitive strain or a degenerative and/or inflammatory
problem, such as arthritis.
Costochondritis (Tietze's syndrome)
is painful inflammation of the cartilage that attaches
the ribs to the sternum. It most commonly affects the
3rd or 4th ribs and may mimic cardiac pain. Symptoms
include chest tightness, sharp chest wall pain with
radiation into the arm, and increased pain with movement.
Onset of the syndrome is generally before age 40 and
both men and women are equally affected. Usually the
cause of the inflammation is unknown, however it can
arise from a chest injury, respiratory infection, or
unusual strenuous physical activity.
For most people, costochondritis lasts from six months
to a year; however, for some people it remains a chronic
Chronic low back pain
accounts for billions of healthcare dollars each year.
Eight out of ten people will have a problem with back
pain at some time during their lives. Back pain is more
likely to occur during the ages of 30 to 50, the most
productive period of most people's lives. While most
episodes of low back pain are self-limited, for some
people these episodes of back pain become chronic. Many
etiologies for chronic back pain exist. Some of the
most common include obesity and physical deconditioning,
spinal injury, nerve root compression, and intervertebral
Occipital neuralgia is
characterized by pain in the cervical and posterior
regions of the head which may or may not radiate into
the sides of the head and into the facial and frontal
regions. The occipital nerves enter the scalp over the
back of the skull and transmit sensation from a large
portion of the scalp. Patients complain of severe headache
over the back, top, and sides of the scalp. The headache
may be described as "burning, stabbing, tingling,
or electric" in nature. There may also be loss
of sensation or numbness over the painful area. Commonly
referred to as “tension Headache”.
Trigeminal neuralgia is
a disorder of the trigeminal, or fifth cranial nerve.
Another common name for trigeminal neuralgia is tic
douloureux . The chief characteristic is sharp electrical
pain which lasts for seconds. This pain is triggered
by touching a specific area of the skin.
are headaches due to nerve pathology in the back of
the neck in the cervical spine area. The upper nerves
of the neck and the trigeminal nerve in the face are
on the same pathway to the brain. The trigeminal nerve
is responsible for the perception of pain in the head.
This connection explains why a cervical nerve disorder
can exhibit headache as a primary symptom. Many patients
who are diagnosed with cervicogenic headache have the
traditional symptoms of tension headache. In addition,
many patients who have positive tests for cervicogenic
headache may also have the symptoms of migraine and