Pain Management

Accurate Diagnosis First Step in Treating Somatoform Disorders

All patients with chronic physical pain are not alike and shouldn't be treated the same. That's the basis of this article on somatoform disorders. Somatoform disorders refer to aches and pains that are amplified (blown out of proportion) because of underlying psychologic or emotional distress. Vague complaints of muscle or joint pain, fatigue, stomach problems, numbness and tingling, headaches, and so on are typical physical complaints associated with somatoform disorders.




I am a chronic back pain sufferer as a result of a simple surgery I had done four years ago. I keep watching the news for any miracle cures. So far: nothing. But I did hear a news report that they have shown there is altered brain function in people like me and maybe this will be a breakthrough in research. What sort of help would that bring me?

Over the past twenty years or so, scientists have been able to take a different research approach to the problem of chronic pain. Using studies like Positron Emission Tomography known as PET scans and Functional Magnetic Resonance Imaging (fMRI), magnetoencephalography (MEG) and the more traditional electroencephalgraphy (EEG) has changed how chronic pain is viewed.




My brother has had chronic back pain ever since a garage door fell on his head at a construction site. After trying everything, he has given up and seems deeply depressed. The doctor says he qualifies for disability and that his pain is a disease. What makes pain a disease? What does that mean?

Pain that occurs after major trauma like the head injury your sustained that lasts indefinitely is labeled chronic. This type of pain has been the focus of neuroimaging studies for the last two decades. Neuroimaging has opened our eyes to the changes in the brain that accompany chronic pain. Changes that affect the anatomy, biochemistry, and neurochemistry of the nervous system.




Unraveling the Complexities of Pain

Pain that lasts beyond the expected time after an injury or pain that seems to develop for no apparent reason continues to baffle scientists and pain specialists around the world. This type of pain labeled chronic has been the focus of neuroimaging studies for the last two decades. Neuroimaging has opened our eyes to the changes in the brain that accompany chronic pain. Changes that affect the anatomy, biochemistry, and neurochemistry of the nervous system.




When my sister was diagnosed with complex regional pain syndrome, her doctor called it something else - reflex sympathetic dystrophy syndrome. Does it have two names and what are its symptoms?

Complex regional pain syndrome, usually called CRPS, used to be called reflex sympathetic dystrophy (RSD). Doctors began using CRPS when they found it was a more accurate way of describing the syndrome.

The symptoms of complex regional pain syndrome include:
- a burning pain in the affected area
- skin sensitivity beyond what you would normally expect
- changes in skin temperature, color, or texture of the affected area, different from the other limb
- shiny or sweaty skin




My cousin has something called CRPS and she says that it affects more women than men. Is this true and if so, why?

CRPS, complex regional pain syndrome, is a painful disorder that does affect more women than men - more than twice the number. Doctors and researchers don't know why it affects more women, but many illnesses do affect one sex more than another.

Philip M. FInch, Lone Knudsen, and Peter D. Drummond. Reduction of allodynia in patients with complex regional pain syndrome: A double-blinded placebo-controlled trial of topical ketamine. In PAIN. Vol. 146. Pp. 18 to 25.




Fear of Re-Injury Makes Injury Last Longer, Delays Return to Work

When people experience a musculoskeletal injury, one that involves muscles or bone, recovery depends on many things ranging from the obvious (treatment) to the not-so-obvious (fear of movement causing pain). While most people who are injured at work are able to return to their position within a reasonable amount of time, up to 20 percent do not recover quickly and live with prolonged pain and disability, resulting in a delayed return to work.




Topical Ketamine Promising in Relieving Allodynia from Complex Regional Pain Syndrome

Complex regional pain syndrome is a little understood but very painful syndrome that can begin after a seemingly minor injury. What makes this syndrome even more puzzling is the allodynia, severe pain results from a relatively harmless action, such as brushing lightly against the affected limb. Because it is neuropathic, or nerve pain, it is particularly hard to treat.




Here's an odd one for you. My mom had shingles and has lots of pain still. Her doctor prescribed Neurontin. I have fibromyalgia and muscle pain that can make it impossible to move. My doctor also prescribed Neurontin. But we have two different kinds of pain. Then, I read that it's really a drug for epilepsy. What is going on?

When medications are first developed, they are usually developed to treat a specific issue. Once the medication is approved for use for that issue, doctors and researchers sometimes notice that other problems may improve when they prescribe the medication to their patients.




I've heard about somatic pain, which is pain that is really in your head but you feel it in your body. How do you deal with that?

Somatic pain isn't really pain that is in your head, although that is an easy way to look at it. Somatic pain is a process of a mental or emotional feeling or stress that becomes a physical feeling. The feeling is very real to the person and the brain is interpreting it as very real.





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