Pain-ABC
Pain terms Index and information
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AIDS-related Pain
HIV and AIDS patients usually experience pain. Pain can stem from the virus itself, various treatments, infections, or cancer. The pain is systemic and significantly affects quality of life. Pain management is often inadequate due to primary HIV or AIDS treatment.
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Arthritis
Rheumatoid arthritis is an inflammatory form of arthritis accompanied by joint pain and damage. Rheumatoid arthritis damages the lining of your joints (synovium) and leads to swelling, which is accompanied by throbbing pain and eventually deformities. Sometimes, rheumatoid arthritis leads to significant difficulties in daily life, such as difficulty opening bottles or walking.
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Osteoarthritis
There are over 100 different forms of arthritis. The most common form is osteoarthritis, which occurs due to joint trauma, joint infections, or aging. Joint damage begins with a breakdown of joint cartilage. In severe cases, adjacent bone remodeling occurs, destroying the joint surface. The consequences are pain, joint stiffness, and movement restrictions. The joints can deform and eventually become completely ossified. Various measures can slow down this process, with joint replacement surgery as the final option. Knee (gonarthrosis) and hip (coxarthrosis) joints, small spinal joints (spondylarthrosis), and finger joints are most commonly affected. By age 50, half of the population has arthritically changed joints. Women are more commonly affected than men.
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Disc Herniations
Disc herniations are the links between the vertebral bodies of the spine. They act like cushions, absorbing shocks. When the discs are damaged, they can rupture or bulge. If they then press on the nerve in the spinal canal or the exiting nerves, they disrupt signal transmission, which can then be perceived as pain.
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Failed Back Surgery Syndrome (FBSS)
This syndrome does not exist; it is rather a very general term for an unsuccessfully operated back patient. There is no identical term for other unsuccessful operations (failed cardiological op. syndrome, failed knee op. syndrome, etc.)
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Fibromyalgia
This medically unexplainable syndrome is characterized by chronic widespread pain and excessive pain upon touch (allodynia). Symptoms include fatigue, sleep disturbances, joint stiffness. Some patients report swallowing difficulties, bladder problems, paresthesia, or numbness, as well as cognitive impairments. James Halliday examined Scottish workers with musculoskeletal pain in 1937 and attributed the cause to suppressed guilt, anxiety, and the like. Today, a somatic cause seems more likely (as with asthma, migraines, stomach ulcers (since 1980, the bacterium Helicobacter pylori has been blamed), epilepsy, all diseases for which a psychological cause was previously believed). The diagnosis based on the 18 tender points is increasingly being questioned (Wolfe, F. 2003. Stop using the American College of Rheumatology Criteria in the Clinc. The Journal of Rheumatology, 30(8), 1671-2). Treatment is difficult even in specialized centers; there were no significant changes even after 7 years in the areas of pain, fatigue, sleep disturbances, anxiety, and depression. The functional level deteriorated (Wolfe, F. et al., 1997. Work and disability status of persons with fibromyalgia. J. Rheumatol., 24, 1171-1178). A questionnaire can be found at: rheumacheck.rheumanet.org/questionnaire.aspx
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Hereditary motor sensory neuropathy (HMSN I)
This is a neural muscle atrophy and belongs to the neuromuscular diseases. 20-30 out of 100000 are affected by a mutation of chromosome 17. Due to denervation, the nerve impulses from the brain do not reach the muscles properly, the nerve conduction velocity decreases from 50 m/s to 40 m/s. As a result, there is weakness or degradation of the affected musculature (atrophy). Increasing weakness of arms and legs from about the age of 10 years are the first symptoms. There is no cure, but supportive treatments such as physiotherapy and occupational therapy.
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Herpes Zoster (Shingles)
Herpes Zoster is a viral infection of the nerve roots. It leads to pain and a rash on one side of the body (band of rash, stripes, or a small area). Diseases occur more frequently in older people, weakened immune systems due to stress, accidents, or the like. Spontaneous healings are the rule.
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Carpal Tunnel
The carpal tunnel is a narrow passage of ligaments and bones at the wrist. It contains nerves and tendons. Swelling in this area leads to compression of the nerves. The symptoms start slowly, as they become stronger, objects can fall out of the hand.
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Complex Regional Pain Syndrome (CRPS)
In CRPS I (sympathetic reflex dystrophy), no nerve lesion is detectable. In addition to sensory disturbances, burning deep spontaneous pain and mechanical allodynia are characteristic. Disturbances in skin blood flow, sweating, edema, and later trophic disorders of the skin, joints, and bones are typical. Motor disturbances include a restriction of muscle strength, tremor, and later dystonic changes. All symptoms are generalized in the distal extremity and not limited to the distribution area of peripheral nerves. CRPS Type II (Causalgia) develops after partial peripheral nerve lesions. The distal generalized symptoms are identical. Treatment is initially conservative (analgesics, immobilization, elevation), if this is not successful, sympathetic blocks may be useful. After spontaneous pain reduction, intensification of physiotherapy is useful.
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Knee Injuries
Your knee consists of bones, cartilage, ligaments, and fluid. Muscles and tendons help to move the knee. If one of these structures is injured or diseased, it can lead to pain and difficulty walking. For the assessment of knee pain, a questionnaire can be found at:
www.meinkniegelenk.ch -
Headaches
The most common type of headaches are tension headaches. Tension headaches result from muscle tension in the shoulders, neck, head, and jaw. Overwork, sleep disturbances, appetite changes, or alcohol consumption lead to a higher likelihood of chronic headaches. Other types of headaches are migraines and cluster headaches. Treatment often involves lifestyle changes, relaxation techniques, and headache medications.
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Cancer Pain
1-3 patients with cancer are pain patients. The pain can be dull, burning, or stabbing, either constant or intermittent, weak, moderate, or severe.
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Lower Back Pain
Lower back pain is pain mostly caused by the lumbar spine. It often leads to radiating pain into the legs (sciatic pain). In addition to accidents and traumas, weak back muscles, sedentary work, overweight, and insufficient exercise (NEAT: non-exercise activity thermogenesis) can be the cause.
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Lupus
Lupus is a chronic autoimmune disease that can damage the skin, joints, and/or organs. In this condition, the immune system can no longer distinguish between harmful influences and healthy tissue. Inflammation, pain, and damage occur in various parts of the body. Further information can be found at:
lupus-rheumanet.de:8443 -
Lyme Borreliosis
A tick bite can cause fever, headaches, fatigue, depression, and skin rashes. These symptoms can often be treated with antibiotics in the early stages. However, delayed or inadequate treatment can lead to more severe symptoms. Occasionally, arthritic complaints may persist. A questionnaire without evaluation can be found at:
www.borreliose-saarland.de/Download/BCS-Anamnese.pdf. -
M. Bechterev (Ankylosing Spondylitis)
M. Bechterev is a type of arthritis affecting the spine. Symptoms include swelling between the vertebrae, in the spinal joints, and in the pelvis. M. Bechterev is an autoimmune disease. The immune system, which normally protects the body from infections, attacks the body’s tissue in this disease. The condition is more common in men. Genetic predisposition appears to play an important role. The surface molecule HLA-B27 is present in the cells of 95% of affected individuals. This molecule plays a role in the immune response and is found more frequently in some families.
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Myofascial Pain
Myofascial pain is a form of chronic muscle pain. The pain is localized to the trigger points of their muscles. These points cause pain when touched and extend over the affected muscle.
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Neck Pain
Most people experience neck pain at some point in their lives. Neck pain can be acute or chronic. The most common causes of neck pain are poor postures at work (in front of the computer, on the assembly line, while sitting), but it can also result from accidents or injuries. The former can be corrected by ergonomic measures and mindfulness, while the latter must be treated medically. For an English questionnaire, see Neck Pain Disability:
www.oarsi.org/pdfs/pain_indexes/NECK_PAIN_DISABILITY_INDEX_QUESTIONNAIRE.pdf -
Neuropathic Pain
Neuropathic pain is a complex chronic pain that typically accompanies tissue damage. In neuropathic pain, the nerve fibers are damaged, dysfunctional, or injured. These damaged nerve fibers send false signals to other pain centers. Nerve fiber injuries lead to changes at the site of the injury and also in areas around the injury. Questionnaires can be found at:
www.neuro.med.tu-muenchen.de/dfns/arzt/paindetect.html. -
Nerve Compression
When cartilage, bone, muscle, or tendons press on a nerve, it is called nerve compression. This pressure impairs the nerve’s function, causing pain, numbness, weakness, or tingling.
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Occipital Neuralgia
Occipital neuralgia is a specific type of mostly one-sided headache in the upper neck, at the back of the head, behind the ear. The pain is stabbing or electrifying, often radiating to the head, forehead, and eyes. Light sensitivity is often present. Local anesthesia of the major occipital nerve can help when common pain medications do not have the desired effect. Questionnaire and article can be found at: http://www.primary-care.ch/pdf/2004/2004-27/2004-27-231.PDF .
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Osteodystrophy
Osteodystrophy deformans is a disorder likely involving viral involvement, with genetic influences assumed in 3-4% of cases (genetic locus 18q21 of the RANK gene). This leads to a calcareous densification and enlargement of bones, which easily break. Other problems include arthritis and hearing problems. The disease is more common in men. Physiotherapy, medical treatment, and, if necessary, operative stabilization of bone fractures lead to an overall good prognosis.
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Peripheral Neuropathy
Symptoms of peripheral neuropathy include burning pain and numbness after traumatic injuries, infections, disrupted metabolism, or exposure to toxins. It most commonly occurs in diabetics. Antidepressants and anticonvulsants are effective treatment options for peripheral neuropathy. Questionnaire (English) can be found at: http://www.virtualmedicalcentre.com/calc_pfizer_pain_detect.asp.
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Phantom Pain
Phantom pains may occur after amputations. Usually, these pains disappear over time. If these pains persist for more than 6 months, the prognosis for spontaneous improvement is poor. The pains can be very intense.
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Whiplash Injury (Cervical Distortion)
A whiplash injury is caused by the traumatic bending and stretching of the cervical spine with tissue damage (usually not detectable with X-rays, CT scans, or MRI). This is associated with a whole complex of symptoms: neck pain, alternating intensively painful conditions, rapid exhaustion, forgetfulness, fatigue, organizational difficulties (hence often inability to work), depression. These symptoms usually disappear within 3 months, but in chronic courses they persist for years. Treatments consist of physiotherapy, medical training therapy, pain treatments, psychiatric therapy, but are overall unsatisfactory for chronic courses. Important: These informations are neither complete nor do they replace consultation with a professional health advisor. The informations are only intended to provide an overview of the various pain conditions.
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Spinal Stenosis
In spinal stenosis, the spinal canal is narrowed. This compression of the spinal cord leads to permanent pain in the buttocks, difficulty walking, or numbness in the legs and reduced physical activity. Physiotherapy, targeted training work, relaxation exercises, electrotherapy, or surgical decompressions or vertebral fusions are successful treatments. Questionnaire on p. 95f. http://www.freidok.uni-freiburg.de/volltexte/7476/pdf/06May2010.pdf
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Syringomyelia
Syringomyelia is a post-traumatic or developmental disorder and is a cavity formation in the gray matter of the spinal cord, especially in the cervical or thoracic spine, over time. The symptoms may include pain, weakness in the back, shoulders, arms, legs. Headaches or the inability to feel temperature differences are often present. Pain therapy is lengthy and difficult, physiotherapy and medical treatment can help. Surgical procedures are also used to alleviate the complaints.
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Thoracic Outlet Syndrome
The thoracic outlet syndrome is a neurovascular compression syndrome. The compression occurs at the vascular nerve bundle plexus brachialis, the subclavian artery, and the subclavian vein (vascular bundle from the neck to the arm). Physiotherapy, strengthening of the shoulder girdle muscles, and heat treatments can help here alongside surgical measures.
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Trigeminal Neuralgia
Pain is felt in the face with this disorder in the area of the trigeminal nerve. The pains are intense and affect the ears, eyes, lips, nose, scalp, forehead, teeth, or jaw.
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Vascular Pain
Vascular pain is caused by the dilation or constriction of blood vessels. Dilation of blood vessels leads to pain when the vessels put pressure on the surrounding nerves. Constriction of blood vessels reduces blood flow, and the tissue around the blood vessel may become inflamed.
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Spinal Injuries
The onset of this disorder is trauma to the spine, injuring or displacing (dislocating) vertebral bodies. Damage begins with the trauma when bone fragments, disc material, or ligaments impinge on the spinal canal. Spinal injuries usually result in permanent disability or paralysis and sensations below the site of injury. Tetraplegia is paralysis of a large portion of the body (arms, legs). Paraplegia is paralysis of only the lower part of the body.
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Vulvodynia
Vulvodynia is the term for pain in a woman’s external genital area. Symptoms include burning pain that spreads across the entire skin of the external genitalia to the anus. The pain is so unpleasant that walking or wearing underwear is already perceived as a burden. 16% of women suffer from these complaints for a longer period in their lives. Fungal or bacterial infections may be causative factors. Treatment with tricyclic antidepressants or anticonvulsants (Lyrica) along with everyday measures can help.
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Central Pain Syndrome
Central pain syndrome is associated with a disorder of the central nervous system (CNS), consisting of the brain, brainstem, and spinal cord. This syndrome can be caused by a stroke, multiple sclerosis, tumors, epilepsy, brain or spinal cord injuries, or Parkinson’s disease. The associated pains are diverse. The pains can be widespread throughout the body or limited to certain parts of the body. The pain is typically constant, burning, and exacerbated by touch, movement, emotions, and temperature changes. Often, there are also needle-like sensations (paresthesias), which are stronger in the feet or hands (periphery). The pain often begins immediately after the injury or damage but can also onset much later.
