Rehabilitation approaches for MPS, including neuromuscular relaxation techniques, heat, or electrical therapy may also help. Physical treatments can also be used in the management of MPS. The “stretch and spray”…
PATHOLOGY This uncommon neuralgia has various etiologies, primarily categorized as neurogenic, vascular, muscular, or osteogenic. Parenthetically, it is important to note that the C1 root, suboccipital nerve, is entirely motor…
Herpes zoster complicates 10% of lymphomas, particularly Hodgkin disease. One in 25 active shingles patients harbor undetected carcinomas, lymphomas, or other diminished T-cell immunity pathophysiology, particularly immunosuppression with corticosteroid or…
Currently, a multistep pharmacologic approach is endorsed by some experts specializing in CPSP treatment; however, no trials are yet published, supporting a polypharmacy algorithm. Some pain physicians advocate tricyclic antidepressants…
PATHOPHYSIOLOGY This is enigmatic; one CRPS theory suggests that cutaneous innervation is altered post-traumatically. Human pathologic studies demonstrate reduced local nociceptive fiber density with aberrant hair follicles and sweat glands…
Neural injury triggers a range of processes affecting primary afferent receptors, their axons and cell bodies, as well as unleashing a complex immune response in central neurons and glial cells….
DISINHIBITION Several local inhibitory circuits and descending inhibitory pathways serve to modulate the perception of pain. However, after peripheral nerve injury, primary afferents, dorsal horn neurons, and gamma-aminobutyric acid (GABA)ergic…
PAIN CHARACTERISTICS The patient typically reports a burning, stinging, stabbing, or shooting pain; hyperalgesia to temperature and touch are often noted. Pain may travel unilaterally from the extremities to sometimes…
The locus ceruleus and the A5 and A7 noradrenergic cell groups of the posterolateral pons are the main source of noradrenergic input to the dorsal horn. These regions send bilateral…
The current model of descending pain modulation involves both inhibitory and facilitatory influences on spinal nociceptive transmission. The balance between inhibition and facilitation is dependent on different behavioral, emotional, and…
