that causes degeneration in the joints as well as to
relieve the pain of the degenerative changes.
Therapeutic methods for chronic pain typically
combine various approaches to find those that are
most effective for the individual. The subjective
nature and diverse causes of chronic pain often
mean effective relief comes through a process of
trial and error. Generally lifestyle measures to
maintain healthy body weight and optimal range
of motion, such as daily physical exercise, are
important for all types of pain. Exercise increases
the body’s release of endorphins and enkephalins,
amino acid structures that act as natural pain
relievers.
CONDITIONS IN WHICH CHRONIC PAIN IS COMMONANKYLOSING SPONDYLITIS BURSITIS
CANCER CARPAL TUNNEL SYNDROME
CERVICAL SPONDYLOSIS CHONDRITIS
CHRONIC FATIGUE SYNDROME chronic SINUSITIS
COMPLEX REGIONAL PAIN SYNDROME EPICONDYLITIS
FIBROCYSTIC BREAST DISEASE FIBROMYALGIA
GOUT HIV/AIDS
INFLAMMATORY BOWEL DISEASE(IBD) interstitial CYSTITIS
IRRITABLE BOWEL SYNDROME(IBS)lowBACK PAIN
migraine HEADACHE myofascial pain syndrome
NEUROGENIC ARTHROPATHY NEUROPATHY
OSTEOARTHRITIS OSTEOMYELITIS
PATELLOFEMORAL SYNDROME REPETITIVE MOTION INJURIES
RHEUMATOID ARTHRITIS SCIATICA
SICKLE CELL DISEASE spastic CEREBRAL PALSY
SPINAL CORD INJURY TENDONITIS
UTERINE FIBROIDS uterine prolapse
VAGINISMUS VULVODYNIA
See also ACUTE PAIN; OSTEOARTHRITIS.complex regional pain syndrome A chronic and
often progressive condition of severe PAIN. There
are two types of complex regional pain syndrome:
type 1 (also called reflex sympathetic dystrophy),
in which there is no identifiable NERVEinjury, and
type 2 (also called causalgia), which follows signif-
icant injury to a nerve. Type 2 is more common
though the symptoms, treatment, and course of
disease are similar for both types. Researchers do
not fully understand the development and pro-
gression of either type of this syndrome but
believe it results from dysfunction of the sympa-
thetic NERVOUS SYSTEM, the functional division of
the nervous system that regulates BLOOD flow.
Complex regional pain syndrome is typically
chronic (ongoing and long term) and often pro-
gressive (symptoms worsen over time). It most
often develops in people who are between the
ages of 40 and 60.Symptoms and Diagnostic Path
The symptoms of complex regional pain syndrome
typically involve a limb, with the arm being more
common than the leg. In addition to pain, the
course of disease causes pathologic (abnormal)
changes in the SKIN, MUSCLE, connective tissue, and
BONE. Early symptoms include- severe burning pain that intensifies with slight
touch, even that of a breeze (a nociceptor dis-
turbance called allodynia) - swelling in the affected arm or leg
- increased HAIRand nail growth
- dry, thin skin that alternates between warm
and cool to the touch without influence from
the external environment and may become
cyanotic (bluish in color) or mottled (areas of
irregular color) - altered sweating (sometimes excessive, some-
times inadequate sweat production)
Symptoms change as the syndrome unfolds.
Later symptoms include- severe burning pain affects larger area of the
limb - diminished ability to move the limb
- decreased hair and nail growth
- permanent changes in the skin’s texture and
color (often becomes mottled) - changes in bone structure and BONE DENSITYthat
are apparent on X-RAY - TENDONcontractions and muscleSPASM
- muscle atrophy (wasting of muscle tissue)
The diagnostic path is primarily clinical because
the symptoms are fairly distinctive, particularly
when there is history of traumatic or surgical
injury to the involved limb. STROKE or HEARTcomplex regional pain syndrome 371