Facts on File Encyclopedia of Health and Medicine

OSTEOARTHRITIS, to be maldynia because the pain,
though persistent and long-term, results from an
identifiable cause. The pain associated with mal-
dynia may be sharp or dull, burning or aching,
generalized or focused, continuous or intermit-
tent. The one constant no matter the nature of the
pain is the absence of any pathologic reason for
the pain to exist.
The diagnostic path differs for each individual,
generally focusing on ruling out potential causes
for pain. Diagnostic procedures that rule out par-
ticular causes of pain may include imaging proce-
dures such as COMPUTED TOMOGRAPHY(CT) SCANor
MAGNETIC RESONANCE IMAGING(MRI), electromyelo-
gram (EMG), evoked potential studies, and NERVE
conduction studies.

Treatment Options and Outlook

Treatment for maldynia ranges from nonnarcotic
and narcotic ANALGESIC MEDICATIONSto nerve block
injections to alternative approaches such as
ACUPUNCTURE and BIOFEEDBACK. For most people
with maldynia, treatment is a process of trial and
error with the goal of allowing participation in
desired daily activities rather than complete relief
from pain. Treatment is unique to the individual
and varies over time, depending on effectiveness
and improvement of the pain. Daily physical activ-
ity to the extent possible releases natural pain

relievers in the body called endorphins. Exercise

also improves balance, MUSCLE tone, and one’s

overall sense of well-being.

Maldynia is a life-altering condition. It inter-

feres with nearly every aspect of life, and often is

partially to completely disabling. Maldynia can

persist for years, go through cycles of improve-

ment and worsening, or suddenly disappear. The

elusive nature of its symptoms makes maldynia a

difficult challenge. However, with appropriate

medical guidance and a positive outlook, many

people are able to achieve a reasonableQUALITY OF

LIFE. It is important to find a doctor who under-

stands and has experience treating chronic pain

syndromes, and to keep the faith that improve-

ment is possible.

Risk Factors and Preventive Measures

Researchers continue to look for the reasons for

maldynia. There does appear to be a correlation

between maldynia and a preceding circumstance

of untreated or undertreatedACUTE PAIN. Appropri-

ate pain relief for acute pain (EUDYNIA) may pre-

vent maldynia from following a significant trauma

such as injury or surgery. Otherwise, there are as

yet no clear risk factors and consequently no

known measures to prevent maldynia.

See also ALTERNATIVE METHODS FOR PAIN RELIEF;

NEUROTRANSMITTER.

maldynia 379

TREATMENT OPTIONS FOR MALDYNIA

Over-the-Counter Prescription Medications Injected Medications Mechanical Approaches Alternative Approaches
Medications

acetaminophen NSAIDs: diclofenac, TRIGGER-POINT MASSAGE THERAPY ACUPUNCTURE
aspirin diflunisal, etodolac, INJECTIONS PHYSICAL THERAPY BIOFEEDBACK
NONSTEROIDAL ANTI- fenoprofen, flurbiprofen, NERVEblocks TRANSCUTANEOUS exercise
INFLAMMATORY DRUGS meclofenamate, injectable narcotics ELECTRICAL NERVE hydrotherapy
(NSAIDS): ibuprofen, oxaprozin, piroxicam epidural blocks STIMULATION(TENS) MEDITATION
ketoprofen, naproxen NARCOTICS: codeine, epidural steroids heat/cold self-hypnosis
topical analgesics hydromorphone, intracathal injection CHIROPRACTIC
topical levorphanol, manipulation
counterirritants oxycodone, oxymorphone SPINAL CORD
antidepressants: selective electrostimulation
serotonin reuptake
inhibitors (SSRIs), tricyclics