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The common chronic pain syndromes of fibromyalgia, regional pain syndrome, and complex regional pain syndrome have been made to appear separate because they have been historically described by different groups and with different criteria, but they are really phenotypically accented expressions of the same processes triggered by emotional distress and filtered or modified by genetics, psychology, and local physical factors.

Objective: To examine the prevalence of migraine in women with chronic pelvic pain with and without endometriosis.Design: Prospective study of headache, pelvic pain, and quality of life before laparoscopic surgery for pelvic pain. Endometriosis was diagnosed pathologically. Headaches were classified as migraine or non-migraine using International Headache Society criteria.Setting: Clinical research hospital.Patient(s): 108 women in a clinical trial for chronic pelvic pain (NCT00001848).Intervention(s): Laparoscopy to diagnose endometriosis, assessment by neurologist to assess headaches.Main Outcome Measure(s): Prevalence of migraine and other headaches in women with chronic pelvic pain with or without endometriosis. Headache frequency, severity and relationship to pelvic pain and endometriosis.Result(s): Lifetime prevalence of definite or possible migraine was 67% of women with chronic pelvic pain. An additional 8% met criteria for possible migraine. Migraine was no more likely in women with endometriosis than those without. Women with the most severe headaches had a lower quality of life compared with those with pelvic pain alone.Conclusion(s): Migraine headache is common in women with chronic pelvic pain, regardless of endometriosis, and contributes to disability in those with both conditions. The strong association suggests a common pathophysiology. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to assess the health-related quality of life [HRQOL] in patients with the myofascial pain syndrome [MPS] and to evaluate the relation between this and various clinical parameters. Methods: Patients with MPS, according to Travell and Simons (7), were recruited from the rehabilitation practice of the authors. Healthy normal controls were recruited from among relatives or friends of the patients. The duration and intensity of pain was noted and the Nottingham Health Profile [NHP] used to assess the HRQOL in both the groups. Results: Thirty-seven patients with MPS and 40 healthy normal control volunteers were included in this study. Except for social isolation score, the mean scores for all parameters of the NHP were higher in the MPS group, which means a worse HRQOL. There was a correlation between NHP pain score and number of trigger points. However, no correlation was found between the NHP scores and other clinical parameters, such as age, duration of pain, and visual analog scale scores. Conclusions: The results of this study suggest that MPS affects many aspects of HRQOL. Besides the clinical and laboratory evaluation, the emotional and physiological parameters should also be considered to define the health status of the patients and plan the appropriate treatment. [ABSTRACT FROM AUTHOR]

Complex regional pain syndrome (CRPS) is a term that describes a variety of chronic pain conditions that are believed to result from dysfunction in the central or peripheral nervous systems. Typical features include dramatic changes in the colour and temperature of the skin over the affected limb or body part, accompanied by an intense pain which is out of proportion to the injury thought responsible. Skin sensitivity, sweating, and swelling are also commonly involved. This case study presents subjective reports of changes in pain and extremity weight bearing capacity in an 8 year-old child with Chronic Region Pain Syndrome Type I. The changes reported occurred over a 12 week conservative course of treatment which included manipulation, nutritional supplementation and rehabilitation. The patient was able to regain full control of her legs and full weight bearing after 3 weeks of treatment. [ABSTRACT FROM AUTHOR]

Abstract: Not all spinal contusions result in mechanical allodynia, in which non-noxious stimuli become noxious. The studies presented use the NYU impactor at 12.5 mm drop or the Infinite Horizons Impactor (150 kdyn, 1 s dwell) devices to model spinal cord injury (SCI). Both of these devices and injury parameters, if done correctly, will result in animals with above level (forelimb), at level (trunk) and below level (hindlimb) mechanical allodynia that model the changes in evoked somatosensation experienced by the majority of people with SCI. The sections are as follows: 1) Mechanisms of remote microglial activation and pain signaling in “below-level” central pain 2) Intracellular signaling mechanisms in central sensitization in “at-level” pain 3) Peripheral sensitization contributes to “above level” injury pain following spinal cord injury and 4) Role of reactive oxygen species in central sensitization in regional neuropathic pain following SCI. To summarize, differential regional mechanisms contribute to the regional chronic pain states. We propose the importance of understanding the mechanisms in the differential regional pain syndromes after SCI in the chronic condition. Targeting regional mechanisms will be of enormous benefit to the SCI population that suffer chronic pain, and will contribute to better treatment strategies for other chronic pain syndromes. [Copyright &y& Elsevier]

Regional soft-tissue complaints are commonplace, and they usually relate to a disease process, such as strain, inflammation or degeneration of a muschle, tendon or related muscle-tendon unit. The clinical features and investigations of the causative processes of these complaints are characteristics, and outcomes to treatments are usually predictable and satisfactory. Regional pain syndromes are different:these syndromes present with regional pain and tenderness, and other sensory symptoms unaccounted for by a simple musculoskeletal mechanistic explanation. Approved classification criteria for regional pain syndromes are lacking, and these syndromes are poorly understood and frequently misdiagnosed. Regional pain syndromes often occur after injury and overlap extensively with other musculoskeletal pain syndromes, in terms of clinical signs and symptoms. The clinician and patient are often confused about the nature of the problem and routine treatments directed to putative tissue damage will fail. Review of the epidemiology of regional pain syndromes combined with knowledge of other similar pain syndromes has enabled an evolving understanding of the condition. The musculoskeletal and central nervous systems both contribute to regional pain syndromes, through spine-related pain mechanisms and central sensitization, respectively. The patient's emotional state, particularly the effect on pain modulation, links these two systems.

Instrumental musicians are prone to a variety of occupationally determined upper limb problems that produce significant disability and loss of earnings. As the majority of these affect the musculoskeletal system in one way or another they assume a particular relevance to the practice of rheumatology. Recent advances in our understanding of the aetiology of these conditions are described together their mode of presentation, differential diagnosis, investigation and the therapeutic options available for them. [ABSTRACT FROM PUBLISHER]

This feature presents information for patients in a question and answer format. It is written to simulate actual questions that many pain patients ask and to provide answers in a context and language that most pain patients will comprehend. Issues addressed in this issue are the role of the biofeedback in pain management and Bier blocks for complex regional pain syndrome. [ABSTRACT FROM AUTHOR]

The common chronic pain syndromes of fibromyalgia, regional pain syndrome, and complex regional pain syndrome have been made to appear separate because they have been historically described by different groups and with different criteria, but they are really phenotypically accented expressions of the same processes triggered by emotional distress and filtered or modified by genetics, psychology, and local physical factors., Competing Interests: No competing interests were disclosed.No competing interests were disclosed.No competing interests were disclosed.

Most autoimmune diseases are associated with pathological pain development. Autoimmune diseases with pathological pain include complex regional pain syndrome, rheumatoid arthritis, and Guillian-Barré syndrome to name a few. The present Review explores research linking the immune system to the development of pathological pain in autoimmune diseases. Pathological pain has been linked to T-cell activation and the release of cytokines from activated microglia in the dorsal horn of the spinal cord. New research on the role of autoantibodies in autoimmunity has generated insights into potential mechanisms of pain associated with autoimmune disease. Autoantibodies may act through various mechanisms in autoimmune disorders. These include the alteration of neuronal excitability via specific antigens such as the voltage-gated potassium channel complexes or by mediating bone destruction in rheumatoid arthritis. Although more research must be done to understand better the role of autoantibodies in autoimmune disease related pain, this may be a promising area of research for new analgesic therapeutic targets. © 2016 Wiley Periodicals, Inc., (© 2016 Wiley Periodicals, Inc.)

Musculoskeletal ultrasonography (MSUS) is a useful imaging technique in the diagnosis of various soft tissue pathologies. High-frequency linear array transducers provide excellent resolution of soft tissue pathology. Pathological changes in subcutaneous tissue, including soft tissue tumours, abscesses, tenosynovitis, ligamentous and tendinous abnormalities, and peripheral nerve lesions, including carpal tunnel syndrome, can be identified. This review addresses the role of US in diagnosing regional pain syndrome, ligament lesions and nerve lesions. [ABSTRACT FROM AUTHOR]