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Hundreds of pain syndromes or disorders make up the spectrum of pain. There
are the most benign, fleeting sensations of pain, such as a pin prick. There
is the pain of childbirth, the pain of a heart attack, and the pain that sometimes
follows amputation of a limb. There is also pain accompanying cancer and the
pain that follows severe trauma, such as that associated with head and spinal
cord injuries. A sampling of common pain syndromes follows, listed alphabetically.
Arachnoiditis is a condition in which one of the three membranes covering
the brain and spinal cord, called the arachnoid membrane, becomes inflamed.
A number of causes, including infection or trauma, can result in inflammation
of this membrane. Arachnoiditis can produce disabling, progressive, and even
permanent pain.
Arthritis. Millions of Americans suffer from arthritic conditions such
as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and gout. These
disorders are characterized by joint pain in the extremities. Many other inflammatory
diseases affect the body's soft tissues, including tendonitis and bursitis.
Back pain has become the high price paid by our modern lifestyle and
is a startlingly common cause of disability for many Americans, including both
active and inactive people. Back pain that spreads to the leg is called sciatica
and is a very common condition (see below). Another common type of back pain
is associated with the discs of the spine, the soft, spongy padding between
the vertebrae (bones) that form the spine. Discs protect the spine by absorbing
shock, but they tend to degenerate over time and may sometimes rupture. Spondylolisthesis
is a back condition that occurs when one vertebra extends over another, causing
pressure on nerves and therefore pain. Also, damage to nerve roots is a serious
condition, called radiculopathy, that can be extremely painful. Treatment
for a damaged disc includes drugs such as painkillers, muscle relaxants, and
steroids; exercise or rest, depending on the patient's condition; adequate support,
such as a brace or better mattress and physical therapy. In some cases, surgery
may be required to remove the damaged portion of the disc and return it to its
previous condition, especially when it is pressing a nerve root. Surgical procedures
include discectomy, laminectomy, or spinal fusion (see section on surgery in
How is Pain Treated? for more information on these treatments).
Burn pain can be profound and poses an extreme challenge to the medical
community. First-degree burns are the least severe; with third-degree burns,
the skin is lost. Depending on the injury, pain accompanying burns can be excruciating,
and even after the wound has healed patients may have chronic pain at the burn
site.
Central pain syndrome-see "Trauma" below.
Cancer pain can accompany the growth of a tumor, the treatment of cancer,
or chronic problems related to cancer's permanent effects on the body. Fortunately,
most cancer pain can be treated to help minimize discomfort and stress to the
patient.
Headaches affect millions of Americans. The three most common types
of chronic headache are migraines, cluster headaches, and tension headaches.
Each comes with its own telltale brand of pain.
Migraines are characterized by throbbing pain and sometimes by other
symptoms, such as nausea and visual disturbances. Migraines are more frequent
in women than men. Stress can trigger a migraine headache, and migraines can
also put the sufferer at risk for stroke.
Cluster headaches are characterized by excruciating, piercing pain
on one side of the head; they occur more frequently in men than women.
Tension headaches are often described as a tight band around the head.
Head and facial pain can be agonizing, whether it results from dental
problems or from disorders such as cranial neuralgia, in which one of the nerves
in the face, head, or neck is inflamed. Another condition, trigeminal neuralgia
(also called tic douloureux), affects the largest of the cranial nerves (see
The Nervous Systems in the Appendix) and is characterized by a stabbing, shooting
pain.
Muscle pain can range from an aching muscle, spasm, or strain, to the
severe spasticity that accompanies paralysis. Another disabling syndrome is
fibromyalgia, a disorder characterized by fatigue, stiffness, joint tenderness,
and widespread muscle pain. Polymyositis, dermatomyositis, and
inclusion body myositis are painful disorders characterized by muscle
inflammation. They may be caused by infection or autoimmune dysfunction and
are sometimes associated with connective tissue disorders, such as lupus and
rheumatoid arthritis.
Myofascial pain syndromes affect sensitive areas known as trigger points,
located within the body's muscles. Myofascial pain syndromes are sometimes misdiagnosed
and can be debilitating. Fibromyalgia is a type of myofascial pain syndrome.
Prepared by: Office of Communications and Public Liaison
National Institute of Neurological Disorders and Stroke
National Institutes of Health
Bethesda, MD
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