Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Otalgia is the sensation of pain in the ear, while referred otalgia is pain felt in the ear but originating from a nonotologic source. Ear pain is a diagnostic problem when examination of the ear shows no pathology. Pain in the ear can be caused by inflammation of the external meatus or the middle ear. Nonotogenic otalgia may be due to referred or reflex pain, neuralgia, or to a psychogenic problem. Otalgia may be referred also from primary carcinoma of the head and neck. A thorough understanding of the anatomy of the head and neck is required. Referred pain is due to irritative lesions involving the fifth, ninth, or tenth cranial nerves and spinal nerves C2 and C3. If pathologic problems in the area supplied by these nerves have been ruled out, the neuralgia should be considered in the differential diagnosis. Psychogenic factors must be identified and treated before any type of surgical therapy is recommended. A basic knowledge of neuroanatomy, with emphasis on the cranial nerves, their course, distribution, and function, is also necessary. The complexity of this field may sometimes require the treating physician to call for consultations from colleagues in the fields of oral surgery, neurology, or neurosurgery. The therapy depends of the causes of the ear-ache.
 ...
PMID:[Etiology and diagnosis of otalgia]. 1253 Jan 71

Knee pain is a common presenting complaint with many possible causes. An awareness of certain patterns can help the family physician identify the underlying cause more efficiently. Teenage girls and young women are more likely to have patellar tracking problems such as patellar subluxation and patellofemoral pain syndrome, whereas teenage boys and young men are more likely to have knee extensor mechanism problems such as tibial apophysitis (Osgood-Schlatter lesion) and patellar tendonitis. Referred pain resulting from hip joint pathology, such as slipped capital femoral epiphysis, also may cause knee pain. Active patients are more likely to have acute ligamentous sprains and overuse injuries such as pes anserine bursitis and medial plica syndrome. Trauma may result in acute ligamentous rupture or fracture, leading to acute knee joint swelling and hemarthrosis. Septic arthritis may develop in patients of any age, but crystal-induced inflammatory arthropathy is more likely in adults. Osteoarthritis of the knee joint is common in older adults.
 ...
PMID:Evaluation of patients presenting with knee pain: Part II. Differential diagnosis. 1367 40

Facial pain can, on rare occasions, be the presenting symptom of lung cancer. This report describes a patient with non-metastatic lung cancer, which was associated with attacks of debilitating facial pain, presenting as cluster headache. Moreover, 32 reported cases of lung cancer-related facial pain (including the present one) are reviewed, and their clinical features are summarized. The facial pain is almost always unilateral, and is most commonly localized to the ear, the jaws, and the temporal region. The pain is frequently described as severe and aching, and may be continuous or intermittent. Aggravation and expansion of the pain, digital clubbing, increased erythrocyte sedimentation rate, and hypertrophic osteopathy, may contribute to the diagnosis. Referred pain, due to invasion or compression of the vagus nerve, as well as paraneoplastic syndrome secondary to the production of circulating humoral factors by the malignant tumor cells, is implicated in the pathophysiology of facial pain associated with non-metastatic lung cancer. Radiotherapy and tumor resection with vagotomy are very effective in aborting the facial pain. Thus, lung cancer should be included in the differential diagnosis of facial pain that is atypical and/or refractory to treatment.
J Orofac Pain 2003
PMID:Facial pain as first manifestation of lung cancer: a case of lung cancer-related cluster headache and a review of the literature. 1455 96

Referred pain from disorders of the cervical spine can be perceived as headache. The mechanism is convergence between trigeminal afferents and afferents of the upper three cervical nerves in the trigeminocervical nucleus. Cervicogenic headache cannot be diagnosed on clinical grounds alone. The definitive criterion is complete relief of pain after controlled diagnostic blocks of cervical structures or their nerve supply. The most rigorously studied example of cervicogenic headache is third occipital headache.
 ...
PMID:The neck and headaches. 1506 32

The basic knowledge related to referred muscle pain is limited. To study referred pain, an experimental model using intramuscular electrical stimulation has been developed. Four experiments were performed: (1) the thresholds for eliciting local (LPT) and referred pain (RPT) were determined; (2) stimulus-response functions relating stimulus intensity, pain intensity ratings and size of pain areas were determined; (3) inter- and intrasession variabilities were assessed; and (4) prolonged stimulations were given with a duration of 10 min to evaluate temporal aspects of the referred muscle pain. Intramuscular electrical stimulation of the tibialis anterior muscle elicited pain at the stimulation site in 94% of the subjects, and referred pain in 78% of the subjects. Referred pain was located in the anterior part of the ankle. The mean RPT was 72% higher than the mean LPT (p<0.01). Correlation was found between stimulus intensity, sensory/pain rating scores and size of pain areas (0.74< or =r< or =0.98,p<0.04). Size of pain areas and sensation/pain rating scores were correlated (0.86< or =r< or =0.97, p<0.01). Intersession variability showed that the LPTs were not significantly different (p>0.16), but the RPTs were disparate (p<0.02). Intrasession values revealed a significant difference between the five LPTs, RPTs, local and referred pain rating scores. The size of the local and referred pain areas remained constant. Prolonged stimulation at 150% of RPT showed that the onset (the first occurrence of pain) of referred pain occurred significantly later (43 s +/- 80 s) than at the local pain site (p<0.03). This study showed that local and referred muscle pain can be elicited by intramuscular electrical stimulation, and indicated that temporal and spatial summation may be involved in the elicitation of referred muscle pain.
Eur J Pain 1997
PMID:Quantification of local and referred pain in humans induced by intramuscular electrical stimulation. 1510 11

Referred pain; feeling pain at a site different than the source of pain; is also included in cancer pain. Mechanisms and treatment of referred pain has been evaluated because of a case with shoulder pain rising from diaphragmatic irritation.
 ...
PMID:[Referred shoulder pain]. 1515 34

Treatment of pain of urogenital origin, chronic pelvic pain syndrome, can be frustrating for patients and physicians. The usual approaches do not always produce the desired results. Visceral pain from pelvic organs and myofascial pain from muscle trigger points share common characteristics. Referred pain from myofascial trigger points can mimic visceral pain syndromes and visceral pain syndromes can induce trigger point development and myofascial pain and dysfunction. The referred pain syndrome can long outlast the initial event, making diagnosis difficult.
Curr Pain Headache Rep 2004 Dec
PMID:Urologic myofascial pain syndromes. 1550 57

The sensory territories of different cutaneous fascicles of the superficial radial nerve were delineated by microneurography at the level of the distal forearm in humans. Three fascicular patterns were found at this level: one supplying the dorsum of the radial aspect of the dorsum of the hand over the first dorsal interosseous space; another supplying the lateral aspect of the first metacarpal extending to the lateral aspect of the thumb; and a third innervating the second interosseous space and the proximal phalanx of the index and middle fingers. The compound fascicular territory is comparable to the classical territory described for the superficial radial nerve. Intraneural microstimulation of individual fascicles did not evoke paraesthesiae or pain beyond their fascicular territory, regardless of the stimulus intensity. We conclude that the superficial radial nerve at the forearm in man is composed of only three fascicles, as shown by the present study and from previous anatomical work. Referred pain seems related to nerve activity in afferent fibres from fascicles supplying deep tissues and muscles, not from cutaneous afferents.
 ...
PMID:Peripheral projections of sensory fascicles in the human superficial radial nerve. 1571 3

Delayed onset muscle soreness (DOMS) involves central and peripheral pain mechanisms. Referred pain patterns following stimulation of DOMS affected tissue have not been fully described. Referred pain may provide information on how central mechanisms are involved in DOMS, as referred pain is a central mechanism. Further, tendon tissue involvement in DOMS is not clear. This study assessed pressure pain threshold (PPT) sensitivity at the tendon, tendon-bone junction (TBJ) and muscle belly sites of tibialis anterior pre- and during DOMS in 45 subjects (34 males, 11 females). Furthermore, pain and referred pain areas at these three sites in response to hypertonic saline injection (n = 15 per injection site) were investigated pre- and during DOMS. DOMS was induced using controlled plantarflexion from a platform (bodyweight as resistance) causing eccentric contraction of the tibialis anterior muscle. DOMS induced PPT decrease was found at the TBJ and muscle belly sites only (P < 0.001). No mechanical effect was found in the unexercised limb. Maximal pain intensity induced by hypertonic saline given pre-DOMS was significantly higher for the tendon and TBJ injections compared to intramuscular injections (P < 0.05). Significantly higher referred pain frequency and enlarged pain areas were found at the muscle belly and TBJ sites following injection during DOMS compared to pre-DOMS. The results indicate that muscle belly and TBJ sites are sensitised while tendon tissue per se is unaffected by DOMS. Central sensitivity changes caused by DOMS may explain the increase in referred pain frequency and enlarged pain areas.
 ...
PMID:Delayed onset muscle soreness at tendon-bone junction and muscle tissue is associated with facilitated referred pain. 1664 16

Referred pain evoked by suboccipital muscle trigger points (TrPs) spreads to the side of the head over the occipital and temporal bones and is usually perceived as bilateral headache. This paper describes the presence of referred pain from suboccipital muscle TrPs in subjects with episodic tension-type headache (ETTH) and in healthy controls. Ten patients presenting with ETTH and 10 matched controls without headache were examined by a blinded assessor for the presence of suboccipital muscle TrPs. Diagnostic criteria described by Simons and Gerwin were adapted to diagnose TrPs, i.e. presence of tenderness in the suboccipital region, referred pain evoked by maintained pressure for 10 s, and increased referred pain on muscle contraction. Six ETTH patients (60%) had active TrPs and 4 had latent TrPs (40%). On the other hand, 2 control subjects also had latent TrPs. Differences in the presence of suboccipital muscle TrPs between both groups were significant for active TrPs (P<0.001), but not for latent TrPs. Active TrPs were only present in ETTH patients, although TrP activity was not related to any clinical variable concerning the intensity and the temporal profile of headache. Myofascial TrPs in the suboccipital muscles might contribute to the origin and/or maintenance of headache, but a comprehensive knowledge of the role of these muscles in tension-type headache awaits further research.
 ...
PMID:Myofascial trigger points in the suboccipital muscles in episodic tension-type headache. 1686 99


<< Previous 1 2 3 4 5 Next >>