CAUSES OF PAIN
– Diseases that Cause Pain
By now I’m sure you understand that pain disorders are
too many as any disease from head to toe can give
rise to pain. There are so many causes but let me
summarize only the most important and significant
diseases.
Generalized pain
Prior
to discussing localized pain syndromes, it is
prudent to see the important reasons for generalized
pain first.
Fibromyalgia
Fibromyalgia is a non-progressive chronic pain syndrome
resulting from Central Nervous System dysfunction. In
fibromyalgia, patients have pain amplification,
musculoskeletal discomfort and systemic symptoms. It is
because pain processing is impaired in patients with
fibromyalgia. It gives rise to allodynia (painful perception
of a non-painful stimulus) and hyperalgesia (intensified and
amplified perception of pain sensation). Usually there is a
history of pain injury in the past. Patients complain about
generalized pain limiting physical activity and easy
fatigability. The pain may be bone pain, head pain, head
neck pain, back and neck pain and pain virtually anywhere
else at rest or with minimal work. They also complain of
increased sensitivity to sounds, lights, odors and
vibrations and perceive them as distracting and painful
sometimes. Insufficient sleep worsens the condition.
Fibromyalgia patients have pain as their main symptom
associated with specific tender points in the body known as
fibromyalgia pain points. They sometimes report discomfort
after very mild exertion, low-grade fever sensitive skin.
Senior citizens have easy fatigability, depression and soft
tissue swelling more commonly rather than having pain per
se.
Fibromyalgia pain medication includes opioids,
NSAIDS, NMDA receptor antagonists, antidepressants
and compatible invasive and natural complementary
treatment.
Chronic
myofascial pain
Myofascia is a thin and almost translucent filmy
structure surrounding almost the whole body, chiefly
muscles. It gives anchor to the blood vessels, nerve
fibers and lymph. It can exist in the form of
superficial, deep or sub serous fascia depending
upon where it is present. It is composed of cells
and ground substance. All the day-to-day cellular
activity of our body has to occur through the
myofascia only. Any injury to the myofascia damages
its functional integrity. The injury may be in the
form of misuse, diseases, injury or abnormal
mobility. It results in the formation of trigger
points, which give rise to pain and tenderness
whenever they are stimulated resulting in chronic
myofascial pain.
Chronic myofascial pain can occur alone and in
association with fibromyalgia. It can also co-exist
with arthritis, depression, esophageal reflux,
infections (eg. HIV, Lyme disease), irritable bowel
syndrome, post polio syndrome and vulvodynia.
Stress, inadequate sleep, poor posture, abnormal
body anatomy, under treated chronic pain predispose
to chronic myofascial pain. Surgery can also
predispose to chronic myofascial pain if pain relief
is inadequate in the perioperative period.
Polyarthritis and
polyarthralgia
These are a diverse group of diseases ranging from
autoimmune to infectious diseases. Inflammation pain
in multiple joints with or without swelling is the
common denominator in all these diseases. The
muscles surrounding the joints and internal organs
can also be affected. Causes of joint pain of this
type are Rheumatoid arthritis, Systemic Lupus Erythematosus, Leptospirosis, Chikungunya fever, HIV
etc. Arthritis pain medicine includes aspirin,
NSAIDS, COX2 inhibitors, steroids, specific
antibiotics as indicated and disease modifying anti
rheumatic agents wherever appropriate. |