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Chronic Pain Conditions - Coggle Diagram
Chronic Pain Conditions
Fibromyalgia
Pathogeneisis
Unknown, heightened sensitivity to pain that results from central sensitization
Diagnosis
Widespread pain index >7, lasts 3 months, no disorder that would otherwise explain pain
DDx
RA, SLE, Polymyalgia rheumatica, Myositis, ANkylosing spondylitis, Hypothyroidism
Natural History
Symptoms are usually stable over time
Treatment
Combination of non pharm (Exercise, CBT, Education, aquatherapy) and pharm (non-narcotics, anti-depressants - TCA, SSRI, SNRI, anti-convulsants, opioids)
Complex Regional Pain Syndrome
Type 1
Tends to occur after MSk injury
Type 2
Secondary to injury of a nerve
Diagnositci criteria
Continuin pain disproportionate to any event
1 category in 2+ (Sensory, vasomotor, sudomotor, motor)
Treatment
Rehab
OT, Pain management (Anti-inflammatories, TCA, anticonvulsants, biphosphonates, interventional treamtents)
Graded motor imagery
Treat pain and movement issues related to altered nervous system
Post-herpetic Neuralgia
Risk factors
Advanced age, immunocompromised, site of HZ involvement
Pathophysiology
Abnormal function of nociceptors that are hypersensitive to light stimulation
Treatmetn
Topical Capsaicin cream, TCAs, Anticonvulsants, SNRIs
Trigeminal Neuralgia
Chronic facial pain syndrome
Hypersensitivity of the trigeminal nerve
Diagnostic
3 Attacks occuring both:
One or more divisions of trigeminal nerve with no radiation
3/4 of the following: Recurring attacks, severe intesity, electric shock like, 3 attacks precipitated by stimuli
Treatment
Carbamazepine -> Other anticonvulsants/Baclofen/Oxcarbazepine -> Surgery
Phantom Limb Pain
Pain felt in part of body that has been amputated
Treatment
Reassurance, pain management, gabapentinoids, anti-depresants, ketamine