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#4 - The Science Of Pain
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#6 - Pain Diagnosis
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The New Science of Pain Relief- Class #5

The Diagnosis of Pain

"A good diagnosis is the first step to a good treatment"

In 80% of cases the cause of pain cannot be established
Quebec Task Force on Spinal Disorders: Spine 1987; 12:S1-S59

85% of pain patients lack a specific diagnosis.
Deyo et al: JAMA 1992;268:760-765

1. Is the pain warning pain, or destructive pain?


































If there is warning pain (tissue damage) it is important to find out what tissue is damaged. Examples; pulled muscle, broken bone, heart attack, kidney stone, anurism, vasular pathology, burn, infection, disc hernuation, nerve entrapment, and many, many other conditions. Some of these conditions can be life threatening.

2. If warning pain - Where is the pain coming from?


Common Pain Generators for Warning Pain

Muscle
Ligament
Nerve
Joint
Disc
Blood Vessels
Organs
Skin

Getting more technical we can have Superficial Somatic Pain, Deep Somatic Pain and Visceral Pain.

Finding the pain generator or source of the pain is very important. Each pain generator will have a different clinical presentation of pain. Depending on the pain generator the treatment will be different. Please talk with your doctor to determine your pain generator.This will also rule out neuropathic causes of pain.

Continued pain will cause changes within the nervous system.

3. When the pain is not warning pain or the warning pain is lasting longer than expected.

Changes occur