OBJECTIVE The sternoclavicular joint (SCJ) is commonly affected by rheumatological conditions. Case reports suggest that it may refer pain to distant areas, potentially leading to delays in diagnosis and inappropriately targeted investigations. Therefore, we studied the patterns of pain referral from the SCJ of nine healthy volunteers. METHODS Hypertonic saline was injected into the SCJ of ni...

No one will deny the common occurrence of pain in the arm, nor the frequency with which the diagnosis of brachial neuritis was formerly made in such cases. Nevertheless, the pathology of brachial neuritis has not yet been described convincingly, and in recent years attention has been focused upon certain other common syndromes, the study of their well-defined morbid anatomy leaving little doubt...

We report a case of thymic carcinoma presenting as unilateral shoulder pain for 13 months. Before an accurate diagnosis was made, the patient received conservative treatment, cervical discectomies, and myofascial trigger point injection, none of which relieved his pain. When thymic carcinoma was eventually diagnosed, he received total resection of the tumor and the shoulder pain subsided comple...

Recent animal studies on the mechanism of migraine show that intracranial pain is accompanied by increased periorbital skin sensitivity. These findings suggest that the pathophysiology of migraine involves not only irritation of meningeal perivascular pain fibers but also a transient increase in the responsiveness (ie, sensitization) of central pain neurons that process information arising from...

Myofascial trigger points (TPs) are a poorly understood phenomenon involving the myofascial system and its related neural, lymphatic, and circulatory elements. Compression or massage of a TP causes localized pain and may cause referred pain and autonomic phenomena. The authors describe a 58-year-old woman who experienced precipitation of substantial psychological symptoms directly related to he...

Active myofascial trigger points (MTrPs) have been found to contribute to chronic tension-type headache and migraine. The purpose of this case series was to examine if active trigger points (TrPs) provoking cluster-type referred pain could be found in cluster headache patients and, if so, to evaluate the effectiveness of active TrPs anaesthetic injections both in the acute and preventive headac...

The appendix is a tubular structure that arises from the cecum and consists primarily of smooth muscle and an abundance of lymphoid tissue. The average adult appendix can reach a length of 10 cm with a luminal width of 6 to 7 mm. Innerva­ tion from sympathetic and vagus nerves accounts for referred pain to the umbilicus when inflammatory changes are present. The location of the appendix (retroc...

Dry needling is a common treatment technique in orthopedic manual physical therapy. Although various dry needling approaches exist, the more common and best supported approach targets myofascial trigger points. This article aims to place trigger point dry needling within the context of pain sciences. From a pain science perspective, trigger points are constant sources of peripheral nociceptive ...

OBJECTIVE To investigate whether providing information about normal findings before a diagnostic test improves patients' reassurance and reduces anxiety about symptoms. DESIGN Randomised controlled trial. SETTING Outpatient cardiology clinic. PARTICIPANTS 92 patients with chest pain referred for a diagnostic exercise stress test. INTERVENTION Before undergoing testing patients were rand...

BACKGROUND Prevalence of pain as a recurrent symptom in children is known to be high, but little is known about children with high impairment from chronic pain seeking specialized treatment. The purpose of this study was the precise description of children with high impairment from chronic pain referred to the German Paediatric Pain Centre over a 5-year period. METHODS Demographic variables, ...