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Arthralgia / Joint Pain

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Arthralgia is pain in one or more of your joints. The pain may be described as sharp, dull, stabbing, burning or throbbing, and may range in intensity from mild to severe. There are many causes of arthralgia, including injury, infection, arthritis, and other ailments. The most common cause is arthritis, which is inflammation of the joints. There are many different types of arthritis.

Arthralgia. Health Grade. https://www.healthgrades.com/conditions/arthralgia

Chronic Pain

Chronic pain is pain that persists over time, lasting longer than six months. It occurs when pain signals keep firing in the nervous system for weeks, months, or even years. Chronic pain can be mild or excruciating, episodic or continuous, merely inconvenient or totally incapacitating. Common chronic pain complaints include headache, low back pain, cancer pain, arthritis pain, neurogenic pain, or psychogenic pain, etc. Generalized muscle or nerve pain can also develop into a chronic condition. Chronic pain may originate with an initial trauma/injury or infection, or there may be an ongoing cause of pain.

In some people, who have long-lasting chronic pain, biochemical changes are triggered in the body, causing a different type of chronic pain (neuropathic pain) that doctors currently find difficult to diagnose and treat. Pain signals are somehow triggered by the nervous system and continue to fire for months or even years. (It is also possible that certain brain chemicals that suppress pain do not work properly.) Regardless of the cause, chronic pain syndrome affects all aspects of your life, straining relationships and making it difficult to keep up with work and home responsibilities.

The emotional toll of chronic pain can also make pain worse. Anxiety, stress, depression, anger, and fatigue interact in complex ways with chronic pain and may decrease the body’s production of natural painkillers; moreover, such negative feelings may increase the level of substances that amplify sensations of pain, causing a vicious cycle of pain for the person. Even the body’s most basic defenses may be compromised: There is considerable evidence that unrelenting pain can suppress the immune system. Because of the mind-body links associated with chronic pain, effective treatment requires addressing psychological as well as physical aspects of the condition.

The symptoms of chronic pain include:

  • Mild to severe pain that does not go away;
  • Pain that may be described as shooting, burning, aching, or electrical; and
  • The feeling of discomfort, soreness, tightness, or stiffness.

Pain is not a symptom that exists alone. Other problems associated with pain can include:

  • Fatigue;
  • Sleeplessness;
  • Withdrawal from activity and increased need to rest;
  • Weakened immune system;
  • Changes in mood including hopelessness, fear, depression, irritability, anxiety, and stress; and
  • Disability

What is Chronic Pain and what are the Symptoms. WebMD (May 23, 2018), https://www.webmd.com/pain-management/guide/understanding-pain-management-chronic-pain#1

Chronic Pain Syndrome (CPS)

Chronic pain syndrome (CPS) is a common problem that presents a major challenge to healthcare providers because of its complex natural history, unclear etiology, and poor response to therapy. CPS is a constellation of syndromes and is managed best with a multidisciplinary approach, requiring good integration and knowledge of multiple organ systems. CPS can affect patients in various ways. Major effects in the patient’s life are depressed mood, poor-quality or nonrestorative sleep, fatigue, reduced activity and libido, excessive use of drugs and alcohol, dependent behavior, and disability out of proportion with impairment. CPS may lead to prolonged physical suffering, marital or family problems, loss of employment, and various adverse medical reactions from long-term therapy.

Common chronic pain complaints include headache, low back pain, cancer pain, arthritis pain, neurogenic pain, or psychogenic pain. There are often musculoskeletal disorders associated with chronic pain including osteoarthritis, degenerative joint disease, spondylosis, and rheumatoid arthritis. Other associated complaints include Lyme disease, disc herniation, fractures of the lumbar vertebrae, poor posture, fibromyalgia, low back pain, muscle sprains and strains, pelvic floor myalgia, and several other painful conditions.

Approximately 35% of Americans have some element of chronic pain, and approximately 50 million Americans are disabled partially or totally due to chronic pain.

Singh, Manish K., M.D. Chronic Pain Syndrome. MedScape, https://emedicine.medscape.com/article/310834-overview


Myalgia is the medical term for muscle pain. Muscle pain originates in any of the muscles in the body. Muscle pain may arise due to injury or overexertion, infections of the soft tissues, or inflammatory conditions. A number of conditions can be associated when generalized aches and pain, such as influenza, that are perceived to be muscle pain. Muscle pain can be localized to one muscle group or diffuse, involving multiple muscle groups. Muscle pain due to injury or overuse is most commonly localized to one area. Depending upon the cause, muscle pain can be mild or severe and debilitating. Muscle pain is the hallmark symptom of some chronic conditions like fibromyalgia. Related symptoms that can occur with muscle pain are tenderness, swelling, redness, or fever.

Melissa Conrad Stoppler, M.D., Muscle Pain (Myalgia): Symptoms and Signs, Medicine Net (updated Mar. 2, 2017), https://www.medicinenet.com/muscle_pain_myalgia/symptoms.htm

Myofascial Pain

Myofascial pain syndrome is a condition that typically occurs after a muscle has been contracted repetitively. The pressure on sensitive points in your muscles (trigger points) causes pain in the muscle and sometimes in seemingly unrelated parts of your body (referred pain). This can be caused by repetitive motions used in jobs hobbies, or by stress-related muscle tension.

Symptoms include deep, aching pain in a muscle, pain that persists or worsens, a tender knot in a muscle, difficulty sleeping due to pain. Factors that may increase the risk of myofascial pain include muscle injury or stress and anxiety.

Some research suggests myofascial pain may develop into fibromyalgia.

Myofascial Pain Syndrome. Mayo Clinic. February 1, 2018. https://www.mayoclinic.org/diseases-conditions/myofascial-pain-syndrome/symptoms-causes/syc-20375444.

Neuropathic Pain Syndrome (Neurogenic Pain)

Neuropathic pain syndrome is a condition of autonomic hyperactivity that can be caused by a number of diseases and injuries such as alcoholism, HIV/AIDS, amputation, diabetes, multiple sclerosis, herniated disks, shingles, etc.

Symptoms include shooting and burning pain as well as tingling and numbness.

Neuropathic Pain Management. WebMD. https://www.webmd.com/pain-management/guide/neuropathic-pain#1

Vertebrogenic Pain Syndrome

Vertebrogenic pain syndrome can differ in their intensity of back pain and may differ in treatments as well. Back pain caused by a lesion of bone and muscle or nervous system can be grouped into this category. Causes are based on irritation of the painful receptors of the spine, tension and compression of sensitive roots, as well as their ischemia and edema. The source of pain in the spice can be spindologic pain, in the heart area against the background of diseases in the vertebral column, or due to pressure of the surface muscle of the back.

Vertebrogenic Pain Syndrome and Its Treatment. Doctors Ask. https://doctorsask.com/vertebrogenic-pain-syndrome-and-its-treatment .

Vulvar Vestibulitis

Vulvar vestibulitis is pain that is localized to the vestibulum (opening) of the vulva and is sometimes referred to as vestibulodynia. While there is not clear cause of vulvar vestibulitis there are a number of factors believed to contribute to symptomology. These include viruses (such as HPV), fungi causing candidiasis, muscular disorders causing muscle spasms and increased tone, and for patients with a long-standing diagnosis there is often an association with psychological symptoms. Vulvar vestibulitis may present as bright red inflammatory spots on the vestibular glands, slight redness and/or evidence of a raw area on the vulva, and ulcers in rare cases. Vulvar vestibulitis can be broken down into two classifications

i. Primary Vulvar Vestibulitis

Symptoms develop from the start of sexual activity or through the time duration it takes to insert a tampon. Speculum examination tends to be painful as well especially for women who have not had any form of sexual activity to date.

ii. Secondary Vulvar Vestibulitis

Symptoms are brought on by the same triggers as primary vulvar vestibulitis but there is a delay between the onset of symptoms and the trigger.

Vulvar Vestibulitis . Vulvar.org

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