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Chronic Pain Syndrome Differential Diagnoses

  • Author: Manish K Singh, MD; Chief Editor: Stephen Kishner, MD, MHA  more...
 
Updated: May 13, 2016
 
 

Diagnostic Considerations

Musculoskeletal and neuropsychological disorders

Musculoskeletal and neuropsychological diseases to consider in the differential diagnosis of chronic pain syndrome (CPS) include the following:

  • Hernias (eg, obturator, sciatic, inguinal, femoral, perineal, spigelian, umbilical)
  • Neoplasia of the spinal cord or sacral nerves
  • Mononeuropathy and nerve entrapment
  • Abdominal epilepsy
  • Abdominal migraines
  • Pelvic floor pain syndrome
  • Rectus abdominis pain
  • Faulty posture and chronic pelvic pain
  • Bipolar disorders and depression
  • Chronic visceral pain syndrome
  • Chronic fatigue syndrome
  • Substance abuse

Reproductive system disorders

Conditions related to the reproductive system to consider in the differential diagnosis of CPS include the following:

  • Adenomyosis
  • Adhesions
  • Adnexal cysts
  • Cervical stenosis
  • Dyspareunia
  • Endocervical and endometrial polyps
  • Endometriosis and endosalpingiosis
  • Uterine leiomyomas
  • Ovarian retention syndrome
  • Ovarian remnant syndrome
  • Pelvic varicosities and pelvic congestion syndrome
  • Vulvodynia
  • Pelvic floor relaxation disorders
  • Accessory and supernumerary ovaries

Urinary system disorders

Urinary conditions to consider in the differential diagnosis of CPS include the following:

  • Chronic and recurrent urinary tract infections
  • Urolithiasis
  • Pelvic floor dysfunction
  • Urethral diverticulum
  • Chronic urethral syndrome

Gastrointestinal system disorders

GI conditions to consider in the differential diagnosis of CPS include the following:

  • Chronic intermittent bowel obstruction
  • Colitis
  • Chronic constipation
  • Diverticular disease
  • Inflammatory bowel disease
  • Irritable bowel syndrome
  • Peritoneal cysts

Other differentials

Other conditions to consider in the differential diagnosis of CPS include the following:

  • Lateral epicondylitis
  • Lumbar degenerative disk disease
  • Lumbar facet arthropathy
  • Lumbar spondylolysis and spondylolisthesis
  • Mechanical low back pain
  • Medial epicondylitis
  • Meralgia paresthetica
  • Mononeuritis multiplex
  • Morton neuroma
  • Myofascial pain
  • Neoplastic brachial plexopathy
  • Neoplastic lumbosacral plexopathy
  • Osteoarthritis
  • Osteoporosis and spinal cord injury
  • Piriformis syndrome
  • Plantar fasciitis
  • Radiation-induced brachial plexopathy
  • Radiation-induced lumbosacral plexopathy
  • Rotator cuff disease
  • Spasticity
  • Thoracic outlet syndrome
  • Traumatic brachial plexopathy
  • Trochanteric bursitis

Differential Diagnoses

 
 
Contributor Information and Disclosures
Author

Manish K Singh, MD Assistant Professor, Department of Neurology, Teaching Faculty for Pain Management and Neurology Residency Program, Hahnemann University Hospital, Drexel College of Medicine; Medical Director, Neurology and Pain Management, Jersey Institute of Neuroscience

Manish K Singh, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Pain Medicine, American Headache Society, American Association of Physicians of Indian Origin, American Medical Association, American Society of Regional Anesthesia and Pain Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Jashvant Patel, MBBS, MS, MD 

Jashvant Patel, MBBS, MS, MD is a member of the following medical societies: Alberta Medical Association, American Academy of Pain Medicine, American Academy of Physical Medicine and Rehabilitation, American Medical Association, American Society of Regional Anesthesia and Pain Medicine, Medical Society of the State of New York

Disclosure: Nothing to disclose.

Rollin McCulloch Gallagher, MD, MPH Clinical Professor, Departments of Psychiatry and Anesthesiology, Director for Health Policy and Primary Care, Penn Pain Medicine, University of Pennsylvania School of Medicine; National Program Director for Pain Management, Veterans Health Administration; Editor-in-Chief, PAIN MEDICINE

Rollin McCulloch Gallagher, MD, MPH is a member of the following medical societies: Academy of Psychosomatic Medicine, American Academy of Pain Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Milton J Klein, DO, MBA Consulting Physiatrist, Heritage Valley Health System-Sewickley Hospital and Ohio Valley General Hospital

Milton J Klein, DO, MBA is a member of the following medical societies: American Academy of Disability Evaluating Physicians, American Academy of Medical Acupuncture, American Academy of Osteopathy, American Academy of Physical Medicine and Rehabilitation, American Medical Association, American Osteopathic Association, American Osteopathic College of Physical Medicine and Rehabilitation, American Pain Society, Pennsylvania Medical Society

Disclosure: Nothing to disclose.

Chief Editor

Stephen Kishner, MD, MHA Professor of Clinical Medicine, Physical Medicine and Rehabilitation Residency Program Director, Louisiana State University School of Medicine in New Orleans

Stephen Kishner, MD, MHA is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine

Disclosure: Nothing to disclose.

Acknowledgements

Martin K Childers, DO, PhD Professor, Department of Neurology, Wake Forest University School of Medicine; Professor, Rehabilitation Program, Institute for Regenerative Medicine, Wake Forest Baptist Medical Center

Martin K Childers, DO, PhD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Congress of Rehabilitation Medicine, American Osteopathic Association, Christian Medical & Dental Society, and Federation of American Societies for Experimental Biology

Disclosure: Allergan pharma Consulting fee Consulting

Richard Salcido, MD Chairman, Erdman Professor of Rehabilitation, Department of Physical Medicine and Rehabilitation, University of Pennsylvania School of Medicine

Richard Salcido, MD is a member of the following medical societies: American Academy of Pain Medicine, American Academy of Physical Medicine and Rehabilitation, American College of Physician Executives, American Medical Association, and American Paraplegia Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

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