Chronic Pain Syndrome Differential Diagnoses

Updated: Feb 22, 2018
  • Author: Manish K Singh, MD; Chief Editor: Stephen Kishner, MD, MHA  more...
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DDx

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