Overview
What is chronic pain syndrome (CPS)?
What complications are associated with chronic pain syndrome (CPS)?
What is involved in the diagnosis and treatment of chronic pain syndrome (CPS)?
Which urologic disorders are associated with chronic pain syndrome (CPS)?
What causes chronic pain syndrome (CPS)?
Which musculoskeletal disorders are associated with chronic pain syndrome (CPS)?
Which neurological disorders are associated with chronic pain syndrome (CPS)?
Which GI disorders are associated with chronic pain syndrome (CPS)?
Which reproductive disorders are associated with chronic pain syndrome (CPS)?
Which psychological disorders are associated with chronic pain syndrome (CPS)?
What other disorders are associated with chronic pain syndrome (CPS)?
What is the risk of fibromyalgia associated with chronic pain syndrome (CPS)?
What is involved in patient education for chronic pain syndrome (CPS)?
Presentation
What are Sternbach's 6 D's of chronic pain syndrome (CPS)?
What is the focus of the history in suspected chronic pain syndrome (CPS)?
How is pain perception measured in the clinical history for chronic pain syndrome (CPS)?
Which physical exam findings are consistent with chronic pain syndrome (CPS)?
DDX
What other differentials should be considered in the diagnosis of chronic pain syndrome (CPS)?
What are the differential diagnoses for Chronic Pain Syndrome?
Workup
Which imaging studies are indicated in the workup of chronic pain syndrome (CPS)?
What are the approach considerations in the workup of chronic pain syndrome (CPS)?
Treatment
What are the approach considerations in the treatment of chronic pain syndrome (CPS)?
Which behaviors in patients with chronic pain syndrome (CPS) merit caution?
What is involved in the care of chronic pain syndrome (CPS)?
What is involved in a physical therapy (PT) program for chronic pain syndrome (CPS)?
How effective is a physical therapy (PT) program in the treatment of chronic pain syndrome (CPS)?
What are the benefits of heat and cold therapy in the treatment of chronic pain syndrome (CPS)?
What are the benefits of occupational and recreational therapy for chronic pain syndrome (CPS)?
When is vocational therapy indicated for chronic pain syndrome (CPS)?
When are nerve blocks indicated for the treatment of chronic pain syndrome (CPS)?
When is spinal cord stimulation indicated for the treatment of chronic pain syndrome (CPS)?
What is involved in psychophysiologic therapy for chronic pain syndrome (CPS)?
How effective is psychophysiologic therapy for chronic pain syndrome (CPS)?
Which specialist consultations are indicated in the treatment of chronic pain syndrome (CPS)?
Medications
How is drug treatment used for chronic pain syndrome (CPS)?
How can patients with chronic pain syndrome (CPS) avoid opioid abuse?
What are the rates of medication use by adolescents with chronic pain syndrome (CPS)?
Which medications are used in the treatment of chronic pain syndrome (CPS)?
Which medications in the drug class Analgesics are used in the treatment of Chronic Pain Syndrome?
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Sagittal magnetic resonance imaging (MRI) scan of the cervical spine in a patient with cervical radiculopathy. This image reveals a C6-C7 herniated nucleus pulposus.
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Axial magnetic resonance imaging (MRI) scan of the cervical spine in a patient with cervical radiculopathy. This image reveals a C6-C7 herniated nucleus pulposus.
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Osteoarthritis of the knee, Kellgren stage III.
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Nerve irritation in the herniated disk occurs at the root (sciatic radiculitis). In piriformis syndrome, the irritation extends to the full thickness of the nerve (sciatic neuritis).
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Changes in the hand caused by rheumatoid arthritis. Photograph by David Effron MD, FACEP.
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Oblique view of the cervical spine demonstrates 2 levels of foraminal stenosis (white arrows) resulting from facet hypertrophy (yellow arrow) and uncovertebral joint hypertrophy.
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T1-weighted sagittal magnetic resonance imaging (MRI) scan of the cervical spine in a patient with rheumatoid arthritis shows basilar invagination with cranial migration of an eroded odontoid peg. There is minimal pannus. The tip of the peg indents the medulla, and there is narrowing of the foramen magnum, due to the presence of the peg. Inflammatory fusion of several cervical vertebral bodies is shown.
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Schematic anatomical representations, sympathetic chain and stellate ganglion.
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Stellate block, important anatomical landmarks (surface and cross-sectional views).
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Pertinent anatomy for lumbar sympathetic block (cross-sectional view).
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Severe colitis noted during colonoscopy. The mucosa is grossly denuded, with active bleeding noted. This patient had her colon resected very shortly after this view was obtained.
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Active endometriosis with red and powder-burn lesions; adhesions from old scarring are present.