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Deep Tissue Hyperalgesia
Published in Robert M. Bennett, The Clinical Neurobiology of Fibromyalgia and Myofascial Pain, 2020
Lars Arendt-Nielsen, Thomas Graven-Nielsen
Referred pain has been known and described for more than a century and has been used extensively as a diagnostic tool in the clinic. Head initially used the term referred tenderness and pain in 1893 (56). It has since then been used to describe pain perceived at a site adjacent to or at a distance from the site of origin. The taxonomy committee of the International Association for the Study of Pain has not made a definition of the term. However, several authors have defined it in different ways. In this paper, the definition “pain felt at a site remote from the site of origin/stimulation” will be used.
Breastfeeding complications
Published in Amy Brown, Wendy Jones, A Guide to Supporting Breastfeeding for the Medical Profession, 2019
Any discomfort at the nipple, whether from infection or attachment, can result in deeper breast pain. Referred pain may even be experienced in the shoulders or back. Mothers may be unaware than the milk ejection reflex (or ‘let-down’) can result in some sharp pains at the start of a feed. This usually becomes less severe over time.
Pain
Published in Laurie K. McCorry, Martin M. Zdanowicz, Cynthia Y. Gonnella, Essentials of Human Physiology and Pathophysiology for Pharmacy and Allied Health, 2019
Laurie K. McCorry, Martin M. Zdanowicz, Cynthia Y. Gonnella
Referred pain is felt in a part of the body that is different from the actual tissue causing the pain. Typically, the pain is initiated in a visceral organ or tissue and referred to an area of the body surface. Classic examples of referred pain include headache and angina. Interestingly, the brain itself does not contain nociceptors. Therefore, the pain perceived as a headache originates in other tissues, such as the eyes, sinuses, muscles of the head and neck, and the meninges. Angina, or chest pain, is caused by coronary ischemia. It may be accompanied by pain referred to the neck, left shoulder and left arm.
Treatment of thoracic spine pain and pseudovisceral symptoms with dry needling and manual therapy in a 78-year-old female: A case report
Published in Physiotherapy Theory and Practice, 2022
Dry needling has been shown to be effective in the immediate reduction in local, referred, and widespread pain (Affaitati et al., 2011; Castro-Sánchez et al., 2017; Dommerholt, 2011; Hsieh et al., 2007; Lewit, 1979) and the restoration of range of motion and muscle activation patterns (Lucas, Polus, and Rich, 2004; Lucas, Rich, and Polus, 2010). Dry needling has been found to be effective in relieving pain caused by myofascial trigger points (Espejo-Antunez et al., 2017; Tekin et al., 2013) in the low back (Liu et al., 2018) neck, and shoulder (Liu et al., 2018) and can also improve range of motion of the: cervical spine (Llamas-Ramos et al., 2014; Mejuto-Vázquez et al., 2014); temporomandibular joint (Fernández-Carnero et al., 2010; Gonzalez-Perez, Infante-Cossio, Granados-Nunez, and Urresti-Lopez, 2012); and shoulder (Clewley, Flynn, and Koppenhaver, 2014; Osborne and Gatt, 2010). Other than the case studies mentioned previously, there is no research demonstrating the effect of dry needling on thoracic pain or range of motion. Since dry needling has been found to be effective in the low back and neck, it was felt it would be effective in thoracic spine as well. In this case, the author utilized dry needling and manual therapy and exercise to reduce thoracic and referred pain caused by myofascial trigger points and to restore thoracic ROM and muscle activation in the thoracic area.
The association between myofascial orofacial pain with and without referral and widespread pain
Published in Acta Odontologica Scandinavica, 2022
Anna Lövgren, Corine M. Visscher, Frank Lobbezoo, Negin Yekkalam, Simon Vallin, Anders Wänman, Birgitta Häggman-Henrikson
In accordance with the DC/TMD and following the International Classification of Orofacial Pain, ICOP [25], myofascial orofacial pain was considered present when the following criteria were fulfilled: self-reported pain within the last 30 days, pain modified by function, and pain confirmed to the masseter or temporal muscles by the examiner together with familiar pain confirmed during jaw movement or muscle palpation during the clinical examination. In a second step, pain referral was considered present in the case of concurrent referred pain outside the muscle border during a 5-second muscle palpation. Based upon these criteria, all individuals were categorized into three groups; no myofascial pain (controls), myofascial pain without referral or myofascial pain with referral, respectively.
Sterile water injections for management of renal colic pain: a systematic review
Published in Scandinavian Journal of Urology, 2022
The analgesic effect of SWI is thought to be based on the mechanisms of counter-irritation [19,20], the noxious stimulation, tissue distension and increased osmotic pressure of SWI triggers pain gate-control cells within the dorsal horn and the stimulation of endorphins suppressing the transmission from pain receptor neurons within the spinal cord [21,22]. This has led to it being described as using ‘referred stimulation’ to relieve referred pain [23]. The effect of SWI suggests a strong referred component of renal colic pain. A number of theories have suggested for the phenomenon of referred pain largely based on the concept of nociceptive dorsal horn neurons receiving convergent inputs from various tissues though many of these theories do not explain particular features of referred pain such as the time delay between the original stimulus and the perceived pain [24]. The quantum tunneling of potassium ions and the time taken for the frequency of action potentials referred to neurons to increase to the point where pain is experienced has been theorised to contribute to the time delay characteristic of referred pain [25]. Interestingly, Di Maio [8] reported that injections of ‘twice distilled water’ given at painful trigger points provided almost complete relief from renal colic pain; however, when this was given for pain associated with congenital hydronephrosis or chronic pyelonephritis the pain relief lasted only a few minutes, suggesting a different pain pathway in these conditions.