Morton's neuroma is a benign fibrotic thickening of a plantar interdigital nerve that is a response to irritation. Also known as Morton's metatarsalgia, Morton's entrapment, interdigital neuroma, intermetatarsal neuroma, and interdigital nerve compression syndrome, it is not a true neuroma, as the condition is a degenerative process rather than a neoplastic process. The mean age at presentation is 55 years. It is 4-15 times more common in women than in men.
Post-herpetic neuralgia occurs when the pain associated with shingles becomes chronic. Definitions of post-herpetic neuralgia differ in terms of the time of onset and duration of pain, and this has resulted in difficulty estimating the prevalence of the disease. One source estimates that approximately 20% of people older than 50 years will develop post-herpetic neuralgia, despite antiviral treatment beginning within 72 hours of rash onset.
The terms adhesive capsulitis, frozen shoulder and periarthritis have been used for patients with shoulder pain and mobility deficits. Adhesive capsulitis is defined as having at least 1 month of shoulder pain, an inability to lie on the affected side, and restricted active and passive shoulder motion in 3 or more planes.
Iliotibial band syndrome is a common source of knee pain. The most common symptom is lateral knee pain caused by inflammation of the distal portion of the iliotibial band. Occasionally, however, the iliotibial band becomes inflamed at its proximal origin and causes referred hip pain. The iliotibial band is a thick band of fascia that crosses the hip joint and extends distally to insert on the patella, tibia, and biceps femoris tendon.
Shoulder pain is defined as chronic when it has been present for longer than six months. Common conditions that can result in chronic shoulder pain include rotator cuff disorders, adhesive capsulitis, shoulder instability, and shoulder arthritis. Rotator cuff disorders include tendinopathy, partial tears, and complete tears.
Occipital neuralgia is defined as a paroxysmal shooting or stabbing pain in the distribution of the greater or lesser occipital nerves accompanied by diminished sensation or dysesthesia in the affected area. The pain originates in the suboccipital region and radiates over the vertex. A suggestive history and clinical examination with short-term pain relief after infiltration with local anesthetic confirm the diagnosis.
Diabetes is a worldwide epidemic, and associated neuropathy is its most costly and disabling complication. Painful diabetic neuropathy is a common condition that will only increase as the diabetes epidemic grows. All physicians need to be aware of this under-recognized condition. Given the rising prevalence of painful diabetic neuropathy, it is increasingly important that we understand the best ways to diagnose and treat this condition. Diagnostic tests in this field are evolving rapidly.
Epicondylitis is one of the most common elbow problems in adults, occurring both laterally and medially. Medial epicondylitis of the elbow, commonly referred to as 'golfer's elbow,' is characterized by pathologic changes to the musculotendonous origin at the medial epicondyle.
Achilles tendinitis exists along the spectrum of peritendinitis to tendinosis or tendinopathy. This is a painful, swollen, and tender area of the Achilles tendon and peritenon usually secondary to repetitive activity or overuse.
Chronic pelvic pain can be defined as intermittent or constant pain in the lower abdomen or pelvis of at least 6 months in duration, not occurring exclusively with menstruation or intercourse and not associated with pregnancy. It is a symptom not a diagnosis. Chronic pelvic pain presents in primary care as frequently as migraine or low-back pain and may significantly impact on a woman’s ability to function.
Trochanteric bursitis is a term used to describe chronic, intermittent pain accompanied by tenderness to palpation overlying the lateral aspect of the hip. First described by Stegemann in 1923, trochanteric bursitis has been referred to as the "Great Mimicker" because it is frequently mistaken for other conditions. Yet, the term 'trochanteric bursitis' may in fact be a misnomer given that three of the cardinal symptoms of inflammation, erythema, edema and rubor are uncommon.
Approximately 96% of all groin hernias are inguinal hernias, with the remaining 4% being femoral. Hernias are bilateral in 20% of cases. The most common abdominal wall hernia is an inguinal hernia with a male to female preponderance of 9 to 1. Femoral hernias are more common in women.
Intercostal neuralgia refers to a neuropathic condition involving the intercostal nerves, manifesting as intense dysesthetic pain, e.g., sharp, shooting, or burning in quality. The pain is localized to one or more of the intercostal spaces. Because the pain can span the chest or upper abdomen, afflicted patients may become alarmed about the possibility of having an underlying serious condition from a visceral origin, e.g., myocardial infarction or gallbladder-related pain, and thus may be apt to solicit medical attention.
Piriformis syndrome is an elusive clinical entity. It is likely that this condition is overlooked and overdiagnosed with equal propensity. It is characterized by buttock pain with a variable component of sciatic nerve irritation and probably represents the most common cause of extraspinal sciatica. Systematic clinical assessment will generally lead to the correct diagnosis.
Chronic abdominal wall pain occurs in about 10–30% of patients presenting with chronic abdominal pain. Entrapment of abdominal cutaneous nerves at the lateral border of the rectus abdominis muscle has been attributed as a cause of abdominal pain. Chronic abdominal wall pain is frequently misdiagnosed asarising from a visceral source, often resulting in inappropriate diagnostic testing and unsatisfactory treatment.
The relationship between the sacroiliac joint (SIJ) and low back pain has been a subject of much debate with some researchers regarding SIJ pain as a major contributor to the low back pain problem, with others regarding it as unimportant or irrelevant. The sacroiliac joint has been shown to be a source of pain in 10% to 27% of suspected cases with chronic low back pain utilizing controlled comparative local anesthetic blocks.
Osteoarthritis is the most prevalent form of arthritis, with an associated risk of mobility disability (defined as needing help with walking or climbing stairs) for those with affected knees being greater than that due to any other medical condition in people aged ≥ 65. Osteoarthritis of the knee causes pain, limits activity, and impairs quality of life. The societal burden (both in terms of personal suffering and use of health resources) is expected to increase with the increasing prevalence of obesity and the ageing of the community.
Phantom-limb pain is a common sequela of amputation, occurring in up to 80% of people who undergo the procedure. It must be differentiated from non-painful phantom phenomena, residual-limb pain, and non-painful residual-limb phenomena. Central changes seem to be a major determinant of phantom-limb pain; however, peripheral and psychological factors may contribute to it.
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