The medical history (history of illness) represents an important component in the diagnosis of chronic pain. Family history What is the general health of your family members? Social history What is your profession? Is there any evidence of psychosocial stress or strain due to your family situation? Current medical history/systemic history (somatic and psychological complaints). … Chronic Pain: Medical History
Diseases that can lead to chronic pain include: Endocrine, nutritional, and metabolic diseases (E00-E90). Fabry disease (synonyms: Fabry disease or Fabry-Anderson disease) – X-linked lysosomal storage disease due to a defect in the gene encoding the enzyme alpha-galactosidase A, resulting in progressive accumulation of the sphingolipid globotriaosylceramide in cells; mean age of manifestation: 3-10 years; … Chronic Pain: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by chronic pain: Psyche – Nervous System (F00-F99; G00-G99). Depression Insomnia (sleep disturbances) – up to 80% of patients with chronic pain. Symptoms and abnormal clinical and laboratory parameters not elsewhere classified (R00-R99). Cachexia (emaciation; very severe emaciation). Tendency to fall … Chronic Pain: Complications
Graduation of chronic pain according to von Korff et al. Grade Description 0 No pain (no pain in the past six months) I Pain with low pain-related functional impairment and low intensity (pain intensity <50 and less than 3 points of pain-related impairment) II Pain with low pain-related functional impairment and higher intensity: (pain intensity … Chronic Pain: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin and mucous membranes Auscultation (listening) of the heart Auscultation of the lungs Palpation (palpation) of the abdomen (abdomen) (tenderness?, knocking pain?, coughing pain?, defensive tension?, hernial orifices?, kidney … Chronic Pain: Examination
Laboratory diagnostics depends on the extent and localization of pain or the underlying disease. 2nd order laboratory parameters – depending on the results of the history, physical examination – for differential diagnostic clarification. Small blood count Differential blood count CRP (C-reactive protein) Borrelia antibodies (IgG, cerebrospinal fluid/serum) Yersinia antibodies (IgA, IgG, IgM) Calcium (e.g., due … Chronic Pain: Lab Test
Medical device diagnostics are based on the exact extent and location of the pain or the underlying condition. Optional medical device diagnostics – depending on the results of the history, physical examination, and obligatory laboratory parameters – for differential diagnostic clarification X-rays of the spine, ribs, etc. – if bony cause is suspected. Abdominal sonography … Chronic Pain: Diagnostic Tests
The following symptoms and complaints may co-occur with chronic pain:Leading symptom. Pain that lasts longer than six months or recurs (keeps coming back). Associated symptoms Sensory disturbances (disturbances of sensation) Motor impairments (limitations of mobility) Reduction in strength Neuropathic pain (NPS): burning, stabbing pain + sensitivity disturbances in the pain area.
Therapy for chronic pain depends on the cause. General measures Sufficient sleep (7-9 hours every night) improves pain tolerance, i.e. leads to less pain sensation! Exercise regularly during the day, but avoid intense exercise after 6:00 p.m.Physical activity and exercise in adult chronic pain significantly improves physical function. Nicotine restriction (refrain from tobacco use) – … Chronic Pain: Therapy
