Abstract
Background: Pain continues to be the main symptom reported by patients. Frequently, clinicians
incorrectly diagnose patients and resulting treatments are ineffective, which may
promote the development of chronic pain. This situation may arise as a result of a
lack of clarity in the literature regarding pain syndromes. Objective: To discuss the differences between nociceptive, neuropathic, and psychologic induction
of pain and provide important clinical correlates to aid in diagnosis and treatment.
Data Sources: The data were accumulated over a period of years by reviewing contemporary articles
and books and subsequently retrieving relevant papers. Articles also were selected
from MEDLINE searches and from manual library searches. Data Synthesis: Nociceptive pain syndromes are responsible for the majority of pain complaints in
clinical practice. Care must be taken to avoid the common mistake of the diagnosis
of neuropathic pain, which can lead to inappropriate treatments. Conclusions: Although the treatment of neuropathic pain is difficult, sufficient evidence in the
literature demonstrates that the treatment of nociceptive pain should be multimodal
and involve spinal manipulation, muscle lengthening/stretching, trigger point therapy,
rehabilitation exercises, electrical modalities, a variety of nutritional factors,
and mental/emotional support. (J Manipulative Physiol Ther 1999;22:458–72)
Keywords
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Article info
Publication history
Received in revised form:
July 8,
1998
Received:
March 23,
1998
Footnotes
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Identification
Copyright
© 1999 JMPT. Published by Elsevier Inc. All rights reserved.
