Regional Pain Syndromes

Regional pain syndromes (1,2), which occur one time or another in most people past the age of 40 years, are central to primary care medicine. They are also fairly frequent in younger people; however, their true frequency and characteristics in the pediatric group have yet to be defined.

Because regional pain syndromes are so diverse and ubiquitous, simplistic attempts at classification are not applicable. It is more effective to pose the clinical problem according to region and syndrome, discuss differential diagnosis, review the need for imaging or other diagnostic documentation, and tailor a treatment program on the basis of what is known about the natural course of the syndrome.

For most regional pain syndromes, treatment is empirical and extrapolated from pathophysiology rather than based on hard science; nevertheless, there is a growing mass of reliable data that will be commented on where applicable in this review. The articles reviewed in this section are common regional pain syndromes affecting the upper and lower extremities, emphasizing diagnosis, treatment, and circumstances in which referral is advisable. A few less common, but more serious, conditions are also described.

Juan J. Canoso   (www.rheumatology.org/publications/primarycare)

<!--[if !supportLists]-->1.    <!--[endif]-->Canoso JJ. Rheumatology in primary care. Philadelphia: WB Saunders; 1997.

<!--[if !supportLists]-->2.    <!--[endif]-->Teitz CC, Garrett WE Jr, Miniaci A, Lee MH, Mann RA. Tendon problems in athletic individuals. J Bone Joint Surg Am 1997;79A:138-52.