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Head and facial pain can be agonizing, whether it results from dental problems or from disorders such as cranial neuralgia, in which one of the nerves in the face, head, or neck is inflamed. Another condition, trigeminal neuralgia (also called tic douloureux), affects the largest of the cranial nerves and is characterized by a stabbing, shooting pain. Muscle pain can range from an aching muscle, spasm, or strain, to the severe spasticity that accompanies paralysis. Another disabling syndrome is fibromyalgia, a disorder characterized by fatigue, stiffness, joint tenderness, and widespread muscle pain. Polymyositis, dermatomyositis, and inclusion body myositis are painful disorders characterized by muscle inflammation. They may be caused by infection or autoimmune dysfunction and are sometimes associated with connective tissue disorders, such as lupus and rheumatoid arthritis. Myofascial pain syndromes affect sensitive areas known as trigger points, located within the body's muscles. Myofascial pain syndromes are sometimes misdiagnosed and can be debilitating. Fibromyalgia is a type of myofascial pain syndrome. Neuropathic pain is a type of pain that can result from injury to nerves, either in the peripheral or central nervous system. Neuropathic pain can occur in any part of the body and is frequently described as a hot, burning sensation, which can be devastating to the affected individual. It can result from diseases that affect nerves (such as diabetes) or from trauma, or, because chemotherapy drugs can affect nerves, it can be a consequence of cancer treatment. Among the many neuropathic pain conditions are diabetic neuropathy (which results from nerve damage secondary to vascular problems that occur with diabetes); reflex sympathetic dystrophy syndrome (see below), which can follow injury; phantom limb and post-amputation pain , which can result from the surgical removal of a limb; postherpetic neuralgia, which can occur after an outbreak of shingles; and central pain syndrome, which can result from trauma to the brain or spinal cord. Reflex sympathetic dystrophy syndrome, or RSDS, is accompanied by burning pain and hypersensitivity to temperature. Often triggered by trauma or nerve damage, RSDS causes the skin of the affected area to become characteristically shiny. In recent years, RSDS has come to be called complex regional pain syndrome (CRPS); in the past it was often called causalgia. Repetitive stress injuries are muscular conditions that result from repeated motions performed in the course of normal work or other daily activities. They include:
Sciatica is a painful condition caused by pressure on the sciatic nerve, the main nerve that branches off the spinal cord and continues down into the thighs, legs, ankles, and feet. Sciatica is characterized by pain in the buttocks and can be caused by a number of factors. Exertion, obesity, and poor posture can all cause pressure on the sciatic nerve. One common cause of sciatica is a herniated disc Shingles and other painful disorders affect the skin. Pain is a common symptom of many skin disorders, even the most common rashes. One of the most vexing neurological disorders is shingles or herpes zoster, an infection that often causes agonizing pain resistant to treatment. Prompt treatment with antiviral agents is important to arrest the infection, which if prolonged can result in an associated condition known as postherpetic neuralgia. Other painful disorders affecting the skin include:
Sports injuries are common. Sprains, strains, bruises, dislocations, and fractures are all well-known words in the language of sports. Pain is another. In extreme cases, sports injuries can take the form of costly and painful spinal cord and head injuries, which cause severe suffering and disability. Spinal stenosis refers to a narrowing of the canal surrounding the spinal cord. The condition occurs naturally with aging. Spinal stenosis causes weakness in the legs and leg pain usually felt while the person is standing up and often relieved by sitting down. Surgical pain may require regional or general anesthesia during the procedure and medications to control discomfort following the operation. Control of pain associated with surgery includes presurgical preparation and careful monitoring of the patient during and after the procedure. nociceptors-the endings of pain-sensitive nerves that, when stimulated by stress, muscular tension, dilated blood vessels, or other triggers, send messages up the nerve fibers to nerve cells in the brain, signaling that a part of the body hurts. ophthalmoplegic migraine-a form of migraine felt around the eye and associated with a droopy eyelid, double vision, and other sight problems. prostaglandins-naturally occurring pain-producing substances thought to be implicated in migraine attacks. Their release is triggered by the dilation of arteries. Prostaglandins are extremely potent chemicals involved in a diverse group of physiological processes. serotonin-a key neurotransmitter that acts as a powerful constrictor of arteries, reducing the blood supply to the brain and contributing to the pain of headache. sinusitis-an infection, either viral or bacterial, of the sinus cavities. The infection leads to inflammation of these cavities, causing pain and sometimes headache. sumatriptan-a commonly used migraine drug that binds to receptors for the neurotransmitter serotonin. status migrainosus-a rare, sustained, and severe type of migraine, characterized by intense pain and nausea and often leading to hospitalization of the patient. thermography-a technique sometimes used for diagnosing headache in which an infrared camera converts skin temperature into a color picture, called a thermogram, with different degrees of heat appearing as different colors. temporomandibular joint dysfunction-a disorder of the joint between the temporal bone (above the ear) and the lower jaw bone that can cause muscle-contraction headaches. tic douloureux-see trigeminal neuralgia traction headaches-headaches caused by pulling or stretching pain-sensitive parts of the head, as, for example, when eye muscles are tensed to compensate for eyestrain. trigeminal neuralgia-a condition resulting from a disorder of the trigeminal nerve. Symptoms are headache and intense facial pain that comes in short, excruciating jabs. vascular headaches- headaches caused by abnormal function of
the brain's blood vessels or vascular system. Migraine is a type of vascular
headache.
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