RT Book, Section A1 Hamid, Basem A2 Longnecker, David E. A2 Brown, David L. A2 Newman, Mark F. A2 Zapol, Warren M. SR Print(0) ID 56657316 T1 Chapter 90. Common Pain Syndromes T2 Anesthesiology, 2e YR 2012 FD 2012 PB The McGraw-Hill Companies PP New York, NY SN 978-0-07-178513-6 LK accessanesthesiology.mhmedical.com/content.aspx?aid=56657316 RD 2024/03/28 AB Central sensitization is a cardinal element of chronic pain syndromes. Targeting factors contributing to this process is the cornerstone of managing chronic pain.Chronic pain has a complex pathophysiology. Treatment should be multidisciplinary and aim for functional restoration.Myofascial pain syndromes are characterized by the presence of trigger points, which have distinctive features that differentiate them from tender points.Fibromyalgia is increasingly diagnosed. It is characterized by widespread pain and the presence of specific tender points. Multiple effective pharmacologic agents are now available.Osteoarthritis (OA) is the most common joint disorder, is one of the most common chronic diseases in the elderly, and is a leading cause of disability. Certain measures may help prevent or slow the progression of OA. Conservative management options may delay or eliminate the need for surgery.Tricyclic antidepressants, serotonin reuptake inhibitors, and antiepileptic drugs, especially calcium channel modulators, are considered good first-line options for treatment of most neuropathic pain syndromes.Treatment of complex regional pain syndrome remains controversial but should start early and focus on mobility of the affected limb. Sympathetic blocks and multimodality analgesia help facilitate this. In advanced cases, more invasive options may be needed such as spinal cord stimulation or intrathecal analgesia.Neck and back pain can be generated by a variety of different anatomic structures, which are targeted in the treatment plan. A careful history and physical examination along with imaging data will help reach the most specific pain generator, which should be targeted in the treatment plan instead of following a blind approach to target all potential generators.Headache syndromes are numerous. The International Headache Society guidelines make the diagnosis of different headache syndromes easy and simple.Tension and migraine headache are the most common primary headache. Preventative therapy is essential to their management.