Biomedical subjects
Publications and source records attributed to P L Escobar.
Numbness and tingling in the ring and little fingers (fourth and fifth digits) is usually associated with a radiculopathy (C8) or compromise of a peripheral nerve (ulnar). The presence of a trigger point in the teres minor muscle may produce similar symptoms. Early diagnosis and appropriate treatment will save the patient unnecessary discomfort and reduce the use of sophisticated diagnostic testing.
Myofascial pain, a general descriptive term, is applied to painful sensations that extend along one or more skeletal muscles and their fascia. Trigger points, discrete hyperesthetic areas within the muscle and its fascia, are characteristically found in myofascial pain. On the other hand, myofascial pain syndrome is a painful condition characterized by the presence of trigger points, local and referred pain, tenderness, referred autonomic phenomena as well as anxiety and depression. Patients affected by myofascial pain, trigger points, or myofascial pain syndrome, represent a significant population group requesting services in the offices of general practitioners, orthopaedic surgeons, and physicians treating musculoskeletal disorders.
This review paper presents a summary of concepts, ideas, theories, symptoms, stages, diagnostic procedures, and treatment modalities of a syndrome causing significant disability in a large segment of the American population. Diagnosis and early treatment will prevent significant and devastating disability in those individuals afflicted with this syndrome.
Pain is an unpleasant, subjective experience which escapes objective measurements. It is the normal response to the disruption of healthy tissues, but its persistence beyond the period of healing should alert the practitioner to other unrecognized causes. On the other hand, learned pain is a condition resulting mainly from socio-emotional factors in the absence of progressive, invasive and, most of the time, demonstrable pathology. The key to success in the management of a painful condition is an accurate diagnosis followed by appropriate intervention and treatment. A complete history and a detailed physical examination, complemented by ancillary laboratory tests and consultations, when necessary, offer the best approach to initial management. This article discusses the pathophysiology of pain, the diagnostic approach and therapeutic interventions for evaluation and management of pain patients. The role of multiple factors as reinforcers of pain behavior deserves careful attention, and a comprehensive, multi-disciplinary approach may be indicated in selected cases.