Common Pain Generating Conditions

This is a condition where the nerves or blood vessels that supply the upper extremity (arm) become compressed by cervical muscles or the upper ribs. Patients experiencing thoracic outlet syndrome may have pain, numbness, tingling, or a combination of these symptoms present in the upper extremity (arms, hands, fingers), often at night. Occasionally, thoracic outlet syndrome may mimic, or coexist with, conditions such as carpal tunnel syndrome. In cases such as this, the patient may be unresponsive to treatment of the carpal tunnel area, thus any time there are arm symptoms the shoulder/cervical region should be examined as well as the area of complaint.

This is a condition characterized by sharp pain on the sole of the foot that is present while stepping/weight bearing. Typically patients suffering from this condition feel their worst pain with the first few steps they take in the morning. This is due to the soft tissue structures of the foot contracting during sleep and then being stretched as the person takes their first steps of the morning. This condition is considered self-limiting in most cases, but can take 18 months or more to resolve without care.

These are tight tender bands within muscle fibers that generate a familiar pain to the patient. Occasionally, MFTP’s can refer pain, or strange sensations such as tingling to other parts of the body. For example MFTP’s in the muscles at the base of the skull (sub-occipital muscles) may generate headache pain that travels from the back of the head over the top of the skull and over the eye. Thus it is important for doctors to look at sites away from your area of pain, to determine if the source may be located elsewhere. MFTP’s are also common players in non-complicated shoulder pain.

As noted in the section on MFTP’s pain can be referred from one area of the body to another. Occasionally, muscle and joint type pain can be referred from internal sources. For example gallbladder issues may refer pain to the mid back area, and as many may know, heart attacks can refer pain to the jaw, arm (left or right), and chest. While this type of referral is less common, this is one reason why unrelenting pain that can’t be provoked by movements/muscle action should be examined by a trained physician.

This condition is classically characterized by lateral knee pain, and is often accompanied by tenderness over the lateral thigh especially near the knee. It occurs as a result of many musculoskeletal factors that lead to tension in the band of fascia that runs along the lateral thigh from the hip to the knee (the IT band). When the muscles of the hip and thigh generate tension in this band it can cause strain on the knee which may result in pain with walking, running, jumping, or other activities.

This is a very broad term as there are a number of structures that can become impinged within the shoulder and thus cause pain. Typically this presents as a condition that begins with no specific cause, and is most aggravated with overhead motions. Pain may be located in various aspects of the shoulder depending on what structures are being affected, but very commonly the front or sides are the sites of pain. This condition often develops due to muscular imbalance in terms of strength and activity. Impingement, if not treated, or rehabbed, can progress from an occasionally painful condition, to a chronic condition that may eventually lead to muscle damage or tendon rupture.