The pharmacologic approach in differential diagnosis of chronic pain.
Chronic pain of unknown cause below waist level was evaluated in 100 patients by using the Differential Spinal Block (DSB) in a multidisciplinary pain clinic setting. The classic DSB approach, refined for better control of psychologic variables, was found to be a safe and effective means of differentiating various pain mechanisms. We found that, of all patients tested, 55% had pain of central or psychogenic origin and 30% had sympathetically mediated pain, as compared with 15% who had somatic pain. A long-term follow-up of these patients confirmed this impression. These results substantiated the importance of psychologic variables, in dicating the necessity for use of behavioral-based therapies in conjunction with the routine use of the refined diagnostic DSB procedure in patients with chronic pain.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001416:Back Pain / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D001521:Behavior Therapy; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007866:Leg; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D010146:Pain / Q000175:diagnosis* / Q000523:psychology; D059408:Pain Management; D011602:Psychophysiologic Disorders / Q000175:diagnosis