IDIOPATHIC PAIN

MODERATED BY :
DR C .SANTHI.
DR RAGHAVA KRISHNA.
PRESENTED BY
SAHITYA MPT 2ND YEAR
SABHITHA MPT 2ND YEAR
SANDHYA RANI MPT 1ST YR
SAMYKYA MPT 1ST YEAR
M GOVINDU NAIK MPT 1ST YR
IDIOPATHIC PAIN
 Introduction
 Idiopathic pain is long-term pain, lasting for more than 6
months, that has no obvious or detectable physical or
organic cause.

 The term itself is derived from the Greek: "idios"

meaning one's own, and "pathos," or suffering.

 Pain may be idiopathic, with an unknown origin, from

the outset. Or pain may become idiopathic over time—
for example, pain than remains long after an injury has
fully healed, with no remaining tissue or nerve damage
detected.
 There are several diseases that are idiopathic in some
sufferers, but have an obvious cause in other cases.

 Pain triggers do vary among patients.

 Treatments that work for some idiopathic pain patients,

don't work at all for others.[1,3,4]
 Idiopathic pain is incredibly frustrating for both the
sufferer and the doctors. The experience may be
characterized by:

1. Never-ending tests - A multitude of tests are made, yet

none give any idea of a cause or appropriate treatment.
2. Change in treatments - Treatments that did give some
relief, may stop working with no logical reason.
3. Disappearing symptoms - Even if the idiopathic pain
condition disappears, the doctors (and patient) have no
idea if it may return.
 There are many things that you can do and try to help
reduce your idiopathic pain
 Idiopathic pain conditions
 The following conditions and illnesses can be idiopathic -
they have no physical detectable cause, symptoms and
successful treatments vary among cases.

 Fibromyalgia syndrome (FMS) : widespread pain,

fatigue and,
cognitive problems.

 Ice-pick headaches : pain in the nerves of the eyes

 Fluid pressure in the brain : headaches,
dizziness and,
loss of vision
 Interstitial cystitis (IC) : urinary tract and,
bladder pain
 Interstitial pulmonary fibrosis (IPF) : chest pain,
cough, and
lack of breath
 Irritable bowel syndrome (IBS) : digestion pain

 Multiple sclerosis (MS) : pain,

fatigue,
tremor and more

 Peripheral neuropathy : numbness,

tingling and
pain in the nerves, not caused
by any damage or compression of the nerves
 Persistent idiopathic facial pain (PIFP) : stabbing or
burning pain in the face with no obvious nerve or tissue
damage

 Temporo-mandibular joint disorder (TMJD) : jaw pain and

headaches

 Vulvodynia - pelvic pain in women with no obvious

nerve, hormone, chemical, infection, or soft tissue cause
These are NOT idiopathic pain:
If you have the following conditions, you do not have
idiopathic pain, even though the underlying conditions
may be idiopathic :
 an injury or inflammation causing pain
 compressed or malfunctioning nerves causing pain,
numbness or tingling (neuromas or a stroke-damaged
central nervous system)
 a bacterial, viral or fungal infection causing fever and pain
 an obvious chemical or hormonal imbalance that can be
detected with a blood test, such as in many auto-immune
diseases
 period pain caused by endometriosis, adenomyosis,
fibroids or cysts
 headaches and migraines caused by tension or
constricted blood vessels
 back pain caused by inflammation, nerve compression,
soft tissue or bone damage
 post operative pain caused by irreversible nerve and soft-
tissue damage or inflammation
 Idiopathic pain is also not caused solely by depression,
although these two illnesses often occur together.
 Therefore many idiopathic pain patients do benefit from
depression treatment.
The search for the cause of idiopathic pain

Genome-sequencing companies and research groups,

such as Scripps and Cypher Genomics, are encouraging
patients with idiopathic pain and diseases to submit
samples in an effort to find common elements among
sufferers.
 Treating idiopathic pain
 Treatment for idiopathic pain uses many different
approaches. A combination of approaches and
treatments are often recommended.
. • Pain medication

• Psychological treatment and pain

management classes
• Physical therapies

• The aim is not to cure the idiopathic pain

, but to improve the quality of life and
reduce pain levels. So the sufferer can
get on with living.
Medications to manage
idiopathic pain
 Patients are often encouraged to trial different types of
medications to find the most simple and effective treatment,
with the fewest side-effects. However, effectiveness may
change in different situations and over time.
 Basic pain medications : paracetamol (acetominophen),
aspirin and,
ibuprofen.
 Strong pain medications :
Opioids (codeine, morphine, and others) are
recommended only for severe break-through pain, as these
are highly addictive and lose effectiveness over time.
 Strong NSAIDs are not recommended unless
significant inflammation is present.

 Muscle relaxants :
diazepam can be used to reduce the tension in
muscles which can aggravate a pain condition.

 Sleeping tablets - recommended when severe pain stops

patients from falling asleep.

 Anticonvulsants :
gabapentin and pregabalin can suppress the pain
response and pain-windup cycle.
 Anti-depressants :
amitriptyline is often recommended for chronic
muscular pain in addition to treating the depression
associated with chronic pain.

 In extreme cases, steroid injections and nerve-block

operations may be recommended to block pain
signals from nerves.
Lifestyle modifications for decreasing idiopathic pain
Many idiopathic pain sufferers struggle to maintain a
healthy lifestyle. However, a healthy diet, exercise,
relaxation and stress management help sufferers cope
with chronic pain.

HEALTHY HABITS
 healthy diet
 aerobic exercise
 flexibility and strength exercises
 posture improvement
 time management
 House hold organization
Stress management
 Meditation
 Cognitive therapy
 Journaling
 Yoga or tai chi
 Support system or support group
 Relaxing hobbies
 A healthy diet, rich with whole foods, vitamins and
minerals gives the body the nutrients it needs to
deal with the pain.
 Vitamin and mineral supplements may be recommended
to correct deficiencies, found in blood tests.

 Moderate exercise, flexibility and mobility training and

good posture often help reduce pain and increase the
ability to cope with pain.

 Stress reduction and positive psychology is extremely

important, as stress and distress amplifies pain.[1]
 Physical therapies treating
idiopathic pain
 Alexander technique - improves posture and may decrease
pain caused by tense muscles.

 Hydrotherapy or warm
water exercises – warms
muscles, calms nerves,
increases mobility and
fitness.
 Massage and myotherapy - calms the nerves and the
pain response to provide short term relief.
 Osteopathy - with more emphasis on the correct posture
during movement, osteopathy is a cross between
physiotherapy and massage.

 Physiotherapy - increases mobility and strength in joints

and muscles, which can decrease pain during
movement. McKenzie exercises may help with idiopathic
back pain.
 Alternative therapies for
idiopathic pain
 Many people who suffer idiopathic pain are ignored or
under-treated by traditional medical fields, and thus turn
to alternative therapies.

 They can be very expensive, as they are usually not

covered by health insurance, and are usually only for
short term relief.

 My rule of thumb: if it works, is legal, and does no harm,

then by all means use it!
Hypnosis or hypnotherapy
 Hypnosis may help patients change bad habits, learn to
relax and stress less, which can result in lowered pain.

 Supplements : Vitamin and mineral supplements may

provide pain relief by fixing deficiencies, detectable using
blood tests.
In particular, vitamin D levels are often low in chronic
pain patients.
 TENS - Transcutaneous electrical nerve
stimulation (TENS)

 sends electrical impulses to nearby nerves in a small

area and may shut down (or increase) the pain
response for a short time.

 Acupuncture - The small amount of local pain stimulates

the nerves, and may quieten (or increase) the pain
response in the brain.

 Aromatherapy - Pleasant scents may be useful to

provide relaxation and distract from pain. Essential oils
can be inhaled or applied to the skin in a carrier oil.
 Chiropractic adjustment - Adjusting the alignment of
joints, outside their normal range of motion, can
decrease pressure on nerves and soft tissue in the short
term, but can also cause damage.

 Homeopathy - The extremely dilute cures used in

homeopathy have no medical basis, however, they may
work as a placebo.
 References
 Idiopathic pain disorders--pathways of vulnerability, L
Diatchenko, et.al., Pain, August 2006, 123(3):226-30
 Chronic Idiopathic Pain Syndrome, Z.J. Lipowski, Annals
of Medicine, 1990 22(4):213-7
 Lack of analgesic effect of opioids on neuropathic and
idiopathic forms of pain, S. Arnér and B.A. Meyerson,
Pain, April 1988, 33(1):11-23
 Clomipramine and mianserin in chronic idiopathic pain
syndrome, D. Loldrup, et.al., Psychopharmacology, 1989
99(1):1-7