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:
 Never-ending tests - A multitude of tests are
made, yet none give any idea of a cause or
appropriate treatment.
 Change in treatments - Treatments that did give
some relief, may stop working with no logical
reason.
 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:

 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.
 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.
 Treating idiopathic pain
 Treatment for idiopathic pain uses many different
approaches. A combination of approaches and
treatments are often recommended.[1,2]
 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 as 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
 Journalling
 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
THANK YOU