Chronic pain

Diagnosis of chronic pain

Medical history and examination

With respect to pain, doctors ask patients about their condition from a range of different perspectives. Examinations include tests of perception and whether or not pain appears in a certain posture, and doctors will also compare the color of the skin on both sides of the body.

Imaging tests

Imaging tests are the first tests carried out to identify the source of pain. MRI and CT images are used to assess lesions that may be causing the pain.

Drug challenge tests

One diagnostic method for investigating the mechanism causing the pain is a type of test called a "drug challenge test." In this method, the patient is given a number of different types of medication that suppress pain by well-known mechanisms, and the patient is asked to tell the doctor to what extent the pain is relieved in order to plan subsequent treatment. The drugs are given as intravenous injections, and a judgment is made on the extent to which they relieve the patient’s pain and which medication is most effective. Normally, one type of drug is given per day, with around five different varieties being tested.

Nerve block

Another method known as “nerve block” that is often used as a treatment can also be used as a method of diagnosis. Normally, a local anesthetic is used as the drug in nerve block, but other substances including alcohol, steroids, and botulinum toxin may be tested by injecting them either directly into the target nerve or into the surrounding tissue.

Nerve block

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