Chronic Pain

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Diagnosis

Chronic pain is diagnosed over time. The diagnosis is based on the patient's history of symptoms, the underlying condition, physical and neurological examination, and diagnostic tests. Patients may be referred to several medical practitioners (e.g., neurologist, orthopedist) for diagnosis and treatment.

Diagnostic tests vary, depending on the underlying condition. Tests may include the following:

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• Blood and urine tests
• Imaging tests (e.g., x-ray, CT scan, MRI scan, bone scan)
• Spinal tap (lumbar puncture; may used to diagnose infection, MS, or other conditions)

Electrophysiological studies of the nerves and muscles (e.g., electromyography [EMG], nerve conduction velocity studies) also may be performed. These tests often are used in combination and are referred to as EMG/NCV studies. They are used to rule out or diagnose conditions that affect the nerves or muscles. EMG records electrical activity in muscle tissue, and nerve conduction velocity studies record the speed at which impulses travel through nerves and measure electrical responses.

Thermography measures the temperature of surface tissue as a function of blood flow. This test may be used to detect altered blood flow to a painful area, which may indicate a vascular condition.

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