The combination of pain symptoms and signs, together with the taking of a careful clinical history
can often point to a probable or ‘differential’ diagnosis in someone suffering from chronic pain.
However pain itself cannot be ‘imaged’ by conventional methods but the underlying causes of pain
may be identified in many cases, especially using modern scanning techniques such as MRI
(magnetic resonance imaging), CT (computerised tomography) PET scanning (positron emission
tomography) ultrasound imaging, nerve conductions testing and laboratory investigations.
The most common pain problems to present to pain clinics such as low back pain and degenerative
joint conditions, frequently can be diagnosed using such techniques, whereas neuropathic
conditions, nerve pain, facial pain and headache frequently show little or no abnormalities on investigation.
It is equally important that investigations can substantially exclude the possibility of an underlying more
serious condition causing pain, or indeed may provide an opportunity for early diagnosis and treatment.
In many cases however the underlying cause for current or continuing pain is unclear and management
centres on functional rehabilitation, mobilization and pain control.
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