PAIN-GENERATORS

SUMMARY

1. This is an anatomical & pathological concept.

2. There are multiple, often overlapping structures that can generate pain.

3. The generator concept applies more to nociceptive, neuropathic & radicular pain.

4. Mechanisms for chronic/persistent pain often do not require an initial nociceptive or neuropathic origin.

5. Correlation with imaging or provocation studies may be limited and highly variable.

6. Hence, it is generally rare that we find an isolated focal pathology that responds sufficiently well to therapy. Even rarer that we see resolution of symptoms, once they become persistent (> 6 months).

Reference(s)

Cifu, D.X. (2020). Braddom’s physical medicine and rehabilitation. Elsevier. Get it on Amazon.
Cuccurullo, S. (2019). Physical medicine and rehabilitation board review. New York: Demosmedical. Get it on Amazon.
O’Young, B., Young, M.A. and Stiens, S.A. (2008). Physical Medicine and Rehabilitation Secrets. Mosby. Get it on Amazon.