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Limb pain

MedGen UID:
10540
Concept ID:
C0030196
Sign or Symptom
Synonyms: Extremity Pain; Limb Pain; Pain in extremities; Pain in limb
SNOMED CT: Pain in limb (90834002); Limb pain (90834002)
 
HPO: HP:0009763

Definition

Chronic pain in the limbs with no clear focal etiology. [from HPO]

Conditions with this feature

Diaphyseal dysplasia
MedGen UID:
4268
Concept ID:
C0011989
Finding
Camurati-Engelmann disease (CED) is characterized by hyperostosis of the long bones and the skull, proximal muscle weakness, limb pain, a wide-based, waddling gait, and joint contractures. Facial features such as macrocephaly, frontal bossing, enlargement of the mandible, proptosis, and cranial nerve impingement resulting in facial palsy are seen in severely affected individuals later in life.
Thromboangiitis obliterans
MedGen UID:
21531
Concept ID:
C0040021
Disease or Syndrome
A rare inflammatory, non-necrotizing, non-atherosclerotic, occlusive vascular disease characterized by thrombosis and recanalization affecting small and medium sized arteries and veins of upper and lower extremities.
Retinal vasculopathy with cerebral leukoencephalopathy and systemic manifestations
MedGen UID:
348124
Concept ID:
C1860518
Disease or Syndrome
Retinal vasculopathy with cerebral leukoencephalopathy and systemic manifestations (RVCL-S) is a small-vessel disease that affects highly vascularized tissues including the retina, brain, liver, and kidneys. Age of onset is often between 35 and 50 years. The most common presenting finding is decreased visual acuity and/or visual field defects. Neurologic manifestations may include hemiparesis, facial weakness, aphasia, and hemianopsia. Migraines and seizures are less frequently described. Renal manifestations may include mild-to-moderate increase in serum creatinine and mild proteinuria; progression to end-stage renal disease (ESRD) is uncommon. Hepatic manifestations frequently include mildly elevated levels of alkaline phosphatase and gamma-glutamyltransferase (GGT). Less common findings include psychiatric disorders, hypertension, mild-to-moderate anemia, and Raynaud phenomenon.
Dystonia 16
MedGen UID:
436979
Concept ID:
C2677567
Disease or Syndrome
Dystonia 16 is one of many forms of dystonia, which is a group of conditions characterized by involuntary movements, twisting (torsion) and tensing of various muscles, and unusual positioning of affected body parts. Dystonia 16 can appear at any age from infancy through adulthood, although it most often begins in childhood.\n\nThe signs and symptoms of dystonia 16 vary among people with the condition. In many affected individuals, the disorder first affects muscles in one or both arms or legs. Tensing (contraction) of the muscles often sets the affected limb in an abnormal position, which may be painful and can lead to difficulty performing tasks, such as walking. In others, muscles in the neck are affected first, causing the head to be pulled backward and positioned with the chin in the air (retrocollis).\n\nIn dystonia 16, muscles of the jaw, lips, and tongue are also commonly affected (oromandibular dystonia), causing difficulty opening and closing the mouth and problems with swallowing and speech. Speech can also be affected by involuntary tensing of the muscles that control the vocal cords (laryngeal dystonia), resulting in a quiet, breathy voice or an inability to speak clearly. Dystonia 16 gradually gets worse, eventually involving muscles in most parts of the body.\n\nSome people with dystonia 16 develop a pattern of movement abnormalities known as parkinsonism. These abnormalities include unusually slow movement (bradykinesia), muscle rigidity, tremors, and an inability to hold the body upright and balanced (postural instability). In dystonia 16, parkinsonism is relatively mild if it develops at all.\n\nThe signs and symptoms of dystonia 16 usually do not get better when treated with drugs that are typically used for movement disorders.

Professional guidelines

PubMed

Culp CJ, Abdi S
Pain Physician 2022 Oct;25(7):E941-E957. PMID: 36288580
Modest JM, Raducha JE, Testa EJ, Eberson CP
R I Med J (2013) 2020 May 1;103(4):19-22. PMID: 32357588
Flor H
Lancet Neurol 2002 Jul;1(3):182-9. doi: 10.1016/s1474-4422(02)00074-1. PMID: 12849487

Recent clinical studies

Etiology

Guémann M, Olié E, Raquin L, Courtet P, Risch N
Eur J Pain 2023 Jan;27(1):3-13. Epub 2022 Sep 19 doi: 10.1002/ejp.2035. PMID: 36094758Free PMC Article
Xie HM, Zhang KX, Wang S, Wang N, Wang N, Li X, Huang LP
Arch Phys Med Rehabil 2022 May;103(5):988-997. Epub 2021 Aug 28 doi: 10.1016/j.apmr.2021.07.810. PMID: 34461084
Anaforoğlu Külünkoğlu B, Erbahçeci F, Alkan A
Turk J Med Sci 2019 Feb 11;49(1):101-109. doi: 10.3906/sag-1712-166. PMID: 30762318Free PMC Article
Isaacs-Itua A, Sedki I
Br J Hosp Med (Lond) 2018 Apr 2;79(4):205-210. doi: 10.12968/hmed.2018.79.4.205. PMID: 29620980
Alviar MJ, Hale T, Dungca M
Cochrane Database Syst Rev 2016 Oct 14;10(10):CD006380. doi: 10.1002/14651858.CD006380.pub3. PMID: 27737513Free PMC Article

Diagnosis

Zhu J, Hu Z, Luo Y, Liu Y, Luo W, Du X, Luo Z, Hu J, Peng S
Front Endocrinol (Lausanne) 2023;14:1265372. Epub 2024 Jan 9 doi: 10.3389/fendo.2023.1265372. PMID: 38264279Free PMC Article
Culp CJ, Abdi S
Pain Physician 2022 Oct;25(7):E941-E957. PMID: 36288580
Siclari F, Valli K, Arnulf I
Lancet Neurol 2020 Oct;19(10):849-859. Epub 2020 Sep 16 doi: 10.1016/S1474-4422(20)30275-1. PMID: 32949545
Urits I, Seifert D, Seats A, Giacomazzi S, Kipp M, Orhurhu V, Kaye AD, Viswanath O
Curr Pain Headache Rep 2019 Jul 29;23(9):64. doi: 10.1007/s11916-019-0802-0. PMID: 31359171
Seror R, Ravaud P, Mariette X, Bootsma H, Theander E, Hansen A, Ramos-Casals M, Dörner T, Bombardieri S, Hachulla E, Brun JG, Kruize AA, Praprotnik S, Tomsic M, Gottenberg JE, Devauchelle V, Devita S, Vollenweider C, Mandl T, Tzioufas A, Carsons S, Saraux A, Sutcliffe N, Vitali C, Bowman SJ; EULAR Sjögren's Task Force
Ann Rheum Dis 2011 Jun;70(6):968-72. Epub 2011 Feb 22 doi: 10.1136/ard.2010.143743. PMID: 21345815

Therapy

Campo-Prieto P, Rodríguez-Fuentes G
Neurologia (Engl Ed) 2022 Oct;37(8):668-681. Epub 2020 Sep 19 doi: 10.1016/j.nrleng.2018.08.005. PMID: 36195376
Xie HM, Zhang KX, Wang S, Wang N, Wang N, Li X, Huang LP
Arch Phys Med Rehabil 2022 May;103(5):988-997. Epub 2021 Aug 28 doi: 10.1016/j.apmr.2021.07.810. PMID: 34461084
Modest JM, Raducha JE, Testa EJ, Eberson CP
R I Med J (2013) 2020 May 1;103(4):19-22. PMID: 32357588
Urits I, Seifert D, Seats A, Giacomazzi S, Kipp M, Orhurhu V, Kaye AD, Viswanath O
Curr Pain Headache Rep 2019 Jul 29;23(9):64. doi: 10.1007/s11916-019-0802-0. PMID: 31359171
Aternali A, Katz J
F1000Res 2019;8 Epub 2019 Jul 23 doi: 10.12688/f1000research.19355.1. PMID: 31354940Free PMC Article

Prognosis

Petersen EA, Stauss TG, Scowcroft JA, Brooks ES, White JL, Sills SM, Amirdelfan K, Guirguis MN, Xu J, Yu C, Nairizi A, Patterson DG, Tsoulfas KC, Creamer MJ, Galan V, Bundschu RH, Paul CA, Mehta ND, Choi H, Sayed D, Lad SP, DiBenedetto DJ, Sethi KA, Goree JH, Bennett MT, Harrison NJ, Israel AF, Chang P, Wu PW, Gekht G, Argoff CE, Nasr CE, Taylor RS, Subbaroyan J, Gliner BE, Caraway DL, Mekhail NA
JAMA Neurol 2021 Jun 1;78(6):687-698. doi: 10.1001/jamaneurol.2021.0538. PMID: 33818600Free PMC Article
Dumanian GA, Potter BK, Mioton LM, Ko JH, Cheesborough JE, Souza JM, Ertl WJ, Tintle SM, Nanos GP, Valerio IL, Kuiken TA, Apkarian AV, Porter K, Jordan SW
Ann Surg 2019 Aug;270(2):238-246. doi: 10.1097/SLA.0000000000003088. PMID: 30371518
Wittkopf PG, Johnson MI
Rev Assoc Med Bras (1992) 2017 Nov;63(11):1000-1005. doi: 10.1590/1806-9282.63.11.1000. PMID: 29451665
McGovern MM, Avetisyan R, Sanson BJ, Lidove O
Orphanet J Rare Dis 2017 Feb 23;12(1):41. doi: 10.1186/s13023-017-0572-x. PMID: 28228103Free PMC Article
Tilak M, Isaac SA, Fletcher J, Vasanthan LT, Subbaiah RS, Babu A, Bhide R, Tharion G
Physiother Res Int 2016 Jun;21(2):109-15. Epub 2015 Apr 1 doi: 10.1002/pri.1626. PMID: 25832306

Clinical prediction guides

Arslan D, Ünal Çevik I
Agri 2022 Jul;34(3):155-165. doi: 10.14744/agri.2021.43078. PMID: 35792695
Huang J, Ji JR, Liang C, Zhang YZ, Sun HC, Yan YH, Xing XB
Ann Palliat Med 2022 Feb;11(2):521-531. doi: 10.21037/apm-21-3710. PMID: 35249330
Xie HM, Zhang KX, Wang S, Wang N, Wang N, Li X, Huang LP
Arch Phys Med Rehabil 2022 May;103(5):988-997. Epub 2021 Aug 28 doi: 10.1016/j.apmr.2021.07.810. PMID: 34461084
Anaforoğlu Külünkoğlu B, Erbahçeci F, Alkan A
Turk J Med Sci 2019 Feb 11;49(1):101-109. doi: 10.3906/sag-1712-166. PMID: 30762318Free PMC Article
Alviar MJ, Hale T, Dungca M
Cochrane Database Syst Rev 2016 Oct 14;10(10):CD006380. doi: 10.1002/14651858.CD006380.pub3. PMID: 27737513Free PMC Article

Recent systematic reviews

Guémann M, Olié E, Raquin L, Courtet P, Risch N
Eur J Pain 2023 Jan;27(1):3-13. Epub 2022 Sep 19 doi: 10.1002/ejp.2035. PMID: 36094758Free PMC Article
Huang J, Ji JR, Liang C, Zhang YZ, Sun HC, Yan YH, Xing XB
Ann Palliat Med 2022 Feb;11(2):521-531. doi: 10.21037/apm-21-3710. PMID: 35249330
Xie HM, Zhang KX, Wang S, Wang N, Wang N, Li X, Huang LP
Arch Phys Med Rehabil 2022 May;103(5):988-997. Epub 2021 Aug 28 doi: 10.1016/j.apmr.2021.07.810. PMID: 34461084
Wylde V, Dennis J, Beswick AD, Bruce J, Eccleston C, Howells N, Peters TJ, Gooberman-Hill R
Br J Surg 2017 Sep;104(10):1293-1306. Epub 2017 Jul 6 doi: 10.1002/bjs.10601. PMID: 28681962Free PMC Article
Barbin J, Seetha V, Casillas JM, Paysant J, Pérennou D
Ann Phys Rehabil Med 2016 Sep;59(4):270-5. Epub 2016 May 30 doi: 10.1016/j.rehab.2016.04.001. PMID: 27256539

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