Referred Pain

A type of pain that is perceived in an area away from the site where the pain arises, such as facial pain caused by lesion of the VAGUS NERVE, or throat problem generating referred pain in the ear.

Also Known As:

Networked: 139 relevant articles (6 outcomes, 16 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Pain (Aches)
2.	Hyperalgesia
3.	Cystitis
4.	Inflammation
5.	Radiculopathy (Radiculopathy, Cervical)

Experts

1.	Arendt-Nielsen, Lars: 12 articles (01/2015 - 03/2004)
2.	Arendt-Nielsen, L: 5 articles (01/2005 - 02/2000)
3.	Ge, Hong-You: 4 articles (06/2012 - 01/2005)
4.	Graven-Nielsen, Thomas: 3 articles (04/2014 - 01/2006)
5.	Macefield, Vaughan G: 3 articles (11/2012 - 08/2009)
6.	Henderson, Luke A: 3 articles (11/2012 - 08/2009)
7.	Rubin, Troy K: 3 articles (11/2012 - 08/2009)
8.	Madeleine, Pascal: 3 articles (06/2012 - 01/2005)
9.	Drewes, Asbjørn Mohr: 3 articles (07/2008 - 03/2004)
10.	Yue, Shou-Wei: 2 articles (06/2012 - 02/2009)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Referred Pain:

1.	Mesna (Coenzyme M)FDA LinkGeneric 10/01/2007 - "TMC asymmetry 1) was generated in strict relation with cystitis, and was absent in disease-free and mesna-treated animals, 2) was restricted to the anterior portion of the paraventricular pars anterior and reuniens nuclei subregion, i.e., the rostralmost part of the paraventricular thalamic nucleus, the only thalamic area associated with viscero-vagal and somatic inputs, via the nucleus of the solitary tract, and via the medial contingent of the spinothalamic tract, respectively, and 3) originated from somatic tissues, i.e., the abdominal wall where bladder inflammation generates secondary somatic hyperesthesia leading to referred pain in humans. "
2.	N-Methylaspartate (NMDA)IBA 04/01/2000 - "The present study showed that mechanisms involved in referred pain, temporal summation, muscular hyperalgesia, and muscle pain at rest were attenuated by the NMDA-antagonist in FMS patients. " 09/01/2006 - "These results suggest that there is a convergence of inputs from SSS and TP afferents on C1 neurons; it is possible that both NMDA and non-NMDA receptors located on C1 neurons may be targets for the treatment of the trigeminal referred pain associated with migraine." 03/01/2001 - "Mechanisms involved in referred pain, temporal summation, muscle hyperalgesia, and muscle pain at rest were attenuated by the N-methyl-D-aspartate (NMDA) antagonist, ketamine, in FM patients. " 04/01/2010 - "Results indicate 17beta-estradiol may activate the phosphatidylinositol-3-kinase cascade, which subsequently phosphorylates the NR2B subunit, via spinal estrogen receptors ERalpha/ERbeta, to facilitate NMDA-dependent cross-organ sensitization, which is presumed to underlie pelvic viscero-visceral referred pain."
3.	Phosphotransferases (Kinase)IBA 03/27/2013 - "Reduction of referred pain was accompanied by a decrease in the spinal levels of extracellular signal-regulated kinase (ERK) phosphorylation, a marker of increased sensory barrage in the lumbosacral spinal cord, and spinal BDNF expression. " 01/01/2010 - "Intrathecal immunoglobulin fusion protein of EphB1 and EphB2 as well as PP2 reversed the reflex sensitization and NR2B phosphorylation caused by MO. All these results suggest that EphBR-ephrinB interactions, which provoke Src-family kinase-dependent NMDAR NR2B phosphorylation at the lumbosacral spinal cord level, are involved in cross-organ sensitization, contributing to the development of viscero-visceral referred pain between the bowel and the urethra." 01/01/2011 - "Recent studies suggest that janus-activated kinases-signal transducer and activator of transcription signaling pathways contribute to increased voiding frequency and referred pain of cyclophosphamide (CYP)-induced cystitis in rats. "
4.	Cyclophosphamide (Cytoxan)FDA LinkGeneric 01/01/2013 - "We did not observe a difference neither in bladder contraction features of double knock-out animals nor in cyclophosphamide-induced referred pain behavior. " 09/01/2003 - "Characterization of cyclophosphamide cystitis, a model of visceral and referred pain, in the mouse: species and strain differences." 01/01/2011 - "Recent studies suggest that janus-activated kinases-signal transducer and activator of transcription signaling pathways contribute to increased voiding frequency and referred pain of cyclophosphamide (CYP)-induced cystitis in rats. "
5.	Opioid Analgesics (Opioids)IBA 09/01/2013 - "Medical inpatients treated with opioids for acute pain referred for psychiatric consultation were administered questionnaires including the Screener and Opioid Assessment for Pain Patients (SOAPP) and the Hospital Misuse Checklist (HMC), developed for this study. " 03/01/2001 - "Successful denervation was associated with a change in the pain diagram and a reduction in the pattern of referred pain, a normalization of SI joint pain provocation tests, and a reduction in the use of opioids. "
6.	tebufenozide (Mimic)IBA 03/01/1992 - "Some types of pain referred from articular structures may mimic sciatica." 04/01/1987 - "Referred pain syndromes occur nearly twice as often and frequently mimic the clinical presentation of nerve root compression syndromes. " 03/01/1981 - "Pain referred from a muscle can mimic both pain from a joint and radicular pain associated with disease of spinal joints, leading to mistakes in diagnosis and in treatment. " 01/01/2015 - "Despite many initial physical examination findings of musculoskeletal dysfunction, this case demonstrates the significance of visceral referred pain, viscerosomatic hyperalgesia & hypertonicity, and how these neurological processes can mimic mechanical pain syndromes. " 12/01/2004 - "Referred pain from myofascial trigger points can mimic visceral pain syndromes and visceral pain syndromes can induce trigger point development and myofascial pain and dysfunction. "
7.	Capsaicin (Zostrix)FDA Link 07/01/2008 - "Viscero-somatic reflexes in referred pain areas evoked by capsaicin stimulation of the human gut." 10/14/1993 - "Capsaicin applied to rat lumbar intervertebral disc causes extravasation in the groin skin: a possible mechanism of referred pain of the intervertebral disc." 02/01/2000 - "Intramuscular and intradermal injection of capsaicin: a comparison of local and referred pain." 07/01/2008 - "Capsaicin evoked pain and referred pain areas in all subjects. " 07/01/2002 - "The intensity, quality, and spatial distribution of muscle and referred pain were not significantly different during resting and increased sympathetic muscle vasoconstrictor discharge, indicating that such activity does not influence pain after intramuscular infusion of capsaicin."
8.	Lidocaine (Xylocaine)FDA LinkGeneric 03/01/2015 - "After the patient identified the area(s) in which the needle insertion produced referred pain, we injected a mixture of 2 % lidocaine and contrast medium into the corresponding SIJ section. " 10/01/2009 - "Systemic lidocaine administration, therefore, may contribute to the alleviation of trigeminal-referred pain associated with tooth pain." 04/01/2003 - "We conducted a retrospective review of the charts of thirty-four patients with neck pain who met three criteria for the diagnosis of shoulder impingement syndrome: (1) a positive impingement sign with pain referred to the neck, (2) radiographic abnormalities, and (3) relief of neck pain after injection of lidocaine and cortisone into the subacromial space. "
9.	KetamineFDA LinkGeneric 09/01/2003 - "The frequency of referred pain was also lower when ketamine was given (3/13, P < 0.05) vs. placebo (9/14). " 04/01/2000 - "Local and referred pain areas were reduced by ketamine (-12. " 04/01/2000 - "Before and after ketamine or placebo, experimental local and referred pain was induced by intramuscular (i.m.) infusion of hypertonic saline (0.7 ml, 5%) into the tibialis anterior (TA) muscle. " 04/01/2000 - "Ketamine reduces muscle pain, temporal summation, and referred pain in fibromyalgia patients." 03/01/2001 - "Mechanisms involved in referred pain, temporal summation, muscle hyperalgesia, and muscle pain at rest were attenuated by the N-methyl-D-aspartate (NMDA) antagonist, ketamine, in FM patients. "
10.	Glutamic Acid (Glutamate)FDA Link 06/01/2012 - "The results showed that maximal pain intensity, the area under the VAS curve, and referred pain area were significantly higher and larger following glutamate injection into latent MTPs than non-MTPs (all, P < .05). " 01/01/2005 - "The PPTs were measured bilaterally in the trapezius muscles (local pain area) and posterolateral neck muscles (referred pain area) after glutamate injection in healthy and age-matched males and females (each n=14). " 06/01/2012 - "Pain intensity (as rated on the visual analog scale [VAS]) and referred pain area following glutamate injections were recorded. "

Therapies and Procedures

1.	Injections 08/01/2010 - "Here we show that weekly injections of hypertonic saline into the tibialis anterior cause decreases in local but increases in referred pain, suggesting central changes in processing noxious inputs." 02/01/2009 - "Furthermore, the MTrPs with referred pain after painful injections were found to show higher VAS(peak) and larger VAS(auc) than those without referred pain (both, P<0.001). " 01/01/2006 - "Hypoalgesia in the referred pain areas after bilateral injections of hypertonic saline into the trapezius muscles of men and women: a potential experimental model of gender-specific differences." 11/01/2003 - "The sample consisted of 81 patients with chronic lumbopelvic pain referred for diagnostic injections. " 05/15/1994 - "Referred pain was produced with all ten injections. "
2.	Nerve Block (Nerve Blocks) 03/01/1999 - "Nerve blocks were applied on the lower limb between the local and the referred pain area for 60 min. Three different studies were performed: (1) no nerve block (2) compression block, and (3) compression block combined with intravenous regional anaesthesia. " 03/01/1999 - "In the combined nerve block experiment, a significant reduction of referred pain intensity (38.5%) was seen after 20 min and until the release of the tourniquet. " 03/01/1999 - "The referred pain intensity was assessed every 5 min. To monitor the blockade of myelinated and unmyelinated nerve fibres, touch, pinprick, position sense and heat and heat-pain detection thresholds were assessed on the dorsal side of the foot every 5 min. A significant reduction in referred pain intensity (40.5%) compared with the control experiment was found after 40 min with the compression ischemia nerve block until release of the tourniquet. "
3.	Musculoskeletal Manipulations (Manipulative Therapy) 01/01/2009 - "Exclusion criteria were pain referred from spinal sites (without diagnosis), referral for surgery, and conditions contraindicated for manipulative therapy. " 01/01/2007 - "Conservative manual therapy and rehabilitative exercises may be an effective treatment for certain cases of cervical radiculopathy and myofascial referred pain." 01/01/2010 - "The cessation of typical TN after manual therapy of cervical spine suggests a conclusion that the painful stimuli from the cervical spine structures can be manifested not only as atypical facial pain and/or a cervicogenic headache, but also as a typical TN (painful stimuli from the cervical spine structures-->trigeminocervical nuclei-->convergence of the painful stimuli-->referred pain in the receptive field of the trigeminal nerve-->typical or atypical TN and/or cervicogenic headache)."
4.	Transplants (Transplant) 09/01/1995 - "To determine the cause of symptoms and efficacy of transcatheter therapy in a series of patients with dialysis grafts and hand pain referred for arteriography. "
5.	Tourniquets 03/01/1999 - "In the combined nerve block experiment, a significant reduction of referred pain intensity (38.5%) was seen after 20 min and until the release of the tourniquet. " 03/01/1999 - "The referred pain intensity was assessed every 5 min. To monitor the blockade of myelinated and unmyelinated nerve fibres, touch, pinprick, position sense and heat and heat-pain detection thresholds were assessed on the dorsal side of the foot every 5 min. A significant reduction in referred pain intensity (40.5%) compared with the control experiment was found after 40 min with the compression ischemia nerve block until release of the tourniquet. "