Journal of hand therapy : official journal of the American Society of Hand Therapists
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This article reviews the role that the peripheral nervous system plays in pain perception. The first section describes the functional properties of the primary sensory element-the nociceptor-and how its behavior is related to pain perception. The second section describes the current state of knowledge concerning the way our nociceptive sensing system changes as a result of tissue injury, including those changes related to sympathetic nervous system modulation of pain.
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Myofascial pain syndromes of the upper extremity are common causes of pain that may follow trauma and are associated with acute or chronic musculoskeletal stress. The syndromes are characterized by the presence of the myofascial trigger point, a physical finding that is reliably identified by palpation. Local and referred pain are hallmarks of the syndrome, and the referred pain patterns may mimic such conditions as radiculopathy and nerve entrapment syndromes. Treatment is directed toward inactivating the myofascial trigger point, correcting underlying perpetuating factors, and restoring the normal relationships between the muscles of the affected functional motor units.