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The authors show that, clinically, the interpretation of pain can be greatly facilitated by eliciting hyperalgesic or tender skin zones which accompany pain. The presence of tenderness, and its distribution, whether local or segmental, have been of great aid in diagnosis and therapy.
The work is based on the fact that, clinically, the combination of segmental pain and tenderness usually appears to be due to factors which irritate roots, ganglia or trunks of the spinal sensory nerves, and not due to painful impulses originating in diseased viscera. The authors believe that pain and segmental tenderness of skin in most instances appear to be of somatic origin rather than of visceral origin.
Segmental pain and tenderness is a symptom complex due to toxic absorption, poor posture, trauma, arthritis of the spine, malignant metastases and other contributing factors. The syndrome has no specific origin.
Much attention is given to the abdominal wall
Pain Syndromes: Treatment by Paravertebral Nerve Block. JAMA. 1949;140(13):1131. doi:10.1001/jama.1949.02900480061027
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