Skip to main content Accessibility help
Hostname: page-component-568f69f84b-d8fc5 Total loading time: 0.171 Render date: 2021-09-20T04:29:18.398Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

Chronic Benign Pain

Published online by Cambridge University Press:  07 November 2014


Chronic benign pain (CBP) can be defined as a type of unpleasant sensory experience that arises from inflammation, visceral stress or damage, or other such pathophysiologic process(es), and that is not associated with a metastatic process. A patient's complaint of pain should be taken seriously by the practitioner, both in terms of the discomfort evoked and the likelihood that the potential cause of the pain requires diagnostic evaluation. This article reviews the diagnosis and treatment of the following common conditions associated with CBP syndromes: fibromyalgia, lower back pain syndrome, sickle-cell disease, reflex sympathetic dystrophy syndrome, and peripheral neuropathies.

Feature Articles
Copyright © Cambridge University Press 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


1.Craze, R. Hell. Berkeley, Calif: Conari Press; 1996:34.Google Scholar
2.Sternbach, RA. Transcutaneous electrical analgesia: a followup analysis. Pain. 1976;2:3541.CrossRefGoogle Scholar
3.Walsh, NE, Dumitru, D, Schoenfeld, LS, Ramamurthy, S. Treatment of the patient with chronic pain. In: DeLisa, JA, Gans, BM, eds. Rehabilitation Medicine. Principles and Practice. 3rd ed. Philadelphia, Pa: Lippincott-Raven; 1998:13851421.Google Scholar
4.Bonica, JJ. General considerations of chronic pain. In: Bonica, JJ, ed. The Management of Pain. 2nd ed. Philadelphia, Pa: Lea & Febiger; 1990:180196.Google Scholar
5.Krych, R, Witt, PH, Franklin, E. A taxonomy of prescription addiction. In: Greenfield, DP, ed. Prescription Drug Abuse and Dependence. Springfield, Ill: Charles C. Thomas; 1995:3040.Google Scholar
6.Bossevain, MD, McCain, GA. Toward an integrated understanding of fibromyalgia syndrome. I. Medical and pathophysiological aspects. Pain. 1991;44:227238.CrossRefGoogle Scholar
7.Smythe, HA. Nonarticular rheumatism and psychogenic musculoskeletal syndromes. In: McCarthy, DJ, ed. Arthritis and Allied Conditions. A Textbook of Rheumatology. 11th ed. Philadelphia, Pa: Lea & Febiger; 1989:12411252.Google Scholar
8.Wolfe, F, Yunus, MB, Smythe, HA, et al.The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum. 1995;38:1929.CrossRefGoogle ScholarPubMed
9.Wolfe, F, Smythe, HA, Yunus, MB. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia: report of the Multicenter Criteria Committee. Arthritis Rheum. 1990;33:160172.CrossRefGoogle ScholarPubMed
10.Bossevain, MS, McCain, GA. Toward an integrated understanding of fibromyalgia syndrome. II. Psychological and phenomenological aspects. Pain. 1991;44:239248.CrossRefGoogle Scholar
11.Birdsall, TC. 5-hydroxytrypthophan: a clinically effective serotonin precursor. Altern Med. 1998;3:271280.Google Scholar
12.Alarcon, GS, Bradley, LA. Advances in the treatment of fibromyalgia: current status and future directions. Am J Med Sci. 1998;35:397404.Google ScholarPubMed
13.Goldenberg, DL. Fibromyalgia: why such controversy? Ann Rheum Dis. 1995;54:310.CrossRefGoogle ScholarPubMed
14.Rosonoff, HL. Do herniated disks produce pain? Adv Pain Res Ther. 1985;9:457460.Google Scholar
15.Cavanaugh, JM, Weinstein, JN. Low back pain: epidemiology, anatomy, and neurophysiology. In: Wall, PD, Melzack, R, eds. Textbook of Pain. 3rd ed. New York, NY: Churchill-Livingstone; 1994:441445.Google Scholar
16.White, AA. Your Aching Back. New York, NY: Bantam Books; 1983.Google Scholar
17.Greenfield, DP, Klein, DA. Chronic pain in spinal cord injury patients: use and abuse of opioids. Presented at: Kessler Institute for Rehabilitation; June 17, 1997; West Orange, NJ.Google Scholar
18.Hendler, NH, Kozikowski, JG. Overlooked physical diagnoses in chronic pain patients involved in litigation. Psychosomatics. 1993;34:494501.CrossRefGoogle ScholarPubMed
19.Landolfi, JC. Chronic malignant pain. CNS Spectrums. 1999;4:3842.CrossRefGoogle ScholarPubMed
20.Potter, WZ, Manji, H, Rudorfer, MV. Tricyclics and tetracyclics. In: Schatzberg, AF, Nemeroff, CB, eds. American Psychiatric Press Textbook of Psychopharmacology. Washington, DC: American Psychiatric Press; 1995:141160.Google Scholar
21.Horenstein, S. Chronic low back pain and the failed back syndrome. Neurol Clin. 1989;7:361385.Google Scholar
22.Seres, JS, Newman, RI. Negative influence of the disability compensation system: perspectives for the clinician. Semin Neurol. 1983;3:360369.CrossRefGoogle Scholar
23.Beutler, E. Disorders of hemoglobin. In: Fauci, AS, Braunwald, E, Isselbacher, KB, et al, eds. Harrison's Principles of Internal Medicine. 14th ed. New York, NY: McGraw-Hill; 1998: 645652.Google Scholar
24.Ballas, SK. Management of sickle pain. Curr Opin Hematol. 1997;4:104111.CrossRefGoogle ScholarPubMed
25.Klein, DA, Greenfield, DP. Chronic pain in a sickle-dell patient. Ombudsman Rounds Case Conference; Montefiore Medical Center/Albert Einstein College of Medicine; May 12, 1998; Bronx, NY.Google Scholar
26.Elander, J, Midence, K. A review of evidence about factors affecting quality of pain management in sickle cell disease. Clin J Pain. 1996;12:180193.CrossRefGoogle ScholarPubMed
27.Agble, YM. Management of sickle-cell disease. Non-addictive analgesics can be as effective as morphine and pethidine (letter). Br Med J. 1998;316:935.CrossRefGoogle Scholar
28.Galer, BS. Painful neuropathy. Neurol Clin. 1998;16:791811.CrossRefGoogle Scholar
29.Tollefson, GD. Selective serotonin reuptake inhibitors. In: Schatzberg, AF, Nemeroff, CB, eds. American Psychiatric Press Textbook of Psychopharmacology. Washington, DC: American Psychiatric Press; 1995:161182.Google Scholar
30.Barohn, RJ, Gronseth, GS, LeForse, BR. Peripheral nervous system involvement in a large cohort of human immunodeficiency virus-infected patients. Arch Neurol. 1993;50:167171.CrossRefGoogle Scholar
31.Kaufman, DN. Clinical Neurology for Psychiatrists. 4th ed. Philadelphia, Pa: WB Saunders Co;1995:7093.Google Scholar
32.Rowland, CP. Diseases of the motor unit. In: Kandel, ER, Schwartz, JH, Jessell, TM, eds. Principles of Neural Science. 3rd ed. New York, NY: Elsevier; 1991:244257.Google Scholar
33.Dalakas, MC. Polymyositis, dermatomyositis, and inclusion-body myositis. N Engl J Med. 1991;325:14871498.CrossRefGoogle ScholarPubMed
34.Hedberg, K, Urbach, D, Slutsker, L, et al.Eosinophilia-myalgia syndrome. Natural history in a population-based cohort. Arch Intern Med. 1992;152:18891892.CrossRefGoogle Scholar
35.Simpson, DM, Citak, KA, Godfrey, E. Myopathies associated with human immunodeficiency virus and zidovudine. Neurology. 1993;43:971976.CrossRefGoogle ScholarPubMed
36.Hans, G, Davar, G. Recent advances in the pharmacology of nerve-injury pain. Neurol Clin. 1998;16:951965.CrossRefGoogle ScholarPubMed
37.Harden, RN, Cole, PA. New developments in rehabilitation of neuropathic pain syndromes. Neurol Clin. 1998;16:937950.CrossRefGoogle ScholarPubMed
38.Greenfield, DP, Narcessian, E. Management and pharmacotherapy of chronic pain syndromes, including opioid pharmacotherapy. CNS Spectrums. 1999;4:4352.CrossRefGoogle ScholarPubMed
39.Merskey, H, Bogduk, N. Classification of Chronic Pain. Seattle, Wash: IASP Press; 1995.Google Scholar
40.Wasner, G, Bachonja, M-M, Baron, R. Traumatic neuralgias. Neurol Clin. 1998;16:851868.CrossRefGoogle ScholarPubMed
41.Empting-Koschorke, LD, Hendler, N, Kolodny, AC, Kraus, H. Tips on hard-to-manage pain syndromes. Patient Care. 1990;24:2646.Google Scholar
42.Shelton, RM, Lewis, CW. Reflex sympathetic dystrophy. A review. J Am Acad Dermatol. 1990;22:513520.CrossRefGoogle ScholarPubMed
43.Schwartzman, RJ, McLellan, TL. Reflex sympathetic dystrophy, a review. Arch Neurol. 1987;44:555561.CrossRefGoogle ScholarPubMed
44.Feinberg, JH, Kirschblum, S. Reflex sympathetic dystrophy syndrome. N.J. Rehab. 1994;6:812.Google Scholar
45.Ford, SR, Forest, MA, Eltherington, L. Treatment of reflex sympathetic dystrophy with intravenous regional bretylium. Anesthesiology. 1988;68:137140.CrossRefGoogle ScholarPubMed
46.Rowlingson, JC, Chalkey, J. Common pain syndromes-diagnosis and management. Seminars in Anesthesia. 1985;4:223230.Google Scholar
47.Marks, RM, Sachar, EJ. Undertreatment of medical inpatients with narcotic analgesics. Ann Intern Med. 1973;78:173181.CrossRefGoogle ScholarPubMed
48.Perry, SW. The undermedication for pain. Psychiatr Ann. 1984;14:808811.CrossRefGoogle Scholar

Send article to Kindle

To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Chronic Benign Pain
Available formats

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Chronic Benign Pain
Available formats

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Chronic Benign Pain
Available formats

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *