Systemic Pain Syndromes — Find & Treat the Dominant Local Pain Source

This short hub points you to patient-friendly guides about systemic pain syndromes, such as fibromyalgia and polyneuropathy. It is written especially for patients whose pain persists despite treatment and who need to understand whether all symptoms are truly caused by systemic pain sensitivity, or whether one or two dominant local pain generators are still maintaining the pain.

In many patients, overall sensitivity is elevated, but the most disabling symptoms are driven by a local source that must be identified separately. For example, low back pain may still come from a lumbar disc, facet joint, sacroiliac joint, muscle-fascial trigger point, or nerve irritation. Neck pain may come from cervical joints, muscles, discs, or nerve roots. Headache may be driven by occipital nerves or cervical structures. Facial pain may be trigeminal, dental, TMJ-related, viral, or peripheral nerve-related. Joint-region pain may come from a tendon, bursa, nerve, or referred spinal source even when the patient also has fibromyalgia.

These dominant local pain sources are often not clearly visible on routine MRI images and must be diagnosed in another way. The guides explain how the dominant source is identified through history, pain mapping, focused examination, and ultrasound-guided diagnostic blocks, and how targeted treatment can be combined with systemic pain management.