ABSTRACT
Sympathetically maintained pain, as described by W. J. Roberts, may begin after even minor soft-tissue or peripheral nerve trauma. Research data indicate that some receptors in skin and skeletal muscle can be influenced by sympathetic activity. The emotional or stress-related aspects noted as possibly etiological in the establishment of sympathetically maintained pain and/or complex regional pain syndrome are also frequently noted in patients with myofascial pain syndrome (MPS). In cases of obvious myofascial pain with trigger points, a sympathetic block will decrease the pain, but not the elements of the MPS, which can then be treated appropriately with an excellent outcome. Sudomotor testing was positive for increased sympathetic activity in the right arm and hand. Clinically, there are many similarities in the diagnosis and the treatment of the MPS and sympathetically maintained pain. It appears that sympathetically maintained pain may be secondary to many of the pathophysiological abnormalities of MPS.
