The Vicious Circle in Causalgia

Ultrasound Guided Transversus Thoracic Plane block, Parasternal block and fascial planes hydrodissection for internal mammary post thoracotomy pain syndrome

“…The administration of systemic LA in treating neuropathic pain is a known therapeutic option (Yousefshahi et al., ), and this requires high doses of drugs. The amount of LA used in peripheral nerve blocks is quite small, and an important reason responsible for long‐lasting pain relieve in this scenario may involve the elimination of the central sensitization maintained by the peripheral input (the ‘old’ vicious cycle of self‐sustained pain hypothesized by Livingston in 1943 and better defined and explained by subsequent researches) (Livingstone, ; Gracely et al., ; Vlassakov et al., ; Werdehausen et al., ).…”

Sympathetically maintained pain

“…Livingston [4,5], one of the American pioneers in the study of pain, also proposed sympathectomy for the same purpose. The concept of RSD and the habit of treating some neuropathic pains with sympathectomy [6] emerged from this background.…”

Development of a Hand Sensitivity Test for the Hypersensitive Hand

“…Hypersensitivity as a result of traumatic injury has been described in the neurological and rehabilitation literature for decades (3)(4)(5)(6)(7). In the 1950s it was determined that tapping a hypersensitive stump with a wooden mallet often decreased pain and discomfort (6).…”

“…In the 1950s it was determined that tapping a hypersensitive stump with a wooden mallet often decreased pain and discomfort (6). Other writers discussed the beneficial effects of vibration, massage, pressure, and normal activity in desensitizing a hypersensitive part (4,5,7). These authors employed stimulation because they believed it would cause the degeneration of neuromatas (6) or inhibit the transmission of pain impulses (8).…”