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Rubin TK et al. - Referred pain is a significant clinical problem, and commonly occurs with pain originating in muscle but not from skin. It is important to know the primary source of the pain so that treatment can be directed to this site rather to the site of referral.

Exclusive Author Commentary
Vaughan G. Macefield, 05/19/09

We know that muscle pain can often refer into sites distal (or proximall) to the site of primary noxious stimulation, but does it depend on an ongoing noxious stimulus or can it be sustained by central processes? In this study we induced muscle pain by intramuscular injection of hypertonic saline and then blocked it by intramuscular injection of local anaesthetic: it turned out that by blocking the primary pain we also blocked the referred pain, emphasising the need to target treatment of the primary rather than referred site.

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