Segmental neuromyotherapy: a novel system for diagnosis of pain at the foot and ankle

Abstract

Many mechanisms may contribute to the pathogenesis of chronic pain at the foot and the ankle. Activation of nociceptive nerve endings by mechanical or chemical painful stimuli are local factors that can produce significant neurochemical changes and reorganizations within the dorsal horn of the spinal cord. These changes include an increased excitability of dorsal horn neurons which produces pain hypersensitivity and allodynia, that may follow a segmental distribution. Improved diagnosis techniques allow the diagnosis of spinal segmental sentitization (SSS). Once these clinical findings are present, the rationale for treatment should also target desensitization maneuvers to control peripheral and central sensitization.