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Segmental Neuralgia in Painful Syndromes

JAMA. 1944;126(18):1177. doi:10.1001/jama.1944.02850530055026.
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Segmental pain and tenderness, or segmental neuralgia, is defined by the authors as an area of spontaneous pain within one or more tender skin sensory segments, generally called dermatomes. This pain and tenderness may arise from any disease process, toxic absorption or mechanical disturbance which directly or indirectly causes irritation of the intraspinal or paraspinal elements which enter into the segmental distribution. Specifically these elements include the spinal roots before their exit from the vertebral column, the dorsal root ganglions, the nerve trunks prior to their formation of the primary divisions and the soft structures close to the intervertebral foramens and nerve trunks. Repeated observations by the authors suggest that the combination of segmental pain and tenderness has its origin within or close to the vertebral column rather than in peripheral or referred visceral stimuli. Their purpose is to show that clinically the interpretation of pain can be greatly facilitated


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