In the first two parts of “The Pain the Brain” series the concept of descending inhibition has been mentioned. This refers to a very elegant part of the central nervous system that originates in the brain and travels down the spinal cord to actual inhibit pain signals that have yet to be transmitted up into the brain—hence its name of “descending inhibition.” It has colloquially been referred to as “pain inhibits pain,” and its complete medical name is diffuse noxious inhibitory control (DNIC). 

  Part 1 of this series described the pain process in the central nervous system, primarily the phenomenon called windup and how it is created. Windup is the beginning of an important change in the central nervous system called central sensitization which is at the heart of the pain felt by patients with FMS. It was mentioned in Part 1 of this series that there is some bad news for FMS patients regarding windup. Here it is.

  The International Association for the Study of Pain has defined pain as both an "unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage." There has been an extensive medical literature published on the multitude of mechanisms responsible for the primary complaint of FMS patients — pain. 

Submitted by the Illinois Pain Institute Sciatica and low back pain are leading complaints of pain and discomfort among adults. Typically, people associate such pain with a pinched nerve or bulging disc.  Often times, some of the other common causes of low back pain are overlooked and subject patients to sometimes unnecessary, invasive, sometimes painful, and expensive diagnostic procedures. Common disorders, symptoms, and physical signs causing low back pain are listed below. Painful Conditions Sacroiliitis Symptoms: Low back and buttock pain; when severe, may radiate to the posterior thigh Physical Signs: Joint tenderness on palpation. Myofascial Pain (Quadratus Lumborum Muscle)     Symptoms: Backache, hip, or buttock pain, abdomen or groin pain     Physical Signs: Tenderness below and close to the 12th rib, just along side of the spine Myofascial Pain (Gluteus Medius Muscle)     Symptoms: Low back and buttock pain; increasing with lying or sitting on affected site     Physical Signs: Tenderness above hip with painful sensations along the side of the leg. Taught band of muscles or knot felt under the skin. Myofascial Pain (Piriformis Muscle)     Symptoms: Pain in lower back, groin, perineum, buttock, hip, posterior thigh, leg, or foot     Physical Signs: Localized tenderness at the tailbone…