What is meant by “inferred pathophysiology”?
Even for well-recognized pain syndromes (e.g., migraine headache or painful diabetic neuropathy), we can rarely define with certainty the pathophysiologic mechanisms underlying a specific pain syndrome. This hinders our ability to specifically target and treat such mechanisms directly. However, a specific set of symptoms may lead us to believe that a pain syndrome is more likely due to nerve injury (neuropathic pain), lesions of muscle or bone (somatic nociceptive pain), or disease of the internal organs (visceral nociceptive pain). This “inferred pathophysiology” implies that we understand some of the basic mechanisms underlying a pain syndrome, and leads to the pathophysiologic classification of pain syndromes. However, this pathophysiologic classification is limited, because we can only infer, and rarely verify, the true mechanism.