The primary cause of pain stems from pathology or injury to the musculoskeletal nervous system, often accompanied by motor weakness [1]. Among pain clinic patients, those with neurological pathology or injury often cite compressive neuropathies such as cervical spondylotic myelopathy, herniated intervertebral discs, spinal stenosis, tardy ulnar neuropathy, and carpal tunnel syndrome as sources of pain. Conversely, those with musculoskeletal pathology or injury typically experience pain from trauma or overuse, including degeneration, myofascial pain syndrome, sprains, or strains. These diseases are frequently accompanied by pain, motor weakness, and sensory deficits [1]. Additionally, neurological impairments can coexist with pain in non-compressive neural disorders and inflammatory or rheumatological musculoskeletal disorders [1].

Given the diverse treatment approaches and prognoses for these conditions, pain physicians must possess ample knowledge of neuromuscular diseases causing motor weakness or sensory deficits and excel in diagnosing and treating these diseases. For instance, anterior lateral sclerosis may be misdiagnosed as radiculopathy and is often observed in pain clinics [2]. Similarly, neuralgic amyotrophy might be misdiagnosed as cervical radiculopathy due to herniated intervertebral discs or foraminal stenosis, while conditions like multifocal motor neuropathy and multifocal acquired demyelinating sensory and motor neuropathy may be mistaken for carpal tunnel syndrome [3,4]. Furthermore, misdiagnosing chronic inflammatory demyelinating polyneuropathy as cervical spondylotic myelopathy can lead to unnecessary surgical treatments [5]. Inadequate knowledge of neuromuscular diseases often results in patient misdiagnosis and inappropriate treatment.

To provide patients with optimal treatment, pain physicians must possess comprehensive knowledge of neuromuscular diseases causing motor weakness and sensory deficits. This understanding enables accurate patient diagnosis, requiring imaging studies, electrodiagnostic studies, and blood tests for a detailed differential diagnosis when necessary. Pain physicians should specialize in neuromuscular disorders to provide the best possible care.

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (No. IRIS RS-2023-00219725).

No potential conflict of interest relevant to this article was reported.