Coat-Hanger pain - Neurology



Supplemental data E Appendix 1

‘Coat-Hanger’ pain

The term ‘coat-hanger pain’ describes the neck pain, specifically in suboccipital and paracervical regions, observed in patients with autonomic dysfunction. It is often ameliorated by lying down (or by other manoeuvres which increase blood pressure) and worsened in the head-up posture. It is noted in 93% of patients with pure autonomic failure and in 51% of patients with multiple system atrophy1. The aetiology is thought to be hypoperfusion in these bulky muscle groups. Consistent with this is the crampy and ischaemic nature of the described pain and its relationship to posture.

1. Bleasdale-Barr KM and Mathias CJ. Neck and other muscle pains in autonomic failure: their association with orthostatic hypotension. J R Soc Med. 1998;91:355-359.

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