Despite an increase in the number of available and effective antidepressants, many patients with depression respond poorly to drug treatment. At least a third of patients make an inadequate response to their first antidepressant monotherapy. Responses to subsequent courses are also limited.
Epidemiology/ Etiology. Discogenic pain is a form of low back pain, caused by chemically or mechanically damaged intervertebral discs.(level: 3A) This damage can find its origin in traumatic events, as well as in deterioration due to aging.
1 Degenerative disc disease in the neck (cervical spondylosis) can cause local neck pain or radiating pain from disc herniation, causing pinching of nerves (cervical radiculopathy). 2  Abnormal conditions involving the spinal cord, heart, lungs, and some abdominal organs also can cause neck and shoulder pain. This can also cause muscle spasms in the neck and shoulder areas. 2  Tendonitis: The tendons connect the muscles to the bones. 3  With strain, the tendons can become swollen and cause pain. 4  This is also referred to as tendinitis. 5  Gallbladder disease: This can cause a pain referred to the right shoulder.