{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T06:07:59Z","timestamp":1785391679002,"version":"3.55.0"},"reference-count":26,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T00:00:00Z","timestamp":1748217600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Interdisciplinary Research Group on Musculoskeletal Disorders"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>Background and Clinical Significance: Altered pain perception is a diagnostic challenge for patients with a history of trauma and substance use. Familial dysautonomia (Riley-Day syndrome) may further complicate the sensory profiles. Case Presentation: We describe a male in his late twenties, originally from Central America, with a history of severe childhood trauma and chronic cannabis use, who reported diminished pain perception despite multiple injuries. Despite the absence of nociceptive pain (nociceptive hypoesthesia), abnormal sensations, such as tingling and itching (paresthesia), and occasionally unpleasant burning sensations (dysesthesia) were common symptoms in this case. Diagnosis: Clinical suspicion of familial dysautonomia was raised based on altered pain perception and minor autonomic signs. However, no genetic testing or neurological evaluation was performed. Psychological assessment revealed high levels of neuroticism, depression, and maladaptive coping. The Central Sensitization Inventory (CSI) and the Symptom Severity Scale (SS) further supported the presence of psychological symptoms suggestive of possible central sensitization. Outcome: Functional improvement was observed after a reduction in substance use and implementation of self-directed physical and cognitive rehabilitation. No standardized follow-up or formal interventions were recorded. Conclusions: This case illustrates the complexity of pain modulation in trauma-affected individuals and emphasizes the need for an integrative, interdisciplinary evaluation of atypical pain presentations.<\/jats:p>","DOI":"10.3390\/reports8020080","type":"journal-article","created":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T04:46:38Z","timestamp":1748493998000},"page":"80","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Altered Pain Perception in a Young Adult with Childhood Trauma and Suspected Riley-Day Syndrome: A Case Report"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2193-2101","authenticated-orcid":false,"given":"Pedro","family":"Mart\u00ednez-Lozano","sequence":"first","affiliation":[{"name":"Department of Physiotherapy, Faculty of Medicine, Health and Sports, Universidad Europea de Madrid, Calle Tajo, s\/n, Urb. El Bosque, 28670 Madrid, Spain"},{"name":"Interdisciplinary Research Group on Musculoskeletal Disorders, Calle Agust\u00edn Querol 5, 28014 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurcio","family":"Sousa-Pitti","sequence":"additional","affiliation":[{"name":"Interdisciplinary Research Group on Musculoskeletal Disorders, Calle Agust\u00edn Querol 5, 28014 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Toro-P\u00e9rez","sequence":"additional","affiliation":[{"name":"Interdisciplinary Research Group on Musculoskeletal Disorders, Calle Agust\u00edn Querol 5, 28014 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Nicol\u00e1s","family":"Cuenca-Zald\u00edvar","sequence":"additional","affiliation":[{"name":"Interdisciplinary Research Group on Musculoskeletal Disorders, Calle Agust\u00edn Querol 5, 28014 Madrid, Spain"},{"name":"Grupo de Investigaci\u00f3n en Fisioterapia y Dolor, Departamento de Fisioterapia, Facultad de Enfermer\u00eda y Fisioterapia, Universidad de Alcal\u00e1, 28801 Alcal\u00e1 de Henares, Spain"},{"name":"Research Group in Nursing and Health Care, Puerta de Hierro Health Research Institute-Segovia de Arana (IDIPHISA), 28222 Majadahonda, Spain"},{"name":"Physical Therapy Unit, Primary Health Care Center \u201cEl Abaj\u00f3n\u201d, 28231 Las Rozas de Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosana","family":"Cid-Verdejo","sequence":"additional","affiliation":[{"name":"Interdisciplinary Research Group on Musculoskeletal Disorders, Calle Agust\u00edn Querol 5, 28014 Madrid, Spain"},{"name":"Faculty of Dentistry, Universidad Complutense de Madrid, Plaza de Ram\u00f3n y Cajal s\/n, 28040 Madrid, Spain"},{"name":"Department of Clinical Dentistry, Faculty of Biomedical Sciences, Universidad Europea de Madrid, Plaza de Francisco Morano s\/n, 28670 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4804-550X","authenticated-orcid":false,"given":"Oliver","family":"Mart\u00ednez-Pozas","sequence":"additional","affiliation":[{"name":"Interdisciplinary Research Group on Musculoskeletal Disorders, Calle Agust\u00edn Querol 5, 28014 Madrid, Spain"},{"name":"Physiotherapy and Orofacial Pain Working Group, Sociedad Espa\u00f1ola de Disfunci\u00f3n Craneomandibular y Dolor Orofacial (SEDCYDO), 28009 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8002-5563","authenticated-orcid":false,"given":"Laura","family":"Jim\u00e9nez-Ortega","sequence":"additional","affiliation":[{"name":"Department of Psychobiology, Complutense University of Madrid (UCM), 28040 Madrid, Spain"},{"name":"Center for Human Evolution and Behavior, Instituto de Salud Carlos III (ISCIII), Complutense University of Madrid (UCM), 28029 Madrid, Spain"},{"name":"Psychology and Orofacial Pain Working Group, Sociedad Espa\u00f1ola de Disfunci\u00f3n Craneomandibular y Dolor Orofacial (SEDCYDO), 28009 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleuterio A.","family":"S\u00e1nchez-Romero","sequence":"additional","affiliation":[{"name":"Interdisciplinary Research Group on Musculoskeletal Disorders, Calle Agust\u00edn Querol 5, 28014 Madrid, Spain"},{"name":"Research Group in Nursing and Health Care, Puerta de Hierro Health Research Institute-Segovia de Arana (IDIPHISA), 28222 Majadahonda, Spain"},{"name":"Physiotherapy and Orofacial Pain Working Group, Sociedad Espa\u00f1ola de Disfunci\u00f3n Craneomandibular y Dolor Orofacial (SEDCYDO), 28009 Madrid, Spain"},{"name":"Department of Rehabilitation Sciences, Florida Gulf Coast University, Fort Myers, FL 33965, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Noe, C. 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