Просмотр полной версии : Pain in the bottom part of a stomach or belly
Hello!
I wish to hear opinion of the independent doctor, nezashorennogo and neotjagoshchennogo turn of patients and a disadvantage of time! Because, in my opinion, the simple statement of the facts and a view can explain to the doctor very much much! And to listen doctors accepting patients similar are not able In fact the simple anamnesis, the close or attentive doctor the most correct diagnosis defines at once and often! So it seems to me!
Of that only I have not had heard plenty, by what only analyses did not do or make, what medicines did not accept All in empty, all with zero result, and often and with deterioration of state of health! This leapfrog 3 years also proceeds!
I carefully listened to own organism, analyzed a status, a pain, bad state of health and have come to the certain conclusions. They can be and erroneous, I not the doctor And nevertheless suspect, that I am right! I very much would like, that you have estimated or appreciated a situation, have drawn a conclusion and something have advised, even so!
And has occured or happened here that
About three years ago, and if is more exact hardly earlier, I have started to feel any painful sensations at the very bottom of a stomach or belly, is even more exact in an inguen, even more exact almost at a root of a sexual member. These pains for some reason appeared after the sexual certificate or act (?!). Any venereal, inflammatory or other phenomena at me was not went it was checked to doctors-urologists (not to one).
The pain was short, no more than 2 - 3 hours, but reminded any spastic stricture as though someone has seized ticks or mites an inguen. Then I passed or took place all also any troubles did not feel. It repeated not always, but happened
And here three years ago I have started to feel precisely such painful sensations, but already hardly above an inguen, beams missing to a girdle. But too occasionally and more often in the evening when went from job.
In one perfect day I having executed the matrimonial duty or debt in the evening, have suddenly felt not so good sensations in an inguen - there was a strong gravity! Has woken up - like all easy in the morning, but it was necessary to me to rise, there was a pain! The Pain proceeded all the day long! And all second day! And all the third the fourth and the fifth ! The pain exasperated me constantly, reaching up to intolerable, but again reminded not the ticks or mites at the very bottom in an inguen, and gave, rose upwards on a stomach or belly more precisely. I have not born - have gone to the urologist!
Analyses and US have not shown anything! Have just in case done to me massage of a prostate and have written out drops "Gentos". Anything certainly has not changed - the pain continued dopekat!
It was necessary to go to the paid urologist. Repeated anonymous analyses, and similar treatment, even with fizioprotsedurami nothing has given! Dopplerografija vessels of legs or foots, too anything "seditious" has not shown!
And then pokatilos the Doctor was hooked (having lost confidence and resoluteness) for hardly the increased vein in a scrotum! Has insisted on operation on excision varikotsele.
Result zero - a pain only vozrasla. Some urologists looked me in hospital and have concluded, what is it not urology! (operation means was imposed and unnecessary!)
Have directed to the gastroenterologist!
Two months at the gastroenterologist - tablets, an enteroclysis , an irrigoscopy. Result - zero!
Have checked up arteries of a solar plexus and have found out a compression stenosis of a celiac artery ! Have insisted on operation! Have made! Cut out, in a load , an appendix! The Pain not only has not disappeared, has increased three times having exhausted me within three months! Ferment or enzymatic preparations of a pancreas - "Kreon", "Pankreoflat" and so forth as nothing of a distance! I have made a tomography tazovoj areas on a spiral tomograph. Has made JAMRT a lumbar department of a backbone. Conclusions of doctors any!
Further my adventures to the psychotherapist (under the insisting of doctors), to kineziologu, to bioenergokorrektoru, to refleksoterapevtu, to the sports doctor, hydrotherapeutic procedures, the baths calming or abirritating grasses, medicines - n and ch e g about n e d and l and!!!
The pain both was, and proceeded! And has remained!
I explained to doctors in detail character be ill or sick - at night, by the morning almost pains completely disappear, amplifying only by the evening or to the middle of day. The pain increases always or is always enlarged after acceptance of thermal procedures - baths. But increases or is enlarged hours through 10 - 12, practically only next day! The Pain increased always or was always enlarged constantly accrueing or increasing on job, it was necessary to me to sit down only on a workplace. Through 30 - 50 minutes the pain appeared and by a dinner she reached or achieved apogee! Not to suffer in forces a pain I left on street and went a fast gait of meters 300 - 500, has found out, that if I move, I go - the pain dissipates (the truth there is a feeling of gravity). But it is necessary to me to stop only and postojat in turn or to come on a workplace and to sit down for the native computer - a pain in 30 minutes again appears. And so in the whole days!
In the evening having come home I laid down and the pain in an hour receded, left there Was a feeling of gravity which by the morning completely disappeared. And next day all repeated all over again!
I was in medtsentre where cleaned an intestine, cleaned a liver - nothing helped or assisted. The pain has risen already on a level of a belly-button, having captured all bottom part of a stomach or belly. The palpation and a petrissage of a stomach or belly did not give any reaction, the pain did not increase or was not enlarged Any pressings gave by nothing.
Has passed or Has taken place more than two years of my excruciatings. Physicians do or make nothing and do not advise.
For the third year the pain has risen on a level of a solar plexus and has captured already top part of a stomach or belly, partially having deviated in area of a liver. Natuzhivanie a stomach or belly, pressing, and even simply lowering of an arm or a hand on a stomach or belly in lying position were very unpleasant and caused sensation raspiranija.
I have moderated a delivery having thought, is what is it connected already with an intestine or with a liver Began to use more than vegetables and fruit, porridges Have dumped or reset a few or a little;little bit weight, the pain has left area of a solar plexus and the top part of a stomach or belly, but in the bottom of a stomach or belly has remained, again having concentrated in the inguen or at a root of a sexual member.
Mysticism this all you will not explain, does not happen in the nature of the miracle phenomena - to it or this there are unequivocal reasons. Moreover, I think the reason of all of it or this one! What, me should seems to tell or say doctors But they do not speak, can be do not know, there can be such doctors...
And my personal opinion to all to it or this is cleanly mechanical squeezing vessels in a sitting position!!! In other words, an overload of vessels! (doctors a leg or foot on a leg or foot, owing to squeezing vessels do not recommend to sit!) a leg or foot on a leg or foot I do not sit, but I sit much and can be I press inguinal vessels. It is imperceptible at once, and not at once too! It is unique, that noticeably is the appeared pain in an inguen.
I not the doctor also cannot do or make conclusions, but after the passed or taken place peripetias I can not estimate or appreciate it differently, as a pain of vessels!
About respect Vitaly. St.-Petersburg.
Let's begin with the extremity or end, Vitaly. Vessels do not hurt.
Further. Stating history of the illness or disease, you have missed series essential detaly: age, weight, the body height, the transferred or carried and chronic diseases, operating conditions and a life, medicinal preparations which prinimete (accepted). All it is important.
Please, do not wait for a miracle from virtual consultation. If the reason hurt it is not established or installed after huge quantity or amount of internal medical consultations we, without survey of the patient, hardly shall appear prozorlivee.
The important question. How long you were observed at the psychotherapist and what treatment received?
And at last. Clearly, that you ustali from a chronic pain. But the request for the help should not sound aggressively (re-read the beginning of the report).
Dear Olga Jurevna! I Am sorry if I have offended medicine or medical workers, but...
You speak - vessels do not hurt!!! It as they can not hurt or not be ill;not be sick, when thousand and millions people suffer from varicose illness or disease or vasospasms of a brain and so forth and so forth Still as hurt! There is even a whole section of medicine - illnesses or diseases of vessels!!!
I understand what to diagnose or give, certainly, consultation on the Internet inconveniently, but here your estimation - same already opinion! No aggression at me and in a mine is present I try to find all the same the reason of pains, instead of to sit, suffer a pain and or to wait sitting houses when the handbell will ring out .
About 10 years ago at me muscles were ill (or tendons) have diagnosed Me - a polyarthritis. But the polyarthritis is a plural disease of joints! And at me the arm or hand, and in the middle of a forearm - a muscle was ill!! Have registered diclofenac - any result. Have appointed or nominated massage - any result! Have appointed or nominated an electrophoresis - the pain in muscles (where put an electrophoresis) has increased so, that it was impossible to suffer or bear. Then began to register Sulfasalazinum, Trentalum, vitamins! Nothing helped or assisted! All only aggravated pains.
And only having ceased to accept all medicines, I was possible manage a pain. Thanks God such does not repeat already for a long time.
In occasion of the "anthropometric" data I can add:
I am thin, body height 184, weight of 75 kg, age of 50 years. Chronic diseases - an insignificant psoriasis. Some doctors define or determine a pain in muscles, as a psoriasis or psoriatic arthritis! But others thus completely deny it! But I repeat, the muscular pain has practically passed or has practically taken place. But there was other misfortune - periodically arising pain or raspiranie in a stomach or belly! Job sedentary - behind a computer! A life the ordinariest - family, children, an apartment, a summer residence. Certainly there were stresses connected with job, as well as at many in 90th years. But there were also pleasures as well as at many in the same years!
The abdominal pain arises (or increases or is enlarged) sometimes after reception of nutrition, almost always after thermal influence (or for all organism, or locally on area of a stomach or belly!), and practically always after long sitting on one place. Influence even local heat and the static sedentary pose the next days - absolutely provokes a pain! Separately these provoking factors can and not work if proceed not for long or not so intensively. Well, for example, today - in the morning it's OK, four hours at a computer - occurrence hurt! In the extremity or end of day - the pain began to exasperate! There was from job in half an hour a pain has dissipated (has started to move!) . Disappearance or Eradication is very characteristic hurt, even strong, at the slightest activity - I sit on a sofa a pain exasperates it is impossible (a static sedentary pose!!! No Analginum helps or assist) , but it is necessary to begin any movements, zakolachivat nails, to rise on chetverenki and drait (shkurit) a floor on a loggia - a pain passes or takes place! She passes or takes place and at horizontal position of a body..., but it is necessary to accept a vertical pose or to sit down on a chair and the pain starts to appear gradually. It is necessary to lay down to lie hour and a pain leaves (where here nerves?, where here a psychosomatic medicine?). In the morning - indifferently. However, there were cases - the overflown bladder provoked a strong pain in the morning. (a bladder to me surveyed - no morbid data are present.)
At the psychotherapist I was not at one! Registered Phenibutum - any effect. Registered sirdalud - any effect. Have forced to make the encephalogram - any "sedition" as the psychotherapist has told or said is not present. The doctor has decided to operate or work with a method of " a dissecting away of pathologies . Has registered all over again a three-week course of Tinctura Valerianae. Result zero! Then has followed - Ludiomilum and Finlepsinum. A monthly course. Result zero. The doctor was taken aback a little. I have then suggested me to come to more venerable psychotherapist To venerable has not gone. And has gone to other psychotherapist who has started me to ask - where was born, where it was christened and so forth and so forth Then has offered the computer test (one of tests was color - whether till now I shall not understand something is possible in general under this test or dough to learn or find out I sat and on a question to what to you likes color on the screen, thought - to choose dark blue or to choose green , and can be violet, or pink eventually has understood, that is necessary though something to name - has told or said dark blue! It is the test???).
Dear Olga Jurevna, I was at bioenergokorrektora - the woman-doctor! Which after six receptions has told or said to me - you the person-riddle ! Thus she in the beginning has vigorously explained to me, that through pair-three sessions I shall run from it or her zdorovenky and bodrenky! Last visit to her was in general a masterpiece - at a cabinet or study there was a head physician of clinic. Two of them puzzled, why the stomach or belly hurts! Then the head physician has brought a set of ampoules napolennyh any liquids. The woman began "to feel" their arm or hand and in five minutes, nichtozhe sumnjashesja, has declared me, that I have poisoned with gasoline!!! I hardly from a chair have not fallen... I of a smell of gasoline am closer than 20 meters did not feel years 10 probably! Having thought and again "having scanned" an arm or a hand she has declared a set of ampoules to me, what is it not gasoline, and ammonia! To me it became sad And in 10 minutes when I already dressed a coat, she has run out and has joyfully declared or announced to me, that the head physician has guessed (!) that at me - a disadvantage of vitamin C!!! Simply shine!
I understand, that medicine it not the mathematician I Understand, that an organism of the person not the car, but nevertheless it is necessary to save professional advantage. Well to not find the reason, you can not "calculate" it or her is advise where to address. I am ready to pay money (and has already paid considerable), but to prompt the person it is possible?! To direct it or him! To direct searches
There is no Olga Jurevna, not aggressively I ask questions I wish to find, find true the reason so longly exasperating pains And I am tired at all from pains, and from futility from a guessing *quot; on coffee uOU?*quot;, instead of search of the reason. Let eventually it will be though nerves, or that another, but somehow it is necessary to find it, someone should (even for professional vanity) to find this reason.
And in occasion of *quot; o?OOOa?y?u*quot; the diagnosis, here I privdu to you an example - the person one, left to live to Japan, almost 30 years was excruciated by gastric problems, a stomach ulcer. Offered operations, he has disagreed. Medicated. Dolshlo that he could not live without tablets any more and 2 hours. At last having grown weak from fruitless attempts of doctors, in the same Japan, has got... In the Internet. And having typed or collected a line *quot; a ulcer ?N?Ona*quot; in poiskovike, has casually come across the report that the stomach ulcer is caused or causes by anything other as the parasite - helikobakter pilori. A course of antiparasitic therapy... And the ulcer has disappeared, as well as was not! Here to you the correct diagnosis...
And more a small detail...
Before opertsiej excisions varikotsele () me have directed the First Medical Institute of SPb to the neurologist on consultation. The woman-doctor, zav.kafedroj neurologies, it is close or attentive very much me has listened, has examined (minutes forty I was at it or her), has then concluded - *quot; you describe vascular pains! *quot;. So, about vessels I have not invented. But it was only one doctor come out such assumption.
One more interesting moment... In the past to year I was on business trip, weeks two. Has gone - the stomach or belly hurted or was ill;was sick, but complain I cannot every day and nyt, it was necessary to go. Only job was such, that I for all the day did not manage to sit down never, only in a dining room. And so in a day, and within 10 days on business trip, I about abdominal pains z and y l!!! She has disappeared, and I and have not paid even attention, only in 5 days have thought - and the pain is not present!!! But she has returned, as soon as I have arrived also villages for a computer at the job.
When a pain long, and strong, sensation such, that in an inguen and in a stomach or belly all has swelled. Pressing on the bottom area of a stomach or belly causes a pain in top, and pressing in the top part causes a unequivocal pain in the bottom part. Crossing of arms or hand on a breast, causes sensation of a strong overload and raspiranija in the bottom part of a stomach or belly. The pain is always practically symmetric, in the form of two points at one level. These points migrate from below upwards or on the contrary within day. Sometimes falling up to a pubic bone or rising up to a level of a belly-button or a solar plexus. Sometimes the pain turns in raspiranie or is imposed on raspiranie. The sensation such, that hurts a forward wall of a stomach or belly. A chair in norm or rate, even excellent or different - one, two times day. Never happens a unilateral pain, in one point.
Unique place where the pain in three days after operation of excision of a stenosis left, and intensive pressing of the right party or side of a stomach or belly even before operation is an area of a liver. But the urgent US in hospital has not shown anything - the doctor almost *quot; auON???o?*quot; talked to me (for some reason including it possible or probable).
Once again I am sorry if someone has offended something the god I of it or this sees did not want or wish
Dear thunderbolt! You have a little confused concepts. Words *quot; i?y*quot; and *quot; ?ai?Noa??N*quot; despite of the general or common root carry a different semantic load. We consider or examine;survey the PAIN as one of signs of DISEASE. Really, there is a huge section meditsiny-an angiologia. And sores there give the God to anybody! But we the colleague had in view of that a blood vessel as the organ is not capable in itself to hurt or be ill;be sick, but to not fall or be ill at all! And here what disturbance of blood supply or other organ by virtue of this or that disease of a vessel, inevitably conducts to a pain. And it is not too rare to enough intolerant, down to necessity very powerful or potent anesthetizing!
And we do not take offence. Unless only that have written down us in one campaign with bioenergokorrektorom!
Spend the test with Nitroglycerinum and a nicotinic acid. I.e., during pains accept something one, and next time another. Only L- under tongue, and nikotinovku it is not necessary to swallow of Nitroglycerinum on an empty stomach. Optshite sensations.
With sincere respect and compassion, DIAMAL.
That's it about it I also meant to tell or say - a pain is caused or causes not in a vessel, and in adjoining tissues, signals from the nervous terminations or endings! But in fact a source... The provoker hurt nevertheless there can be a vessel! Just as a source hurt like not an intervertebral disk, and peredavlennyj a nervous trunk though the provoker of a pain is nevertheless the protruding or evaginated disk!
And that up to bioenergokorrektora - that I also did not think to write down you there. Simply I would like to learn or find out opinion of surgeons-professionals on the developed situation. Here-O-O and everything, also can be receive efficient advice or council - what to make and where, to itself can be address! And the foreign view on a problem can sometimes deduce or remove from deadlock...
I did not try or taste Nitroglycerinum, and naturally nicotinic acid too did not try or taste. Thanks for advice or council...
One I cannot understand - how a pain (if it not vessels!) disappears in horizontal position how she disappears at activization of movement, and in the same way appears in the static clamped or sedentary pose (if it is the possible or probable neurologic reasons!) a backbone to me looked - anything seditious have not found!
It completely agree with the colleague concerning explanations rather *quot; vascular i??*quot;.
Assay with Nitroglycerinum and with a nicotinic acid to spend expediently.
Two more questions:
Whether the surgeon your stomach or belly at height of a painful syndrome looked?
What reception of medicinal preparations though reduced a pain a little?
shushona
01.09.2004, 19:30
Dear thunderbolt! You have a little confused concepts. Words *quot; i?y*quot; and *quot; ?ai?Noa??N*quot; despite of the general or common root carry a different semantic load. We consider or examine;survey the PAIN as one of signs of DISEASE. Really, there is a huge section meditsiny-an angiologia. And sores there give the God to anybody! But we the colleague had in view of that a blood vessel as the organ is not capable in itself to hurt or be ill;be sick, but to not fall or be ill at all! And here what disturbance of blood supply or other organ by virtue of this or that disease of a vessel, inevitably conducts to a pain. And it is not too rare to enough intolerant, down to necessity very powerful or potent anesthetizing!
And we do not take offence. Unless only that have written down us in one campaign with bioenergokorrektorom!
Spend the test with Nitroglycerinum and a nicotinic acid. I.e., during pains accept something one, and next time another. Only L- under tongue, and nikotinovku it is not necessary to swallow of Nitroglycerinum on an empty stomach. Optshite sensations.
With sincere respect and compassion, DIAMAL
Hello!
I have tried or tasted the test Nitroglycerinum and a nicotinic acid. Nitroglycerinum has tried or tasted only once. And somehow not so it was pleasant to me. Is not present with unpleasant sensations (pressure, compression or a small pain) all remains, as well as was. Easier speaking, reactions were not any in general, neither in the inferior, nor in the best party or side. Only when has taken under tongue Nitroglycerinum, in a minute there was an easy or a light;a mild dyspnea or short wind and has thrown in fever. Minutes through four there was a sensation of an overload, as after three-kilometer jog. Minutes through 20 - 30 this all has disappeared, but during this time there was even an easy or a light;a mild sensation of a giddiness. And in an hour the head has started to hurt or be ill;be sick a little. (the head in general hurts me very seldom, it is possible to tell or say, that does not hurt at all never! And here...).
And here a nicotinic acid tried or tasted some times, time three or four. And too any reactivity was not. As though did not drink! *quot; e?NU?*quot; in an inguen as were and have remained.
In a word, reaction in the form of intensifying or decreases of a pain in inguinal area were not.
And here, that I was not in time (have forgotten) to write. Once to me the doctor-urologist has prescribed medicine *quot; aNOOa?N?*quot;. And so I have started to drink it or him and two-rub or -three days felt in an inguen pulsing kolujushchie pains. Not strong and not frequent, but were. Directly as a needle. And the most interesting - in that place in those points, where these or thus most *quot; ?NU?*quot; vpisajutsja to me in an inguen. Then, certainly, the pain has passed or has taken place. But upon termination of a course *quot; aNOOa?N?a*quot; and during it or him too, the pain in an inguen was and did not disappear. Amplified, but also did not vanish.
Pain or raspiranie often arose after reception even a small amount of nutrition. It has begun in a year-one and a half after the beginning of pains as soon as the pain has started to rise (!) on a level of a belly-button and a solar plexus. Now I eat basically vegetative nutrition, have a little dumped or reset weight (the stomach or belly has decreased, though he at me not very much and big, but naduvanie a stomach or belly last time was very unpleasant - the overload any on all stomach or belly at once was felt), and raspiranie have passed or have taken place practically absolutely. And even the pain in a solar plexus and at a level of a belly-button has disappeared. And here in an inguen has remained.
On former movement the pain, and a static pose disseminates it or her causes.
I communicated with surgeons only up to, during, and it is a little after operation on excision of a stenosis of a celiac artery. And all. Any control of painful sensations over dynamics or changes, doctors did not spend.
It seems to me is necessary to consider or examine such variant as hronic pelvic pain syndrome - a chronic syndrome tazovyh of pains and according to its or his reason, as miofastsialnaja dysfunction of muscles tazovogo a bottom or fundus, tazovaja mionejropatija. The description of a painful syndrome, current of disease very much reminds the given pathology. Abdominal pains also can be result miofastsialnogo a painful syndrome, that at all does not exclude tazovyh pains, and only is diffusion of dysfunction on other departments. A word the God ordered to address to you in the center *quot; C?nO?*quot;, andros.ru to doctor Alexey Viktorovichu Zhivovu.
Leonid_E
01.09.2004, 19:30
Hm... The Reference of application detraleksa in lips of the urologist is represented a little strange. Well good! By the way, reaction to Nitroglycerinum at you absolutely adequate, as well as at other 99 % of people. Regrettably also, that presently any tool inspection is interfaced or integrated not only to time or temporary costs, but also with appreciable material inputs.
And now periodicity and duration of coituses do not influence in any way a status?
Journal of Occupational and Environmental Medicine Volume 40 * Number 5 * May 1998 Letters to the Editor
Pelvic Joint Dysfunctions, Lifting Injuries, and Testicular Pain
To the Editor:
I read your recent Occupational Medicine Forum entitled *quot; Can Heavy Lifting Cause Epididymitis? *quot; with interest. [1] I have seen and treated cases of so-called *quot; sterile epididymitis*quot; in the past and have discussed this with urologic colleagues. Until your article, however, I was unable to find any references in the literature to corroborate this diagnosis. This article by Dr. Lerner is a welcome addition to my library.
The issue of testicular pain from lifting raises the important issue of an alternative pathology often misdiagnosed as epididymitis or other conditions. To illustrate, a 41-year-old male was lifting and twisting heavy lawn ornaments when he experienced sudden severe right testicular pain. When it worsened, he was evaluated at an emergency department, diagnosed presumptively with epididymitis, and started on a course of antibiotics. Two days later, he returned to the emergency department with unrelenting pain, and was started on a different course of antibiotics. His symptoms persisted. He also had developed right-sided low back pain and bloody diarrhoea.
He was admitted to the hospital one week later in extreme distress, and a diagnostic workup ensued. A urology consult documented no epididymitis, and cystoscopy and prostate evaluation results were negative. Barium enema, colonoscopy, colon biopsy, and magnetic resonance imaging (MRI) results of the back and pelvis were all negative. He was diagnosed and treated for an iatrogenic case of Clostridium difficile diarrhea. An orthopedic surgeon did not feel that there was a surgical back lesion. After a two-week hospital course costing tens of thousands of dollars, he was discharged home without a diagnosis. At that point his testicle pain was not improved and his low back pain was increasing. He was later referred to me, and the diagnosis of a pelvic joint dysfunction was made. He was treated, with eventual resolution of all symptoms.
In the osteopathic literature, there is a variety of dysfunctions within the joints of the pelvis, including the symphysis pubis [2] joint. Often, symphysis pubis dysfunctions are accompanied by dysfunctions within the sacroiliac (SI) joints. These combined dysfunctions usually manifest as a rotation (anterior or posterior) or a shear (superior or inferior) of the entire bony hemipelvis (inominate).
Symptoms
When there is a dysfunctional symphysis pubis, pain is often referred to the testicle or vagina, and sometimes down the medial thigh toward the knee on the affected side. If only the symphysis is dysfunctional, the scenario of testicle pain after heavy lifting occurs. When the SI joints are also involved, low back pain occurs.
Physical Examination
The examination of the pelvic joints involves a number of otion-palpation maneuvers, which have been previously described in detail. [2] These skills require some training and are offered at various institutions. Studies have shown high interobserver consistency among trained examiners in evaluating pelvic joints. [3] Ballotment is a simple diagnostic test, easily performed by an examiner, regardless of training. The examiner places the heel of the palm on either the symphysis pubis (with the patient supine) or the SI joints (prone patient). Pushing and releasing to ballot the joint will cause pain if the joints are dysfunctional or inflamed.
Diagnosis and Treatment
Diagnosis is primarily by history and physical but may be confirmed with plain radiographs using special stress views, [4 [5] [6] and with bone scans. [7] One of my patients had an edema signal detected within the symphysis pubis on a pelvic MRI. MRI may thus be an additional diagnostic tool.
Treatment involves manipulative techniques that are easily learned. Occasionally, repeat manipulations may be necessary until the joint stabilizes and the surrounding soft tissues tighten. A home program of directed stretching and strengthening is also advisable. An excellent discussion of treatment principles for pelvic joint dysfunctions is extensively covered elsewhere. [2]
Expeditious treatment improves the clinical outcome. Delay of diagnosis allows the joint to stay in a dysfunctional position, prolonging the attended stretch of supporting ligaments, muscles, and tendons. This leads to joint instability, muscle imbalance, and muscle weakness. Presumably, chronic inflammation and possible adhesions within the joint may also be a factor in the chronic pain and prolonged impairment that may result.
Differential Diagnosis
Since patients presenting with pelvic joint dysfunctions do not fit the standard medical paradigms regarding low back or groin pain, this clinical picture poses a diagnostic dilemma to physicians not trained in manual medicine techniques. Misdiagnosis is common. The pain does not follow a radicular pattern, and radiculopathy can be excluded with a thorough neurologic evaluation. Further complicating the presentation, secondary trigger points within the gluteus medius, piriformis, and other pelvic muscles may exist as a consequence of the joint imbalances. These trigger points refer symptoms down the leg in nonradicular patterns classic for myofascial pain, as described by Travell and Simons. [8] Epididymitis is also often confused with symphysis dysfunction. The pain is distinctly different in these two conditions. The pain of sterile epididymitis is a burning ache. The testicles and scrotum may be too tender to allow the wearing of underwear. Oral antibiotic treatment can result in marked improvement in as little as 24 hours.
In contrast, the pain with symphysis dysfunction tends to be sharper. This pain is generally located above the penis, in the midline, and sometimes just off to the side. The testicles are not usually as tender to palpation, or are nontender, and there is no difficulty wearing clothing. Response to a diagnostic-therapeutic trial of manipulation is often immediate and complete.
Symphysis dysfunctions are also commonly misdiagnosed as acute inguinal hernias. This is not surprising since heavy lifting is associated with both conditions. In fact, I have seen many patients where an incidental, preexisting, but asymptomatic hernia was treated by herniorrhaphy. Their *quot; hernia*quot; pain remained despite surgery, only to disappear after identification and treatment of the symphysis dysfunction.
When patients have both a symphysis dysfunction as well as a hernia, careful palpation is helpful in distinguishing which is the painful condition. By placing the examining digit in the inguinal canal and gently curving the finger medially, one can palpate directly over the symphysis. Comparing tenderness at the symphysis to that at the hernia, it is generally easy to distinguish which is more painful. Palpation in this manner over the normal symphysis or at an old hernia is typically nontender.
In acute inguinal hernia, tenderness and pain usually persists for a minimum of 3-4 weeks. If treating the symphysis, without treating the hernia, abolishes all pain in less than 1 week, one may conclude that the hernia was old and asymptomatic and that the symphysis dysfunction was causing the groin pain. The painless hernia may later be addressed as indicated. Certainly it does not harm the patient to proceed in this manner, in the absence of an incarceration. Alternatively, surgical hernia repair without addressing the painful symphysis prolongs suffering and disability and may lead to chronic impairment.
Symphysis dysfunctions are also misdiagnosed often as acute or chronic prostatitis. Typically these patients have had many negative culture results and have often been treated with multiple antibiotic regimens. Sometimes they have been instrumented or even examined under anesthesia. Usually these treatment approaches have failed to improve symptoms, in some cases despite years of trying. Such patients generally report greater improvement with manipulation of the pelvis than with prior regimens.
iryna_segal
01.09.2004, 19:30
As a further illustration of the potentially drastic consequences of misdiagnosis, one unfortunate patient had so much testicle pain that he even submitted to unilateral orchiectomy. When this did not improve his testicle pain, even in the absence of the testis, he sought further consultation with me. Once his symphysis pubis dysfunction was treated, the pain disappeared. At that point, he was pleased with the pain relief but dissatisfied with the absence of his testicle.
Discussion
These conditions are not new. The mobility of the symphysis has been documented as far back as 1929. [4] Symphysis pubis dysfunctions have been discussed and described under a variety of different terms: *quot; pubic stress symphysitis, *quot; [9] *quot; osteitis pubis, *quot; [10] *quot; public symphysis instability, *quot; [11] and several others. [12] It is commonly seen in runners, athletes, pregnant women, and workers involved with heavy manual materials handling. Until I learned about pelvic joint dysfunctions, I might have argued that these conditions did not exist. Upon greater awareness, however, I have been astounded at the frequency with which they occur.
Pelvic joint dysfunctions are very common in patients with acute as well as chronic low back pain. Greenman recently looked at the incidence of pubic dysfunction in a population of 183 patients with chronic failed low back pain. The pubis was found to be dysfunctional in 75.4 % of the population. In his words, *quot; it clearly is a significant, but underrecognized, and undertreated problem with low back pain populations. And quot; (P.E. Greenman, personal communication, 1992). I would conservatively estimate that 30 %-50 % of my patients with acute low back pain have some component of a pelvic joint dysfunction. Approximately 15 % of these people have symptoms referable directly to the symphysis.
If we assume that only 10 % of patients presenting with acute low back pain have a pelvic joint dysfunction (a very conservative estimate!), it is easy to imagine the magnitude of this problem. Low back pain is the second most frequent presenting complaint to primary care doctors in this country. The yearly prevalence of back pain is 50 % in working-age adults, 15 %-20 % of whom seek medical care. [12] Recognizing that very few physicians are trained in diagnosing pelvic joint dysfunctions, my judgment is that these are the most frequently misdiagnosed (or nondiagnosed) conditions in the United States, effecting millions of patients annually.
If the diagnosis is missed, why then do so many of these patients improve? One possibility is that some of these dysfunctions are treated with maneuvers similar to exercises commonly utilized for the low back, such as William's flexion stretches. The patients may thus be unwittingly manipulating themselves with standard regimens. Also, many back pain patients with pelvic dysfunctions are accurately diagnosed and treated by physical therapists whose clinical notes are either ignored, never seen, or misunderstood by the treating doctor. It is consequently no surprise that the doctor may not realize what the true problem is. More importantly, the morbidity and consequences of incorrect treatment are staggering.
In writing this report, I hope that my colleagues will have a greater awareness of a condition causing significant discomfort, dysfunction, and morbidity. Inaccurate diagnosis is exceedingly common and often leads to inappropriate treatment, needless and costly diagnostic tests (some of which may be invasive), hospitalization, or even surgery. When the diagnosis is not forthcoming because it is not part of our typical paradigm, the physician may be tempted to improperly ascribe symptoms to presumed psychosocial pathology or motivations of secondary gain.
Medicine, in addition to being both science and art, is also a belief system. Unless we doctors believe in a disease process, we are unlikely to diagnose it. I am convinced that if my colleagues remain open-minded, yet appropriately skeptical, they will begin to recognize patients with pelvic dysfunctions. If the diagnosing physician is unable to perform the manual medicine techniques, there is an increasing number of qualified physical therapists, physicians, doctors of osteopathy, or chiropractors who can. Through improved diagnostic accuracy and treatment, doctors will better relieve the pain of countless patients in the future.
Orrin Mann MD, MPH
Medical Director Department of Occupational Health Multicare Associates of the Twin Cities Rosedale, MN
Kindgott
01.09.2004, 19:30
Influences...! Also influences, as influenced earlier, even before occurrence of proof abdominal pains, only more strongly and almost always! Usually it was shown by sensation of a spastic stricture in an inguen, during two-three hours after affinity. But it was not so often - I could not understand the nature of this phenomenon, and even somehow intelligibly explain, what is it such to myself. Especially to explain to the doctor...
And then it has poured out in a steady pain in the same place, but hardly later the pain has spread on all stomach or belly and has risen already up to a solar plexus. And more the characteristic moment - the constant active pain has begun after affinity, more precisely speaking there was a feeling of unusual gravity in the evening, and next day gravity has turned to a pain! And pokatilos... Cunningly that I could not wear trousers, the belt (I unbuttoned trousers or suspended them on braces) could not dress, could not stay on one place more than 20 minutes. It was a nightmare! Now hardly it became better, easier, but all the same all proceeds at a little lower level of a pain.
Now after intimal affinity I test intensifying a status of gravity in the bottom part of the stomach or belly, proceeding hour two-rub or -three, and happens and all the day, and there is a coitus provokes intensifying hurt for some days! Earlier I did not understand it or this, did not understand why and for what reason the stomach or belly hurts. Has then found out, that the pain provokes termovozdejstvie. And hardly began to pay attention to consequences of intimal affinity Here only interestingly later is happens not always...! Often, but not always, that is it is very difficult to guide or come to see statistics and to define or determine it, as any urological or other pain.
The doctor-urologist has registered to me Detraleks trying *quot; naoshchup, o??NO?*quot; to catch a source hurt and to try to clean or remove, treat it or her.
Means, as I have understood, otsutstvvie reactions to Nitroglycerinum and a nicotinic acid speaks about absence *quot; ??On??O*quot; the reasons of pains.
Here in occasion of nervologicheskogo parentages of pains, the reasons of a pain is I for the first time I hear! Give the god if it to me will help or assist to define or determine really the diagnosis and to recover!
It would be desirable to learn or find out (can be from the neurologists who have come here) - treatment from such misfortune probably (?), how long can be tightened or delayed protsesss treatments (?) in what he can consist (?)...
Here only a question: clinic *quot; C?nO?*quot; is urological, andrologicheskaja clinic...! She deals with such problems (a neurology!)?
And more a question: such prospective diagnosis is a neurology, a psychotherapy or something another. To what doctor in that case it is better to address?!
To EVP. Many thanks, very interestingly!
At the Second International Prostatitis Collaborative Network Workshop the University of Washington made a presentation which concluded that *quot; Men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) have more abnormal pelvic floor and abdominal muscular pathologic findings as compared with a group of men without pain. And quot;
Chris Vincent MD
Department of Family Medicine, Swedish Family Practice Residency,
University of Washington School of Medicine, Seattle, Washington
PERIRECTAL PAIN SYNDROMES: LEVATOR ANI SYNDROME AND PROCTALGIA FUGAX
Definition and Epidemiology
Proctalgia, or perirectal pain, was first described in the 19th century. Three terms are used to classify proctalgia: levator ani (or levator spasm) syndrome, proctalgia fugax, and coccygodynia. Levator ani syndrome refers to chronic or recurrent rectal pain or aching, with episodes lasting 20 minutes or longer in the absence of organic disease that could account for the pain. Proctalgia fugax connotes anal or rectal pain, lasting for seconds to minutes and then disappearing for days to months, in the absence of organic disease to account for these symptoms. Coccygodynia usually describes tenderness of the tip of the coccyx and is synonymous with levator ani syndrome. Unfortunately, the three terms have been used interchangeably in the literature, making precise recommendations for treatment difficult.
Both levator ani syndrome and proctalgia fugax are common disorders. It is estimated that 6 % of the United States population suffers from levator ani syndrome, while 8 % have proctalgia fugax. Proctalgia fugax was at one time thought to be a disorder of perfectionistic young men. It is now apparent that both proctalgia fugax and levator ani syndrome occur slightly more often in women. Both are more common in patients under age 45; psychological factors are not always present (see below).
Cause and Pathophysiology
Levator Ani Syndrome
Thiele generally is acknowledged as the first to recognize the relationship between levator ani muscle spasm and chronic intermittent rectal pain. The levator ani consists of three muscles: the ileococcygeus the puborectalis, and pubococcygeus. These three surround the anus to form a muscular sling that supports the rectum. The muscle is palpated easily during a digital rectal examination. Chronic tension of the levator muscle is thought to cause the pain that characterizes levator ani syndrome.
Proctalgia Fugax
The cause of proctalgia fugax is not known, but current theories favor rectal muscle spasm. Anal manometric studies have demonstrated that patients with proctalgia fugax have normal anorectal muscle function at rest, but develop anal smooth muscle dysfunction during a painful attack. Two families with hereditary proctalgia fugax have been studied. Members of both families had endosonographic evidence of thickened internal anal sphincter muscles. Anal manometry of affected persons showed increased resting pressure and prominent ultraslow wave pressure oscillations. The latter were thought to be caused by smooth muscle contractions of the internal anal sphincter, and peaks in pressure were associated with characteristic pain. Furthermore, drugs known to relax smooth muscles may have relieved attacks of proctalgia fugax.
Proctalgia fugax may be associated with functional gastrointestinal disorders. Abdominal pain and distension, frequent loose stools, and a sensation of incomplete evacuation after defecation have been noted more often in patients with proctalgia fugax. The significance of this remains a mystery.
An investigation of the psychological aspects of proctalgia fugax done in the 1960s found most sufferers to be anxious, tense, and perfectionistic. There was, however, no control group for the subjects. Current consensus does not support a psychosomatic origin for either proctalgia fugax or levator ani syndrome, although stressful events may trigger attacks.
Diagnosis and Clinical Features
Grant et al in an analysis of 316 cases observed that patients with levator ani syndrome complained of a vague, indefinite rectal discomfort or pain. The pain was felt high in the rectum and was sometimes associated with a sensation of pressure like a ball or other intrarectal object. Others note the pain may be aggravated by sitting or by the need to defecate, and relieved by walking or lying down.
By definition, the pain of proctalgia fugax is brief and self limited. Patients with proctalgia fugax complain of sudden onset of intense, sharp, stabbing or cramping pain in the anorectum. The pain occurs at any time of the day and typically awakens the sufferer from a sound sleep.
The physical examination of patients with levator ani syndrome and proctalgia fugax usually is unremarkable. In patients with levator ani syndrome, palpation of the levator muscle while performing a digital rectal examination usually reproduces their pain. Grant noted that in patients with levator ani syndrome, their levator muscle may be felt as a firm band beneath the examining finger as it is passed from a lateral to an anterior position within the rectum. He also observed these patients had tenderness of the levator muscle, and that in most it was unilateral and on the left, a finding confirmed by others.
There are no diagnostic studies to exclude or confirm levator ani syndrome or proctalgia fugax. The inexperienced practitioner should consider other causes of anorectal pain and obtain further investigations or consultations as appropriate. Other causes of anorectal pain are *
Anal fissure External hemorrhoids (thrombosed or infected) Fecal impaction or foreign body Myopathy (hereditary) Neoplasm (anorectal, ovarian, or prostatic) Perirectal abscess Prostatitis
Treatment and Patient Education
Management of levator ani syndrome and proctalgia fugax is controversial. No single treatment has been unusually successful in all patients. Patients with levator ani syndrome and proctalgia fugax should be reassured that their painful attacks are benign and often diminish over time.
Levator Ani Syndrome
For patients with levator ani syndrome, initial conservative treatment with hot baths, nonsteroidal anti-inflammatory drugs, muscle relaxants, or levator muscle massage is recommended. Levator muscle massage consists of high, deep, digital pressure over the puborectalis portion of the levator floor. This procedure is repeated every 2 to 3 weeks for two to three courses. One-half to two-thirds of levator ani syndrome sufferers improve with the above measures.
In the 1980s, several researchers tried electrogalvanic stimulation of the levator muscle. Early studies reporteda 90 % success rate, but subsequent investigations demonstrated a long-term failure rate of 32 % to 60 %. More recently, researchers using EMG-based biofeedback have shown improvement in pain in some studies. The findings of these studies may be unreliable because of the small number of subjects, lack of controls, and high dropout rate.
Proctalgia Fugax
Recommendations for treatment of proctalgia fugax are limited to anecdotal reports and a single randomized controlled trial. Fortunately for most patients, the attacks are brief and infrequent. For patients with frequent attacks, physical modalities such as hot packs or direct anal pressure with a finger or closed fist may alleviate the pain. Diltiazem has helped at least two patients, and oral clonidine provided relief for another. A recent, randomized, controlled trial of albuterol in 18 patients with proctalgia fugax showed significant reduction in duration of pain compared with placebo. Although intriguing, the authors could not commit to recommending albuterol for proctalgia fugax without further studies confirming efficacy.
Dear Vitaly, it not neurologic in the pure state a problem and if it is possible so to be expressed a multifactorial problem. Read texts, that I have placed above. One of the reasons can be blockade (dysfunction) of bones of a symphysis (pubic bones), blockade of a sacroiliac joint, the so-called slanting or braided basin (the osteopathic term). The strain in the certain groups myshts-internal muscles of a basin, cluneal muscles, muscles of a femur, muscles of a stomach or belly As a result develops. In turn on one of hypotheses it can lead to chronic influence on nerves of a basin (*quot; o?a?N???*quot; nerves). Process without treatment can last years, is above written, that the doctor has helped or assisted itself having developed technics or technical equipment of exercises and has got rid of pains with which suffered 22 years. Whether to check up there are problems with joints and muscles absolutely usual palpation (palpation) of prospective painful zones allows usual or not (pubic bones-press on a pubic joint, there is a pain? Then to look for painful points in direct and slanting muscles of a stomach or belly having probed (propalpirovav) a forward abdominal wall, then to turn on a stomach or belly and let somebody will suppress by turns on the right and left sacroiliac joint (it approximately where pits or holes;dimples at women), other aspects of diagnostics are accessible only to the expert-it or -this;-thus an estimation of a tonus of a levator ani per rectum, an estimation of volume of movements in joints, etc. Treatment even in the USA a problem, but I think, that for the beginning it is necessary taki to be convinced all of available given pathology at you. The center Andros really urological, doctors there high qualification, especially A.V.Zhivov, chronic tazovoj pains in the world are engaged in a syndrome just urologists. I.e. for diagnostics it is necessary to address. And in treatment and accompanying consultation the help manualnogo the therapist and the psychotherapist most likely is required.
Here that else I wished to add (to ask)...
In the past to year I have bought or purchased the apparatus *quot; -003 CiA*quot; - subtracted or deducted, somehow, that the apparatus very good, many diseases treats, complex influence.:rolleyes:
Has bought or purchased, has tried or tasted! Now I do not know, whether I correctly did or made procedures, but on average power (average of 5 possible or probable levels), I have spent nearby 6 - 8 sessions, daily, on inguinal area (a bottom of a stomach or belly)! The pain has steadily increased, for long time. I have been angry - such good device, obviously good and again any result!
proshl year and I have again decided to try or taste action of the device - the stomach or belly hurted or was ill;was sick. And again the same reaction.:rolleyes:
Whether this device can affect or influence my problem somehow in general? Whether it is possible in general for me for them to use?
I understand, that *quot; without medical consultation it is impossible to do or make any ONnOOU*quot;, but... I addressed to several doctors...! They did not hear in general, that such device exists. Naturally could not prompt anything!:rolleyes:
Now, if to assume, that the pain miofastsialnaja there can be this device and will appear effective, only on other regimens, less powerful or potent, more or less long.
I, certainly, do not approve or confirm, but can be, under observation of the doctor-neurologist this device will appear effective!
Rules takie-all over again internal survey of the doctor, then treatment.
By the way A.V.Zhivov now at a forum on urology-set to him questions interesting you.
In the past to year I have bought or purchased the apparatus *quot; -003 CiA*quot; - subtracted or deducted, somehow, that the apparatus very good, many diseases treats, complex influence.:rolleyes:
Has bought or purchased, has tried or tasted! Now I do not know, whether I correctly did or made procedures, but on average power (average of 5 possible or probable levels), I have spent nearby 6 - 8 sessions, daily, on inguinal area (a bottom of a stomach or belly)! The pain has steadily increased, for long time. I have been angry - such good device, obviously good and again any result!
proshl year and I have again decided to try or taste action of the device - the stomach or belly hurted or was ill;was sick. And again the same reaction.:rolleyes:
Whether this device can affect or influence my problem somehow in general? Whether it is possible in general for me for them to use?
I understand, that *quot; without medical consultation it is impossible to do or make any ONnOOU*quot;, but... I addressed to several doctors...! They did not hear in general, that such device exists. Naturally could not prompt anything!:rolleyes:
Now, if to assume, that the pain miofastsialnaja there can be this device and will appear effective, only on other regimens, less powerful or potent, more or less long.
I, certainly, do not approve or confirm, but can be, under observation of the doctor-neurologist this device will appear effective!
In this apparatus the principle of treatment by currents D'Arsonvalja - one of the oldest physiotherapeutic techniques is used.
Before to define or determine, which treatment is shown to you (including fizio-), it is necessary to be defined or determined with the diagnosis. Besides treatment is appointed or nominated only after internal consultation.
As to intensifying pains after fizioprotsedur, it or this could be expected: in fact you repeatedly marked or celebrated, that warmly strengthens a pain. And the majority fizioprotsedur (including the darsonvalization) lead to effect of a trichangiectasia of a skin, thus is marked or celebrated rising a thermolysis.
Igor Nikolaevich!
Thanks you for the information, you have fine educated me!
Now looking through retrospktivno I absolutely on another have looked or seen the problems at a situation.
I have enough for a long time (I seem wrote) cervical muscles hurt. Year an one and a half what depart from a neck were ill, and leave in shoulders - in general they almost lateral. (when you take a load in an arm or a hand, these muscles stretch more all! Them it is visible!) As so it has turned out, that they were ill, I till now do not understand. I did or made nothing, gravity did not wear..., and suddenly, such steady pain.
Some doctors, generally neurologists and psychologists approved or confirmed, that this pain in a neck, and in muscles - from nervous loads, from stresses. Understand, to me painfully simple resume - nerves, and all would be desirable to look in another way somehow at a problem... So, and further that what further to do or make!!! To treat it is necessary, if it is nerves... But I shall not remember something, that someone from doctors has particularly specified to me the neurologist or - it was necessary most to search for the psychotherapist, under own initiative, possible sazat most to finish thinking that occurs or happens to me. I touched any variants, but to konktetnym till now have not come. Well for example: the doctor-rheumatologist asks me - you have morning pains...? I speak was not present! And never was! On the contrary, I am always vigorous in the morning and I move easy, and only in the afternoon or by the evening there is a pain! The doctor either is perplexed, or considers or counts, that the pain should be, and it is strange why it or her is not present. Continues to register to me tablets from which to me becomes worse, or changing them from which to me too it is bad!
And so, I also have thought - whether instead of one is the reason be ill or sick... miofastsialnyj a painful syndrome!
Somehow very similar!
And more, wished to ask a question! In the beginning of year passed or took place treatment in clinic Abaja Emshi (east medicine in St.-Petersburg). To me there did or made reflexotherapy, manualnyj massage, etc. procedures. The doctor- as it seemed to me very good (anyway he it is explanatory or sensible has approached or suited to a problem... The truth has become puzzled fine, as well as many other things doctors, was in perplexity, but ideas stated efficient) was there. I think probably it is necessary to go under the scheme or plan - the urologist (a problem tazovyh pains), the neurologist (exaltation of vegetative nervous system, VSD) and kineziolog (putting off or taking out of strains from muscles of a neck, a stomach or belly if they will prove to be true though strains I nechuvstvuju).
For a long time has very much noticed - there is some kind of medicines which it is very negative on me operates or works. It has appeared about 4 years ago. It is necessary to me to start to drink these medicines and it becomes difficult to breathe, there is a weariness (as well as after reception of a thermal bath), and there is a pain - both in a neck and in a stomach or belly. But in a neck can not arise, and in a stomach or belly absolutely! And after that sometimes I feel a strong reactivity from a stomach or belly..., impression such, that all stomach or belly as a spring - it is necessary to touch and on muscles of a stomach or belly waves of exaltation, as hot boiled water miss simply. It happens very seldom, few times in a year, but happens and it is very unpleasant. I think also it too is muscular-nervous exaltation.
One problem or task arises: how now to calm nervous system and to affect or influence thus abdominal pains. Probably, it is gymnastics, easy or light;mild massage, the doctor- advised to take aromatic baths...
To the neurologist explanatory or sensible to talk...
Dear Vitaly, miofastsialnye pains can arise in any part of a body where there are striated muscles, on that they and miofastsialnye. Presence of muscular pains in one part of a body as you have understood does not exclude their possible or probable presence at other muscles, at other zones. For the concrete reasons for you most to search it is not necessary, as usually it is the whole complex - here and disturbance of a posture, disturbance of a statics and dynamics or changes of a spine column, possible or probable functional blockade PDS (pozvonochnyj an impellent segment) and peripheric joints, joints of a basin. The contribution brings also presence of psychoemotional disturbances. For example the American scientists had been proved communication or connection of chronic pains in the bottom part of a back (loin) with a dissatisfaction at sick of the status in working collective.
Influences perception be ill or sick as well a functional status of your antipainful system (is such at the person, allows to develop or produce in an organism of substance reducing a pain) that is caused even by the genetic reasons, etc. the expert can establish or install the Full picture only. I would advise you to address to doctors in a little bit other porjadke-the urologist (exception of a urological pathology and diagnostics of a syndrome chronic tazovoj pains), not kineziolog, and the doctor- the therapist owning technics or technical equipment of a postisometric relaxation and punkturnoj of an analgesia, the doctor the psychotherapist, and also the medical psychologist for an experimental research-psychological (it is simple testing so is called), well and the neurologist already then if necessary. The matter is that not all and not always neurologists dealt with similar problems. And what medicines act on you in a similar way?
... For example the American scientists had been proved communication or connection of chronic pains in the bottom part of a back (loin) with a dissatisfaction at sick of the status in working collective....
Could not give the link?
And I when am strongly upset, I start to limp because of interlocking one of hip joints.
Dear colleagues and patients!
I not only not the neurologist, but also at all or absolutely not the clinician, however shall dare to express a subject in which steadfastly I am engaged almost year.
The person was formed in conditions of constant movement - look or see at children and monkeys. Our muscles are not adapted for long conservation of static poses. The person is not adapted and to monotonous (let weak) to monotonous movements. These two not physiological muscular loads - the most frequent reasons of occurrence miofastsialnogo a syndrome. The third reason - sharp movements, i.e. traumas of muscles.
As a result of one (or several) the specified reasons there is an overload of any muscle (or in English literature "abusing" of a muscle). If this overload long - i.e. despite of weariness and even a pain the person continues to load a muscle in her the so-called trigger point - a small site spazmirovannoj muscles is formed. The trigger point at pressing is very morbid (if you do not touch or tamper with it or her, the pain usually is not present). But this smallest trouble which she carries. The trigger point gives a synalgia - usually aside a joint or in a joint. I.e. the patient feels a pain not in that place where there is its or her source! The second trouble, which many trigger points (especially muscles of a neck and a head) - carry vegetative signs (disturbance of a rhythm of heart, change of salivation, disturbance of vision and hearing, job of organs of digestion ). All it - not opening of last days, all it is known for a long time. Also it is stated in fundamental two-volume book Dzh. Trevell. Simons - Miofastsialnye pains (Translation or Transfer under red. And. Vayne's M.) M. Medicine 1989. Moreover, these talented authors are not openers miofastsialnogo a syndrome - he was known much earlier. However, their work till now is the bible of any doctor working with muscles. By the way, the two-volume book was republished in 1998 practically without changes.
If you vozmyote this book we can discuss more particularly methods of treatment and a selftreatment of trigger points.
P.S. First two chapters or heads it is possible to look or see on a site www.manualtherapy.agava.ru
Could not give the link?
-set of people appear predisposed to a dorsodynia not so much owing to physiological, how much because of the psychosocial factor. Set of researchers approve or confirm, that such factors as psychological stress, residing at loneliness and satisfaction or, on the contrary, discontent with own life and job can be reflected on health of your back.
- You wish to tell or say, what people who are dissatisfied with the job, can test because of it or this a dorsodynia?
- Yes, or, at least, they show complaints is more often. Questionnaire of 31 200 serving airlines *quot; u??u*quot; has shown, that those from them, who, on their recognition, *quot; almost ??una*quot; did not receive pleasure from the job, in 2,5 times to the doctor with a dorsodynia, rather than those who felt pleasure from the job *quot is more often addressed; almost o?Nuna*quot;.
Besides these researches have revealed more frequent diseases of a backbone at those employees, whose job received a low estimation within last six months. It has appeared, what even personal conflicts to the chief have communication or connection with occurrence of a dorsodynia. *quot; job not so strongly affects yours health, as your attitudes or relations with ?a?a?y?Oo?*quot;, - has noted Stenli Dzh. Bigos, director of Clinic on studying a backbone in Seattle, the main inspirer and .organizator the mentioned research.
S.Salmans *quot; the Pain in ???N*quot;
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