Гипертиреоз – Hypertheriosis

These occur when there is an inflammation of the body’s muscular system. Myofascial pain is a term that refers to the muscles and to the cellophane-like membrane that covers the muscles.

Such conditions are difficult to diagnose as there are no effective examinations or techniques to indicate their presence. The diagnosis is sometimes made only in the absence of neurological or orthopaedic factors.

Myofascial syndromes often mimic conditions such as disc disease and arthritis of the spine. The causes of such syndromes include whiplash, injuries to the neck, excessive exercise, and muscle tension such as typists feel in their shoulders after sitting through a long day.

In these cases, muscles which usually slide freely against one another are pinned down by adhesions caused by a muscular injury. Muscles pulling on the tight areas cause muscle spasm.

Australia has just experienced an epidemic of myofascial-type syndromes in otherwise healthy young individuals who usually complain that the condition is caused by sitting at computer keyboards

for long periods.

In Australia, such conditions are often labelled RSI (repetitive

strain injury).

One of the only ways to diagnose myofascial syndrome is to induce pain as an identifiable trigger point in the back or other muscles. Trigger points are parts of the muscles or ligaments that when pressed with a finger cause severe pain to radiate away from the pressure point.

Although the precise cause of such trigger points is not yet fully understood, it is thought that perhaps restrictive muscle movement causes initial pain. In turn, this restriction is believed to produce muscle spasm that pulls the sensitive covering over a bone to which the muscle is attached.

Treatments Myofascial syndromes are often treated well by physicians using the techniques of TENS therapy and acupuncture. Non-steroidal anti-inflammatory drugs may help relieve inflammation initially and relaxation techniques are often used as a back-up treatment to the physical treatments and appropriate medications.

Temporomandibular joint or TMJ syndrome

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Patterns of pain behaviour are very self-destructive.Yet sometimes people discover that there are coincidental, secondary rewards for suffering, such as increased attention, decreased family responsibility and avoidance of sexual activity. Alternatively, the pain can be used to provide a convenient tool which can be used to manipulate others.The attraction of such games may be strong enough to keep pain patients from recovering. They thus find it worth their while to adopt a certain posture and particular movements which may have been prevented, or alleviated, by taking the appropriate prescribed drugs at the recommended level.

Consequently, they may continue the posture, or the limp,or the drugs — even if such habits no longer have credibility. It is all part of the convincing pain games that a small, but important, minority of patients play.

Some pain sufferers may have found that their pain habits elicit sympathy, feelings of concern, or even approval — rewards they are willing to buy at the expense of being in pain. A particular facial expression, a moan, or a particular ‘pained’ look may offer a pleasant pay-off because others usually respond with kind words or efforts to help.

More common is the patient who is extremely hostile to doctors or members of their families who refuse to act sympathetically to gestures of pain. And there’s the type of patient who wants to ‘even the score’ with a spouse not considered sympathetic enough.

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Bruce was riding his motor bike along the heavily treed banks of a river and failed to see a large tree branch which caught his shoulder. The immediate result was of a tearing pain at the base of his neck followed almost instantaneously by total paralysis of the affected arm. A moment later the motorcycle hit another tree, head-on, causing an immediate loss of consciousness. His paralysed arm was removed and he had been given a number of neurosurgical procedures aimed at controlling his constant almost unbearable pain. Ten years after when he came to the pain clinic he was still suffering constant pain. Fortunately he had an almost miraculous response to TENS therapy and a small dose of Rivotril.

Gunshot wounds

Gunshot wounds, too, fall into the violent trauma category. Damage to peripheral nerves in the arms or legs by such wounds is accompanied by excruciating pain, persisting long after the tissues have healed. These pains may also occur spontaneously for no apparent reason, as in the neuralgia following shingles. The pain has been described by victims as ‘burning’, ‘cramping’ or ‘shooting’. Sometimes the pain is triggered by such an unlikely event as a gentle touch or even a puff of wind! Spontaneous attacks of pain may take minutes or hours to subside. Many occur daily for years after the injury.

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Many of the problems arising between doctors and patients appear from the perceived and common myths regarding chronic pain: It’s all in your head

To some extent all pain is in your head. Because pain is a purely subjective experience — pain is what you say hurts!

Just ignore that pain and it will go away

Many forms of chronic pain simply cannot be ignored. The person experiencing severe unending pain may be able to use distraction but the pain may well still be an intrusion into every waking moment.

Nobody ever felt as bad as you

Although it is true that no-one else ever felt what you feel, it is likely that there are-others who share similar experiences to yours.

God is punishing you for a past mistake .

It is highly unlikely that the Creator has taken the time to specifically torment you for some past misdemeanour.

You’ve been abusing your body so take the consequences

Unfortunately pain occurs in those who abuse their bodies and also

in those who were previously fit. Chronic pain plays no favourites.

All pain is the same

As mentioned earlier all pain is subjective and is thus different for each one who experiences pain.

You just look too healthy to have chronic pain

Since no-one has yet invented a pain meter what is observed by an outsider can be totally misinterpreted. Until the day an external pain measurement device is invented some patients will appear to casual observers as though they are pain-free.

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