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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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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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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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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Some groups of drugs used in the control of blood pressure can cause headaches. As part of their normal action they alter the muscle tone in the arteries, which are the high pressure side of the circulation. Control of blood pressure is by means of muscles lining the walls of the smaller arteries (the arterioles). If these muscles relax, the bore of the arteriole gets bigger; if they relax too much, blood at a higher pressure than usual can flow through to the organ the artery supplies. In some cases this distends the organ unpleasantly, causing pain. This is particularly important in the case of those arterioles which supply the brain. Certain drugs which make the muscles in these arterioles relax cause a pounding headache to develop. The most noticeable drug to do this is glyceryl trinitrate (GTN), which is commonly used under the tongue to abort attacks of angina (transient heart pain).

GTN works by dilating the arteries of the heart so that more blood can flow through to the heart muscle; however, the same action also happens in the arteries supplying the brain. As his heart pain diminishes, the patient also gets a bounding headache for a short period of time, as blood enters the brain under higher pressure than usual. Although with ordinary GTN this bounding headache always goes away quickly, other slow-release nitrates taken by mouth act on the heart for a longer period – and can also produce headaches in susceptible people.

Other drugs used to control blood pressure can cause headaches as a side-effect, especially if they act by reducing arteriolar muscle tone. Many drugs used to control blood pressure act in this way, but the sensitivity of individual patients varies considerably and what may cause terrible side-effects in one may not affect another at all.

Again, the cure is simple – avoid the offending drug. However, don’t suddenly
discontinue a prescribed drug without first talking to your doctor. This can be very
dangerous especially if you’re taking something like beta-blockers. It’s usually of
little value to try to treat headaches caused by specific drugs. It’s much better to
avoid the culprit drug, and change to an alternative preparation.

The contraceptive Pill can exacerbate existing migraines, or even (rather

dangerously) cause them to start in a patient who previously didn’t have migraines.

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Recognising that you have a psychological cause for your headache is the first step towards healing it. If you are constantly striving to prove that there is a physical cause as a way of evading your responsibility to tackle your psychological problems, then you will make no headway. For some reason society tends to make out that people with psychological problems are evil or guilty, while those with physical problems are not. It really isn’t like that at all. True, you may have made decisions which, with hindsight, yon realise have contributed to your own current unhappiness. But for many sufferers from psychological illnesses, sufferings have been imposed from outside – the woman who was abused as a child; the adolescent who doesn’t love himself because his parents never really loved him; the man who is never allowed to show his anger because anger was always taboo in the family. Psychologically speaking, depression is often in-turned aggression -anger that you have not been able to express and so you turn it in upon yourself. So just because there is a psychological cause doesn’t mean that you are necessarily guilty; certainly, no more than if you had broken a leg skiing.

The second part of self-help is to recognise that although you are depressed you mustn’t wallow in it. Those who are depressed can get terribly self-absorbed with their depression and after a time some of them, as the saying goes, enjoy ill-health. Once you start wallowing in it you self-perpetuate the illness, and if you continue with the self-pity you’re likely to find that you quickly start running out of friends.

The third self-help method is honestly and courageously to face up to the things that are bothering you. Often it is an unspoken subconscious fear that you are too frightened to approach; perhaps it’s the fear of death; or that you can’t adjust to your sexuality; or you feel worthless as a result of being unemployed; or maybe you just feel unloved and unlovable. Courageously going headfirst into whatever problem is bugging you is often the quickest way to get out of those types of depression which are purely psychological in origin. Trying to evade the problem merely prolongs the issue and will lead you into more misery.

This is not easy to do. Facing up to those fearsome problems that are so hard to handle that you try to forget about them and bury them in your subconscious, is a very frightening activity, and you will need a lot of emotional support to do it. Tackling deep-rooted, fearsome problems like this is often where professional guidance and counselling come in.

Finally, make sure you get enough exercise. The apathy of depression is quite enough to stop you doing things, but exercise really can make you feel a lot better. Physically speaking, exercise releases the body’s own morphine-like chemicals (the endorphins) inside the brain, and these contribute to an increased sense of well-being. In addition, exercise uses up the extra adrenalin that will be swilling round your system if you’re anxious.

Depression often has its roots in in-turned aggression – an inability to vent anger. Very often the condition can be improved by learning how to appropriately dissipate it. Assertiveness training is part of this technique – learning how not to be trampled on can be very important. It is all about making sure that you are able to put your point of view forward and be listened to. Some people were never taught to be assertive; they find themselves doing what others want simply because they’ve never learned to stand up for themselves.

Physical contact is often a necessity in cases of depression. We humans need the constant physical encouragement of human contact, and families and spouses can often help by making a point of touching. The hand on the arm, the arm round the shoulder, the kiss, the cuddle; these all say ‘You’re important to me, you’re valuable in yourself – sentiments that the depressed person longs to hear.

It will help considerably to express your feelings more often. In depression the emotions often get buttoned up, and expressing them can help (particularly as these emotions can be very strong in depression). In our stiff-upper-lip society, it’s not always easy to let your emotions out, and expressing what you feel in art, music or dance may help. Art, dance and music therapy can be extremely helpful .

Although you might think that religion would be a consolation in depression -and sometimes it is – some depressed people perceive their religious beliefs as a burden rather than as a liberation. This is often tied in with a sense of guilt, worthlessness or failure. It is important to realise that these fears are a reflection of your depression, not an indictment of your beliefs.

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Treatment is principally by recognising the cause of the problem and avoiding it where possible. Better ventilation may be all that is necessary. Proper anti-fungal treatment of air-conditioning systems; anti-allergic treatment such as antihistamines, etc. may be needed; in severe cases of allergy to fungal spores, desensitising injections can be given, but only through your local hospital. Homoeopathic desensitisation may also work.

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Every year many children are unexpectedly diagnosed as being short-sighted when they and their parents didn’t think that anything was wrong. Often it’s only spotted because the child doesn’t seem to be doing well at school. Then someone thinks to check whether she can read the blackboard – and she can’t. The trouble is, if the child’s vision has always been that way she doesn’t know any better; she thinks vision is like that for everyone, so she doesn’t complain.

Minor degrees of squinting can also remain undiagnosed for a considerable time, especially where the child can normally compensate for the squint by extra muscular action. Note also that astigmatism (an inability to focus on horizontal and vertical lines at the same time) is a particularly potent cause of headaches.

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Acupuncture can stimulate the body to deal more effectively with anxiety, depression, stress and irritability. It is supposed also to improve the balance of hormones, which will reduce the symptoms of the menopause. Headaches and migraine can he relieved by treatment to produce the body’s natural painkillers (the endorphins).

Aromatherapy can have a soothing effect – particularly techniques involving bath and massage. Analgesic oils such as lavender and camomile can be used to massage the head, shoulders and neck in order to remove tension and improve circulation. Headaches and migraine can be treated in this way. Clary sage is said to help balance hormones.

An osteopath or chiropractor can reduce the headaches and migraines triggered by stress or neck problems, reducing nervous pressure and tension.

A clinical nutritionist would probably suggest supplementary pituitary glandulars. Avoid spices, alcohol, caffeine and smoking, and reduce your fat intake – all of which help prevent headaches, by reducing the number of potential trigger factors.

A naturopath will suggest a healthy diet, exercise and regular sleep. Various dietary supplements might be recommended; in particular, the IS vitamins, and Vitamins C and E.

An in-depth consultation would be required for a homoeopath to effectively relieve the symptoms of menopause. Cimicifuga might be suggested for psychological symptoms (which can just as easily cause headaches), sanguinara for headaches and hot flushes, subphylum for tension and anxiety, and lachesis for headaches.

Sage has an effect on the oestrogen levels and can be used for problems associated with hormone imbalance. Angus castus, false unicorn, oats and St John’s wort can all be drunk, or taken in tinctures. Skullcap may ease anxiety or depression. Geranium oil is said to affect hormone balance, and the essential oil of rose is supposed to have a toning effect on the reproductive system in general.

Vitamin E is said to keep your reproductive organs healthy.

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