Neurologist Dr. Doping tells about the characteristics of the pain, the myths of the Spine and pain threshold. The pain is different from acute chronic? What is the difficulty of establishing the source of pain? Why is untenable theory of osteoarthritis?
What is pain? The pain is familiar to all of us, we once felt it, once it felt. The concept of medical pain and the concept of medical pain problem - it's a little different. Pain in the normal sense - a signal that is indicative of possible damage to tissue this tissue damage or described in terms of such damage. Medical problems as such constitute the two characteristics of pain: acute pain associated with acute trauma, acute injury, which often involved surgeons, trauma specialists urgent occupations, and chronic pain.
By itself, the pain - it is the chain dog of health, which is responsible for your health and protect your health from adverse reactions. If you accidentally forget your hand on the stove turned on, you'll get a pain-free barbecue, the pain you will feel the pain and time will remove limb.
What pain is a problem and danger? The first is a sharp pain. Tissue damage may be different, and the treatment of acute pain to identify its causes - not the best option. Under this option, the main thing - it's diagnosis, determination of the source, which causes pain and gives development. The second - is chronic pain, which can exist without the primary source as a "trace of comets".
Characteristic of acute pain is pain that is faster than healing of damage occurs. The pain from the injection into the muscle or pain from an injury received while nailing passes before was a bruise. That is, we see that the signal is ended, the signal is said that you did something wrong and he ended his role was lost, went on tissue repair.
Chronic pain is a pain that lasts much longer healing period. People with such pain turn to neurologists to vertebrology, a podiatrist, a traumatologist, to physicians, to different specialists, who are responsible for the pathology of various organs, systems and tissues. This is a big problem, often associated not so much with the medicine the pain itself, but with the expectation and the patient's perception.
You can reduce pain by Solcoseryl gel, Adrenaline (Epinephrine) injection.
What is pain? In general, what is in our life with you? From the plans that we are building. Pain interferes with these plans, it is their significantly varies depending on your cultural beliefs and family traditions and mixes them together. This psychosocial factors pain, which, unfortunately, there are in any pathology. If today you hit yourself on the thumb with a hammer, then tomorrow you will not be able to play the piano - you understand it perfectly. The same applies to any kind of pain at other sites.
What are some types of pain? The first type is nociceptive pain. Nociception is this irritation nociogenic receptor, a pain receptor. It is pain that occurs during stimulation of a needle. When you were at the doctor when someone stabbed you a needle, a needle pricked themselves - this is a typical nociceptive pain. It's a pain that appears in the inflammatory or traumatic practice, mechanical pain is nagging, aching sensation in the area of damage. You can, in principle, to locate them - can be clearly, perhaps, not very clear, but you know their location.
The second option is pain is neuropathic pain is caused by damage to structures, conducting pain. The most typical example is when you hit an elbow on the arm of the chair, you feel backache, horripilation- all, hello, neuropathic pain. This set of examples of pain that occurs, in fact, in most people.
Isolated any kind of pain is difficult to imagine, it is most often a mixture.
The latter type of pain - the pain is psychogenic, those psychosocial factors. Most often, again, it is a mixture of all these factors, depending on your settings. Depending on your concerns, fears, all mixed together.
The classic expression of nociceptive pain is a burn, when there is no damage to the pathways, there is only damage to tissue and pain receptors. The classic manifestation of neuropathic pain is postherpetic neuralgia, when there is no damage to the manifestations of pain receptors, but there is damage to the conduction system. More often than anything else is a mixture. Psychogenic pain - a pain when we clearly believe that there is no damage to any of the mechanisms, but often even with very modern methods of examination to exclude some of the mechanisms of pain is very difficult.
Fears of patients and their awareness of pain mechanisms play a cruel joke. Pain and pain research, understanding of the causes of pain, not to mention her treatment is a fertile ground for abuse. Who among us you do not give all the money to find out where the pain come from? Let us give. Patients often communicating with each other and sharing information, as a result of earning such initiative, which often interferes with their own survey.
Not all methods of diagnosis of pain allow to clearly establish its cause. Often, the reason lies on the surface, and the patient digs himself to the ground, find some reason finds what bind: injury to a child, falling in the childhood of the tree - and on his whole life is connected with the curse of the tree, the curse of the fall.
Clear diagnosis and treatment standards that exist in the world of professional recommendations in professional societies, make it possible to save on time and money spent on inspection.
Where the pain occurs? Pain is found not only in neurology, orthopedics not only, Spine - any pathology. In the first place, as well as acute pain, is determining the source of pain, not its treatment, and only then treated. This pain is surgical, gynecological, trauma. The problem arises when the pain is at the crossroads of different professions. For example, chronic pelvic pain - joint gynecology, proctology, urology and neurology. Chest pain - joint cardiology and neurology with Spine and Orthopedics. Pain in the face - dentistry, ENT and neurology again.
Unfortunately, undue popularity in recent years receives a so-called theory of degenerative disc disease, vertebral or pain. One of the myths of modern medicine is about the omnipotence of Spine and all kinds of violations that it can cause. It may be, but not all. The problem is related to the excessive diagnosis, with redundant treatments, with excess funds, leaving the treatment of vertebral disorders.
Who of us with you the correct posture? I'm wrong, you have the wrong, five people I met on the road, wrong. And if this is the cause of pain, they suffer pain? Not always. Maybe, and suffer, perhaps, they complain. However, changes may be all the same, but different pain. Pain each person has an individual person and individual coloring.
Speaking about the realities of Russian medicine. Russia, unfortunately - the birthplace of elephants. Concepts diagnosis of degenerative disc disease and diseases that hurt us all, young and old, around the world almost non-existent. It is solely our finding, which was invented in order to describe non-specific changes in X-ray or MRI. And suddenly, for no apparent reason it has become a diagnosis justifying why it hurts.
Naturally, the picture changes in brain imaging, MRI or X-ray stable. Pain may appear or disappear. Moreover, there is evidence that more than 80% of patients do not complain of pain, there is the same change. And often the pain can be present in the absence of any changes and additional methods of research.
This casts doubt on such a popular idea osteoarthritis and various methods of its treatment.
That speaks about the perception of pain and why someone is ill, and someone does not hurt? There is a notion of the pain threshold. In addition nociogene structures that conduct pain, there is the concept of anti-nociceptive structures which suppress pain. Pain - is a regular signal is sent to the center from the periphery to the information about all the good and all is not well. At some point, the pain threshold is reduced. Either reduced pain threshold, and we feel the pain, or increased pain stimulus. Accidentally in the course of conversation I have banged a hammer - the stimulus increased. Accidentally have decreased pain threshold, you feel any grit in the shoe - that's the source of pain.
The level of pain threshold - is a concept that requires a separate study, special attention and individual papers. And scientific works, unfortunately, studied not only on patients, something patients who can find the changes, but also on healthy people and healthy people to drive in modern conditions for the study of any kind has been the characteristics of their health in the absence of their complaints, in principle, very difficult.