Some patients react very angrily and sometimes violently when told that their pain is a mind-body interaction. They become enraged, begin to spit, throw things around and trample them underfoot. They hear only one thing: "Your pain is only in your head." But it is not so. Nobody says pain is unreal. No, she is very real. It's just because of what is called muscle tension syndrome, not what most doctors tell their patients.
The reason patients react so emotionally is because they put their pain first so they don't face their other problems. Rejecting the truth that the symptoms of their illness are created by internal forces, they fall for the deception created by their own cunning brain, and their problems continue.
- Get a medical check-up. Make sure you are not seriously ill with anything. Be responsible for your health.
- Take a look at the results of your physical examination with a grain of salt. If the physical examination reveals nothing other than a herniated disc, arthritis, spurs, curvature of the back, narrowing of the spinal canal (stenosis), or any other normal change, then you have no reason to be sad. All of these disorders do not cause back pain. No matter how many doctors confuse patients on this issue, experience shows that most people have such anatomical changes. For some it causes pain, for others it goes away painlessly. The pain is due to the restriction of oxygen access. Regardless of the location of the pain, be it in the back, limbs or elsewhere, its origin is rarely local. Most often, pain occurs due to myoneural tension syndrome.
- Reject the one-size-fits-all approach. This approach consists in the following words: "We do not know the cause of your pain, so let's try all kinds of methods, one of them will definitely work." These methods include manual therapy, acupuncture, surgical techniques, injections, strengthening of the muscle corset, weight loss, and so on. Almost all of them have the same effect as a placebo. Paradoxically, these methods will leave you painful. If they help the patient, it is only because he believed in them. But the relief does not last long, and this approach should continue indefinitely, since the pain does not go away from the lower back. This approach is the main cause of pain epidemics. Never try to relieve pain - just eliminate it!
- Beware of misdiagnoses. A vertebral hernia does not cause back pain. This myth was exposed decades ago in the seminal work of pain pioneer John E. Sarno, MD. He coined the term "muscle tension syndrome". Spinal surgeons are only now beginning to realize that Dr. Sarno was right. You cannot compress the nerve, as instant paralysis will follow and the pain will disappear. The dead nerve cannot transmit signals. You cannot dislocate your back. The vertebral discs are firmly attached to both sides of the spine and cannot be removed and reinserted. You don't have to strengthen your corset to heal, and scoliosis is pain-free. Proof of this is the fact that almost everyone is cured if they can get rid of these outdated myths. Any part of the body can be damaged, which naturally causes pain. But subsequently the body recovers quickly. Pain does not become chronic if it is not supported by emotional processes and / or conditioned reflexes.
- Understand the cause of your pain. With the help of almost any pain, the brain redirects the patient's attention to the affected part of his body. Pain arises from hidden emotional processes such as anger, fear, sadness, and frustration. When these powerful emotions pass a certain threshold, the brain will reduce the oxygen supply to the damaged area of the body to distract attention from it and prevent emotional pain. Pain is never imaginary or fake, it is always very real and palpable.
- Take a different look at what's going on in your life. Almost everyone I helped heal was able to trace the origin of their back pain to a specific event or period in their life. Is your marriage going through a rough time? Are you unhappy with your job? Is this very unnerving? Has anyone close to you died or is sick? Have you recently retired? Are you a consummate perfectionist trying to please everyone? Don't know how to show your emotions? Feeling abandoned like a child? Are you too responsible and anxious person? Just reaching puberty? Put all the facts about your pain together and heal. The awareness of what is happening unconsciously has tremendous healing power. Once you change your behavior, pain is no longer a major distraction for you.
- Try to understand why you need to believe that you have a bad back. When I declare to someone that there is a real way to get rid of back pain, the most often they say to me: “No! My pain is real! " Yes, the pain is always real. The question is why don't you ask how to heal when you are presented with a prescription. Why would anyone have to fight the pain while still staying with it? This is critical to understanding the purpose of pain. The most common task of pain is to hide emotions that are too powerful or dangerous. The brain creates a terrible sensation of pain in order to firmly convince the patient that he has more serious structural problems than existing worries and unresolved issues. And the patient, of course, will believe that there are problems, because his brain is talking about it.
Modern science, in its unsuccessful efforts to outsmart Mother Nature, is the root cause of the ongoing epidemic of pain from fibromyalgia to chronic fatigue. The truth about the cure does not benefit an almighty monster called the "medical industry" who is obsessed with endlessly continuing pain management without concrete results.
Any message on how to recover is blocked every time by people in this industry who profit from such treatment and articles that are published with money from advertising products of this industry. Thus, the epidemic of pain is on the rise, despite the fact that humanity now has the most advanced technology in its history.
Everyone can be cured if they overcome the old idea of pain and begin treatment again, applying the already deeper knowledge of the root of the problem. The question remains open: do the patients really want to be cured or are they just treating their bodies? These two goals are always at odds with each other.
Health ecology: A psychophysiological disease is any disease in which physical symptoms ...
A psychophysiological illness is any illness in which physical symptoms are believed to be a direct result of psychological or emotional factors. This diagnosis means that psychological factors have either initiated or are contributing to back pain, or both.
It should be emphasized that although psychological factors can be the cause of physical symptoms, the symptoms are not reasoned using imaging techniques. However, real physical problems (such as back pain) can be triggered by emotional factors.
History of "stress back pain"
Dr. John Sarno, MD, a professor in the Department of Physical Medicine and Rehabilitation at New York University, recently popularized the idea of "stress back pain", which he calls "Muscle Tense Syndrome" (SUI), even though the concept was coined as early as 1820. year.
From Paralysis to Fatigue by Dr. Edward Shorter, the history of psychosomatic illness is detailed. And back in the 1820s, the diagnosis was made as "irritated spine" and this is essentially equivalent to the modern idea of stressful back pain. The diagnosis of irritated spine was quite popular and spread throughout the world at that time.
Interestingly, Dr. Shorter was of the opinion that many doctors and patients of that era began to firmly believe in this diagnosis, although there was no obvious pathology. Dr. Shorter noted that doctors put this diagnosis in the patient's head, increasing fears that a serious illness existed, and recommended bed rest for patients.
The diagnosis of spinal irritation remained fairly common until the early 1900s. Dr. Shorter believes that the diagnosis served "the need to remain competitive with other medical clinics in" medicalizing "patients with certain subjective complaints. possible psychological and emotional factors, since most patients did not want to admit the presence of psychological problems.
The history of the diagnosis of spinal irritation is helpful in understanding current medical approaches to back pain. Even today, some physicians focus primarily on structural "explanations" for back pain, and convince their patient that "diagnostic findings" are the cause of the pain, thereby instilling fear in the patient, and then advise the "justified" treatment. However, if stress is the real cause of back pain, then aggressive physical therapy may not be effective and cause more stress in the patient.
And if you go back to Dr. John Sarno's conceptualization of "stress-related pain", you can see similarities with the concept of "spinal irritation". The most important difference is that Dr. Sarno places primary causal factors (psychological and emotional) at the forefront of his treatment plan; while some doctors continue to use only "physical" treatments.
In particular, Dr. Sarno's theory is of the opinion that in most cases of back pain treated by the medical community using "organic" approaches, it is in fact stress-related. It is important to note that this theory and treatment approaches are ambiguously accepted in the medical and psychological community, and have not yet been clearly supported by scientific research.
How does stress cause back pain?
There are many theories about the causes of stress-related back pain. It is important to note that the overriding principle of all these theories is that psychological and emotional factors cause certain physical changes, and as a result, back pain occurs.
In most theories of stress back pain, the cyclical pain gets worse as it goes on, leading the patient to anxiety and problems with daily activities.
Cyclic pain is characterized by:
- The patient becomes unnecessarily limited in many functions of daily life.
- This decrease in activity is due to the patient's fear of pain or injury.
- This fear can be aggravated by the advice of a doctor (loved ones) to calm down due to the presence of diagnosed small structural changes (which may actually have nothing to do with back pain).
- Restrictions in movement and activity contribute to disruption of physical condition and muscle weakening, which in turn leads to increased back pain.
Of course, such a cycle provokes increased pain, increased fear, and even greater physical maladjustment, along with other reactions such as social isolation, depression and anxiety.
Dr. Sarno's theory
In the formulation of Dr. Sarno SNM, back pain is not related to mechanical or physical factors, but is due to the patient's feelings, personality and subconscious problems. Key emotions include unconscious anger and rage. In addition, he describes people who can develop muscle tension syndrome as personality type with the following characteristics:
- Has a strong intrinsic motivation for success.
- Has a great sense of responsibility.
- Purposeful and disciplined.
- Self-critical.
- Perfectionist and compulsive.
Dr. Sarno's theory argues that these personality traits interact with stressful life situations and this leads to back pain. It is also noted that the source of psychological and emotional stress is not always obvious.
Dr. Sarno TMS's theory describes the mechanism by which emotional tension is pushed from awareness by the mind into the unconscious. This unconscious tension causes changes in the nervous system. The changes lead to narrowing of blood vessels and decreased blood flow to various soft tissues, including muscles, tendons, ligaments and nerves of the spine. This leads to a decrease in oxygen supply, as well as the accumulation of biochemical waste in the muscles. In turn, this leads to muscle tension, spasms and back pain that the patient experiences.
Diagnostics of the "stress pain" in the back
A diagnosis of stress back pain is often made on the basis of careful collection of medical history and physical examination findings. But patients should be careful when trying to self-diagnose "stress pain" in the back, as the pain syndrome can be caused by a serious medical condition (such as a spinal tumor or infection). A thorough medical examination using imaging techniques will usually rule out more serious structural causes of back pain in most patients.
In cases where back pain is associated with stress, the history of back pain is often quite variable. The pain may appear after a specific incident, or it may appear suddenly. For example, often pain begins with an incident of muscle and ligament sprains, but does not disappear due to the influence of emotional factors, although the muscles and ligaments have already recovered from the injury.
In many cases, an MRI scan can reveal disc protrusion or osteochondrosis, although stress is actually the cause of back pain. In these cases, the MRI findings are not clinically significant and ultimately these changes are not considered to be the cause of the pain.
Common characteristics of stress back pain include symptoms such as:
- Back pain and / or neck pain
- Diffuse muscle pain
- Painful points in the muscles
- Sleep disturbance and fatigue
- In many cases of stressful back pain, patients complain of pain migration
In general, the symptoms of stress back pain are similar to those seen in fibromyalgia.
According to Dr. Sarno, the diagnosis of SUI is made only when the organic causes of pain are completely excluded, and at the same time, there are characteristic features of SUI.
Treating stress-related back pain
Just as there are many theories about how stress and other emotional or psychological factors can cause back pain, there are many treatment approaches. But the main approach can be distinguished - complex.
With an integrated approach, the treatment of stress back pain is carried out in a more advanced way than defined by Dr. Sarno's SUI concept.
With an integrated approach, doctors do not always see clear characteristics of the personality, which is important according to Dr. Sarno, and do not focus on unconscious anger as a focal psychological problem.
A comprehensive approach to treatment takes into account various factors: physical, emotional, cognitive and environmental factors, and aims to affect all aspects. In this way, the impact of treatment is carried out on the following aspects:
- Physical, including weakened muscles, nerve irritation, etc.
- Emotional, including depression, anxiety, anger, etc.
- Cognitive, such as negative thoughts, pessimism, despair, etc.
- Environmental factors such as job loss, financial problems, etc.
A comprehensive treatment program may include procedures such as:
- Treatment of physical factors with physiotherapy, analgesics and exercise therapy.
- Treating physical and emotional factors using appropriate medications (antidepressants or muscle relaxants).
- Treating emotional and cognitive factors with psychological pain management and biofeedback.
- Treatment of environmental factors through consultation.
Such complex therapy for the treatment of back pain has been used for over 25 years and has proven its effectiveness, although the key factor in the outcome of treatment is the patient's motivation to complete the course of treatment and rehabilitation. published by
BO IV IN THE BACK
PEOPLE SHOULD KNOW THE TRUTH
JOHN E. SARNO
Healing
BACK PAIN
THE MIND-BODY CONNECTION
Attention This book is not describing a new approach to back treatment, but a new DIAGNOSIS requiring adequate treatment. Every year, millions of people learn from doctors that the cause of their suffering is osteochondrosis, pinched nerve, arthritis, spinal stenosis, herniated disc and so on. But if all these diagnoses are correct, then why does medicine fail to cope with its duties? Why has not a neuropathologist been born who would once and for all cure at least one of his patients? Dr. Sarno challenges dogma. He claims people are being treated not because of why they need to be treated, and he gives his patients a diagnosis of muscle tension syndrome (MS) unknown to orthodox medicine. Whether his theory is correct Let's leave these controversies to scientists. Practice is much more important for us - the fact that thanks to Dr. Sarno, thousands of people have already recovered!
Sarno John How to cure back pain People need to know the truth Transl. from English - M LLC Publishing House Sofia,
2010 .-- 224 p.
UDC 615.851
BBK 53.57
S S Sofia, 2010
© Publishing House Sofia LLC, 2010
ISBN 978-5-399-00148-7
UDC 615.851
LBC All rights reserved, including the right to reproduce in whole or in part in whatever form © 1991 by John E. Sarno, M.D.
Healing Back Pain. The mind-body connection
This edition published with arrangement with Grand Central Publishing,
New York, New York, USA. All rights Translated from English by N. Bolkhovetskaya
WARNING
Keep in mind this book, like any other, is not a substitute for a doctor. It was not written to help diagnose oneself. If you are in pain, be sure to get a medical examination to rule out a serious illness.
INTRODUCTION
P
In my opinion, the main cause of pain in the neck, shoulders, back, lower back and joints is the so-called muscle tension syndrome (MSS). This syndrome is a daunting medical problem. According to statistics, eighty percent of US citizens suffer from back pain to one degree or another. In an article published in 1986 in the August issue of the magazine
Forbes, the following figures are cited annually for the treatment of the pathologies behind these pains about fifty six billion dollars are spent Back pain ranks first among the reasons for absenteeism due to illness and the second - in the number of visits to the doctor. Moreover, it is obvious that over the past thirty years the situation has deteriorated significantly. But why Really, after millions of years of evolution, the backs of Americans have ceased to cope with their functions Where did so many sick people come from? And why did doctors suddenly find themselves powerless in the face of an illness? The purpose of my book is to answer these and many other questions concerning this widespread problem. I believe that it is necessary to look at the topic I have raised from a broader perspective than it is usually looked at, since the reason for the described epidemic (yes - epidemic) lies in the actual inability
HOW TO CURE BACK PAINS medicine to recognize the true nature of the disease, that is, to make an accurate diagnosis. Likewise, while people knew nothing about bacteriology and epidemiology, plague devastated entire countries. Of course, it is quite difficult to believe in such incompetence of representatives of modern high-tech medicine. Nevertheless, it is a fact. After all, doctors are also people, which means that they are by no means omniscient and may well be mistaken. Here is one of the most common mistaken stereotypes that guide doctors, back pain must necessarily be the result of structural abnormalities in the spine or muscle damage. Another medical misconception is that emotions cannot induce physiological changes in the body. My experience with SMN treatment disproves both of these stereotypes. The disorders in question are accompanied by small (albeit very painful) changes in the soft tissues of the body (not the spine) and are of a psychoemotional nature. I first noticed this problem in
1965, when he headed the outpatient department of the Howard Rusk Institute of Rehabilitation Medicine at New York University Medical Center. It was there that I encountered a huge number of patients suffering from pain in the neck, shoulders, back and lower back. From the point of view of traditional medicine, the causes of their suffering were various kinds of structural disorders - arthritis of displacement of the intervertebral discs and so on, as well as muscle pathologies associated with improper posture, overexertion and insufficient physical activity. Pain in the legs and arms was attributed to pinched nerves.
INTRODUCTION 9 At the same time, the mechanism of the onset of pain remained unclear. Is it possible in such a situation to talk about the meaningfulness of the prescribed treatment - all kinds of injections, deep warming up with ultrasound, massage and special exercises. Of course not. No one really understood how such procedures affect the body. Doctors were content with primitive ideas - they say that exercise prevents pain, as it helps to stretch and strengthen the muscles of the abdomen and back, which support the spinal column. As a result, the treatment of such patients could not be called truly successful. The situation was further complicated by the fact that, as a result of examinations, it was far from always possible to establish a direct connection between pain and their alleged causes. For example, according to the diagnosis, there are degenerative arthritic changes in the patient's lumbar spine, but the incident is that completely other parts of the body hurt him. Or the patient's intervertebral disc in the lumbar spine is displaced to the left, and for some reason he feels pain in the right leg. But the most important observation was the following in eighty-eight percent of patients with problems such as migraine, heartburn, hiatal hernia, stomach ulcer, colitis, irritable bowel syndrome, hay fever, asthma, eczema, and so on, exacerbations of the disease are triggered by nervous tension. But then it is logical to assume that the painful condition of the muscles is also associated with nervous tension. Or rather, with muscle tension syndrome (MSS).
HOW TO TREAT BACK PAIN When we put this assumption to the test and started treating people appropriately, the results were very positive. This was the beginning of the Diagnostic and Therapeutic Program, which will be discussed in this book. It is necessary to clarify that the book does not describe a new approach to back treatment, but a new diagnosis -
SMN requiring appropriate diagnosis and treatment. When doctors learned that bacteria are the cause of many infections, they began to look for weapons against them - this is how antibiotics appeared. Likewise, if psycho-emotional factors are found to be the cause of back pain, appropriate new therapeutic techniques should be applied. Obviously, traditional psychotherapeutic methods are inapplicable in this case. Nevertheless, experience shows that in order for the treatment to be successful, it is necessary to explain to the patient what is really happening to him. Are we talking about holistic medicine now? Unfortunately, what is hidden under this term is a mixture of science, pseudoscience and folklore. However, the basis of the holistic approach to the healing of patients is the wise principle of a person who must be perceived and treated as a whole. Unfortunately, this principle is ignored by certified doctors. Perhaps, “holistic” should be called healing methods that take into account both the bodily and psychoemotional components of health and illness. And at the same time, in no case should one abandon the scientific approach to the treatment of diseases. That is, I'm not talking about the official and not about the "holistic"
INTRODUCTION it's just about good medicine. Although the cause of SMD is nervous tension, it is diagnosed in the traditional way in clinical neurology - based on the physical rather than psychological state of the person. Doctors dealing with such things should learn to see the relationship between body and mind and get, figuratively speaking, a diploma in holistic sciences. Because medicine is not worth a price, which ignores the influence of emotions on the state of health of people.
I ask you not to forget SMN - physical ailment, the development of which is triggered by emotions. This malaise should be diagnosed by a versatile doctor, whose qualifications allow us to determine both the physiological and psychoemotional component of the problem.
Psychologists, unlike neuropathologists, are able to discern the cause of muscle pain in the mental disorder of the patient. But since they do not have the necessary training in neurology, they cannot make a diagnosis of SMI with complete confidence. And vice versa - it is difficult to find a neuropathologist who is able to skillfully recognize the psychoemotional roots of certain physiological disorders. As a result, the CMN falls through, so to speak, between two chairs and the patients leave with the wrong diagnosis. What do doctors think about SMI It is unlikely that they understand well what is at stake. Judging by the reactions of doctors I know when it comes to HMD, most doctors either deny this diagnosis altogether or ignore it. Some of my colleagues admit that they simply do not know how to treat such patients.
HOW TO CURE BACK PAIN comrade. I have written several medical articles and special manuals about SMN, but they are available only to a narrow circle of specialists, mainly physiotherapists and rehabilitation therapists. Moreover, in recent years, it has become almost impossible to publish a work on the topic of SMD, since this diagnosis contradicts medical dogma. So I want to ask the doctors who will read my book, it contains much more complete information than any of the articles I have previously published, so it would be nice if you took it seriously, despite the fact that I addressed it to a wide audience ... How to deal with readers who have neck, shoulder, back, or buttock pain and think they have
SMN? Keep in mind that this book, like any other, cannot replace a doctor; it was not written in order to diagnose oneself with it. I find it at least unethical to instill hope in people that they can acquire the proper medical qualifications through reading popular literature or watching DVDs. If a person experiences recurring pain in any part of the body, they should be carefully studied to exclude such serious diseases as cancer, all kinds of tumors, bone diseases and other pathologies. In other words, he definitely needs to consult a doctor and undergo an examination. The scientific approach requires that any new idea be reliably validated. A newborn concept can be adopted only after unconditional evidence of it is obtained.
INTRODUCTION 13 truth. That is why it is extremely important that all the thoughts voiced here become the object of close attention of specialists. I urge my colleagues to either confirm my conclusions based on their own experience, or to argue with me reasonably. The only thing they should not do is remain indifferent, because the problem of back pain is too serious and urgently needs an effective solution.
Chapter MANIFESTATION OF MUSCULAR SYNDROME
VOLTAGE
I AM
I have never seen a patient complaining of neck, shoulder, back or buttock pain who was not sure that their problems were due to accidental injury or excessive physical exertion during sports training. I injured my leg while jogging (basketball, tennis, bowling. I felt pain when I lifted my daughter in my arms when I tried to open a jammed window. Ten years ago I had an accident and since then I constantly feel back pain. In the minds of Americans) the thought that the causes of pain can only be trauma or other kind of external or internal damage has become firmly entrenched.Of course, if pain occurs during or after
15
physical activity, it is easy to assume that there is a direct connection between the others (although, as you will later learn, such assumptions are often wrong. before the repetition of pain and therefore move with extreme caution. For decades, this idea has been guided by both traditional doctors and various types of healers. They tell their patients that pain in the neck, shoulders, back and buttocks is caused by an injury or illness of the spine and related with him structures, or as a result of dysfunction of muscles and other joints, without giving, however, any convincing arguments in favor of their diagnoses. nerves, tendons and fascia. The proof of the correctness of my point of view is the high percentage of healings after applying the simple and quick-acting Program described in this book. The doctors' misconceptions about the spine are rooted in the very system of their education and are conditioned by the philosophy of medicine. The point is that modern health science deals with mechanisms and structures. The body, explicitly or implicitly, is viewed as an extremely complex machine, and disease as its breakdown as a result of infection, trauma, hereditary pathologies, tissue degeneration and, of course, cancer. The medicine
HOW TO CURE BACK PAIN can not live without laboratory studies, believing that only they are worth attention. I am not going to belittle the role that these studies played in its development (invention of penicillin, insulin and the like. But, unfortunately, when it comes to a person, not everything can be measured with instruments and described by means of numbers. First of all, it concerns the human mind and the brain responsible for it.It is impossible to put in a test tube and weigh or measure emotions, therefore, for modern medical science, there are none. practicing doctors ignore the fact that emotions can be the cause of physiological disorders, although many of them recognize that the patient's experiences often aggravate his illness.
Generally speaking, traditional doctors feel extremely uncomfortable with their emotions. They draw a clear line between the problems of mind and body and know much better how to deal with bodily dysfunctions. A good example of the above is the treatment of gastric and duodenal ulcers. Although it has long been known that the cause of this disease is psycho-emotional stress, most therapists, contrary to all logic, prefer to prescribe exclusively medication, prescribing drugs that lower the acidity of the stomach, and frankly ignore psychotherapy. In other words, they do not care about the cause of the disease and they offer exclusively symptomatic treatment - exactly as taught in medical schools.
CHAPTER. MANIFESTATIONS OF SYNDROMES Y SH ECH NO GONA YARN NI
17
Since doctors focus mainly on healing the body, the psycho-emotional side of the disease is not considered by them at all, even if it is the main cause of the patient's suffering. That is why it is the doctors who bear the bulk of the responsibility for such a widespread, one might say epidemic, diseases of this type. Although, in fairness, it should be noted that some doctors still talk about nervous tension, but somehow casually you need to relax and rest, you work too much. The purpose of this book is to remedy this situation. In the first chapter we will talk about who is amazed
SMN, in which parts of the body it manifests itself, how different pain sensations can be and how they affect the general state of a person's health and his daily life. Subsequent chapters are devoted to the psychoemotional side of SMI with which, in fact, everything starts, its physiology and how to deal with this syndrome. In addition, I devoted a separate chapter to describing the connections that exist between the mind and body, in total, how they affect health. WHOM DOES SMM HIT?
Someone might say that SMI is a disease without age, since this syndrome can manifest itself not only in adults, but also in children from five to six years old. Although, of course, the symptoms of a child are different from those of an adult. I am sure that the neuralgic pains so often observed in childhood have never been properly studied, especially since doctors do not
HOW TO TREAT BACK PAIN You have to especially strain in order to convince mothers of the prevalence of this problem and that it does not, in general, pose a threat to the health of the child. Once during a conversation with a young mother, who complained that her daughter was experiencing severe pain in her leg at night, it dawned on me that the child was feeling, it was very similar to sciatica in adults, which is one of the most common manifestations
CMN. This means that this syndrome may well occur in children. It is not surprising that no one is able to explain the nature of the so-called neuralgic pains, because
SMM leaves no obvious physical traces of their presence. You can track a temporary spasm of the blood vessels causing the characteristic symptoms, but then everything returns to normal. The emotional stimulus that provokes a painful attack in children and in adults is the same - this is anxiety. Some believe that in this way the child has a kind of replacement of the nightmare with a painful physiological reaction - instead of painful experiences that are unbearable for him, he experiences physical pain. In adults, essentially the same thing happens. I have observed the manifestation of SMD even in eighty years old. That is, this condition has no age and potentially threatens any person capable of experiencing emotions. Still, at what age does SMD appear most often and what lessons can we learn from this kind of statistics?
1982, 177 patients participated in the course of treatment for SMI. Seventy-seven percent of them were in the thirty-sixty age group.
CHAPTER. MANIFESTATIONS OF SYNDROMES Y SH ECH NO GONA YARN NI
19
years, nine percent are between twenty and thirty, two percent are adolescents, seven percent are between sixty and seventy, and four percent are over seventy. These statistics confirm that the causes of back pain are primarily of an emotional nature, because the period of a person's life from thirty to sixty is the years of his highest responsibility. At this age, we strive to achieve success, to achieve material well-being, and it is then that SMN most often develops. If the main cause of back pain were degenerative changes in the spine (for example, osteoarthritis, displacement of discs, herniated discs, arthrosis of the joints, stenosis of the spine, these statistics would look different, since SMI would primarily affect the elderly. the question Who strikes the CMD? "You can safely answer Anyone. And I can definitely say the following this syndrome most often occurs in the middle of a person's life - in the years of highest responsibility. Let's look at the main signs of CMD. WHERE DOES CMD MANIFEST?
Muscle
First of all, the syndrome described here affects muscles (hence its name. Muscles suffering from SMD are located in the back of the neck, back, buttocks and are called tonic or posture. It is they who are responsible for the correct position of the head, trunk and ensure effective work hands.
HOW TO TREAT BACK PAIN According to statistics, SMD most often manifests itself in the lumbar-gluteal region - in about two-thirds of patients. Sometimes the gluteal and lumbar muscles are affected separately.
The second most common area of the lesion is the muscles of the neck and shoulders. Usually, pain is felt in the side of the neck and upper shoulder, as well as in the trapezius muscle.
SMI can appear in any part of the back - from the shoulders to the lower back, but much less frequently than in the above two areas. Most often, the patient complains of pain in the watery part of the body listed above, for example, in the left buttock or right shoulder, but at the same time, a medical examination reveals something very interesting. Almost every patient with SMI on palpation has an increased sensitivity or soreness of the muscles in the outer region of both buttocks (sometimes in the entire buttock, lumbar region and both trapezius muscles. failure, but is actually generated by the brain.
Nerves
The second substrate on which SMN manifests itself is nerves, especially peripheral ones. And most often it affects those nerves that are located in close proximity to the muscles. The sciatic nerves are located deep in the gluteus muscles (one on each side, the lumbar nerves below the paraspinal muscles in the girdle region
CHAPTER. MANIFESTATIONS OF SYNDROMES Y SH ECH NO GONA YARN NI
21
legs, occipital nerves, also nerves of the brachial plexus under the upper part of the trapezius muscles. It is these nerves that are most commonly affected by SMI. As a rule, SMN covers a fairly large area of the back, not limited to one local area. All tissues in this area suffer from a lack of oxygen, so a person may experience pain in the muscles, and the hike of the nerve trunks. When muscles and / or nerves are affected, pain of various kinds occurs. The pain can be sharp, burning, cutting, aching, pressing. In addition, if the nerves are affected, it is not uncommon for a tingling or numbness sensation to develop, sometimes extending to the muscles of the arms or legs. In some cases, muscle weakness is observed, which can be recorded using electromyography. When SMN affects the lumbar and sciatic nerves, leg pain occurs. If the occipital and brachial nerves are affected, pain appears in the arm. The traditional diagnosis for leg pain is usually herniated disc, and for arm pain, pinched nerve (see Chapter 5).
SMI can affect any of the nerves in the neck, shoulders, back, and buttocks, causing extraordinary pain. One of the most frightening symptoms of it is chest pain. An anxious person immediately decides the Heart - and for peace of mind he absolutely needs to know that everything is in order with his heart. Convinced of this, he that the cause of severe pain in the chest area can be the oxygen deprivation of the nerves serving the upper back and front of the torso caused by SMN.
2 2 HOW TO TREAT BACK PAIN In this case, a person may complain of strange concomitant sensations and weakness.
Remember: in order not to miss a serious illness, be sure to consult with a physician. This book is not a self-instruction manual for those who want to make diagnoses on their own. Its purpose is to describe a clinical phenomenon called SMN.
During a physical examination, tendon reflexes and muscle strength should be checked to find out how much oxygen deprivation has affected the nerves - whether it affected motor skills and the speed of transmission of nerve impulses. In addition, sensory tests should be performed (eg, a pinprick test to ensure that the affected nerve is intact. The main purpose of diagnosing and documenting sensory or motor impairments is the subsequent opportunity to discuss them with patients who need to be persuaded. the fact that the feelings of weakness, numbness or tingling they experience do not pose any threat.
During the examination, a leg lift test is mandatory. There may be several reasons for this test. If the patient feels severe pain in the buttock, he will not be able to raise the straightened leg high. The reason for this state of affairs lies in the muscle or in the nerve, or both. However, in most cases, this does not mean at all that the displaced intervertebral disc presses on the sciatic nerve, as patients often say.
CHAPTER. MANIFESTATIONS OF SYNDROMES Y SH E CH NO GONA YARN
2 When pain occurs in the shoulder or arm, the arm is tested in a similar manner.
Sometimes patients have bilateral pain. People also often report that in addition to pain in, for example, the right buttock or leg, they feel periodic soreness in the neck or watery shoulder. There is nothing unusual in such situations, as the media can affect any muscle or all muscles of the trunk at the same time.
To narrow your search results, you can refine your query by specifying the fields to search for. The list of fields is presented above. For instance:
You can search by several fields at the same time:
Logical operators
The default operator is AND.
Operator AND means that the document must match all elements in the group:
research development
Operator OR means that the document must match one of the values in the group:
study OR development
Operator NOT excludes documents containing this element:
study NOT development
Search type
When writing a request, you can specify the way in which the phrase will be searched. Four methods are supported: search with morphology, without morphology, search for a prefix, search for a phrase.
By default, the search is performed taking into account the morphology.
To search without morphology, just put a dollar sign in front of the words in the phrase:
$ study $ development
To search for a prefix, you need to put an asterisk after the request:
study *
To search for a phrase, you need to enclose the query in double quotes:
" research and development "
Search by synonyms
To include the word synonyms in the search results, put a hash " #
"before a word or before an expression in parentheses.
When applied to one word, up to three synonyms will be found for it.
When applied to a parenthesized expression, a synonym will be appended to each word if found.
Cannot be combined with non-morphology search, prefix search, or phrase search.
# study
Grouping
In order to group search phrases, you need to use brackets. This allows you to control the boolean logic of the request.
For example, you need to make a request: find documents whose author is Ivanov or Petrov, and the title contains the words research or development:
Approximate word search
For an approximate search, you need to put a tilde " ~ "at the end of a word from a phrase. For example:
bromine ~
The search will find words such as "bromine", "rum", "prom", etc.
You can additionally specify the maximum number of possible edits: 0, 1 or 2. For example:
bromine ~1
By default, 2 edits are allowed.
Proximity criterion
To search by proximity, you need to put a tilde " ~ "at the end of a phrase. For example, to find documents with the words research and development within 2 words, use the following query:
" research development "~2
Expression Relevance
Use the " ^
"at the end of the expression, and then indicate the level of relevance of this expression in relation to the rest.
The higher the level, the more relevant the expression is.
For example, in this expression, the word "research" is four times more relevant than the word "development":
study ^4 development
By default, the level is 1. Allowed values are a positive real number.
Interval search
To indicate the interval in which the value of a field should be, specify the boundary values in brackets, separated by the operator TO.
Lexicographic sorting will be performed.
Such a query will return results with an author ranging from Ivanov to Petrov, but Ivanov and Petrov will not be included in the result.
To include a value in an interval, use square brackets. Use curly braces to exclude a value.
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