Effective pain relief. Neurologist's advice.
Head Svetlana Evgenievna Rovdo told the TUT.BY portal about how neurologists manage to cope with pain relief in patients by the neurology office of the "Tomography" MC.
Including answered a number of pressing questions:
- How to identify the cause of the pain?
- What to do with back pain?
- What new approaches in the treatment of neurological diseases with pain syndrome have appeared recently?
- and etc.
The interview is available on the TUT.BY portal in the “Health” section, as well as on our website below.
- Are neurological diseases often accompanied by pain?
- Yes, this is a fairly wide range of conditions. But, I think, few people are interested in their names. Patients go to see a neurologist if they have headaches, facial pains, back pain and limb pain. The doctor's business is to understand their mechanisms. For example, back pain in most patients causes abnormal muscle conditions when they are not properly tensioned or contracted. This can lead to:
- physical disharmony as a result of the structural features of the skeleton,
- emotional stress,
- inaccuracies in nutrition,
- hormonal dysfunction,
- diseases of internal organs, etc.
Much less often, it is caused by changes in the spine itself:
- herniated intervertebral discs;
- instability of the vertebrae;
- arthrosis of the joints of the spine and pelvis;
- narrow spinal canal.
Chronic muscle discomfort is a common cause of pain in the cervical spine. Today, an increasing number of people sit at the computer throughout the working day. In this case, the muscles are constantly in a state of tension. Blood cannot circulate through tissue to feed it. As a result, painful muscle seals are formed, and then myogelia - small nodules in which elastic muscle fibers have been replaced by inextensible connective fibers. Such "wedge points" often become a source of intense pain, not only localized, but also reflected in other parts of the body. For example, a "wedge point" in the shoulder can lead to pain in the temple.
- How can you effectively help a patient in such situations?
- It is important not only to satisfy the pain, but to find and eliminate its cause. Pain relievers should be given short-term for acute and severe pain. With the abuse of such drugs, for example in the case of chronic headache, each pain pill taken can trigger another attack. These are the so-called abusal (drug) headaches.
- How can you identify the cause of the pain?
- Scientists have found that the human body is able to "answer" what is functioning incorrectly in it, if it is "asked" about it. Applied kinesiologists are now doing this testing. But, of course, such skills are useful for both neurologists and doctors of other specialties, since they allow to “unwind” the chain of pathological and compensatory reactions in the body and to reveal the root cause of the disease. An important role is played, of course, by the collection of anamnesis, and a classical neurological examination, and modern highly informative instrumental methods of examination.
The most important in this regard is magnetic resonance imaging (MRI). For example, quite severe headaches are caused by migraines, trigeminal neuralgia, and herniated discs. MRI on a high-field tomograph with a power of 3T allows us to conduct accurate differential diagnosis of these diseases with strokes, tumors of the brain, spinal cord, nerve roots and other serious pathologies of the nervous system.
Today, we are increasingly diagnosing patients with temporomandibular joint (TMJ) pathology, which can cause facial, headache, and neck-shoulder pain. A unique MRI examination of the temporomandibular joint allows you to understand the slightest violations of its functioning.
- Let's say a person has acute back pain. What should he do?
- Seek medical attention in case of acute pain. After all, this is not always an exacerbation of osteochondrosis or muscle pain. For example, girdle pain in the thoracic region is also characteristic of diseases of the heart, lungs, and pleura. And trying to self-medicate can be a disservice to yourself.
The doctor determines the methods for relieving pain and treating the diseases that cause it. They are different for acute and chronic pain. So, for example, in case of an exacerbation of a herniated disc in our Center, epidural blocks with corticosteroids are effectively used, which quickly relieve inflammation and swelling, and therefore pain. In case of damage to the joints of the spine and pelvis, we use hyaluronic acid blockade, which improves their structure and function.
- In your opinion, are acupuncture methods for relief of pain syndromes outdated yet?
- Well, what are you! On the contrary! And today there are many new methods of reflexology, when acupuncture points are affected not only with needles, but also with other therapeutic factors - electric current (electropuncture), laser beam (laser puncture). Various drugs (pharmacopuncture), carbon dioxide (carboxyreflexotherapy), bee venom are injected into the points (apireflexotherapy), leech hirudin (hirudotherapy). We are already using some of these methods at the Tomography Center, others are awaiting their application in the center's rehabilitation branch in the near future.
- Is there a scientific justification for such a natural method of treatment as bee sting?
- Yes, apireflexotherapy is one of the most effective ways to deal with pain. This happens due to the stimulation of the pituitary-adrenal cortex system by the poison and an increase in the level of endogenous cortisol in the blood, which has a systemic anti-inflammatory effect. MSD, a venom peptide, also blocks inflammation, and adolapine acts like endorphins. Bee venom not only relieves pain, but also improves blood circulation, lowers blood pressure, strengthens immunity, has an anticonvulsant, antiarrhythmic effect, improves the functions of the nervous system, etc. All this makes it an indispensable natural healing and healing agent. However, the procedure also has contraindications, and therefore should be carried out only after consultation and under the supervision of a doctor.
- What new approaches in the treatment of neurological diseases with pain syndrome have appeared recently and do you apply them in practice?
- For example, patients are very impressed by the method of TAP-therapy - therapy with autologous plasma. Its advantage is simplicity, effectiveness and absence of side effects. The patient's own plasma, centrifuged and enriched with platelets, is injected directly into the pathological focus, after which platelet growth factors begin to be produced in it, improving trophism, blood circulation and leading to healing, restoration and rejuvenation of tissues.
- What pain is more difficult to deal with: acute or chronic?
- Acute pain is a protective reaction of the body, a signal of danger, after the elimination of which it quickly passes.
Chronic pain is the result of an "internal" breakdown that has developed as a result of a combination of many factors and is supported by them.
A sedentary lifestyle, poor posture, improper body postures do not allow muscles to effectively relax. If you have one leg shorter than the other, a skewed pelvis or a dislocated jaw, disharmony in the work of the muscles is guaranteed. And yet, for many years, it can be compensated for and not cause you concern.
If emotional stress is added to this, then muscle tension already causes pain. The latter always attacks the weakest link in the body. Muscles that are under tension as a result of poor skeletal structure are excellent targets for stress.
Pain is always a mental experience. Therefore, anxiety and depression increase the sensitivity to pain. This is what makes it advisable to prescribe antidepressants for a limited time.
- FDM therapy is often used in your prescriptions. What it is?
- FDM-therapy is a fascial distortion model. The method involves the rapid and sometimes complete elimination of pain by manual methods of exposure to muscles, fascia, tendons and ligaments. The method is based on the idea that any pain is caused by one of six known types of pathological changes in connective tissue - fascial distortions. In FDM diagnostics, “body language” plays an important role; description and demonstration by the patient of the nature and area of distribution of pain. The method can be used both independently and in combination with other influences.
- Manual methods in patients are usually associated with classical manual therapy. It turns out that she is no longer needed?
- Why not? These two treatments have slightly different approaches to the same problem. Some of the manipulations they have in common. It is bad when patients start treatment with a chiropractor. In a number of cases, both methods are indicated not in the acute period of the disease, but in the period of fading exacerbation or during the chronicity of the process, when pain is caused by persisting muscle dysfunctions and functional blocks. Many specialists in the manual direction today combine kinesiological, osteopathic, classical manual and FDM techniques in their work.
- What advice can you give to patients who, due to their profession, have to spend the whole day at the computer?
- The musculoskeletal system is otherwise called the musculoskeletal system. But it is precisely the motor function with our sedentary lifestyle that we deprive it. The only salvation here is correct, I emphasize, correct and regular physical exercises in order to decompress the vertebrae and strengthen the muscular corset. It happens that a person damages muscles by exercising too zealously. Therefore, it is always better to consult with professionals at the beginning of the journey and work out the complex under their supervision.
- What advice could you give our readers at the end of our conversation?
- There is no magic pill. It is impossible to force a person to become healthy until he wants to and will not work on it day after day. Recovery is always a process, close collaboration