Bolečine v nogah - kako prepoznati in obvladovati različne oblike bolečin?

Overview of symptoms and solutions for leg pain

SYMPTOM	DISEASE/PROBLEM	WHAT TO DO?	OTHER INFORMATION
Pain in the leg after the injury, but you can move the leg	Soft tissue injury	Try: rest, ice (wrap ice cubes in a thin cloth), compression (tight but not too tight bandage), elevation of the affected limb (with pillows).sleep bandage), elevation of the affected limb (with pillows).	Do not strain the affected muscle until the pain is gone.
Pain in the leg after an injury, you can't move your leg and can't walk; severe pain even at rest.	Fracture or dislocation	Call your doctor immediately.	As an addition to conventional treatment, you can initially use the homeopathic medicine arnica, which reduces swelling and bruising.
Pain and swelling after sports or other physical exertion.	Overuse injury	Reduce or stop the activity that caused the injury.	Overuse injuries of the leg are mdr. painful shin and tendinitis.
Dull pains in the legs, swelling of the ankles and feet, especially after a prolonged condition; sometimes prominent, dark blue veins on the legs.	Varicose Veins.	Wear elastic socks and take an anti-inflammatory pain reliever, e.g. ibuprofen. Medical treatment options include: laser treatment, injections and surgery.	The cause is a malfunction of the valves in the veins, which causes poor circulation in the legs. Deep varicose veins are less common, but can cause dangerous circulatory disorders.
Cramping pain in the arms, thigh, foot or hip while walking or exercising, the pain ceases at rest; muscle fatigue.	Peripheral vascular disease (clogged arteries and other diseases of the arteries and veins).	See a doctor. Treatment depends on the cause: drugs to improve circulation or surgical intervention - vascular bypass.	It will help if you stop smoking, improve your diet and exercise regularly.
Piercing or burning pain in the buttock and down the back of one leg; worsens when coughing, sneezing, bending or lifting the leg.	Sciatica.	See a doctor. Treatment includes muscle relaxants, analgesics and/or physiotherapy.	Acupuncture helps with mild or acute sciatica. A chiropractor can use manipulation to reduce pressure on the nerve.
Throbbing or burning pain under the skin of the leg; a red, warm, tender, coiled vein is visible.	Superficial phlebitis.	To ease the pain, lie down and raise your legs 15 to 30 cm above heart level. Place a heating pad or warm compress on the swollen area.	Doctors recommend compression stockings, acetylsalicylic acid to reduce inflammation and, if an infection is found, an antibiotic.
Pain and swelling all over the leg, especially when the leg is bent.	Deep phlebitis.	Takoj poiščite zdravnika. Morda vas bodo sprejeli v bolnišnico zaradi uvedbe antikoagulacijskega zdravljenja in mirovanja.	The danger is that a clot in a deep vein breaks off and gets stuck in the lungs (pulmonary embolism), which can end in death.
Constant, severe pain in one part of the leg; fever above 38 °C; general malaise; a tender or red area over the bone.	Bone infection.	Takoj obiščite zdravnika. Stanje je treba zdraviti z antibiotiki.	Infection occurs after a fracture or open injury.

Source: Družinski zdravstveni vodnik. Konvencionalno in alternativno zdravljenje 

Let's heal body pains

Nerves involved in lower back and leg pain

Think of the nervous system as a very special network of electrical wiring: Wires (nerve fibers) run from the brain down the spinal cord, connect to other wires that go to the muscles, and carry messages instructing them to move. These wires are known as motor nerves. What is special about the nervous system is that other nerve fibers go in the opposite direction - from the skin, muscles, joints, tendons - back to the brain they bring sensory messages of pain, temperature, positions of body parts and many other sensations, so that the brain knows , what is happening where and how they should act. These nerves are called sensory nerve fibers. Spinal nerves consist of both types of nerve fibers, motor and sensory. They come off the spinal cord from the neck down to the sacrum (at the end of the tailbone) and carry messages to and from the brain.

It is important to know the anatomical relationship between the intervertebral discs and the spinal nerves that are nearby. The plates are inserted between the spinal bones (vertebrae) and act as shock absorbers and facilitate turning. The location of the disc is indicated by the two vertebral units between which it lies: fourth lumbar - fifth lumbar (L4-L5), for example. (We know seven cervical, twelve thoracic, five lumbar.) Regardless of the level of the spine, the nerves separate from the spinal cord, one on each side, and run past one of the intervertebral discs. The fifth lumbar spinal nerve passes through the L4-L5 plate. The first sacral spinal nerve passes through the plate between the fifth, last, vertebra and the sacrum, which is the L5-S1 plate.

This anatomical proximity is the source of many problems. If a patient has a slipped disc at L4-L5 and develops leg pain, the culprit will always be a herniated disc, although in my experience this is rarely the case. This diagnosis is the basis for a large number of operations on the spine.

If TMS (TMS - tension muscle syndrome) manifests in the lumbar muscles, the lumbar spinal nerves may be involved. Suppose the lumbar spinal nerve supplying the groin, Ll, is involved in the TMS process. He is slightly malnourished.

Motor nerve fibers are not involved in TMS, but sensory nerve fibers tell the brain what is happening in the groin area. When sensory fibers are deprived of oxygen, several different symptoms can occur, including all forms of pain, burning, squeezing, numbness, or tingling. Any of these symptoms in the groin and occasionally in the scrotum or vulva tells us that the Ll spinal nerve on that side is involved.

Spinal nerves L2, L3, or L4 carry important motor fibers to the anterior thigh muscle (quadriceps). If one or more spinal nerves are involved, the knee reflex may be weak or absent. The hamstrings can also be weak. L4, along with L5, helps the muscles lift the foot and toes, which helps prevent tripping while walking. Weakness in these muscles results in foot drop. Partial or total foot drop is very common with TMS. The second through fifth lumbar spinal nerves provide sensory function to the front and outer side of the leg. Pain in the front and outer side of the thigh is called paresthetic meralgia (from the Greek meaning pain (algos) in the thigh (meros)), which is a descriptive term because no one knows what causes it. But pain is undoubtedly a sign of TMS.

If someone has a slipped disc at the lowest level - between the L5 and Sl discs, which can affect the first sacral spinal nerve Sl - and experiences pain or other abnormal sensations in the front of the thighs, you should know that the disc pathology is not responsible for the pain, because is Sl connected to the back of the leg. Conversely, people with a slipped disc at the L4-L5 level, where the fifth lumbar spinal nerve L5 works, often have pain in the back of the leg, further confirming that the disc pathology is not responsible for the pain, as the back of the leg is related to spinal nerves Sl and S2 and not L5. Spinal nerves are often involved in TMS and are the cause of pain in these cases.

These diagnostic contradictions initially led me to believe that disc chemistry was probably not the cause of the pain. Occasionally, the location of the chemistry and the symptoms match. This is not just a coincidence, as I believe that the clear brain knows full well that there is chemistry somewhere and deliberately chooses to place the symptoms in that area.

Sciatica

Another peripheral nerve that is often involved in TMS pain in the legs is the sciatic nerve. The term sciatica is familiar to everyone. Although doctors and patients use the term as a diagnosis, it only applies to leg pain. Patients are routinely told about a pinched disc pressing on the sciatic nerve and causing pain. This is anatomically impossible. What the medical professional is reporting is that the pinched disc substance is pressing on one of the spinal nerves, which extends its branch to the sciatic nerve. Five spinal nerves L3, L4, L5, Sl and S2 send branches to the sciatic nerve. Neurophysiological logic shows that continued compression of the nerve may be painful for a short time, but after a longer time you would completely lose the sensation of pain, because the nerve cannot function with prolonged continuous compression. In practice, I have found that the lumbar spinal nerves in the lumbar region and/or the sciatic nerve are often involved in the TMS process, and that it is the lack of oxygen that causes the symptoms, not nerve compression. That is why people with "sciatica" feel pain in such different parts of the legs, in such different forms, that they even move from one side to the other. A structural abnormality such as a slipped disc cannot cause such a clinical picture. Many patients with sciatica have no demonstrable structural abnormality at all, as demonstrated by X-ray or other imaging.

How can I be sure that the TMS is the cause of the pain and not a disc or some other structural abnormality? Over many years, I have seen thousands of patients with abnormal discs or other structural abnormalities who were told that these changes were responsible for their pain. Their medical history and physical examination suggest a diagnosis of TMS. When I treated them accordingly, often after weeks or months of incapacitating pain, they immediately got better.

Pavlovian conditioning - programming

One of the most important clinical features of TMS is the tendency for sufferers to develop a specific pain pattern, including a schedule of when during the day or night the pain will occur, what activity or body position will trigger it, what things they can and can't do. they laugh.
These are programmed reactions. They develop automatically and unconsciously with a stimulus, just as Pavlov's dogs learned to associate the presence of food with the sound of a bell. Once the dogs were programmed, he just rang the bell and they started salivating. Humans are just as programmable as animals. Some patterns are very common, others are quite unusual. It is very striking, for example, that a large number of patients with low back pain cannot sit without a sharp pain after only a few minutes. Some can sit on a certain type of chair, others can't at all. Most people can't stand sitting in a car, especially not in the driver's seat. Another patient with pain in the same area may report that sitting is fine, but the pain appears after a minute or two if he stands. Any of these problems

it can be very disruptive to a person's everyday life. Patients with pain in the upper lumbar region that is not even close to the anatomical sitting area may complain of the same problems.
Thus, in recent years it has become clear that the pattern that the patient develops and that is common to all TMS patients is the fruit of Pavlovian conditioning, or more modernly speaking, programming. People very quickly and unconsciously associate activities, positions and parts of the day or night with the emergence of pain. Just as Paul's dogs associated food with a bell, we associate various phenomena with the onset of pain.

Some common patterns

• You wake up feeling pretty good, but the pain gets worse as the day goes on. By evening you can hardly move.
• Mornings are the worst, you struggle to get out of bed. After a hot shower, you feel a little better and by the time you leave for work, you can move around. You feel better and better as the day goes on.
• You feel pretty good during the day, but the nights are terrible. You get up and legate all night and can't possibly find a favorable position. Swallowing pills all night is quite common.
• You sleep well at night, but the pain during the day is impossible.
• Every night you wake up with a sharp pain at exactly three o'clock, you could set a whole hour to this rhythm, which never fails.
• You have a van and you can load and unload all day without pain, but when you lean over the sink to shave, you feel a sharp pain.
• If you stand still, pain will inevitably occur. Waiting in line at the supermarket is terrifying.
• As soon as you step onto the tennis court, even before you hit the ball for the first time, pain sets in.
• You can sail smoothly, but you can't sit in a soft chair.
• You can walk just a few tens of meters on the street and already have pain, but you can play an entire round of golf without pain.
• Nothing hurts while riding, but walking up stairs is painful.
• You can hike hills for hours without pain, but walking on concrete is very painful.

Here is an excerpt of the letter where the programming is very well described:
After two months of stopping your program, my symptoms were almost gone. But more importantly, I got rid of the constant fear of injury. Perhaps the pivotal day when I knew I was “cured” was when I plucked up the courage to sit on the exercise bike that had been gathering dust in the corner of the bedroom for years. In the past, every time I tried to cycle - maybe just for a minute - my back hurt for days or even weeks. No chiropractor or orthopedist could explain to me why I was able to ride my ten-speed bike without problems (when my back wasn't bothering me too much, of course) even though I was leaning into the position I was warned to avoid on it . You have taught me that my aversion to the exercise bike is a conditioned response, that I believe that I once injured myself on it and that I will cause further injury if I try it again.

After a few weeks of constant mental reminders and sneaking glances out of the corner of my eye towards the accused device, I was ready. The first time I tried it, and even though I only cycled for five minutes, I knew the nightmare was over. By then I was pretty sure nothing could happen to me and all I had to do was try. Of course, that was completely true. Soon I increased my time on the bike and increased my speed. I admit that I was so taken with this newfound freedom that for a short time I became somewhat fanatical about using this device.

Fear, misinformation and incompetence control our beliefs about back pain to such an extent that it is no wonder that we become programmed to develop pain in association with a very wide range of concepts. When and how the programming begins is not clear, we only know that it occurs shortly after the onset of pain. Programming is a real and very important part of the clinical picture and should be a source of reassurance for people with back pain, as the pain pattern is a product of conditioning, not a pathological condition. In other words, sitting does not cause pain because it would be bad for the back. Pain arises when it arises because the onset of pain is programmed. Fortunately, the programming is reversible. In my patients, the conditioning stopped a few weeks after they started attending the treatment program. People who feel better after studying my TMS books are no longer conditioning themselves because of the knowledge gained from the books.

Physical examination of patients with low back and leg pain

I begin the examination by observing how the patient walks and stands. Weakness in the legs is not unusual, so it may happen that the patient uses one leg more than the other. The muscle that lifts the foot can sometimes become so weak that it is noticeable during the gait cycle. Leaning of the body to one side or the other is common, oblique as the main factor involved lumbar paraspinal muscles. Even asking the patient to bend at the waist reveals a lot: Many patients resist this because they are afraid that pain will be triggered or because they have been told that bending is bad for the back. Most of those who are willing to bow out mention that they are not as flexible as they used to be. Although some people bow normally without fear of pain, most complain of pain in their back or legs while bowing.

With the patient standing upright, I perform functional testing of the ankle and knee muscle strength. To examine the reflexes of the knee-knee and ankle tendons, the patient sits. That's when I notice motor weakness in my legs.

On the examination table, I check the circulation in the legs by looking for a pulse in the foot and ankle. I look for pain by palpating the tendons around the knee and along the iliotibial tract. This is a long tendon that runs along the entire length of the outer thigh and runs behind the bony prominence in the hip known as the trochanter. Pain in this connective tissue is experienced by approximately 80 percent of TMS patients, regardless of the location of the pain (neck, shoulder, upper back, mid back, or lower back). With the "extended leg raise" test, I just check what the patient can do and whether I provoke pain with this movement. I found this test to have absolutely no diagnostic value.

When the patient is lying down, I feel the whole back to find the so-called tender points. In 99 percent of all TMS patients, I found by palpation the points where they felt pain of varying intensity on both sides (bilaterally) of the upper outer area of the buttocks, deep in the lumbar paraspinal muscles, and in the upper part of the trapezius muscle at the top of the shoulders. All of these sites are painful regardless of where the underlying site of the main pain is. This strongly suggests that the origin of the process responsible for pain is in the central nervous system, in the brain.

Finally, I do an additional neurological test to check if any nerve structures are involved. If I find objective nerve anomalies, it does not mean that I have made a diagnosis. This only allows the doctor to talk to the patient and ascertain his symptoms.

Common diagnoses for lower back and leg pain

You should know that in patients with TMS, any abnormality detected by X-ray or other imaging is routinely determined as the cause of the pain. In my experience, however, irregularities are rarely the source of pain.

Diagnoses can be divided into two major categories.
1. Structural abnormalities of the spine, both congenital and acquired
2. Painful disturbances in muscles of unknown origin

Structural abnormalities

Degenerative arthritis (osteoarthrosis)

The most common of all structural groups are age-related changes in the spine. We call them aitiosis or degenerative arthritis. They start already in the second decade of life and are usually more advanced in those parts of the spine that are subject to the most activity - the last two lumbar vertebrae and the middle of the neck. This group includes osteophytes (bone growths), which can appear anywhere on the spine. We know them under the term spondylosis. Age-related changes in the spinal joints, known as facet joint syndrome, are now considered symptomless, although they have been treated as a clinical condition for years. In 1976, doctors at Hadassah Hospital in Jerusalem reported that they found no difference in the occurrence of low back pain. in people with or without osteoarthritis of the spine.

A group of doctors from the University of Copenhagen compared the X-ray images of 238 patients with low back pain with 66 patients who had no such history. They reported that they found no difference in the radiographs of the two groups with respect to disc degeneration and the presence of spondylosis. They noticed that the incidence of these changes increases with age, as can be expected, since these are normal anomalies.

Spinal astenosis

One of the most important age-related changes is spinal stenosis, as it is often treated surgically. As we age, the spinal canal (the space where the spinal cord and spinal nerves travel) gradually narrows in the lumbar region due to accumulation of growths. If they find this condition in a patient with TMS who is suffering from severe pain, they suggest surgery, and if the patient is on the verge of despair, they often perform it. Among the huge number of patients with this diagnosis, I myself recognized only one who really needed an operation. More convincing is the fact that these patients are relieved of pain when treated with TMS, even though the stenosis is still present.

Neurosurgeon H.L. Rosomoff announced that most cases of spinal stenosis could be treated without surgery. This is especially worthy of respect, as he himself treated patients surgically for many years.
In the first observational survey we conducted among our patients with back pain, most of them were between the ages of 30 and 60. After the sixtieth year of the session, their number decreased significantly. Therefore, if age-related changes were responsible for back pain, we would expect an increase in the number of patients with aging. In fact, middle-aged people, the years when they experience the most stress and problems, have these pain syndromes most often. This strongly suggests that TMS causes pain, not structural changes in the spine.
Pathology of intervertebral discs.

Statistically, the most common and by far the most annoying age-related changes are related to intervertebral discs. They act as intervertebral shock absorbers, but they start to wear out at an early age. The plate between the last lumbar vertebra L5 and the sacrum degenerates in most people by the age of twenty. Degeneration means that the disc has lost its substance and has become thinner, so two adjacent vertebrae move closer together, or the disc substance slips through the worn surrounding tissue, called the outer annulus; as a result, with the increasing level of pain, swelling or protrusion or slippage of the plate substance (core) appears. Bump and slip are commonly known as disc chemistry.

In my experience, even larger disc slips are usually not the cause of lasting pain, although they can cause some pain when the slip occurs.
For a long time I was puzzled by the fact that the location of pain in someone with lumbar disc chemo sometimes matched the location of the chemo exactly. For example, if a herniated disc occurred near the first sacral spinal nerve (Sl), pain may occur in the area of the leg supplied by this nerve. I can easily understand someone attributing a patient's pain to chemistry. However, the persistence of symptoms for weeks and months in the presence of TMS signs and symptoms gave me

knowing that the disc pathology may indeed have caused the initial pain, but is in no way responsible for the continued pain.
Why did the brain decide to point to the tile as the culprit? The answer lies in research into the strategy the brain uses when it creates TMS. They often trigger symptoms when a person engages in some physical activity, the more vigorous the better, and they promote the idea that the activity caused the pain. In reality, the physical event is only the trigger and not the cause of the pain. This is an extremely important concept, because if we do not recognize it, millions of people remain in slavery to pain and in
fear of physical activity.

A slipped disc, like a physical accident, is only a trigger for TMS, and a very imaginative one at that. The brain is aware of the presence of an abnormality of the intervertebral disc and therefore decides to put the symptoms in the right place. But what often happens is that they overdo it and involve a large part of the leg, for example, or they shift the pain from one side to the other. In some cases, however, the pain already appears on the wrong side.

If this idea seems strange, scary or strange to you, remember what the purpose of the pain syndrome is. It is an illogical reaction of the unconscious mind in response to something that is probably much more dangerous than pain.
What can we read in the medical literature about slipped lumbar discs? What follows is just a short selection.

Neurosurgeon H.L. Rosomoff found that slipped lumbar discs are responsible for lower back and leg pain in less than 3 percent of all cases, so he treats his patients conservatively, not surgically.
World-renowned low back pain researcher Alf Nachemson stated that in most cases the cause is unknown and that 98 percent of patients should be treated conservatively.

A group of researchers reported that a slipped disc in the lumbar region was detected by myelography in 108 patients, who did not feel any pain. They tracked their condition and found that within three years, 68 percent of the patients developed nervous symptoms. The researchers concluded that the pain was due to the original hernia.

I strongly doubted this and suggested that these patients had developed TMS. The idea of late symptoms is contradicted by a study done by a group of doctors from the Universities of Rome and L'Aquila. They found that 63 percent of the patients from the group who were diagnosed with lumbar disc herniation by the MRI method and were not treated surgically, had the herniation reduced when the MRI was repeated six to fifteen months later.

A group from George Washington University published an interesting study in the journal Spine in 1984. Lumbar CT images of pain-free patients were reviewed by neuroradiologists who knew nothing about the patients' clinical history. They found disc abnormalities, stenosis and other changes that come with aging in 35.4 percent of the group of 52 patients, and in 50 percent of the group older than forty years. These are normal irregularities and in most cases do not cause any pain. Richard Deyo, John Loeser and Stanley Bigos from the University of Washington wrote that only 5 to 10 percent of patients with lumbar hernias require surgery. But surgery would be necessary if the hernia was documented by CT or MRI imaging, if patients had typical pain and neurological weakness, and if they were unresponsive to six weeks of conservative treatment.

I have found that these criteria for performing surgery are not reliable, as TMS can produce "typical" pain and neurological changes that can persist for weeks or months if not properly diagnosed and treated.
Maureen Jensen and her colleagues published a more recent study in the New England Journal of Medicine, which attracted a lot of attention in the press. 98 people who had no history of back or leg pain and 27 who had symptoms had lumbar MRI scans. 36 percent had normal plaques at all levels, 52 percent had swollen plaques at one or more levels, 27 percent had bulging plaques, and 1 percent had slippage. Their conclusion: "The discovery of disc swelling or bulging in people with low back pain is often purely coincidental."

In 1987, I conducted an observational survey of 109 patients with back pain attributed to a slipped disc. In each of them, the hernia was documented by CT imaging. These patients were treated from 1984 to 1986 before MRI imaging was established. But the slip can be accurately determined by CT imaging. I diagnosed TMS in each patient based on clinical history and physical examination. It follows that the slip was not the cause of the pain. All participated in the educational program, and when I interviewed them a year or three later, 96 (88 percent) were either completely cured or sufficiently pain-free to lead a normal life without physical limitations or fear. Eleven of them (10 percent) were better, but were still somewhat limited or scared. Two (2 percent) did not improve.
In my years of treating these patients, I didn't bother to see if these would-be patients would accept the idea that their pain was caused by emotions. This means that some patients may not have fully accepted the diagnosis. Patients who do not acknowledge psychological causation do not fare better. I now interview patients before accepting them into our program.

It is right that medical research seeks evidence for diagnostic theories and new treatments. The best proof of the futility of the TMS diagnosis is that we have now achieved that 90 percent of the patients we have treated (often after many years of recurring, debilitating pain) are now permanently pain free. I can think of no more compelling evidence that TMS is the correct diagnosis. A critical factor in this or any other epidemic is diagnosis. As long as the medical community refuses to diagnose TMS, the epidemic will continue.
I must mention other structural diagnoses, as they are still routinely blamed for back pain.

Scoliosis

This is a well-known spinal abnormality in which the spine curves sideways, usually involving the entire spine. The cause of this irregularity has not yet been determined. It usually appears in the second decade of life and is always painless in teenagers, although the curvature may be so great as to warrant surgery, especially if the condition worsens. I myself wonder at the belief that scoliosis in adults is supposed to be painful. As the doctors find no alternative explanation for the pain, logic escapes. TMS pain is repeatedly attributed to certain structural abnormalities or physical or mechanical processes because the medical profession is unaware of the existence of TMS.

I remember a woman who had two surgeries for back pain that they believed was caused by scoliosis. When she was hospitalized in the third grade, a hospital psychologist who knew about TMS came across her before surgery. He mentioned to the surgeon that the cause of her pain could be of a psychological nature. Instead of a third operation, the woman came to us and entered the program. Within a few weeks, the pain was gone and is still there today.

Spondylolisthesis

This irregularity looks quite dramatic. A lumbar vertebra moves out of line with the vertebrae below it, usually forward. There are mild and severe cases. The cause of this condition is still a mystery, but in my experience the disorder is painless. I have pictures of several consecutive x-rays of a young woman who had no idea she had developed this abnormality as she was in no pain. She had the imaging done for some other reason and the spondylolisthesis was discovered by accident. This does not surprise me at all, as I have never met anyone with spondylolisthesis who did not have TMS.

Piriformis syndrome

Deep in the buttock is the piriformis muscle, which lies very close to the sciatic nerve, which runs through the great sciatic foramen towards the leg. I don't know where or when they first diagnosed it, but they theorized that buttock pain was the result of pressure from the piriformis muscle on the sciatic nerve. It has not been scientifically explained why this happens or under what conditions. I personally think that such a diagnosis has no basis and was given only because they had no better explanation for the pain in the buttocks. Of course, TMS offers the best explanation for the pain. Otherwise, the diagnosis of piriformis syndrome is a fad that seems to be slowly fading.

Osteoarthritis of the hip

Osteoarthritis of the hip is another condition on the list of structural changes that are wrongly accused of causing back pain. Degenerative changes in the hip joint are quite common, as is TMS pain in the buttock. Following a common pattern, hip pain is often attributed to the hip joint. Hip replacement is done this way even if the degenerations are very mild. In quite a few cases, I intervened in the pre-operative preparation and successfully cured the pain without surgery. What's more, I've seen patients who have had hip surgery and it hasn't relieved their pain.

Birth defects

Three congenital defects of the spine are said to be the cause of back pain: spina bifida occulta; spondylosis and transitional vertebra. In the first two, part of the bone is missing in the spine, and in the third there is an additional bone. Researchers Alexander Magora and Armin Schwartz found that these errors were just as common in people with back pain as in those without. I myself find that they do not cause pain.

The place of pain is the muscle

I have given only a cursory description of these disease states, as it is beyond the scope and purposes of this book to address them exhaustively. What must be stated clearly and unequivocally is that these diseases are psychogenic, that they are triggered by an unconscious emotional phenomenon. Fibromyalgia, MBS and SČS are part of the TMS syndrome. Many studies have been carried out all over the world to try to understand these conditions, but they have only been able to identify individual elements or consequences of these processes, but not their cause. So far, no one has organized a study to test the hypothesis that these are psychogenic states, although some have already flirted with the idea. Until such studies are conducted, doctors will continue to be embarrassed. The continued success we have with TMS treatment, even when it was originally diagnosed as fibromyalgia, MBS, or SCS, should point the way.

Reflex sympathetic dystrophy

This disease is characterized by pain, swelling, taut and shiny skin, and bone abnormalities that can be seen on X-rays. It can strain one or more limbs and can completely disable a person. The symptoms identified during the examination are believed to be caused by overstimulation of the sympathetic nerves, resulting in a general decrease in blood flow and lack of oxygen. A similar thing happens with TMS, but in this disease it is more severe and involves muscles, nerves, tendons, skin and bones.
The following description of the course of the disease state is illustrative.

A twenty-eight-year-old woman, six months pregnant, suddenly felt pain in both shoulders and arms. In the period leading up to the baby's birth, the pain became increasingly severe and seriously incapacitated her. Her doctor diagnosed her with reflex sympathetic dystrophy and began treating her with standard physical therapy and steroids, but there was no improvement. In the first year after the diagnosis, she went to psychotherapy twice for a short time, but in vain. Seven months before she contacted me, she visited a pain center, again with no visible results.

On her first visit to me, she complained of severe pain in her shoulders, arms and upper back. She also complained of severe weakness in the shoulders and arms, weakness, tenderness and stiffness in the lower back, buttocks and knees. Even the mildest physical activity lasted no more than thirty minutes, after which she had to rest for thirty or forty minutes. It is clear that she could not function as either a mother or a housewife. As a teenager, she overcame mild intestinal disorders, asthma and hay fever.

Examination by a neurologist was normal. Range of motion was limited in both arms. She felt pain on the top of both shoulders, the outer sides of the buttocks and the outer sides of the thighs (iliotibial tract) when pressed with her fingers. Her medical history and physical examination suggested two diagnoses: TMS and psychogenic regional pain.

She took part in our therapy program and immediately began group and individual psychotherapy. She quickly grasped the concept of diagnosis, but the process of psychotherapy was lengthy. Nevertheless, after eight months of working with our group, she was able to take care of her child to a limited extent. After twelve months of the program, she could stay up for up to five hours, after sixteen months she could be active for half a day. Slowly but steadily, her condition improved and eventually she became a full-time mother and housewife. What's more, she started playing tennis and skiing again, and since the sessions showed that she was fully recovered psychologically and physically, she decided to have a second child. Such an outcome would not have been possible if she had not been given a correct diagnosis and without effective psychotherapy - both were important. Her symptoms were clearly psychogenic. Strong emotional factors can cause pathological activation of sympathetic nerves.

Post-polio syndrome

In recent years, something called post-polio syndrome has received a lot of attention. Here we are talking about people whose polio has left them with weakness in their legs, which increases with age, accompanied by pain in the buttocks and legs. Increased weakness was medically documented many years ago as something that occurs in all people who have polio. Pain is a new phenomenon, hence the emergence of a new syndrome. In the patients I examined, the pain was due to TMS, and this was no doubt due to the fear and helplessness associated with increasing weakness. Pain is not part of polio.

Here is another example where they failed to recognize the presence of TMS and the emergence of a new clinical condition as a consequence. Thirty years ago I worked with many patients who had overcome polio and were suffering from the excruciating experience of increased weakness. At the time, TMS was not talked about the way we talk about it today, and patients did not sue because of the accompanying pain. At that time, the post-polio syndrome did not yet exist. I helped them adjust to the loss of power, sometimes with the help of gadgets, but always with plenty of support and advice.

Tension myalgia

This diagnosis was made at the Mayo Clinic fifty years ago and refers to muscle pain (myalgia). Since the word tension here is meant more in a psychological sense and not so much as muscle tension, you would think that this was an extremely enlightening diagnosis. However, a summary of the study published by Jeffrey Thompson in the Mayo Clinic Proceedings reveals: “The word tension or tension suggests that psychological tension or stress may play an important role. When the diagnosis is presented in this way, patients more easily accept the possibility that their muscle pain disorder is influenced by psychological conditions and are more willing to take action to solve the problem. At the same time, the doctor confirms that a psychological disorder is not the original cause (I put it in italics)."

This statement may sound contradictory, but it is not. The doctor says that psychological factors worsen the pain, but do not cause it. In doing so, he hit the heart of the pain epidemic that has now engulfed the United States. In fibromyalgia, tension myalgia, and other similarly diagnosed conditions, modern medicine recognizes that psychological factors play a "large role," but cannot accept the idea that they are the primary cause. In short, they remained undiagnosed because, in their opinion, psychological conditions only worsen the problems.

Another interesting fact. The author states, "... when the diagnosis is presented in this way, patients are more likely to accept the possibility that their muscle pain disorder is influenced by psychological conditions and are more willing to take action to resolve the problem." Taking steps to address psychological factors would only eliminate those pain that is said to be aggravated by psychological factors. The underlying pain would remain as the cause would not be addressed.

I have to admit that this utter confusion and inability of the medical profession to solve pain problems makes me extremely sad. They are firmly attached to the idea that "psychological factors are not the primary cause." Because in reality this is not a psychological disorder, it is a normal state. A program works in all of us, according to which we react to internal tension with physical symptoms. The inability to recognize this fact creates an epidemic.

Source: book: Ozdravimo bolečine telesa

Sources

Vir: Ozdravimo bolečine telesa, zdravilo za um in telo, SARNO JOHN E.

1. Sciatica - https://my.clevelandclinic.org/health/diseases/12792-sciatica

2. Sciatica - https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/sciatica

3. 2 Walking Tips to Avoid Sciatica Pain - https://www.spine-health.com/blog/2-walking-tips-avoid-sciatica-pain