Persistent muscle pain following whiplash is commonly considered the result of poor psychosocial status, illness behaviour, or failing coping skills. However, there is much evidence that this persistent pain may be due to neurophysiologic mechanisms involving peripheral and central nerve sensitisation. Myofascial trigger points may play a crucial role in maintaing this sensitisation. Recent research suggests that the chemical environment of myofascial trigger points is an important factor. Several consequences are reviewed when central pain mechanisms and myofascial trigger points are included in the differential diagnosis and in the management of patients with persistent pain following whiplash. Continue reading Whiplash Injuries & Trigger Points
Doctors and nurses have known for many years that some people are more sensitive to pain than others. Now brain scans of people experiencing the same painful stimulus have provided the first proof that this is so. But the scans also suggest that how much something hurts really is “all in the mind”.
“We saw a huge variation between responses to the same stimulus,” says project leader Bob Coghill of the Wake Forest University School of Medicine in Winston-Salem, North Carolina. “The message is: trust what patients are telling you.” Continue reading Pain really is “All in the Mind”
BACK pain has a mysterious link with brain damage. Brain scans have shown that patients with chronic lower back pain have lost grey matter from two brain areas. Scientists are not yet sure whether this is the cause of back pain or the result, but the finding could lead to new drug treatments for backache that target the brain rather than the back or spine.
The discovery was made by Vania Apkarian of Northwestern University in Chicago, when he and his colleagues scanned the brains of 26 patients who had suffered lower back pain for at least a year. Some had damage to their sciatic nerve, which emerges at the base of the spine, while the others had no known injury. The team found that all the patients had lost grey matter in two brain regions known to be important in pain perception. Continue reading Back Pain linked to shrinking Brain
Seemingly simple, it is actually a difficult problem for the clinician interested in determining the aetiology of the pain, as well as in managing the pain.
The two common muscle pain conditions are Fibromyalgia and Myofascial Pain Syndrome.
Fibromyalgia is a chronic, widespread muscle tenderness syndrome, associated with central sensitisation. It is often accompanied by chronic sleep disturbance and fatigue, visceral pain syndromes like irritable bowel syndrome and interstitial cystitis.
Myofascial pain syndrome is an overuse or muscle stress syndrome characterised by the presence of trigger points in muscle.
The problem these syndromes pose lies not in making the diagnosis of muscle pain. Rather, it is the need to identify the underlying causes of persistent or chronic muscle pain in order to develop a specific treatment plan.
Chronic myalgia may not improve until the underlying precipitating or perpetuating factors are themselves managed.
Precipitating or perpetuating causes of chronic myalgia include structural or mechanical causes like scoliosis, localised joint hypo-mobility, or generalised or local joint laxity; and metabolic factors like depleted tissue iron stores, hypothyroidism or Vitamin D deficiency.
Sometimes, correction of an underlying cause of myalgia is all that is needed to resolve the condition. Continue reading Treating Chronic Muscle Pain by Robert Gerwin
People are risking their health by working on smartphones, tablets and laptops after they have left the office, according to the Chartered Society of Physiotherapy.
The society said poor posture in these environments could lead to back and neck pain.
Unions said people needed to learn to switch off their devices.
An online survey, of 2,010 office workers by the Society found that nearly two-thirds of those questioned continued working outside office hours.
The organisation said people were topping up their working day with more than two hours of extra screen – time, on average, every day.
The data suggested that having too much work and easing pressure during the day were the two main reasons for the extra workload. Continue reading Smartphone users ‘risking health’ with overuse of devices
The term “ergonomics” is derived from two Greek words: “ergon,” meaning work, and “nomoi,” meaning natural laws. Ergonomists study human capabilities in relationship to work demands.
In recent years, ergonomists have attempted to define postures which minimise unnecessary static work and reduce the forces acting on the body. All of us could significantly reduce our risk of injury if we could adhere to the following ergonomic principles: