All the stresses we face affect our body. Thyroid gland, stomach, muscles, backs, intervertebral joints – these and other organs and structures can suffer as a result of prolonged stress loads. Psychosomatic pain – the price our body pays for living in stress and being unable to sort out a certain problem. In neurology, these are frequent back pains and tension headaches. So thinks Alexey Pelepeychenko – neurologist, medical director of the network of Time + clinics. In an interview for estet-portal.com, the doctor told how to determine the psychosomatic causes of pain in the back and head and what treatments are used to solve these problems.
- Why psychosomatic back and neck pain occurs
- A smart strategy for treating back and neck pain
- How to tell if back pain is psychosomatic
- How stress leads to physical back and neck pain
- What are the psychosomatic causes of intervertebral hernias
- What are the indications for surgical treatment of intervertebral hernia
- Main Causes of Headaches
- What do you think of alternative treatments: drips, acupuncture
AP: Why can stress cause pain? During a stressful load, a subconscious reflex tension of the muscles of the neck, lumbar, and abdominal muscles occurs, motor stereotype, gait changes. The person pays no attention to it. However, in this case, certain sections of the spine are overloaded and reversible functional blocks of the intervertebral joints occur, which provide a range of motion, i.e. spinal mobility. At this stage, the patient goes to the doctor with complaints of back pain.
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It is important to understand: if the pain in the neck or spine
passes on the background of treatment within 2–6 weeks – this is a variant of the norm, that is, such a pain syndrome does not have a psychosomatic component.
Competent strategy for the treatment of back and neck painAP: Treatment of back and neck pain should be built competently and comprehensively, based on modern standards and protocols of evidence-based medicine. Unfortunately, our market is dominated by unproven treatments. For example, instead of 1 & ndash; 2 patients are often prescribed 10 & ndash; 12 treatment procedures or 5 & ndash; 7 drugs instead of one. This speaks of excessive commercialization and the financial burden on the patient, not to mention the burden on the body in general and the nervous system in particular.
Read also:Doctor: 7 types of pain caused by – stress The treatment of back and neck pain is based on three pillars:
1. Pharmacotherapy
For acute pain in the back and / or neck, 1-2 drugs are prescribed. These are paracetamol, aspirin or their derivatives – any non-steroidal anti-inflammatory drugs for which the patient has no contraindications: bronchial asthma, allergies to aspirin-like drugs, peptic ulcer of the stomach and duodenum.
2. Manual Therapy
Unfortunately, in our country, manual therapy for some reason is given into the hands of, to put it mildly, unqualified specialists. Legislation does not regulate the system of training manual therapists. Manual therapy should be carried out by:
neurologist;
- orthopedist;
- Specially trained general practitioner.
- A person with a secondary medical or near-medical education is not allowed to practice manual therapy.
The meaning of manual therapy – not to "set something", but to restore the range of motion in the spine, i.e. in the intervertebral joints. Procedures are carried out maximum 1 time per week, up to 5 sessions.
3. Therapeutic gymnastics
The meaning of therapeutic gymnastics (physical education) is to restructure the stereotypes of movements, since pain occurs due to improper load on the spine due to:
stress – muscle spasms, postural stress (prolonged sitting);
- microtrauma;
- comorbidities, etc.
- Therefore, the patient is prescribed 1–3 exercise therapy sessions per week, which must be carried out systematically.
Are your lower back muscles sore? A simple stretch will solve the problem
Pain in the back or neck may return after treatment if the doctor has incorrectly assessed the patient or missed some important points forHow to determine if back pain has a psychosomatic cause
A.P.: See a doctor. Determine the cause of back pain – task of a qualified specialist. If a well-designed treatment regimen does not lead to improvement after 4-6 weeks, it is worth thinking about the psychosomatic causes of pain. At the doctor's appointment, it is important to mention about long-term stress, if such has occurred in your life.
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Even the most experienced doctors from the first visit cannot always determine the psychosomatic cause of pain, because patients are silent about their problems, sometimes remembering them in the last
How stress leads to physical back and neck pain
A.P.: Stress affects the nervous system and any organ of the human body can react to it.
If we talk about the neck, muscle overload caused by overstrain manifests itself as an inflammatory process and leads to the appearance of symmetrical pains in the collar, trapezius muscle, occiput, under the occiput, in the area of the shoulder joints.30% of our patients receive psychological help and take antidepressants because back pain can often be a sign of depression. In this case, they are difficult to treat.
If it is the lumbar region, the lumbosacral junction suffers the most. In this case, the person moves normally, but with little pain, i.e. discomfort caused by muscle tension. Often patients suspect problems with the spine, but in fact, stress-induced pain can localize in the muscles.
What are the psychosomatic causes of intervertebral hernias
AP: I wouldn't say they exist. The spine consists of two main blocks: the anterior, where the intervertebral discs are located, and the posterior, where the intervertebral joints are located.
Hernias appear due to an incorrect stereotype of movement, increased load on the vertebral bodies. As a result, the disc is overloaded, the fibrous ring develops and the nucleus pulposus compresses the nerve root.
If a patient with a herniated disc has some kind of depressive or psychosomatic background, he will recover much longer. Because nagainst the background of stress, the threshold of pain sensitivity changes – he feels pain
more than it should be.
What are the indications for surgical treatment of intervertebral hernia
A.P.:
Indications for surgical treatment of intervertebral hernia – intractable pain syndrome. That is, if the patient underwent therapy according to the protocol and did not receive an effect within 4 & ndash; 6 weeks, it makes sense to think about surgical intervention.You may also be interested in:Protrusion of the intervertebral discs: why it occurs and how to treat it
In the case of the lumbar spine, hernia surgery is indicated in case of
bladder dysfunction.Main causes of headaches There are many causes of headaches that can be difficult to pinpoint. It is necessary to be examined.
new intense, thunderous headache with no previous episodes;
headache accompanied by visual disturbances – flies in front of galasmi, light stripes, etc.;
Headache during which nausea and vomiting occur.
With such conditions, it is necessary to- seek
- a doctor as soon as possible, as their causes may be aneurysms, vascular malformations, brain tumors.
All other headaches pains may occur in case of:
cervical spine pathologies;
ENT diseases;
dental pathologies; psychosomatic and a number of other reasons.
- You may also be interested in: How spinal problems are related to headaches
- A very serious problem – uncontrolled use of painkillers
- . Within 3 months, you can not take more than 10 tablets containing analgin, paracetamol, caffeine, codeine, metamizole. These drugs cause rebound headaches that cause stress and anxiety. And the patient takes the pill again. Thus a vicious circle is formed. Headache is very difficult to treat and it is extremely difficult to remove patients from drugs in
How do you feel about alternative treatments: drips, acupuncture A.P.:
Acupuncture for back pain – it is distraction therapy
. The latest protocol from 2016 states “do not offer acupuncture for back pain with or without radiculopathy.” The effectiveness of this method has not been scientifically proven. Yes, in 30% of cases the placebo effect can work. But I do not prescribe to patients what I would not prescribe to myself and which is not scientifically proven.More interesting videos on our YouTube-channel!
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