1/4. A systematic history for the patient with chronic pelvic pain.Chronic pelvic pain is a source of frustration to both the physician and the patient. physicians have been ill equipped by their training to confront the multifaceted nature of the complaints of patients with chronic pelvic pain. patients have experienced a repetitive dismissal of their complaints by physicians too busy in their practices to address their problems comprehensively. The approach to the patient with chronic pelvic pain must take into account six major sources of the origin of this pain: 1) gynecological, 2) psychological, 3) myofascial, 4) musculoskeletal, 5) urological, and 6) gastrointestinal. Only by addressing and evaluating each of these components by a very careful history and physical examination and by approaching the patient in a comprehensive manner can the source of the pain be determined and appropriate therapy be administered. This article was developed to provide the clinician with a set of tools and a methodology by which the patient with this complaint can be approached.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/4. Interstitial cystitis, pelvic pain, and the relationship to myofascial pain and dysfunction: a report on four patients.Treatment of chronic pelvic pain (CPP), interstitial cystitis (IC), prostatodynia, and irritative voiding symptoms can be frustrating for both patients and physicians. The usual approaches do not always produce the desired results. We found that when we treated myofascial trigger points (TrP) in pelvic floor muscles as well as the gluteus, piriform, infraspinatus, and supraspinatus muscles, symptoms improved or resolved. Various palpation techniques were used to isolate active myofascial TrPs in these muscles of four patients with severe CPP, IC, and irritative voiding symptoms. Injection and stretch techniques for these muscles were performed. Visual twitch responses at the skin surface and in the muscles were used to verify successful needle piercing of a TrP. The patients were asked to verbally describe exactly where the flash of distant pain was felt, a process that permitted an accurate recording of the precise pattern of pain referred by that TrP. The findings involved with the four patients substantiate the need for myofascial evaluation prior to considering more invasive treatments for IC, CPP, and irritative voiding symptoms. Referred pain and motor activity to the pelvic floor muscles (sphincters), as well as to the pelvic organs, can be the sole cause of IC, CPP, and irritative voiding dysfunction and certainly needs further investigation.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
3/4. Myofascial pain syndrome.Myofascial pain, a general descriptive term, is applied to painful sensations that extend along one or more skeletal muscles and their fascia. trigger points, discrete hyperesthetic areas within the muscle and its fascia, are characteristically found in myofascial pain. On the other hand, myofascial pain syndrome is a painful condition characterized by the presence of trigger points, local and referred pain, tenderness, referred autonomic phenomena as well as anxiety and depression. patients affected by myofascial pain, trigger points, or myofascial pain syndrome, represent a significant population group requesting services in the offices of general practitioners, orthopaedic surgeons, and physicians treating musculoskeletal disorders.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
4/4. Exacerbation of soft tissue rheumatism by excess vitamin a: case reviews with clinical vignette.In certain situations, health problems can arise if physicians are not aware of over-the-counter medications and vitamins a patient may be taking in addition to their regular prescriptions. Since many people do not consider OTC drugs to be medications, they often do not relay this information while discussing their medical histories. This article describes how the symptoms of soft tissue rheumatism can become worse if patients ingest an excess amount of vitamin a.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |