Sunday, April 1, 2012

Generalized pain


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Rheumatoid Arthritis

If a person has generalized pain symptoms and pain in several locations or almost everywhere, the sufferer starts suspecting the risk of rheumatoid arthritis. This usually, however, is not the case—normally diagnosis of generalized pain condition points to something benign even when there is pain all over.

Typical rheumatoid arthritis begins with progressive joint symptoms. First symptoms appear in the knuckles otherwise called the metacarpophalangeal joints, in the joints between the first and second finger bones otherwise called proximal interphalangeal joints of the fingers or in the base joints otherwise called metatarsophalangeal joints of the toes, in ankles, wrists or knees. Rheumatoid arthritis typically causes swelling of several joints both on the right and left side simultaneously.

The inflamed joints are tender and stiff, especially in the morning or when not used for some time. There may be a burning sensation in them and they may become warm. In addition to joint inflammation, irritation may be experienced in the attachments of the tendons to the joints and inflammation of the mucous bursas near the joints. In the long run, if the disease progresses, the range of motion in joints limits, and they may deform.

Symptoms preceding the onset of illness include fatigue, appetite and weight loss, fever and some other symptoms seen with many other illnesses. Because this disease is by nature a systemic connective tissue disease, the patient may experience varying symptoms.

The basic cause for rheumatoid arthritis is still not fully understood. It is thought to be an autoimmune disease, in other words a confusion of the immune system. The immune system participates in defending the body, among other duties. In autoimmune diseases, the immune system takes healthy tissue as foreign substances and, as a result, attacks its own body. An infection may play a role in the mixing of the immune system and the onset of rheumatoid arthritis.

The clinical picture is often the main tool for diagnosis. Laboratory tests may show changes characteristic to rheumatoid arthritis such as an increased sedimentation rate. The rheumatoid factor level may be higher, but this may be the case also in a person who does not have rheumatoid arthritis. Over time, x-rays show changes in the finger and toe joints that are compatible with the condition.

Medication plays a key role in rheumatoid arthritis. Early start improves the treatment outcome. Treatment should be left to an experienced rheumatology specialist. The outcome of treatment varies from person to person. Some patients have an aggressive form of the disease; others may have fewer symptoms over time. In cases of rheumatoid arthritis, it is necessary to maintain mobility of joints by using the joints in a manner that is appropriate with each stage of the disease.

The systemic connective tissue disease group includes as well other, rarer diseases .


Post-infectious pain

It is common to experience joint, tendon, or muscle symptoms after various infections, particularly in the case of intestinal or urinary tract infections. Post-infection symptoms that cannot be easily connected to the infection often appear after the infection.

Post-infection joint symptoms are present in only a few joints simultaneously and usually asymmetrically. Muscle and tendon symptoms may vary widely.

If these symptoms remain for a long time, a doctor should be visited. Most post-infection symptoms require no treatment and will go away in time. Some may require treatment to ease the pain they cause.

Lyme disease

Borreliosis otherwise called Lyme disease, which contracts via tick bites, may cause joint symptoms. If there is a ring-like outwards expanding rash in the area of the bite, a doctor should be seen immediately. Other symptoms in the initial stage may be fever, headache and fatigue. The disease is easily treated with antibiotics at this point. If one does not detect a rash, or it does not appear in a typical way, the disease can be diagnosed with the help of the clinical picture, the findings, and the serological blood test showing increased antibodies.

In the later stages when bacteria spreads by circulation, these outwards expanding circular rashes may arise at various sites of the body even far away from the site of the first bite.

There may be later muscle and joint symptoms and symptoms in other organs including the brain, nerves, eyes and heart. The later the disease is diagnosed, the more complex the treatment and the more uncertain the results are.



Fibromyalgia

Fibromyalgia has been a generalized pain syndrome in the center of attention in recent years. Fibromyalgia causes a wide-ranging pain and a painful response to pressure accompanied by other symptoms such as weakness, sleep disorders, and morning stiffness.

The pain in this generalized pain disorder is typically a dull, vague ache. Often one area is more painful than others are. According to some research, the first symptoms appear most often in the area of wrists and hands. Powerful fatigue is common and may be present onwards immediately after waking up. Sleep disorders include waking at night and difficulty falling back asleep.

Many patients with fibromyalgia also have other symptoms such as irritated colon, tension headaches, muscle spasms and twitching, weakness in the limbs, menstrual problems, an impaired concentration and memory, depression, anxiety and heart symptoms.

A doctor’s examination shows particularly severe pain in typical points in several different areas. The doctor has to exclude other illnesses and generalized pain causes that can offer similar symptoms. Only after that can the fibromyalgia diagnosis be made.

Physical therapy may worsen the condition. Massages, such a lymphatic massage, work for some patients. Cold compresses may be helpful.

Sleep disorders should be reduced with medication. Anti-depressants often work well here, as they have the best effect on fibromyalgia-related sleep disorders. A lower dosage is usually sufficient in the case of fibromyalgia.

Treatment often does not make all the symptoms disappear. The main issue is not to let the disease control everyday life. A normal life and moderate use are beneficial. The worst possible alternative is to stay at home alone and mull over the pain.

Similar wide-ranging mild symptoms may be associated with many other conditions. If the problems of wide area pains stay for a long time, a doctor´s check should be organized.

Self-treatment for fibromyalgia includes OTC anti-inflammatory medication when needed and ointments for the painful areas, if they are helpful. Cold compresses 20 minutes at a time several times a day may be useful. Sometimes heat pads work better.

In some people, taking saunas aggravates the symptoms. A long cold shower, after a sauna or bath, may reduce the next night’s misery.

A overall good fitness form should be held. When one is in a good condition, the pain is usually milder, and it is tolerated better. Aerobic exercises should be done for 20 minutes three times a week, in a way that pulse rate goes up. Swimming, walking with or without poles, biking, gym or group exercises are usually tolerated well enough.

Anaerobic exercises causing lactic acid to build up are usually tolerated worse. In persons suffering from fibromyalgia, muscles get sore more easily this way. In general, the exercise intensity should be raised gradually and not too fast with this condition because the muscles get easily aggravated.

Warm baths and salt baths help some. Whirlpool baths may help. Winter swimming keeps the symptoms in check for some people. Temporary extreme cold treatments in special treatment rooms have also been used for this condition. Traditional tempering treatments may also work.

Fasting alleviates the pain temporarily. Vegetarian diet works for some patients. It might be worthwhile to have a diet diary and track the impact of diet on the pain symptoms.

A warm and dry climate with few daily changes suits some patients better than the northern cold and humid climate. This is true especially in spring and fall, when the weather can change quickly, and many people travel to warmer countries from the colder regions during these seasons.


Generalized Pain in Children

Also in children there may be generalized pain Healthy children may have pain in the bones, joints, and muscles. If there are other complaints and findings like losing weight, fever, fatigue, severe local pain or findings in the joints like restriction of movements or swellings, a doctor should be consulted. Growing pains and variations, traumas or overuse, may cause benign pains for a long time.

See a Doctor

Obvious swelling in a joint.
Pain and an earlier tick bite.
All prolonged wide-ranging pain.
Pain that makes everyday life difficult.
Pain that worries you.

Generalized pain, more information:

Mayoclinic.com pages on rheumatoid arthritis.
webMD about rheumatoid arthritis.
Medicinenet.com slideshow about rheumatoid arthritis.
Mayoclinic.com pages on fibromyalgia.
ArthritisResearchUK pages on fibromyalgia.
Familydoctor.org pages about Lyme disease.
Emedicine pages about polymyositis and dermatomyositis.
KidsHealth.org about growing pains.

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