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What does one do if she experiences major chest pains and medical examinations reveal no heart or BP abnormalities? This is a particularly good question because it applies to all fields of medicine, and to all people who at some time in their lives will become patients (Yes, even doctors). If a person is experiencing symptoms that are not accompanied by signs of disease, or evidence in the form of an abnormal test, the diagnostic work-up will sometimes cease. Yet the patient still has the symptoms. What should be done? First, were all the elements of your complaint dealt with? Please see my prior posting about preparing for a visit to a cardiologist. It is appropriate for a visit to any physician. Second, what constitutes a full work-up for chest pain? This is actually different depending upon the likelihood of different processes causing the discomfort. Arteriosclerotic coronary artery disease is quite unlikely in very young people (but congenital disease may be more ...
Why does sitting for long periods of time increase back pain sometimes? This question has been studied for the past 50 years and researchers still find controversy when trying to answer the question. At the heart of the dilemma is a mechanical dynamic between body weight, body posture, and spinal disc load.
A loading, compressive force on a spinal disc creates a certain amount of pressure within the disc which is like a marshmallow in between two graham crackers being squished together. This pressure can be measured with special devices inserted into the disc. With various body positions like lying down, sitting, standing and bending forward, the pressure amounts vary and were first reported in the landmark study performed by Dr. Nachemson in 1981. In this study, he found that sitting produced higher pressures in the spinal disc than standing. So, for the past thirty years, clinicians have told patients with degenerative disc related back pain to avoid prolong sitting because h...
One of the most common problems seen in a primary care medical practice is low back pain. It accounts for more discomfort, lost work and productivity, and frustration for many patients than any other malady. Some think it is the price we, as humans, pay for walking upright. The lower back is a complex structure made of bone, muscles, connective tissue and nerves that, along with our legs, hold us erect, allow us to bend, run, twist, catch a football, or just lay down and rest. However, once a problem arises, the complexity of its structure makes pain in the lower back difficult to diagnose and treat. The lower back consists of a spinal column from the lumbar region of the mid-back down to the tail bone or coccyx. The spinal column consists of 5 lumbar vertebrae which are cylindrical bony structures with a ring like component behind the cylinder also made of bone. In between the vertebrae are disc shaped cushions filled with a gelatinous central core known as the nucleus pulposis
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