PAIN

Fibromyalgia is a chronic disease accompanied by frequent muscle pains, fatigue, headache, sleep disorders -thus, waking up exhausted in the morning- and sometimes with problems during defecation. Its most distinct characteristic is frequent muscle pains. While some patients experience pain in a large area, some others identify tender points where the pain is concentrated.

Although it can be seen at any age and in both genders, the disease is more prevalent at ages 25-55. The majority of the patients are women aged 25-60. Women are ten times more likely to develop this disease compared to men.

There is no specific test or medical method for diagnosing fibromyalgia. Blood tests and radiologic examinations may wield normal results.

Diagnosis of fibromyalgia is made based on the history of disease and clinical examination. In order to diagnose a patient with fibromyalgia, complaints and symptoms must have been going on for three months and must be continuing, and there should be sensitivity to pain in specific points.

Diagnostical criteria for fibromyalgia syndrome as determined by the American College of Rheumatology are pain manifesting for at least three months in a large area of the body: Continuous pain both on the left and right of the body, on the upper part of the waist, on the lower part of the waist, on the chest, on the neck, on the middle or lower back, and the presence of sensitive points in various regions of the body.

A multifaceted treatment is applied in the treatment of fibromyalgia. Therapeutic methods used include pharmacological treatment, stress reduction, regular workout, massage, physical therapy and regulation of sleep. Regulation of diet is also valid and psychiatric support should also be sought if needed. Treatment is planned to reduce pain and fatigue and minimize other symptoms.

Popularly known as calcification, osteoarthritis is a joint disease characterized by abrasion on joint surfaces, degeneration, erosion and thinning of cartilage and loss of cartilage. It is more prevalent on the knee, hip, wrist and spine. It is the uninflamed rheumatism of arthrosis joints and manifests with pain in one or more joints.

In advanced stages, the cartilage is completely lost, and bone surfaces start to come into contact. Joint pain manifests with advancing cartilage destruction. What causes destruction is either overuse and strain, or over-erosion caused by ageing.

The condition is more frequently seen in middle aged and overweight individuals, in those who exercise a profession where there is repeated pressure on the joints, in men aged 45 and under, and in women aged 55 and above. Prevalence is of approximately 96% at age 75 and above.

Advanced age, gender, obesity, sedentary lifestyle, bone deformities, previous diseases, exposure to injuries where the joint has been affected, congenital joint disease and professions that put an extreme or long strain on joints may increase the risk of osteoarthritis.

• Pain (pain decreases with rest. The more defects and erosion in the joint cartilage advance, the more pain may be experienced during rest as well.)
• Slight increase of heat
• Slight redness
• Morning stiffness (Morning stiffness / Lasts for 30 minutes or less and relaxes after a while with some exercises)
• Movement restriction and deformity. When moving after a long rest or seating position, patients may experience a short-lived stiffness. This changes with movement. However, the more erosion advances, the more movements may become restricted and hinder daily life activities.

Osteoarthritis is diagnosed with examination. Its degree is identified with imaging techniques. It has a 4-stage radiography, the 1st degree being the mildest and the 4th degree being the most severe.

Since it is not possible to restore the impaired cartilage tissue, there is no treatment that can ensure full recovery from the disease. Main objectives in the treatment of osteoarthritis are relieving the pain, correcting movement restrictions, ensuring that daily activities are carried out without any problems and preventing the disease from advancing.

Osteoarthritis is treated pharmacologically and with physical therapy. Albeit rarely, surgery may be needed at advanced stages. Losing weight and working out are two important components of treatment. Getting rid of excess weight may also occasionally ensure some relief since it will reduce weight put on the knees, the hips and the waist.

Headache is the common name given to pains manifesting in the head, neck or upper part of the back. These are pains caused by the vasodilatation of vessels on the head and neck region, spasms in muscles, pathologies of jaw joints and tensions of the scalp. Headaches are thought to be brain aches, but since the brain does not have the sensation of pain, in reality headache is perceived via the brain's periphery, the membranes that surround it, bones that constitute the skull, muscles and nerves coming out of the brain stem.

We can talk about two types of headaches: primary and secondary headaches. Pains caused by another disease are classified as "secondary headaches". Those that are not caused by another disease are part of the "primary headaches" group. While primary headaches are migraines, tensions and cluster headaches etc., secondary headaches are serious conditions caused by head and neck injuries, brain neurovascular diseases, brain tumors and infections, sinusitis, increase in brain pressure, and they can result in death or severe permanent disabilities.

The most prevalent type of headache is the tension-type headache that constitutes more than 50% of headaches. However, migraine is more prevalent than is thought. The condition is more prevalent in women than men. Aside from that, there are also rarer types of headaches such as cluster headaches, daily chronic headaches.

These are generally double-sided and are rather felt on the head and neck region, the temples or above the muscles and manifest as heaviness, compression and a feeling of pressure on the head. It is the most prevalent type of headache. Tension is present on head and neck muscles. Its causes are stress, fatigue or spasms of various causes in the muscles in this region. While it may last for 5-10 minutes, it may as well continue non-stop for days. These pains that rarely manifest episodically can become extremely uncomfortable when they become chronic.

These usually are hemicrania (aches felt on only one side of the head) characterized by throbbing and they can be observed in other forms too. These pains may be accompanied by a sensitivity to light and sound, nausea and vomiting. Patients usually prefer staying in silent and dark rooms. The pain manifests in episodes and visual impairment (aural type) occurs at onset. Head and physical movements increase the pain.

It is a very severe pain that hinders daily activities and that does not respond easily to pharmacological treatment, having a monitoring and treatment of its own.

These are severe, knifelike sharp pains. They are one-sided and are mostly felt on the eyes and temples. They last for minutes but repeat throughout the day, causing redness, tearing, pupil constriction in the eye, nasal congestion and discharge on the side of the head they manifest.

If the headache has started suddenly and very sharply, if it is accompanied by fever or vomiting, changes in consciousness and a predisposition towards sleep, you must got to the emergency department.