The Diagnosis of Persistent Somatoform Pain Disorder

According to the clinical diagnostic guidelines ICD-10 should be criticized in several ways:

1. Ignoring the organic substrate does not reflect the reality of the pain, even if they are primarily psychological or psychosocial reasons. With this diagnosis, the body-soul dualism Cartesian reflect that there is "real", that pain-related physical and imaginary, that is mentally induced pain. After the biopsychosocial model of disease different definitions would be more appropriate. The term "pain disorder" without "somatoform" when he was elected in the DSM-IV, not the fact that the "psychogenic" pain caused by organic substrates (may) have, although this is due to the current state of the science is often still not sufficiently known. The concept of persistent somatoform pain disorder according to the clinical diagnostic guidelines for ICD-10 exposed to the risk that should initially umdiagnostiziert as "somatoform" pain disorder is defined through the advancement of medical science, more and more, because of the organic substrate is detected, although at the same symptoms of mental and psychosocial factors involved as before.
2. Realization of psycho-physiological mechanisms, such as is the case with painful muscle tension (tension headaches), will lead to a different diagnosis of F45.4, which is the main code of non-psychiatric field, although psychosocial stressors known as triggers. This criticism is not mitigated by the fact that the ICD-10 pain described also not pure organic referred to as "somatoform".
3. In ICD-10, which is quite important differences between acute and chronic somatoform pain disappear. The suffix "persistent" ignores the difference between acute and chronic pain, such as that carried out in the DSM-IV. With the requirement for persistent pain pain disorders in ICD-10 is ignored so that last less than six months. In pain lasting psychological and social factors that are shorter also play an important role.

ICD-10 diagnosis of "persistent somatoform pain disorder" diagnosis is based on the same problematic "somatoform pain disorder" of the previous American Psychiatric diagnostic scheme DSM-III-R. This diagnosis is not suitable for many patients with chronic pain and does not apply to patients with acute pain, where both psychological and social factors in pain trigger or amplify.

DSM-III-R call for continued work with the pain for at least six months, while DSM-IV considers the pain itself as the main criteria for diagnosis. It was at that time not yet distinguish between acute and chronic pain.

Chest pain | What is chest pain?

Chest pain is a painful sensation in the chest or otherwise objectionable, which may or may not be associated with cardiac damage. Chest pain in adults can have several causes, some of which include:

Lung: may have pneumonia or other lung infections that can cause chest pain. Coughing can also cause pain.

Musculoskeletal: a common cause of chest pain include pain due to injury or strain on the joints or muscles. If you have some damage to the ribs, injury or tumor, it can cause you to feel pain in your chest.

Gastrointestinal: You may have the kind of gastroesophageal reflux. In this case the contents of the stomach back into the esophagus instead of down. This can cause pain after eating in abundance, lying down or bending. Antacids, such as famotidine (Pepcid), omeprazole (Prilosec) or Mylanta can relieve these symptoms.

Angina can be a cause of chest pain that can occur as a feeling of "tightness" in the chest. Anxiety or depression can cause you to feel angina. Some other causes of angina include:

Coronary artery disease (the most common cause of angina) from time to time, can form fatty deposits (called atherosclerosis), which damage the walls of the arteries that carry blood to the heart, restricting blood flow and occur less oxygen to the heart muscle. The lack of oxygen causes angina.

Coronary artery spasm may cause spasm of the coronary arteries which creates a temporary constriction of blood flow and lack of oxygen to the heart muscle while. When seizures disappear, usually the pain goes away because the blood flow returns to normal.

Anemia: homoglobina low levels (Hb) levels may cause angina. The hemoglobin carries oxygen in the blood.

Polycythemia: This occurs when the blood has too many red blood cells (erythrocytes). This causes the blood to thicken. Polycythemia may be the result of a lifelong disease, such as chronic obstructive pulmonary disease (COPD), or because of problems with the blood itself,

or irregular heart rhythm, heart problems and thyroid disease valve also cause angina.

Chest pain should not be ignored for any reason. Here, we show some serious symptoms to consider. If you experience any of these symptoms, you should seek emergency care, and then tell your doctor.

NERVOUS AND BREAST psychosomatic prick | Breast Pain

Nervous heart complaints relate mainly to the increased activity of the heart, but also palpitations, feeling of pressure and pain in the chest is one of the symptoms. Behind it there is a problem of heart performance, but increased excitability. Heart is also controlled in function primarily by the autonomic nervous system and reacts very well to the imbalance resulting from the interaction between body and soul. Often, there are other vegeative symptoms such as anxiety, sleep disorders, bladder pressure or irritable bowel syndrome.

All situations and conflicts that can lead to stress the individual (eg, excessive job demands, interpersonal stress or internal conflict) came as a reinforcement of these symptoms. If the internal conflicts that exist on a subconscious level is permanent, so it -in the sense Psychosomatik- be at the physical level, for example, expressed as a "pain in the chest." For people who feel the sting even physically, it takes a long time until they can usually accept this statement alone. This defense can be understood from the point of self-organizing organism, which seems more like symptoms run with fear and therefore may tend to occur in the foreground. In this case, the symptoms have a protective function, which should not be hastily abandoned.

Therapists who use the interpretations related organs in their work, assume that breast stab of fear for his own heart on each actor must have the same background. When the liver is close by referring to its own rhythm of life, perception, and act out their own feelings, injury (eg, sadness, heartache) in this sense.

Help because this aspect can be, in too rigid application also always the danger for the person concerned to impose an explanation about what can cause resistance to healing.

PROCEDURE MANUAL

From the point of view of the mechanical point of view, the movement needs to be improved in the chest area. Methods such as osteopathy and Rolfing mentioned above relate this to the whole body and static in the examination and treatment.

This movement of the chest breathing and mobility tested and treated the existing movement restrictions. In addition, chest and structures that are placed in relation to the whole body and check for voltage distribution as a whole organism and treated if necessary. Therefore, for example osteopathy ienen also interesting to see whether the person concerned in addition to pain in the chest above example, temporomandibular joint problems, back pain, leg pain or lump in the throat Klagen- what patients are initially came as an osteopath for pain in the chest, can be confusing.

Direct procedure used for the concept of the fascia (FDM). In this case, also manual, treat straight points and the areas to be tested, which prepares pain affected and treated. Timely in stitches in the chest, it is clear from the FDM interference with bone or bone tendon junction transition band in the sternum. These points are treated by the pressure of the thumb and immediately retested.