Foot Clinic in Novi Sad, Serbia

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About: Pain can be: acute (till 3 weeks), subacute (3 weeks till 3 months) and chronic (more than 3 months). Acute pain is useful only at the beginning of the illness because it indicates that there is a pathological process. Any pain that lasts longer than 3 weeks tends to remain persistent and to become an illness by itself. Thats why it should be treated at a very beginning. Chronic pain persistent to usual therapy is frequent. 25% of the population need sometimes therapy for chronic pain in their life. It can be cancerous and noncancerous pain. Musculosceletal and neuropathic pain represents 80% of all chronic pain syndromes PAIN ANATOMY Most of these pain syndromes have similar diagnostic and therapeutic approach. Following facts can be applied to most pain locations from head to heel like: headache, Facial pain, Neck pain, Shoulder pain, Arm pain, Back pain, Leg pain, Knee pain, Foot pain, Heel pain etc. Essential for successful treatment of any pain is to identify: Which anatomical structure is a source of the pain (pain anatomy) What kind of pathologic process is in that structure. When anatomical sources and pathological process are identified success in pain treatment (healing or significant reduce) is in 70-90% of the patients. ( They mention that these patients have been suffering from pain for a long time without therapy effect.) Pain anatomy means that every region of the body can have 10-20 possible sources of pain such as: muscleS, nervS, ligamentS, joint, tendonS, fascia, bursa, etc. Pathologic proccess in or arround these structures can be: inflammation, pressure, strein, overstrech, spasm, neuropathy. For example: Like on the picture below the same sciatica can be caused by disc prolaps or by inflammation and spasm of some muscles causing irritation of sciatic nerve. If this is not known the problem is when nothing is evident on spine CT or MRI. Even bigger problem could be if asymptomatic discus hernia is visible on images. Than unnecessary surgery could be performed. Without knowing real cause of the pain mostly diagnoses which are not accurate enough are set as final diagnoses. Exaples like: sciatica, cervical syndrome, lumbar degenerative pain, spondilopathy, gonarthrosis, rheumatic disease, headache, etc. In these situations usually contributing factors are proclaimed to be the main reasons of the pain like: old age, obesity, bad posture, degenerative changes, psychological overreaction, circle cell anemia, etc. Even if these factors cannot be changed easily it doesnt mean that in that period patient has to suffer the pain. PAIN DIAGNOSIS To determine which anatomical structure is the cause of pain essential is long conversation with patient covering all important information. In practice this conversation is too often made without real listening to the patient and without entry into important information. Examination of the patients must include specific examinations. There are great number of specific tests for different anatomical structures. Without knowing this examinations real cause of the pain and successful treatment cannot be performed. Diagnostic images usually mean: X-Ray, CT (Computer tomography), EMNG, MRI, […]

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