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Неизвестные боли: происхождение и характеристика

13 Январь, 2021

Dolores desconocidos_01_20210112

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In a new entry in his videoblog, Dr. Francisco del Piñal addresses unknown pain, overcoming this diagnostic label through the analysis of its most common foci and characteristics, together with placing value on the examination and history of the patient in the process of identification of ailments and pathologies.

Unknown pain appears when after consulting a specialist and performing tests according to the patient’s condition, the origin of the pain or ache cannot be established. In addition to unspecified pain, people in this situation also often suffer from strong psychological pressure in their interpersonal relationships and in the workplace.

Among the causes of this type of pain, Dr Piñal points out benign nerve tumours known as glomus tumors, which hurt in the area of the nail or on the fingers pads. In turn, he cites neuromas, cuts in the terminal branch of nerves that lead to a painful ending to appear.

The Spanish surgeon also mentions the sequelae of crushing cases, among which is the loss of padding on the fingertips, which causes pain with minimal trauma.

Another large segment associated with this diagnostic category is that of patients with sprains or trauma to the fingers, especially those who suffer from volar plate contractures. Also in the fingers, there are the tenosynovitis of the flexor tendons, with or without snagging in function.

During his presentation, Piñal addresses what he considers to be the largest group of unspecified pains: pains associated with wrist injuries in people with non-consolidated fractures, ligamentous damage or with erroneous diagnoses for their clinical picture; situations in which he emphasizes the role of arthroscopy for an adequate diagnosis.

Likewise, he highlights the tendonitis of the upper limb or nerve injuries that escape tests such as the electromyogram or magnetic resonance imaging, and that cause compression pain in the hand, especially of the median nerve.

In all the cases listed, Dr. Piñal raises the need to take into account that medical tests are operator dependent, that is, their results are fallible and vary depending on their methodology and the expertise and knowledge of the physician who evaluates them. For this reason, he advocates an adequate combination of tests, exploration and history of the patient.