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  • Common Causes of Ear Pain.
  • Stormy Weather?
  • Chronic, Subtle, Systemic Inflammation?
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National Institutes of Health. Accessed November 11, Related Female breast anatomy Breast lumps. Mayo Clinic Marketplace Check out these best-sellers and special offers on books and newsletters from Mayo Clinic. Usually affects both breasts, particularly the upper, outer portions, and can radiate to the underarm.


Diagnosis of Ear Pain

Usually affects one breast, in a localized area, but may spread more diffusely across the breast. Intensifies during the two weeks leading up to the start of your period, then eases up afterward. To some extent inflammation is just a part of life, the inevitable cost of having an immune system. Like a society must balance police and military powers against civil liberties, evolution has had to juggle the pros and cons of a potent defense system.

We know that metabolic syndrome is clearly associated with at least some common pain problems, like neck pain 4 and back pain. And to be inflamed excessively may be synomous with premature aging … which is probably affected by both your genes and lifestyle. Many people get overzealous about ideas like this. Quacks and cranks love to blame all or most health problems on subtle, speculative causes like low-grade inflammation or infection and of course they always believe they have the cure.

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  6. A lot of inflammation is not easy to detect. It may hide effectively in specific tissues and systems, only detectable with complicated, expensive, invasive testing. This is one of the main reasons that some diseases have been so mysterious for so long. There are more accessible blood tests that are quite sensitive to various signs of inflammation, but — because biology is messy — they are not super reliable, and even people with serious inflammatory diseases do not always get a clear result.

    This is a common and easy test, and who knows: The pain of fibromyalgia [Mayo] is an unexplained sensory dysfunction resulting in widespread oversensitivity to stimuli, exhaustion, and mental fog, among other things. And fibromyalgia patients are probably actually inflamed! Or perhaps even the other way around.

    Fibromyalgia does routinely seem to involve sensitivity — the nervous system is over-reacting to stimuli — but inflammation constitutes an actual insult to tissues. Molecules produced by immune system activity, normally associated with infection and injury, are stimulating nerve endings nociception.

    The information is sent to the spinal cord and brain for consideration, where the experience of pain may or may not be generated but it probably will be. Subjectively, it is nearly impossible to tell the difference between the pain of an oversensitive nervous system and the pain of a nervous system that is actually detecting inflammation all over. There are strong but murky links between chronic pain and stress.

    It might even be the way. We suspect that rough childhoods may be a risk factor for several disorders that probably share inflammation as a mechanism. In the very short term minutes , stress is indeed an immune stimulator inflammatory. But then, almost right away, that effect gets reeled in to prevent collateral damage: But in chronic stress, the stimulatory phase keeps happening over and over again, and the suppressive phase never quite catches up, and so overall immune system activation gradually ratchets up and up and up.

    Ergo, long term stress is inflammatory. The relationship between metabolic syndrome and inflammation is clear, but there may also be a link between metabolic syndrome and stress, 22 and is almost certainly a link with sleep disturbance which overlaps with stress, obviously.

    Anterior Vaginal Wall Tenderness (AVWT) as a Physical Symptom in Chronic Pelvic Pain

    The world is full of unexplained pain. I publish a busy website about pain, and so I get email like this more often than I change my socks:. But something is causing my pain. What else is there? What else is left? What else causes pain? How else can pain start, change, worsen? This article summarizes some of the not-so-obvious ways to hurt, the things that might help you understand pain that has defied diagnosis or explanation so far. Pain itself often modifies the way the central nervous system processes pain, so that a patient actually becomes more sensitive and gets more pain with less provocation.

    Sensitized patients are not only more sensitive to things that should hurt, but also to ordinary touch and pressure as well. For more information, see Central Sensitization in Chronic Pain: Pain itself can change how pain works, resulting in more pain with less provocation.

    Chronic and acute pain are radically different. Chronic pain is not just acute pain that kept going. Over several weeks, the nature of pain changes. It probably involves a complex stew of the ideas in this article. For instance, sensitization see above is clearly a major factor. Translation and the important thing for desperate patients to understand: The pain is a kind of ghost of the original, a tormenting poltergeist. Like an ulcer, there can be a physical problem, but one that is also sensitive to your emotional state. Like picking at a scab, the brain can become excessively focused on a pain problem.

    For more information, see Pain is Weird: Pain science reveals a volatile, misleading sensation that is often more than just a symptom, and sometimes worse than whatever started it. There are two main kinds of pain: Nociceptive pain is the most familiar because it arises from damaged tissue, like a cut or a burn. Neuropathic is more rare, because it is caused by damage to the damage-reporting system itself, the nervous system.

    Pain is also either somatic skin, muscle, joints or visceral organs. Like other complicated things in life, pain may not have any specific cause at all. Although we often speak of pain being multifactorial , we still tend to assume that just one of those factors is the specific cause of pain, and the others — sleep loss, stress, etc — are only piling on , making a bad situation worse. That picture may be wrong: It may crop up only with an unholy combination of many factors. The idea of pain that truly has no specific cause is something more patients probably need to consider. Pain without no one cause is a good news scenario in the sense that it might be treated by relieving enough of the contributing factors … but bad news in the sense that it may be like fighting a hydra.

    Muscle tissue is everywhere — our most massive biological system — and its subtler hijinks can cause a lot of discomfort without giving itself away. No one has any doubt about the cause of pain when they get a massive calf or foot cramp, but not all cramps are so obvious, and there are other types of insidious, uncomfortable muscle contractions. Using just wide brush for now, the types of unwanted contractions that cause the most trouble without being easy to diagnose are cramps, dystonia, spasticity.

    The biology and treatment of unwanted muscle contractions. Anything that hurts inside the body — anything deeper than skin — is harder for the brain to locate. Despite the fact that this phenomenon is well known, it still results in an amazing amount of medical barking up the wrong tree.

    For instance, both of the examples at the beginning of this article were cases where referred pain fooled doctors — in both cases, the pain was caused by a trigger point in a nearby muscle, not by vital organs. The doctors simply looked in the wrong place! How long can you last? Within an hour you will probably be in severe pain.

    But we seem to be wired to avoid stagnancy, probably because every cell in our body depends on nearly constant movement to survive. The exact mechanism of pain is probably nerve endings that detect tension on cartilage, ligaments, and tendons, and which in turn is interpreted by the brain as a surprisingly serious threat.

    It can be caused by surprisingly subtle postural stresses like from poor ergonomics , or anything that deprives tissue of full movement. This is may be the main causes of neck cricks , for instance, and scads of other miscellaneous aches and pains. Neutrophils are defender cells that are supposed to destroy bacteria that invade wounds, a normal part of the inflammatory response to injury. Bizarrely, neutrophils go to work even when the wound is sterile, not open to the outside world. Like an overzealous police force with nothing better to do, they also attack a common cellular organ, mitochondria, whenever it is spilled from cells by injury.

    Mitochondria are actually honoured symbiotic guests that convert our food to energy for us. Normally we live out our lives in perfect harmony with mitochondria, biological BFFs. Inflammation often seems excessive because it is, because every trauma causes pain that is too loud for too long, because a significant portion of the inflammation is due to this SNAFU immune system policy of attacking mitochondria.

    There are many perverse sources of pain in pathology, but this one really stands out as being particularly ridiculous and unfair. It does have one practical implication: For more information, see Why Does Pain Hurt? How an evolutionary wrong turn led to a biological glitch that condemned the animal kingdom — you included — to much louder, longer pain.

    Chronic, subtle, systemic inflammation is a possible factor in stubborn musculoskeletal pain.


    The greatest culprit is metabolic syndrome: See Chronic, Subtle, Systemic Inflammation: One possible sneaky cause of puzzling chronic pain. This is probably not one disease. Usually when you have a pinched nerve, the symptoms are obvious: Unfortunately, peripheral neuropathy does not always announce itself so clearly. Sometimes all you get is pain.

    Clinical Evaluation

    Consider this remarkable case study of cluneal nerve entrapment…. The cluneal nerve pass from the low back and sacrum into the buttocks, just under the skin, and they can get tangled up with ligaments and connective tissue on their way, potentially causing chronic low back pain. The patient was decisively cured.

    Which is pretty cool. But that was after years of suffering, and a pointless surgery on her intervertebral discs. No one really knows.