Muscle relaxants are drugs for osteochondrosis, which are prescribed during an exacerbation of the disease, with acute and chronic spasms. Osteochondrosis is a fairly common disease in modern world caused by an unhealthy lifestyle, inactivity, unwillingness to play sports and pay attention to health.

Will muscle relaxants help with osteochondrosis?

This disease can only be cured complex therapy. Treatment includes a variety of medications prescribe physiotherapy, therapeutic exercises. Often, medications such as muscle relaxants are included in the course of treatment, which help relieve pain, relax muscles, eliminate spasms and discomfort. The use of such drugs allows several times to reduce and speed up the healing process, reduce the dose of other drugs.

There are 2 main types of muscle relaxants, differing in areas of activity:

First, drugs peripheral action which are aimed at treating pathologies in the neuromuscular system. Applicable for surgical operations, starting from what types of receptors need to be affected.
Secondly, central action designed to affect the central nervous system. Having a relaxing effect, they help to treat osteochondrosis of various complexities and types, including the cervical region.

List of muscle relaxants

List of the most effective drugs quite extensive. Muscle relaxants in osteochondrosis have a special mechanism of action on muscles, which manifests itself in the following. With such a disease, it is important to relax the muscles, so drugs are prescribed that affect neurons in spinal cord. They are responsible for regulating muscle tone.

Muscles under the influence of drugs will contract at rest, as a result of which tension is relieved, unnecessary tone goes away.

The use of muscle relaxants for cervical osteochondrosis or another kind of illness allows you to remove spasms in the skeletal muscles of the back, pains that tend to repeat again and again.

Indications for taking drugs may be the following symptoms or conditions observed in a sick person:

There is numbness, a feeling of goosebumps.
Decreased tactile sensitivity in direction sciatic nerve, i.e. on the back of the thigh. In this case, a strip or "lampas" is formed, which passes from top to bottom, under the hole located under the knee.
So-called radicular symptoms may appear. A person will constantly or from time to time be disturbed by sharp and shooting pains, which feel like electric shocks. manifest similar signs can with sneezing, coughing, straining, laughing, sudden movements. Sometimes there are backaches in the lumbar or cervical region. All this suggests that the patient has a compression of the sensitive part of one or another nerve.
Pain in different parts of the spine (thoracic, cervical or lumbar), having a pressing, sometimes aching character. The places of localization are the shoulder girdle, the paravertebral muscles, located to the right and left of the spine, the latissimus dorsi, muscles (especially the one on the back).

In order to treat osteochondrosis, apply the following types muscle relaxants:

Baclofen is prescribed by a therapist when back pain in osteochondrosis is of moderate to high severity. It can be used with other drugs, which significantly speeds up treatment and reduces the time of therapy.
Tolperizon is an analogue of midokalm, which is available in tablets and solutions for injections. The effect has a prolonged effect, begins to develop in the body already on the first day after the start of administration, helping to locally reduce pain.
Tizanidine is the main drug used to treat spasms in dorsal muscles, reduces the level of their resistance when a person makes passive movements.

Other drug names are also known:

Cyclobenzaprine;
Methocarbamol;
Orphenadrine.

Mydocalm is one of the safest and most proven medicines, which is distinguished by its effectiveness and high results. Patients tolerate it well, there is a decrease in the amount of use. nonsteroidal drugs designed to relieve inflammation. This is facilitated by the substance mydocalm and lidocaine, which has an analgesic effect. It is also important that people who use the medicine do not lose physical and mental activity.

Sirdalud is prescribed by doctors when it is necessary to relieve chronic, acute and severe spasms.

This is a list of the main names of muscle relaxants that doctors can prescribe for osteochondrosis. Among the features of drugs is not only the ability to relax skeletal muscles, but also have a long-term effect, relieving pain, tension, restoring mobility to individual segments cervicothoracic spine. There is a relief of pain, which greatly facilitates the patient's condition, allows him to return to his usual way of life, returns mobility.

Muscle relaxants for osteochondrosis in self-treatment not used, only in combination with other drugs, therapeutic gymnastics, massages that can relax the muscles and musculature.

Reception takes place only under the supervision of a doctor who prescribes the drug, prescribes the regimen and dosage of administration, based on the indications, the results of the analysis and the patient's condition.

Muscle relaxants are prescribed only when the pain becomes severe, the patient loses mobility, other drugs do not help at all.

On average, the course of treatment with muscle relaxants does not last long, ranging from 3 to 7 days, although most often the therapy lasts 10 sessions. After that, a pause is made for a certain time, then the drug course. It all depends on the pain, the intensity of the spasms and the degree of damage. Both tablets and injections are prescribed, in which the effectiveness of treatment is higher.

Contraindications and side effects

Reception of muscle relaxants has a number of contraindications and side effects. Among the contraindications when it is impossible to use drugs, it is worth noting the following factors:

the presence of renal failure;
pregnancy and lactation;
atherosclerosis;
stomach ulcer;
Parkinson's disease;
renal pathologies;
epilepsy;
dependence on drugs and alcohol;
allergic reactions for drugs;
myasthenia gravis;
psychiatric disorders;
ulcers.

Such reactions develop due to the fact that the drugs are rapidly absorbed by the digestive tract. metabolic processes occur in the liver and are excreted through the kidneys. Because of this, the list of side effects is very extensive. The most common is weight gain and the development of an addictive effect, which reduces the effectiveness of taking medications. Drowsiness, apathy, depressive states, problems with urination, various allergic reactions, sleep problems, abdominal pain, convulsions, dysfunction of the kidneys, liver, headache weakness in the legs and arms.

In this regard, drugs should not be used thoughtlessly, deviating from the regimen prescribed by the doctor. Usually, muscle relaxant treatment is carried out in a hospital to control the development of complications and side effects.

Knee arthroscopy - recovery after surgery

Arthroscopy is a minimally invasive surgical procedure performed to diagnose and treat joint diseases. To date, it is the most modern and less traumatic method of the above activities. It should be noted that after knee arthroscopy, recovery after surgery is much faster than with classical arthrotomy.

How and why is arthroscopy performed?

This surgical procedure is performed under local anesthesia. Its essence lies in the performance of several punctures of the articulation, one is needed for the introduction of the arthroscope port, and the other for the introduction of additional instruments.

The image transmitted by the arthroscope is displayed on a large monitor in front of the doctor's eyes. Thanks to this, he can perfectly examine the joint cavity (all its structures) for pathological neoplasms, changes and injuries. When such things are identified, the doctor can perform surgical treatment without completing the procedure.

With the help of arthroscopy, at the current stage of the development of surgery, it is possible to perform a number of surgical interventions that were previously performed only with the help of arthrotomy (dissection of the joint). These surgical interventions include:

Meniscus treatment
Recovery cruciate ligaments(front and back)
Operative treatment of various cartilage destructions
Becker's cyst treatment
Elimination of contractures
Correction of deforming arthrosis
Treatment of osteochondritis dissecans

Therefore, it is highly undesirable to active image life for at least 1 week. During this period, immobilization of the limb on which the operation was performed is recommended.

Advantages of arthroscopy

Minimal joint trauma
Small cosmetic defect at the surgical site
Short hospital stay (on average 1-2 days)
Rapid recovery after knee surgery
No need to wear a plaster splint
Most accurate diagnosis knee joint diseases

Rehabilitation

As a rule, rehabilitation after surgery on the knee joint is mandatory and can take up to 6 months. For athletes, it is absolutely necessary to do exercises to strengthen muscles. lower limb, for the best effect.
AT rehabilitation measures includes:

Dressings postoperative wound(for 2, 4 and 9 days)
The use of drugs that relieve inflammation
If necessary, lymphatic drainage is performed
Passing courses of electrical stimulation of the thigh muscles
Special exercise therapy exercises

exercise therapy

It should be noted that exercise therapy after surgery on knee joint has a very importance. After all, the functionality of the operated limb and the duration of rehabilitation depend on its implementation.
A set of exercise therapy exercises is not difficult; people who have undergone arthroscopy can easily perform it. The main exercises include:

Lying on his back, the patient should raise and lower the leg straightened at the knee joint. It is advisable to perform this exercise every 2 hours, 15 times and three sets.
Lying on your side (side of the healthy leg), try to raise the leg on which the arthroscopy was performed. When lifting a leg, it must be held for 10 seconds. This exercise should be performed 10 times, every 2-3 hours.
Perform massaging movements and at the same time try to shift kneecap way down.
Not long, calm walks are vital, but not more than 1 kilometer.
Try to ride a bike at least once a week and for at least 15 minutes.
Exercises aimed at contracting the hamstring muscles: lying on your back, bend your knees and press your heel to the floor. Perform this exercise daily, several times a day.
Exercises aimed at contracting the anterior muscles of the thigh: lying on your stomach, press your foot on the roller, which was previously placed under it, try to straighten your leg as much as possible.

Possible consequences

Since the structure of the knee is extremely complex, complications can arise in the postoperative period. All this depends on how long exercise therapy exercises and other recommendations of an orthopedic traumatologist will be performed. It very rarely happens that pain in the knee joint area can continue for 12-18 months after arthroscopy, but this is purely due to individual characteristics organism. It should be noted that the most susceptible to the consequences, people old age due to degenerative (age-related) changes in the knee joint.

Despite all of the above, postoperative period is more favorable than after classical arthrotomy, as well as the risk of developing serious complications negligible. In general, everything that can happen in the first 3-4 months after this surgery depends only on the patient and her conscientious implementation of the recommendations.

The reasons

Most often, spastic pain in the abdomen occurs due to disruption of the digestive system due to malnutrition, unhealthy lifestyle, often recurring psychological stress. For example, a muscle spasm can cause a sudden fright. Also, the cause of pain is often diseases of the internal organs. Pain syndrome can develop with liver damage ( hepatic colic), kidneys and genitourinary system(renal colic), stomach and pancreas. And violations fat metabolism, various poisonings, diabetes, porphyrin disease is usually caused by intestinal colic. Spasms and thrombosis also suffer blood vessels located in the abdominal cavity. Many people are aware of spastic pain during an attack of appendicitis, when painful contractions appendix - appendix of the caecum.

Most women reproductive age monthly experience muscle pain in the lower abdomen during menstruation. This natural phenomenon occurs due to a temporary change hormonal background in which contraction of the muscles of the uterus occurs due to advanced level prostaglandins. At the same time, the muscles of nearby organs located near the uterus can also contract.

A characteristic phenomenon of the present is irritable bowel syndrome. This disease, accompanied by cramps and pain in the abdomen, usually affects young and middle-aged people. This pathology occurs due to emotional failure and disruption of work nervous system under the influence of frequent stressful situations. Except muscle spasms, nausea, flatulence, with irritable bowel syndrome, psychovegetative symptoms also develop: fatigue, sweating, headache, arterial hypotension, tachycardia.

Symptoms

The main symptom of abdominal muscle spasms is cramping pain, which is localized in the navel. If at the place of localization pain syndrome push, relief comes. Therefore, when a spasm occurs, a person tries to lie on his stomach or bend over. And if spasms occur against the background inflammatory diseases abdominal organs, the patient cannot even take a normal breath. The pain periodically recedes, then resumes again. As a rule, body temperature does not rise.

Treatment

First of all, with functional disorders associated with the occurrence of spastic pain, it is necessary to normalize the diet, treat concomitant diseases and try to avoid stressful situations. Must be abandoned bad habits, exclude the use of alcohol, carbonated drinks and other foods that irritate the stomach, practice frequent appointments food in small portions.

If muscle spasms in the abdominal organs are not a consequence serious illnesses, you can eliminate pain with the help of painkillers and antispasmodics such as Baralgin, Spazmalgon, Papaverine, No-Shpa. Very effective antispasmodic- hyoscine butyl bromide (Buscopan). This is a quaternary ammonium compound that can accumulate in intestinal smooth muscle cells and block muscarinic cholinergic receptors, thereby relaxing spasmodic areas.

Of course, medications make a person feel better, but it is necessary to find out the causes of spastic pains. severe spasms abdominal muscles that occur at regular intervals cannot be ignored. This careless attitude can lead to grave consequences. In these cases, you should consult a doctor as soon as possible, who, after diagnosing and identifying true reasons muscle spasms, prescribe appropriate treatment. Take care of your health!

What are the causes of cramping pain in the lower abdomen?

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Clinical significance of the symptom "cramping pain in the lower abdomen"

cramping lower abdominal pain, as a rule, indicates a strong contraction of the smooth muscle of hollow organs located in the lower floor of the abdominal cavity and in the small pelvis, such as the uterus, fallopian tubes, intestines, ureters, bladder.

The smooth muscle of the hollow organs contracts constantly, ensuring the normal movement of their contents. However, in the absence of pathology, this happens absolutely painlessly, so that we do not feel muscle contraction. Bladder, translational movements of the walls of the ureters and intestinal motility.

Normally, women do not worry about contractions fallopian tubes, ensuring the promotion of a mature egg, nor the tone of the muscles of the uterus, due to which this organ is timely released from menstrual blood.

Cramping pain in the lower abdomen can be very an alarming symptom, indicating a violation of the movement of the contents through the hollow organ (blockage of the ureter by a stone, blockage of the intestine by a ball of ascaris, etc.). Acute obstruction urinary system or digestive tract requires prompt and adequate action, as we are talking about saving lives.

However, smooth muscle spasms can also be caused by functional disorders. So, if the internal genital organs become the source of cramping pains in the lower abdomen in women, then this may indicate both a severe pathology (spontaneous abortion, the birth of a myomatous node with uterine fibromyoma), and less dangerous functional disorders(cramping pains during painful menstruation).

In addition, the subjectivity of the symptom should be taken into account.: different people have varying degrees sensitivity to pain, so that the strength and nature of the pain syndrome may not correspond to the degree organic damage. This is especially true for diseases that are combined with dysfunction of the nervous system (irritable bowel syndrome, chronic spastic colitis, vegetative-vascular dystonia).

Thus, cramping pain in the lower abdomen may indicate a variety of diseases, many of which require immediate medical attention. Therefore, when the appearance given symptom need to apply in a timely manner medical assistance.

Cramping pain in the lower abdomen with spontaneous abortion

Cramping pain in the lower abdomen during pregnancy may indicate its spontaneous interruption (miscarriage, self-abortion). In such cases, the appearance of a cramping pain syndrome, as a rule, is preceded by pulling pains in the lower abdomen, radiating to the sacrum.

Increasing intensity pain, the cramping nature of the pain and the appearance of spotting bloody discharge from the vagina indicate the onset of detachment of the fetal egg, therefore, they are an indication for emergency hospitalization. Even at this stage of self-abortion, with timely and adequate medical care Often the pregnancy can be saved.

Spontaneous termination of pregnancy threatens the development of life-threatening massive bleeding. In addition, after self-abortion, particles of the fetal egg often remain in the uterine cavity, which should be removed in order to avoid septic complications, such as acute endometritis, acute purulent salpingo-oophoritis, peritonitis, blood poisoning.

Therefore, even in cases where a woman is not interested in maintaining pregnancy, with the appearance of cramping pains in the lower abdomen, combined with spotting, it is necessary to call emergency assistance.

Cramping pain in the lower abdomen during an ectopic pregnancy

Cramping pains in the lower abdomen that appear from time to time may indicate a tubal abortion of an ectopic pregnancy. Such a pregnancy occurs when a fertilized egg, for one reason or another, does not enter the uterine cavity, but is implanted in the mucous membrane of the fallopian tube.

Of course tubal pregnancy cannot develop normally, so either a rupture of the fallopian tube occurs, or the expulsion of the fetal egg - a tubal abortion.

Unlike a tubal rupture, which is a one-time gynecological disaster, the tubal abortion process can take days or even weeks. Spasmodic contractions of the fallopian tube, causing a gradual detachment of the fetal egg, are subjectively perceived as bouts of cramping pain. Pain syndrome, as a rule, is accompanied by bloody discharge from the vagina.

Such bleeding is often perceived by a woman as the onset of menstruation, which greatly complicates the diagnosis of ectopic pregnancy.

Cramping pain in the lower abdomen with obstructive intestinal obstruction has a periodic paroxysmal character. Between contractions there may be short periods of complete disappearance of pain (up to 1-2 minutes). In the case of strangulation obstruction, due to compression of the nerves located in the mesentery of the intestine, the pain does not completely subside and remains quite strong even between contractions.

As the pathology progresses, the nervous apparatus of the intestine is depleted and the cramping pain subsides. The complete disappearance of pain is an extremely unfavorable prognostic sign.

All types of acute mechanical intestinal obstruction require immediate hospitalization in intensive care unit, but medical tactics may be different. Strangulation obstruction requires urgent surgical intervention, and with obstructive intestinal obstruction, in some cases it is possible to manage with conservative methods.
The most common types of acute intestinal obstruction, occurring with cramping pain in the lower abdomen, are the following pathologies:

intestinal volvulus;

intestinal intussusception;

obstructive intestinal obstruction associated with blockage of the intestine by a tumor or fecal stone;

acute intestinal obstruction caused by adhesive process in the small pelvis;

acute intestinal obstruction associated with infringement of the inguinal or femoral hernia.

Cramping pain in the lower abdomen on the left with volvulus of the sigmoid colon

Intestinal volvulus is a pathology in which there is an abnormal twist-twisting of the intestinal loops along with the mesentery by 180-360 degrees or more.

Cramping pain in the lower abdomen on the left occurs when twisting sigmoid colon- pathology, comprising from 50 to 80% of all types of intestinal volvulus.

The sigmoid colon is located in the left iliac region(below the navel on the left) and is an S-shaped curved section of the large intestine, directly flowing into the final section of the digestive tract - the rectum.

The occurrence of volvulus of the sigmoid colon is facilitated by congenital anatomical abnormalities in the structure of this segment of the intestine, such as increased length, increased mobility due to lengthening of the mesentery of the intestine, as well as acquired pathologies (age-related or inflammatory bowel deformities).

The resolving factor may be a plentiful intake of roughage in combination with increased physical activity.

Most often, volvulus of the sigmoid colon develops in the elderly and senile age. In most patients, it is possible to trace the characteristic triad of symptoms preceding the development of pathology: seizures pulling pains lower abdomen on the left, constipation and flatulence.
Cramping pain in the lower abdomen on the left during volvulus of the sigmoid colon develops suddenly, while in the period between contractions intense pain persists, felt in the depths of the abdomen. From the very beginning of the disease, there is a delay in feces and gases.

There is asymmetry of the abdomen with a protrusion formed by the swollen sigmoid colon on the left. Since intestinal obstruction develops at the level of the most distal parts of the digestive tract during volvulus of the sigmoid colon, vomiting in this pathology develops much less frequently than in other types of intestinal volvulus.

Cramping pain in the lower abdomen on the right with volvulus of the caecum

Volvulus of the caecum is much less common. Predisposing factors for the development of this pathology are acute and chronic diseases adjacent parts of the intestine chronic appendicitis, diverticula ileum, Crohn's disease, chronic inflammation caecum, etc.).

Clinic volvulus of the caecum is in many ways similar to the volvulus of the sigmoid colon. However, the level of intestinal obstruction is much higher, so often after the development of cramping pains in the lower abdomen on the left, loosening of the stool (most often a single liquid stool) is possible, which is replaced by a delay in stool and gases. In addition, repeated exhausting vomiting is more characteristic: at first, reflex - the food eaten the day before, then stagnant intestinal contents and feces appear in the vomit.

To avoid volvulus of the caecum and sigmoid colon, inflammatory bowel disease should be treated in a timely manner. Elderly people, as well as patients with chronic inflammatory processes in lower sections digestive tract, large quantities of coarse food should be avoided.

Cramping pain in the lower abdomen with intussusception

Intussusception of the intestine is the introduction of the overlying part of the intestine into the lumen of the underlying. This type of intestinal obstruction is called mixed, because as a result of invagination, the intestinal lumen sharply narrows (obstructive intestinal obstruction) and the mesentery of the intruding intestinal area is infringed (strangulation intestinal obstruction).

Intestinal intussusception develops more often in children than in adults, in men more often than in women. In children, pathology often occurs after suffering adenovirus infection that caused a violation of normal intestinal motility.

Cramping pain in the lower abdomen on the right develops with the introduction of the final site small intestine into the large intestine (the so-called ileocolic intussusception), this type of pathology accounts for about 25% of all intussusceptions.

Contribute to the occurrence of ileocolic intussusception congenital features the structure of this section of the intestine (obtuse angle between the final section of the small and large intestines, insufficiency of the natural valve between the large and small intestines, especially the ratio of the lumen of the small and large intestines).

The immediate cause of intussusception may be helminthic invasion, foreign body, the exit of the gallstone, the intake of rough food.

Cramping pain intensity and severity accompanying symptoms with intussusception of the intestine depends on the degree of infringement of the mesentery. With a strong infringement, the disease takes a hyperacute course with early necrosis of the intussusceptum and the development of peritonitis, so that patients, in the absence of adequate assistance, die within one day. In cases where the violation of blood circulation in the mesentery is not very pronounced, it may take several days or even weeks before the development of peritonitis.

Iliocolic invagination begins with cramping pains in the lower abdomen on the right, at first there are light intervals between contractions, then the pain during contractions becomes unbearable and does not completely disappear between contractions.

A specific sign of intussusception is the appearance of bloody discharge from the anus, but this symptom appears 6-12 hours after the onset of cramping pain.

Cramping pains in the lower abdomen with obstruction of the rectum or sigmoid colon

Cramping pain in the lower abdomen on the left occurs with obstructive intestinal obstruction caused by a sharp narrowing of the lumen of the final sections of the intestine - the sigmoid or rectum.

For obstructive obstruction is characterized especially strong peristalsis intestines, seeking to push the intestinal contents through the narrowed lumen. So often peristaltic waves can be observed through the anterior wall of the abdomen. In this case, pain and peristalsis increase after palpation (palpation) of the affected area.

It should be noted that obstructive intestinal obstruction most often develops in the terminal sections of the intestine. As a rule, obstruction of the distal gastrointestinal tract is associated with cancer of the rectum or sigmoid colon.

Features of the structure and functioning of the final sections of the intestine (relative narrowness of the lumen, natural bends and narrowing of the sigmoid colon, dense consistency of the contents) lead to the fact that intestinal obstruction in malignant tumors of the rectum and sigmoid colon develops quite early and often becomes the cause of tumor detection.

As a rule, intestinal obstruction in malignant tumors develops gradually, so that patients note a tendency to constipation, a ribbon-like feces and the periodic appearance of pulling pains in the lower abdomen. Then episodes of transient obstructive intestinal obstruction begin to occur: attacks of cramping pains in the lower abdomen, accompanied by retention of feces and gases.

And, finally, acute obstructive intestinal obstruction develops with all the characteristic symptoms: the appearance of cramping pains in the lower abdomen, the intensity of which increases with time, so that the pain becomes unbearable; retention of feces and gases, vomiting, sharp deterioration general condition of the patient.

With obstructive obstruction caused by cancer of the rectum or sigmoid colon, the treatment is exclusively surgical. The choice of the method of surgical intervention depends on the condition of the patient and the size of the tumor.

Much less often, fecal stones (coprolites) become the cause of obstruction of the rectum or sigmoid colon. As a rule, this type of acute intestinal obstruction develops in old age and is associated with age-related or inflammatory deformities of the terminal part of the digestive tract.

Most often, obturation with fecal stones develops in older women with a tendency to prolonged constipation. The clinic in such cases is similar to the course of acute intestinal obstruction caused by malignant tumor: excruciating cramping pain in the lower abdomen on the left, retention of feces and gases, visible asymmetry of the abdomen, due to the swollen sigmoid colon. In patients with normal or low weight, intestinal motility can be observed through abdominal wall.

Treatment of acute intestinal failure caused by obturation of the final section of the digestive tract with fecal stones is mainly conservative (siphon and oil enemas are used, digital removal of coprolites).

Cramping pain in the lower abdomen with acute intestinal failure caused by adhesive disease

Cramping pain in the lower abdomen may also indicate acute intestinal obstruction caused by adhesive disease. The intensity of the pain syndrome, as well as the severity and dynamics of the accompanying symptoms, depend on the form of intestinal obstruction (strangulation or obturation) and on the site of the affected intestine (this may be the final section of the small intestine, the caecum or sigmoid colon).

Adhesion formation is a protective process aimed at limiting the inflammatory process. A special substance is released - fibrin, from which the thinnest films are formed that prevent the spread of infection throughout the abdominal cavity. Normally, all processes in the body are balanced, so that the adhesions caused by the inflammatory process resolve over time.

However, in some cases, fibrin adhesions thicken, vascularize and nervous tissue, so that abnormal strands are formed between various bodies abdominal cavity. These strands make it difficult normal functioning intestines, and under unfavorable circumstances lead to acute intestinal obstruction.

As a rule, the development of acute intestinal obstruction is preceded by episodes of attacks of cramping pain in the lower abdomen and a tendency to constipation, indicating transient disturbances in the passage of intestinal contents.

In addition, for adhesive disease characteristic specific symptoms: Carnot's symptom (appearance or intensification of pain with a sharp extension of the trunk), Leotte's symptom (appearance or intensification of pain with displacement skin fold abdomen) and other signs of the formation of abnormal adhesions in the abdominal cavity.

Among the causes of the development of adhesive disease, the leading place is occupied by surgical interventions(first of all, removal of the appendix with acute appendicitis) and infectious and inflammatory diseases of the internal genital organs in women. Therefore, patients at risk should be especially careful and, if episodic cramping tumors appear in the lower abdomen, seek medical help.

Cramping pain in the lower abdomen with infringement of the inguinal or femoral hernia

A hernia is an abnormal penetration of internal organs (most often intestinal loops) through the abdominal wall under the skin without violating the integrity of the latter. Wherein internal organs surrounded by a parietal peritoneum (a membrane lining the abdominal cavity) - the so-called hernial sac.

The penetration of the hernial sac through the abdominal wall occurs in the most weak points(navel, surgical sutures, anatomical channels through which nerves, blood vessels or other organs normally pass). The place where the hernial sac passes through the abdominal wall is called the hernial orifice.

Severe deadly dangerous complication hernia is its infringement in the hernial orifice. In cases where the intestinal loop located in the hernial sac is infringed, acute mechanical strangulation intestinal obstruction develops (the mesentery of the intestine is clamped and blood circulation in the affected intestine is disturbed).

Cramping pain in the lower abdomen develops when the most common inguinal and femoral hernias are infringed. These hernias pass through natural anatomical canals (inguinal and femoral, respectively) and, at the stage of a resolved hernia, are found as a protrusion in the region of the inner part of the inguinal fold.

Large hernias are easily identified visually, so diagnosis in such cases is not difficult. However, herniation is enough insidious disease, so that in some cases the diagnosis is made after the development of acute mechanical intestinal obstruction (especially in the case of femoral hernia in obese women).

If an incarcerated hernia is suspected, emergency hospitalization is necessary, the treatment is exclusively surgical: an operation is urgently performed to free the affected intestine.

Cramping pain in the lower abdomen with dysentery

Cramping pain in the lower abdomen with dysentery is associated with spastic contractions of the affected parts of the intestine. The favorite habitat of pathogens of bacterial dysentery is the sigmoid and rectum.

Therefore, dysentery occurs with symptoms acute inflammation end segments of the intestine: pulling and cramping pain in the lower abdomen on the left, frequent loose stools and painful urge to defecate. In severe cases, the frequency of stool reaches 20 times a day or more. At the same time, it is observed characteristic symptom"rectal spitting": during defecation, a small amount of mucopurulent contents with bloody streaks is released.

Dysentery is a contagious disease, the transmission of infection occurs only from person to person through dirty hands, dishes, food. In summer, the "fly" factor is of some importance (flies carry pathogenic bacteria on paws).

With the appearance of cramping pain in the lower abdomen, combined with symptoms of dysentery, you should immediately seek help in order to avoid severe complications and not endanger the health of loved ones.

Cramping pain in the lower abdomen with renal colic

Cramping pain in the lower abdomen can occur with renal colic. The mechanism of development of the pain syndrome consists in increased peristalsis of the ureter, which is trying to push through the obstacle that impeded the outflow of urine.

The most common cause renal colic becomes urolithiasis, in which the formed urinary stones descend into the ureter and block its lumen. Less often, an inflammatory process becomes the cause of blockage of the ureter (the lumen is blocked by a blood clot, pus, or a dead area renal tissue) or oncological disease(blockage with a piece of decaying tumor).

Regardless of the cause of blockage, the clinic of renal colic is homogeneous and quite specific: severe cramping pain in the lower abdomen on the right or left (depending on the affected ureter), which does not subside at rest. The pain radiates down along the ureter to the genitals and inner surface hips. Often there is a reflex vomiting that does not bring relief (usually single).

As a rule, patients note soreness in the kidney area on the affected side. The survey often reveals predisposing factors (episodes of renal colic in the past, hereditary predisposition to urolithiasis).

Unlike other pathologies that occur with the symptom of "cramping pain in the lower abdomen", with renal colic, as a rule, general state patient long time remains relatively satisfactory, so patients do not lie in bed, but rush around the room, trying to alleviate the pain syndrome.

If cramping pain in the lower abdomen raises suspicion of renal colic, you should immediately consult a doctor. Diagnosed with renal colic medical tactics expectant, since in the majority of cases the attack can be stopped with the help of conservative measures (antispasmodics, analgesics, warm bath, bed rest, diet).

However, monitoring is necessary as complications such as acute delay urine, followed by the formation of dropsy of the kidney or the addition of a secondary infection with the development of purulent pyelonephritis.

Which doctor should I contact with cramping pain in the lower abdomen?

Cramping pain in the lower abdomen can be a symptom of various diseases of any organs located in this area (female genital organs, large intestine, kidneys, ureters, bladder, etc.), so it’s unambiguous to say which doctor to contact when this appears warning sign, impossible. Moreover, in some cases, cramping pain in the lower abdomen may indicate the development of serious conditions that require immediate medical intervention to save lives, because in the absence qualified assistance the person will simply die.

Therefore, below we will indicate in which cases cramping pain in the lower abdomen should be considered a sign of a life-threatening condition and, accordingly, should be immediately called " ambulance". And in what cases such pains do not represent a life-threatening condition, and therefore require a visit to the doctor in a planned manner. It is for cases of the necessary planned visit to the doctor that we will consider which specialist should be visited depending on the accompanying symptoms.

Dangerous for life, and therefore requiring immediate call"First aid", it is considered cramping pain in the lower abdomen, which does not subside with time, but, on the contrary, intensifies, is combined with high fever, general weakness, vomiting that does not give relief, bloody discharge from the genital tract, headaches , sharp decline blood pressure, fainting, sometimes asymmetry of the abdomen, and also gives to the groin, sacrum, anus, navel area and other parts of the body. Such symptom complexes indicate that a person has developed serious condition(for example, ectopic pregnancy, intestinal obstruction, volvulus, etc.), life-threatening, and therefore immediate medical intervention is necessary to save it. That is why, in the event of the appearance of these pains in the lower abdomen, you need to urgently call an ambulance or get to the nearest hospital with your own transport.

If a woman has cramping pains in the lower abdomen during menstruation, then you should contact gynecologist (make an appointment), since a similar symptom may indicate diseases of the genital organs (for example, narrowing of the cervical canal, adhesions in the uterine cavity, scars or deformities of the uterus, fallopian tubes and cervix, etc.).

In addition, it is necessary to contact a gynecologist if a woman experiences severe cramping pains in the lower abdomen, which are initially felt on the right and left, and then migrate only to the right or only to the left, can appear suddenly or after stress, hypothermia, physical activity, and also spread to the sacrum , lower back, groin or rectum and be combined with pain when urinating, irregular cycle, fatigue, irascibility, irritability, vaginal discharge inflammatory nature(greenish, yellowish, grayish, mixed with vesicles, flakes, pus, mucus, etc.) or elevated temperature body. Similar cramping pains in women are usually a sign inflammatory process in the genitals, for example, adnexitis, salpingitis, pyosalpinx, etc.

Also, appeals to a gynecologist require cramping pains in the lower abdomen, if they are provoked by sexual intercourse, aggravated during menstruation, spread to the lower back, coccyx, sacrum, combined with bleeding from the genitals, since such symptoms may indicate the presence of tumor or tumor-like formations in the genitals .

When there is severe cramping pain in the lower abdomen, which does not radiate to other parts of the abdomen and to the perineum, but is often felt simultaneously in the lower abdomen and in the navel, is combined with constipation, diarrhea, bloating, flatulence, rumbling, frequent defecation or painful urge to defecate, then you need to contact Gastroenterologist (make an appointment) or therapist (sign up), since such symptoms may be due to intestinal diseases, such as colitis, enterocolitis, Crohn's disease, ulcerative colitis, diverticulitis, irritable bowel syndrome.

When cramping pains in the lower abdomen are combined with pain in the anus, rectum, frequent urge to defecate, diarrhea, increased pain during bowel movements, then you need to turn to proctologist (make an appointment) or surgeon (make an appointment), since such a symptom complex may indicate proctosigmoiditis.

When cramping pains in the lower abdomen are simultaneously felt or given to the groin and lower back, combined with urination disorder (blood in the urine, painful, frequent urination), force a person to constantly change position (since it is impossible to find a position in which the pain subsides even a little), then you should refer to urologist (make an appointment) or a surgeon, since this symptom complex indicates renal colic on the background of urolithiasis, blockage of the ureter with a stone, etc.

When cramping pain in the lower abdomen is combined with frequent liquid or mushy stools with impurities of blood or mucus, rumbling, bloating, pain during bowel movements, lack of relief after a bowel movement, and in some cases with nausea and vomiting, then the person needs to turn to infectious disease doctor (make an appointment), since such symptoms indicate an intestinal infection (dysentery, etc.).

What tests can doctors prescribe for cramping pain in the lower abdomen?

Due to the fact that cramping pains in the lower abdomen can be provoked various diseases, the doctor prescribes different examinations for this symptom, depending on what kind of pathology he suspects based on accompanying signs. Thus, the list of tests and examinations in each case with cramping pain in the lower abdomen is determined by the accompanying symptoms.

In cases where the symptoms allow one to suspect an intestinal disease, that is, a person suffers from cramping pains in the lower abdomen, which can be felt simultaneously in the navel or not, and the presence of constipation, diarrhea, frequent bowel movements is also possible soft stool, frequent urge to defecate, bloating, rumbling in the abdomen, flatulence, pain in the anus and intestines, increased pain during bowel movements, the doctor prescribes the following tests and examinations to identify a specific intestinal pathology:

General blood analysis ;
Analysis of feces for worm eggs;
Coprological analysis of feces;
Analysis of feces for dysbacteriosis (sign up);
A stool culture or blood test for Clostridium;
Ultrasound of the abdominal organs (make an appointment);
Colonoscopy (make an appointment)/sigmoidoscopy (make an appointment);
Irrigoscopy ( X-ray intestines with contrast) (sign up);
Computer or magnetic resonance imaging (make an appointment);
Analysis of feces for calprotectin;
Blood test for the presence of antineutrophil cytoplasmic antibodies (enroll);
Blood test for the presence of antibodies to saccharomycetes.

The specified list of tests and examinations is not prescribed immediately in full, since, first of all, the doctor directs a person only to those studies that allow a diagnosis to be made in the vast majority of cases. This means that usually the doctor first prescribes general analysis blood, coprological analysis of feces, analysis of feces for worm eggs, ultrasound of the abdominal cavity and small pelvis, as well as colonoscopy or sigmoidoscopy. In most situations, these tests are sufficient to identify and confirm the pathology, therefore, other examinations from the above list, if the diagnosis is already there, are not prescribed as unnecessary. However, if the minimum list of examinations was not enough to make a diagnosis, the doctor may prescribe irrigoscopy or computed tomography, and these methods are used as alternatives, that is, either irrigoscopy or computed tomography is performed, but not both at once. An analysis of feces for clostridium is prescribed only in one case - when the doctor suspects that colitis is caused by taking antibiotics. Fecal tests for calprotectin, blood tests for Saccharomyces antibodies, and antineutrophil cytoplasmic antibodies are given to people who are suspected of having Crohn's disease or ulcerative colitis and who for some reason cannot undergo a colonoscopy, sigmoidoscopy, barium enema, or computed tomography.

If a person is concerned about cramping pain in the lower abdomen, resembling a picture of renal colic, that is, the pain is localized on the right or left, spreads to the groin, lower back and inner thigh, is combined with urination disorders (blood in the urine, pain when urinating, frequent urges to urination, etc.) and makes you constantly rush around the apartment or bed, trying to find a position in which the pain will decrease at least a little, then the doctor usually prescribes the following tests and examinations:

General urine analysis ;
General blood analysis;
Ultrasound of the kidneys (make an appointment) and bladder;
Cystoscopy (make an appointment);
Urography (X-ray of the organs of the urinary system with X-ray contrast agent) (to make an appointment);
Renal scintigraphy (book now) and urinary tract;
CT scan.

Usually, the doctor first prescribes a complete blood and urine test, Ultrasound of the bladder (make an appointment) and kidneys, urography, since it is these studies from the list that make it possible to make a diagnosis in the vast majority of cases. And if the diagnosis is made, then other examinations from the list are already unnecessary, as a result of which it is obvious that scintigraphy, cystoscopy and computed tomography are used only in cases where the minimum set of studies was insufficient for diagnosis. If it is technically possible, the doctor can immediately prescribe computed tomography instead of urography.

If cramping pain in the lower abdomen is combined with frequent bowel movements liquid stool with or without an admixture of mucus and blood, rumbling in the abdomen, bloating, lack of relief after a bowel movement, and sometimes vomiting, the doctor suspects an intestinal infection and prescribes the following tests and examinations:

Bacteriological culture of feces, vomit or washings;
Blood test for the presence of antibodies to pathogens of intestinal infections ( salmonella (sign up), shigella, vibrio cholerae, rotavirus, etc.) by ELISA and RNGA;
Analysis for the detection of DNA of pathogens of intestinal infections (Salmonella, Shigella, Vibrio cholerae, Rotavirus, etc.) by PCR in feces, vomit, washings, blood;
Colonoscopy or sigmoidoscopy;
Irrigoscopy.

First of all, tests are prescribed to identify the pathogen intestinal infection (bacteriological cultures feces, vomit, washings, PCR to detect pathogens of intestinal infections in feces, vomit, washings, blood, as well as the detection of antibodies in the blood to pathogens of intestinal infections by ELISA and RNGA), since clinical picture indicates just such a disease and requires identification of the infection in order to carry out the necessary sanitary and epidemiological measures. In practice, bacteriological cultures of feces, vomit and washings and a blood test for antibodies by the RNGA method are most often prescribed. And the analyzes PCR method and ELISA is prescribed if it is technically possible, or if RNHA and bacteriological cultures did not allow to identify the causative agent of intestinal infection. Colonoscopy, sigmoidoscopy or irrigoscopy are prescribed only if, according to the results of the tests, the causative agent of the intestinal infection was not identified, and therefore the doctor suspected that another, more serious disease intestines, simply flowing with an atypical clinic.

Paroxysmal pains in the lower abdomen, which first cover the entire area of the lower abdomen, but then move to the right or left, radiate to the sacrum, lower back, groin, or rectum, which can be combined with pain when urinating, irregular menstrual cycles, irritability, severe fatigue, or fever , lead to suspicions about the presence of inflammatory diseases of the female genital organs, especially the ovaries and fallopian tubes. Therefore, in the presence of such cramping pains in the lower abdomen in a woman, the gynecologist prescribes the following tests and examinations:

Gynecological bimanual examination (sign up);
General blood analysis;
General urine analysis;
A smear on the flora from the vagina (sign up));
Hysterosalpingography (sign up).

First of all, the doctor prescribes a gynecological bimanual examination, during which he feels the internal genital organs with his hands and assesses their condition (size, shape, mobility, elasticity, soreness, etc.). In addition to a bimanual examination, an ultrasound of the pelvic organs, a smear on the flora, and general blood and urine tests are mandatory. Usually, this incomplete list of tests and examinations is enough to make a diagnosis, as a result of which the doctor may not prescribe other tests as unnecessary. However, if the minimum set of tests did not allow clarifying the diagnosis, then the doctor additionally prescribes other studies from the list above.

If a woman periodically has cramping pains in the lower abdomen on the right, left or left, right and middle at the same time, which can be given to the lower back, coccyx, sacrum or rectum, provoked by sexual intercourse, aggravated during menstruation, combined with bleeding, lengthening menstrual cycle, clots in menstrual blood, then the doctor prescribes, first of all, a bimanual gynecological examination, ultrasound of the pelvic organs, a smear from the vagina on the flora, as well as a general blood and urine test. These studies allow either to fully determine the diagnosis, or give the doctor the right direction for reflection. If ultrasound, smear on flora, bimanual examination and blood and urine tests did not allow a diagnosis, then the doctor prescribes hysteroscopy (make an appointment) or computed/magnetic resonance imaging. In addition, in addition to assessing the general condition of the body and identifying possible causes disease, the doctor may prescribe a blood test for clotting ( coagulogram (sign up)), on the concentration of luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone and prolactin (sign up), as well as biochemical analysis blood.

With painful menstruation, first of all, the doctor prescribes the following tests and studies:

Bimanual gynecological examination;
A smear on the flora from the vagina;
Ultrasound of the pelvic organs;
General urine analysis;
General blood analysis;
Coagulogram (blood test for clotting);
Blood chemistry;
A blood test for the concentration of hormones (LH, FSH, testosterone, prolactin, estradiol, etc.).

The specified list of analyzes allows you to identify the causes painful menstruation In many cases. But if these studies were not enough, then in addition to finding out the causes of pain during menstruation, hysteroscopy, computed or magnetic resonance imaging, and any other studies that the doctor considers necessary can be prescribed.

What diseases does pain in the lower abdomen indicate? - Video

Before use, you should consult with a specialist.

Nervous tic is a neurological disorder characterized by involuntary contraction various groups muscles. This disease occurs in both children and adults.

Several types of nervous tics are diagnosed, which have various symptoms. A neurological disease in which a person does not control the same type of muscle contraction manifests itself in different ways: frequent blinking, twitching of the corner of the mouth, monotonous movement of the limbs, head tilts, and so on. Sometimes facial grimaces or twitching of limbs can be accompanied by uncontrolled pronunciation of various sounds: screams, smacking, laughing, coughing, pronouncing words of the same type, howling. Depending on which muscle groups do not obey a person, mimic or nervous tics of the limbs are distinguished.

Tics are divided into complex and simple types and may be localized or generalized in nature. Simple neurological tics are usually localized and the person does not control one muscle group.

Complex tics are most often generalized and involve several muscle groups. human body. Complex tics are uncontrollable actions that a person automatically performs: twitching all limbs, monotonous walking in a circle or a straight line, twisting hair around fingers, or shuddering with the whole body.

Nervous tics are primary and secondary. The primary ones are characterized by a disruption in the functioning of the nervous system, and the secondary ones are the result of brain damage. The most common simple tics are twitching of the eyelid, but it is not uncommon for a person to feel a nervous tic in the lower abdomen. With this pathology, a person feels a rhythmic contraction of the muscles of the entire peritoneum or only in one place. A nervous tick in the abdomen is especially felt in a relaxed state or during a period of great excitement.

So what is the cause of nervous tics? The primary tic, which is characterized by a local character, causes disturbances in the functioning of the nervous system. This is facilitated by constant overwork, stress, neuroses, increased anxiety. A constant load on the nervous system causes a malfunction in its work and because of this, brain cells are activated and begin to send signals to muscle groups. These signals cannot be controlled by humans.

Treatment of such a pathology as a tick in the abdomen should be carried out comprehensively and under the supervision of a neurologist. First of all, a person must begin to take sedatives which will partially relieve the load on the nervous system. also in without fail during the treatment period, the patient should avoid stressful conditions, rest more.

Psychokinesiology sessions also effectively help to get rid of the same type of uncontrolled muscles. These are tests and psychological exercises, which are designed to normalize the regulation of the human nervous system. This method gives good results.

Another way to help the patient relax and get rid of a nervous tic is holotropic breathing. This is a special breathing technique with which a person relaxes all muscle groups and heals the nervous system.

In addition to the primary nervous tic, there are more complex pathology- secondary nervous tic, which occurs due to damage to the brain. The most common cause of complex neurological disease are head injuries, infectious diseases affecting the brain. Nervous tic can also begin in the background oxygen starvation or poisoning toxic substances. Another cause of a serious illness is heredity. Tourette's syndrome, which causes involuntary muscle contractions, is inherited and virtually untreatable.

If it is found that a nervous tic has developed against the background of oxygen starvation, the patient is prescribed drugs that restore blood circulation.

Pulsation in the abdomen frequent occurrence, which gives a feeling of discomfort in people of different age categories regardless of gender. Sometimes this sign can be commonplace, and may indicate serious pathologies. Quite often, a symptom is diagnosed in people in the central part of the abdomen, on the left or below.

Etiology

There can be many reasons for the appearance of a pulsation in the abdomen. The most common of these are related to:

disruption of the digestive tract;
ailments of the abdominal aorta;
the influence of the menstrual cycle;
maybe during pregnancy.

In men and women, this symptom is often diagnosed as a result of improper bowel function. Pulsation can be formed on the basis of, or overeating.

With the development of pathology, such a sign indicates progression. However, if the pulsation manifested itself only a few times, then, most likely, external factors served as the cause.

Pathological causes of pulsating sensations can be not only an aortic aneurysm, but also other ailments:

tumors;
narrowing of the abdominal aorta;
liver disease;
violation of the functionality of the heart muscle.

Certain abdominal pain and discomfort can be provoked physical activity, playing sports or staying in an uncomfortable position for a long time. Quite often, doctors note such causes of the onset of a symptom:

binge eating;
lean body and tall.

Most diseases develop on nervous ground. Frequent, provoke increased motor skills and throbbing in the navel.

It can also pulsate in the lower right abdomen in women and young girls during menstruation. Doctors consider this a normal natural process in which the fairer sex feels pain and discomfort.

Unpleasant feelings overcome a woman during menstruation due to uterine contractions. At the beginning of the menstrual cycle in female body the endometrium is rejected in order to finally get rid of the contents, the uterus has to shrink. That is why women are so often in pain.

However, it should be understood that pain attacks should be mild and not disturb the general condition and health of the woman. If the pulsations are intense, then this may indicate uterine hypertonicity, which is dangerous state. In this regard, if there is a strong symptomatology, then the woman is recommended to immediately contact a gynecologist.

Pulsation during pregnancy

Pulsation in the lower abdomen during pregnancy is a fairly common occurrence that can occur on different terms bearing a child. The appearance of a symptom is associated with an increase in the uterus, which begins to compress the vessels. This feature is especially characteristic of expectant mothers who are carrying twins or triplets. With such sensations, doctors recommend that a woman calm down, lie down, relax a little and think about something pleasant.

In the third trimester, a pregnant woman may feel throbbing due to the baby's hiccups. During the last months, the fetus may swallow amniotic fluid, but there is nothing to worry about in this process. Doctors recommend drinking sweet juice, eating chocolate, or losing some weight. If the baby's pulsation and hiccups continue, then a gynecologist's consultation is needed.

Pulsation in the abdomen during pregnancy can also be triggered by partial or complete clamping of the vena cava. Since on last trimester when the uterus is maximally enlarged, this vein is located along the spine, pain attacks and discomfort may occur.

Symptoms

The clinical picture with pulsation in the abdomen does not have clear indicators, since this symptom manifests itself when various diseases that have characteristic symptoms.

The most common pathological cause the onset of the disease is an aortic aneurysm. In order to recognize the disease in time, doctors pay attention to such complaints:

constant bouts of pain;
pale shade of the skin;
significant tingling;
disturbed sensitivity.

If a throbbing pain in the lower abdomen on the left, right or in the center manifests itself in a person for a short time and without additional symptoms, then there is nothing to worry about. In case of deterioration of the condition, the addition of other manifestations of ailments and prolonged pulsation in the abdomen, you should seek medical help.

Treatment

When a person's stomach pulsates from the left or from right side, then this is a reason for consultation in medical institution. If the symptom manifested itself once, then there is no reason to worry. With frequent throbbing pains, which are accompanied by other signs, an urgent diagnosis of a physician is needed.

In the treatment of such an indicator, the patient must be provided with first aid:

soothe;
identify the nature and strength of manifestations;
determine whether the symptoms depend on a change in body position;
find out the presence of other pathologies;
by determining the cause, you can stop the pain if it bothers.

If the patient is diagnosed with the appearance of unpleasant discomfort due to an aortic aneurysm, then the treatment is performed surgically.

In the event of a pulsating sensation in the abdomen due to a violation of the diet, diet or the formation of pathologies from the digestive tract, leading role will play diet therapy. Purpose medical preparations will depend on the affected organ.

An important role in the relief of this symptom is the normalization of the vegetative-vascular system, for which sedatives, vitamin and mineral complexes psychotherapy sessions.

If a woman often has a pulsating belly during pregnancy, then you should definitely visit your doctor to make sure normal condition health. Most often, doctors advise expectant mothers to just calm down, as well as:

change the posture while staying in a horizontal position to a sitting or standing position. After a certain activity, the mother’s blood circulation improves and the discomfort in the abdomen will pass;
if the cause was the hiccups of the child, then you just need to wait. If the symptom occurs frequently and intensely, a more detailed examination should be performed;
if bleeding and throbbing pains in the area of the uterus are detected, urgent hospitalization of the patient is necessary.

Prevention

Depending on the possible etiological factors, a person needs to adhere to certain prevention. In order to prevent the formation of a symptom by physiological reasons, doctors recommend resting more, balancing the diet, moderating sports, moving away from stress and worries.

You need to regularly examine your health, and also use the right products that will not cause the progression of discomfort.