Muscular Rheumatism |
||
|
|
||
|
This is the most common form of rheumatism, and the least troublesome. It consist of pains, sometimes sharp, sometimes dull, in the muscles, chiefly in the neck, shoulders and back; the pains move about from place to place. One can frequently find tender lumps or 'nodules' in the modules, especially when those round the shoulder blades are affected; they may act as 'trigger points' which bring on the pain whenever they are touched. At one time it was thought that these lumps were the result of inflammation of the fibrous tissue which binds the muscles together. The name fibrositis was coined for this and it remains a useful word so long as you don't believe that there really is inflamed fibrous tissue: later work has shown that there is not.
Other people will try to convince you that muscular rheumatism is all caused by the discs in the spine slipping, or 'prolapsing', and pressing on the the nerve. I do not doubt that discs can slip but I find that the theory about slipped discs has to be twisted so far to fit some of the facts that I cannot believe that slipped discs are responsible for more than a few cases of muscular rheumatism.
The pain is often more frequent or worse during times of worry and stress; tense people have tense muscles and tense muscles may be painful. This does not mean that worry and 'nerves' are the causes of the pain, but they may be some of several causes acting at once; if they are, a sedative may make you less tense, thereby making the muscles less tense and less painful.
Yet another cause of muscular rheumatism is cold. This may not necessarily be severe cold such as occurs in the Arctic; it may just be slightly cooler weather than usual, particularly if it is damp as well, that brings on an attach of pain. I cannot tell you why weather should affect rheumatism. I can only tell you that it does, and that it affects a variety of other illnesses including coronary thrombosis and appendicitis. This is just one of the many mysteries which, if we are honest, we admit have not yet been solved.
Yet another of the causes of muscular rheumatism, as of other forms of rheumatism, is to be found in heredity. Over and over again when I am seeing a patient with muscular rheumatism I can turn to the notes of parent of the patient and find an account of similar paints. This seems reasonable enough -- our bodies are in some respects similar to those of parents in size and shape. Why should they not also be similar in their defects?
Which parts of the body are affected may sometimes be decided by what work we do. A right-handed housewife, inclined to fibrositis, working at an unsuitable ironing board, is likely to develop it round the right shoulder; a driver plagued by a badly placed gear lever worked with his left hand is more to develop it round the left shoulder.
Muscular rheumatism is thus the result of a variety of causes acting together in ways that are mostly not well understood. It frequently shifts from place to place: in the a pain that appears first in one place and then in another is nothing worse than muscular rheumatism --- that it is harmless. Now matter how much it hurts at present, no matter what you do to relieve it, no matter whether you do nothing at all, it will always get better. |
||