Biomedical subjects
Publications and source records attributed to J Murtagh.
The main causes of low back pain are intervertebral disc and facet joint dysfunction and spondylosis. It is important to differentiate between the pain of inflammation (worse at rest, relieved by activity) and that of mechanical dysfunction (worse on activity, relieved by rest). The key to diagnosis is understanding the daily patterns of back pain.
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Pain in the leg is a common yet confusing problem. It has many causes, varying from a simple cramp to an arterial occlusion. Overuse of the leg, as in athletic competitions, can lead to a multiplicity of painful leg syndromes, once again varying from simple sprains and strains of soft tissue to compartment syndromes. This paper presents an overview of the causes of painful lower limit, especially the more general causes, without discussion of specific areas such as the knee and foot.
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Mastalgia (breast pain) is the commonest breast problem women present with in general practice. Mastalgia can be apparent, when due to referred pain or costochondritis, for instance; or real, when it can be localised or diffused. Diffused pain can be cyclical or non cyclical. An important association of cyclical mastalgia is benign mammary dysplasia (fibroadenosis). It is important to exclude malignancy and to reassure patients.
There are many common causes of pain in the foot, such as ingrowing toenails and skin problems, that are obvious, but other causes such as vascular insufficiency and nerve entrapment present diagnostic difficulties. For doubtful problems radiological investigation is important.
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The problem of vaginal discharge requires careful attention to the diagnostic process with analysis of the nature of the discharge, physical examination including a thorough inspection and the performing of a wet film. Physiological discharge and other non infective causes, including feminine hygiene preparations, should be considered. Treatment should be tailored to the cause and psychosexual sequelae should be prevented by proper advice and counselling.
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Anger in patients and their relatives is a common reaction in the emotive area of sickness and healing. The anger, which may be concealed or overt, might be a communication of fear and insecurity. When confronted the practitioner should be prepared to remain calm, interested and concerned. It is important to listen intently and allow time for the patient to ventilate his or her feelings so that an amicable solution is achieved.