Temporal arteritis

Horton's syndrome, temporal arteritis or giant cell arteritis - all these designations refer to the same disease and are synonymous.

This pathological change in the body is systemic in nature, bringing a lot of unpleasant minutes to the person, and sometimes hours.

Causes of temporal arteritis

This pathology is expressed by changes that affect, as it is not strange, the medium and large blood vessels that are located in close proximity to the carotid artery, while small capillaries practically do not suffer. Predominantly, these lesions affect individual arteries that supply blood to individual areas of the head. It can be the optic nerve, the vessels feeding the eye or a specific section of the cortex of the brain.

In this case, the most severe complication of temporal arteritis is the loss of sick people's sight. Therefore, to brush aside this pathology, "maybe it will pass by itself," does not follow. So what are the causes of temporal arteritis, how dangerous is it, and how to minimize this problem with the least losses for the human body? We will try to find answers to all of these and some other questions in this article.

To date, doctors are not able to unequivocally voice the reasons that can cause the onset and progression of Horton's syndrome. One of the sources of the disease specialists consider the infectious track of the disease, since in a third of patients who received the diagnosis in question, antibodies and antigens formed against the background of infectious diseases such as influenza and various forms of hepatitis were detected in the blood and mucous tissues of pathologically altered vessels .

Some experts reasonably suggest a genetic theory of adherence to the disease. Based on statistical data, there are reasons to believe that this disease predominantly affects representatives of the white race. Quite often this disease affects identical twins. If one of the brothers (sisters) has this pathology, then the probability is high that his brother also has a history in this disease.

Not so long ago, there was another theory, according to which Horton's syndrome is classified as pathology of collagenous nature. This is a group of diseases in which there is a systemic lesion of connective tissue and vessels. Such conclusions are made by specialists on the basis of the revealed uniformity of the examined pathology with periarteritis of nodular character. It is comparable at the level of form, structure, color and other parameters.

But whatever the causes of temporal arteritis, the mechanism of its origin and progression is one: the inflammatory process that develops in the patient's body affects the tissues of the mucous walls of the vessels. Due to this there is a violation of tissue structures, as well as a narrowing of the vessel's passageway is observed, which provokes a deterioration in the nutrition of organs "served" by these blood vessels. In the light of the fact that the blood flow in the site of inflammation worsens, it allows in this place to form a thrombus, which is able to clog the existing lumen completely.

From what kind of blood artery is clogged and the consequences of blood clotting depend - it may be, for example, ischemic acute impairment of cerebral circulation or loss of vision. And the likelihood of protrusion of the artery wall is also increased (less often, the veins) due to its thinning or stretching (arterial aneurysm), which, at high arterial pressure, can provoke the rupture of the artery, and, accordingly, the patients receiving acute cerebral blood flow disorders of hemorrhagic nature.

[3], [5], [7]

Symptoms of temporal arteritis

Depending on the stage and severity of damage to the human vascular system, the symptoms of temporal arteritis somewhat differ, but there are those that are present at all stages of the development of pathology.

1. Pain symptomatology localized in the temporal region. The intensity of pain is different, it is dull and monotonous or, which is more common, acute and pulsating.
2. Pain symptoms also affect the scalp. Touching usually intensifies the pain.
3. In the temple area, swelling can be observed.
4. Such people lose the desire to eat.
5. Pain can spread to the neck.
6. If Horton's syndrome is accompanied by rheumatoid polymyalgia, pain symptoms of humeral and pelvic localization are added to the symptoms of temporal arteritis.
7. Strengthening of pain intensity in the temple and lower jaw joint during chewing.
8. The patient during a headache attack can feel temporary deterioration of vision. In the eyes can double and appear shroud.
9. For the most part, Horton's syndrome affects pensioners. In this case, as statistics show, a weak half is subject to this disease much more often than the male half of the population.
10. Depending on the individual characteristics of the human body during the attack, it is possible to observe an increase in the body's temperature indices.
11. When a headache gets sick often enough and lasts a long time, such a person may gradually develop a depressed state.
12. A person feels a general malaise.
13. The patient may have problems with the raising of the eyelid.
14. The triggered temporal arteritis can cause blindness. This is due to a decrease in blood flow, which nourishes the eye nerves.
15. Due to the developing aneurysm, an ischemic or hemorrhagic stroke can occur.
16. The skin around the temporal region is slightly hyperemic.
17. Fever.

Giant cell temporal arteritis

Granulomatous vascular disease is necessarily characterized by structural disturbance of the walls of the temporal arteries. The selective branch is also affected by smaller branches of the blood column. Very often giant cell temporal arteritis, being a violation of a systemic nature, is accompanied by another pathology - rheumatic polymyalgia.

With pathological changes, which doctors call giant cell temporal arteritis, immune reactions of the organism of the patient with humoral and cellular genesis that affect the elasticity of the vessel walls are clearly observed.

During the acute attack of the disease, blood tests showed a slight increase in the quantitative indices of immune complexes and serum immunoglobulins. In the active phase of the disease, an increase in the level of circulating lymphoblasts in the patient's plasma can be observed. Although such factors are documented, they do not give an unambiguous reason to confirm a change in the immune status of a person whose history has giant cell temporal arteritis.

The histological picture of the location of vascular disorders is consonant with Takayasu's syndrome, but there are also significant differences, especially they relate to the age group of patients.

Giant cellular temporal arteritis is a disease of the elderly. On the average, the threshold for the onset of pathological changes is indicated by a figure of seventy years. In real life, this indicator falls in the interval from 50 to 90 years. At an earlier age, the appearance of this disease is extremely rare and is the exception rather than the rule of this pathology, which always raises doubts about the correctness of the diagnosis.

As clinical observations show, the disease under consideration turns out to be diagnosed in elderly people with good health for their age, indicating that their immune status is sufficiently high. Based on this conclusion, physicians assume that to start the mechanism of development of this pathology requires high immunity.

Temporal arteritis in children

As mentioned above, the development of Horton's syndrome is strongly related to the age of the patient. This pathology is a disease of the elderly. Therefore, temporal arteritis in children is nonsense. But from any rule there may be rare exceptions.

Diagnosis of temporal arteritis

If pain symptoms occur, it is advisable to consult a neurologist. Diagnosis of temporal arteritis includes:

• Analysis of patient complaints.
• Clarifying the age of the patient.
• The study of blood plasma, in the presence of temporal arteritis, shows a burst of ESR (sedimentation rate of erythrocytes) to units of 50 to 70 mm / h.
• When analyzing blood, a decrease in the number of red blood cells (erythrocytes) is detected, while the physiological characteristics of the color identity are maintained. Leukocytes, in the diagnosis of temporal arteritis, remain, mainly, unchanged.
• The C-reactivity index of the protein is determined. This enzyme is synthesized in the liver. Its appearance in the serum says (as well as a high level of ESR) about the presence of a strong inflammation in the human body.
• As a final feature in the diagnosis of the pathology in question, a temporal artery biopsy is performed. The study is performed using local anesthesia. Take a sample of a small piece of the temporal artery. Samples are carried out using medical equipment, equipped with lenses of multiple magnification. This study allows you to recognize inflammation-affected cells and correct the correct definition of the disease.

The correct recognition of the disease in question is complicated by the fact that physicians do not fully know the causes and specificity of the symptoms of this pathology.

[8], [9], [13], [14]

Treatment of temporal arteritis

To date, the treatment of temporal arteritis is carried out using two main ways: surgical intervention and drug-based methods of reducing the problem.

To therapeutic methods of treatment of the disease is attributed to the appointment of the patient glucocorticosteroid hormones. In this case, the patient is taken to take high enough dosages of these drugs. Very often in the diagnosis of this disease prednisolone is prescribed, as well as such analogues as decortine, prednisolone hemisuccinate, prednisolone sodium phosphate, medo- pred, prednisol, salt decoratin and others.

Prednisolone belongs to the group of drugs of hormones of the adrenal cortex. The quantitative component of this drug is prescribed individually for each patient.

Primarily, the starting daily dosage of the drug administered is determined by a dose of 20-30 mg, which corresponds to four to six tablets. But, based on the pattern of pathology, the neuropathologist can prescribe to the patient a higher dosage of the medication administered.

In the acute stage of the disease, usually prednisolone in the form of injections is administered intravenously or intramuscularly. And only after removing the severity of the attack, you can again return to the tablet form of taking the drug.

The duration of treatment is determined by the treating doctor, on average, this period is two weeks. Against the background of glucocorticosteroid hormone therapy, regular monitoring of the patient's blood pressure is recommended. It is necessary to control the level of sugar and electrolyte balance, as well as conduct a test analysis of stool and urine.

With prolonged use of prednisolone, medication is included in the protocol of treatment, which can maintain the level of potassium in the patient's blood, and also corrects the diet. This will make it possible to prevent the development of hypokalemia (decrease in the amount of potassium (K) in the body). To reduce the risk of catabolism (differentiation, the process of metabolic decomposition of tissue structures), as well as the progression of osteoporosis (a disease that leads to the elution of calcium salts from bone tissue), methandrostenolone is prescribed.

Contraindication to the use of the drug in question is the individual intolerance of the patient's body components of the drug, as well as persistent indicators of high blood pressure, diabetes mellitus, acute endocarditis, nephritis, ulcerative lesions of the mucous organs of the gastrointestinal tract, Icenko-Cushing's disease, psychoses of a different nature, postoperative period , active form of tuberculosis.

Methandrostenolone is administered intravenously before meals with 5-10 mg, which corresponds to one tablet with an active ingredient concentration of 0.001 g (1 mg) or 0.005 g (5 mg). The drug is taken once or twice a day. With therapeutic need, the daily dosage of the drug can be increased to 30 to 50 mg.

If a given drug has to be taken for a long time, the dose of a single-dose drug is reduced to an amount of 5 mg.

Contraindications to the drug in question include prostatitis, malignant neoplasm in the prostate gland, acute form of liver dysfunction, as well as pregnancy and lactation of the baby.

To prevent thrombosis of the arteries, the patient is assigned heparin therapy.

Doses and methods of applying anticoagulant direct action of heparin are determined by the treating doctor for each patient individually. One way to use the drug in question is to inject it intravenously with a solution for intravenous infusion at doses of 15,000 to 20,000 units, or the drug is administered intramuscularly at 5,000 to 10,000 units every four hours. The daily rate is 40,000 units. The duration of therapy is five to six days. Against the background of carrying out heparin therapy, it is necessary to monitor the coagulability of blood. This figure should be twice the norm.

For a couple of days before taking the medicine, the dosage taken by the patient is smoothly reduced by 5000 - 2500 units with each subsequent introduction, the interval remains the same. After complete removal of heparin, therapy can be continued with indirect anticoagulants.

It is strictly recommended not to prescribe the drug under consideration for individual intolerance of the component formulation of the drug, if the patient has a history of hemorrhagic diathesis and other pathologies that cause a slowdown of blood clotting. Heparin is contraindicated with increased vascular permeability, severe disorders in kidney and liver function, anemia, venous gangrene, acute and chronic leukemia, subacute bacterial endocarditis, bleeding of any site, and also in the case of acute aneurysm.

If there are contraindications to the use of heparin, the doctor may prescribe one of his analogues: kurantil, clopidogrel, aspirin - angioprotective drugs. To restore blood microcirculation in the affected artery, the protocol of treatment is introduced xanthinal nicotinate or pentoxifylline.

The curantil is prescribed by a dosage from 0.075 to 0.225 g, separated by three to six injections. After achieving the necessary therapeutic effect, the dosage of the drug can be reduced to 0.025-0.05 g. The maximum daily amount of the drug should not exceed a figure of 0.6 g.

The medication is taken on an empty stomach or not earlier than an hour after ingestion.

The drug is contraindicated in case the patient's body does not tolerate dipyridamole or other component components of the curette, as well as with severe hypotension, terminal stage of cardiac or renal dysfunction, acute stage of myocardial infarction, bleeding of unclear etiology, subaortic stenosis.

In a particularly difficult case of treatment of temporal arteritis, the doctor can decide on a surgical procedure. Angioprotezirovanie - is the removal of affected areas of the venous bed. Indication for this operation may be one of the complications of Horton's syndrome, for example, an aneurysm of blood vessels, an impaired blood supply to the eyeball, an oncological neoplasm affecting the arterial trunk that feeds the temporal region.

The duration of therapy for the diagnosis of temporal arteritis is long enough and can range from ten months to a year, or even longer.

Treatment of temporal arteritis by alternative means

It should be noted immediately that pain symptoms affecting the head, may be a sign that indicates the presence in the human body of a serious disease. Therefore, the treatment of temporal arteritis by alternative means is only an "ambulance" to alleviate the condition and relieve the severity of the attack. But to delay with a campaign to the expert in such situation does not follow. The earlier the diagnosis is made, the greater the likelihood that the treatment will solve the problem with a pathology troubling the patient with the least complications for the body.

First, consider herbal decoctions and tinctures, which allow to weaken or completely remove the intense headache.

• Marin the root thoroughly chop and pour vodka. The ideal ratio for obtaining infusion is one part of the plant and ten parts of alcohol. The composition should be allowed to stand for eight to ten days, then drain. Drink one teaspoon three times throughout the day. The greatest effect is achieved when taking the tincture for 15 - 20 minutes before the expected meal. In parallel with this, it is desirable to take flower pollen - half a teaspoon, just three times during the day.
• With the diagnosis of temporal arteritis, high efficiency shows the decoction of elder Siberian flowers. One glass of freshly boiled water pour one tablespoon of vegetable raw materials. Hold for twenty minutes and drain. Take in case of an attack of a headache on a quarter of a glass with a small amount of honey, practicing three to four doses, administered five minutes before meals.
• The expected result is given by the herb of St. John's wort. A tablespoon of the crushed plant is poured a glass of boiling water and put on a small fire for 15 minutes, after which the decoction is filtered. Take a headache on a quarter cup three times throughout the day.
• Good results for headache shows infusion of peppermint. Half a dining room or one teaspoon pour a glass of hot boiled water. Cover the container with the infusion and cover it a little. In a water bath, stirring constantly, hold on a small flame, for 15 minutes. Then set aside the plates and let them stand for 45 minutes. After the infusion has cooled, drain and add to the volume of 200 ml of boiled water at room temperature. Drink infusion warm for 30 - 60 ml one - three times throughout the day for a quarter of an hour before eating. This "medicine" is stored in the refrigerator for no longer than two days without the risk of reducing its medicinal properties.
• Two teaspoons dried and crushed leaves of herb mother - and - stepmother pour one glass of freshly boiled water and leave to stand under the closed lid for half an hour. Drink this product after straining four to six times an hour before the intended meal.
• With a diagnosis of temporal arteritis, a good result shows an infusion of leaves of Artemisia vulgaris. Shredded vegetable raw materials in the volume of one teaspoon is poured 200 ml of boiling water. Covering the jar with the lid in which the medicinal mixture is located, and, wrapping it, let the wormwood infuse for three to four hours. Eat one third of the glass infusion, pre-exuding the mixture, three times a day.
• Half a liter of boiling water pour one tablespoon of chopped oregano. The vessel in which the infusion is located is properly wrapped and left to insist for half an hour, after the expiration of this time, the composition should be filtered off. With a fit of pain in the head take half or a whole glass, making two or three approaches throughout the day. But there is also a warning - this "medicine" should not be taken by women in the period of bearing a baby.
• Two teaspoons dried and crushed flowers of clover grass meadow is filled with one glass of freshly boiled water and left to stand under the closed lid for half an hour. Drink this product after straining three times a day.
• The expected result in the treatment of temporal arteritis is given by the infusion of valerian root. A tablespoon of chopped rhizome is poured with a glass of water at room temperature and left for six to eight hours to infuse, after which the infusion is decanted. Take a headache for one tablespoon three times throughout the day.
• In a half cup of boiling water to enter one tablespoon of seeds of dill garden. For half an hour, let it boil and drain. Take this infusion throughout the day before the withdrawal of pain symptoms.

There are many methods and tools of alternative medicine in the therapy of headache:

• In order to relieve the pain, you can take a large sheet of indoor aloe. Cut it along into two halves. Apply a cut to the temporal and frontal parts of the head. Lie down in a dark room for half an hour. The intensity of pain should decrease, or even completely disappear.
• Another method of treatment shows quite good efficiency. With painful symptoms, it is sufficient to apply garlic juice with a cotton swab to the frontal and temporal areas.
• It is worth trying and this method of getting rid of a headache. In 50 ml of milk put ten cloves of garlic and put on a small fire. Bring to a boil and from this moment stand five minutes. Allow the broth to stand for a while and cool to a warm state, then drain. Five - ten drops of "medicine" by pipetting into the ear canal and hold for a minute. Then tilt the head so that the liquid comes out. A similar procedure is performed with the other ear. This technique perfectly removes painful sensations, localized in various areas of the head, including in the region of the temples.
• You can try to treat a headache slices of raw potatoes, which are placed in cheesecloth and using a bandage fix on the temple or forehead.
• Perfectly in this situation, the compress from the potatoes cooked in a "uniform" works. It is applied in a warm form to the temporal or frontal part of the head. Such a procedure can contribute to the attenuation of the inflammatory process occurring in the tissue layers of the systems and organs of the head.
• You can try to just sit down, relax and meditate.
• It does not hurt the pain and juice of raw potatoes, which is cooked no later than 15 minutes before admission. In case the pain disturbs constantly, juice should be drunk on a quarter of a glass one or three times during the day half an hour before meals. Preventive and therapeutic course is from seven to ten days.
• If a person is being tormented by severe pain in his head, then one can try to use such advice of alternative medicine: during the day, eat potatoes. To do this, clean and boil without using salt kilogram of potatoes. Check the tubers for readiness, drain fluid. Eat throughout the day, lightly dipping in sugar. You may have a desire to drink, but you should endure until the next morning. The preventive course can be repeated at monthly intervals.
• Sometimes it is useful to just relax with your eyes closed or get some sleep.

You can also offer a set of recipes for the famous prophetess Vanga:

• Take a pillow, and fill it with a well-dried grass immortelle sandy (it is also called: Helichrusum arenarium L., cumin sand, Bogorodskaya grass, gray flowers). After the patient spent the night on this pillow, take this immortal herb and, after chopping it well, pour water and boil a little. Set aside on the side, let it stand for a while and cool. After washing your head, rinse it with the resulting broth.
• The technique of using decoction of peppermint (Mentha peperita L.) is similar. The way to get a decoction is similar to the previous one.
• If the patient suspects that the pulsation in the temporal part has appeared due to a stressful situation, then Vanga recommends that a table spoon of sugar - sand should be placed in the mouth just before going to bed in the evening. Drink it with 200 ml of warm boiled water, drinking small sips.
• In the case of chronic manifestations of headache, Vanga recommends that a decoction of thyme should be given (or else called savory). Water should be at least five liters, or even more. Brew grass in the classical way. Before going to sleep, put your head in a decoction and sit for about ten to fifteen minutes. After the time is up, with the same water, pour and rub the entire body.
• From the headache, it is very useful, according to the prophetess's recommendations, to get up early in the morning and there is still dew on the grass, walking barefoot along it.
• A good effect shows the consumption of chamomile or melissa tea.
• With a headache, a warm bath is a good idea. Increase its effectiveness will help introduce into it sea salt, as well as added to the water plant broth from the rhizome of valerian, oat straw and other plant components with similar properties.
• The prophetess thinks that the headache will help to remove the yellow card made on the gastrocnemius area, as well as the area of the scapula (only not in the region of the heart) or the neck from the back, slightly below the hair. It is necessary to sustain 10 - 15 minutes and remove the mustard plaster.
• Instead of mustard, similar compresses can be applied, using fried horseradish or radish.
• In some cases, the composition applied to the temporal region can help: boil until ready to cook, grind them well and mix with grated garlic and vegetable oil. It is better to use this "ointment" for the night.
• A headache and juices made of black currant or viburnum are not bad. The juice should be fresh. It is drunk one by one - three tablespoons, three times throughout the day. This method is effective for severe headaches.
• Sometimes it is enough just to eat some fresh berries and the intensity of pain decreases. In this case, a cowberry or strawberry is suitable.
• With a headache, a seizure splashes meadow. Shredded vegetable raw materials in the volume of one tablespoon is filled with half a glass of hot boiled water. Covering the jar with the lid in which the medicinal mixture is located, and, wrapping it, give an hour to brew. Eat one third of the glass infusion, pre-exuding the mixture, three times a day.
• Well-established elderly medicinal flowers. Two teaspoons of dried and shredded raw material is poured into one glass of freshly boiled water and left to stand under the closed lid for fifteen minutes. Drink this product after straining three times throughout the day for half a glass. To increase the effectiveness of the infusion, when you use, you can add one teaspoon of honey.
• Excellent showed itself in the treatment of temporal arteritis cinnamon infusion. One gram of the crushed product pour 20 ml of water with a temperature of 70 - 80 оС. Enter a little sugar, but better honey (if there is no allergy to beekeeping products). Drink a couple of sips at an interval of one hour. In parallel, this tincture can be applied in the form of compresses on the frontal part of the head and whists.
• Prepare the collection: take one serving of herb tea, two norms of peppermint, two servings of herbaceous motherwort. Gather properly. 15 g of the composition mixed with 200 ml of cold boiled water and put on a small light. From the moment of boiling to sustain five to seven minutes, then let it brew for about an hour. Before you take this decoction, enter into it one clove (spice). Liquid drink warm, one to three tablespoons 30 minutes before meals. This broth is effective in case of severe pain in the temples.
• When chronic headaches are very useful on an empty stomach to drink half a glass of buttermilk, curdled milk or whey.
• There is also such a proven way to at least partially relieve the pain - attach a forehead to the window glass and so relax a little.
• Works well and just torn sheet of lilac. It is necessary in the role of compress to attach to the harassing site. If necessary, slightly wilted sheet can be replaced with fresh, just ripped off.
• The cabbage leaf works in a similar way.
• The headache with the temporal arteritis will pass if a two-centimeter-cut and a peeled lemon peel are applied to the temples. Apply a moist side to the sore spot, and stand until until under the rind does not appear hyperemia, and the skin does not begin to itch.
• Vanga recommends poprinimat infusion of roots of madder. Infusion is easy to prepare at home under the classical scheme. Drink a third of the glass throughout the day, making one - three approaches.
• A small amount of clay with water to bring the consistency of very thick sour cream (it should not spread). Introduce a few drops of vinegar into the resulting mush. The resulting "medicine" is applied to the soles of the patient's legs. Such an exercise makes it possible to provoke a partial outflow of blood from the vessels of the head, which contributes to the reduction of pain, and even to the complete disappearance of it. After applying the ointment, lower extremities should be wrapped with a napkin and placed on top with warm socks. It is advisable to keep this compress for about an hour.
• A more simple method of getting rid of pain is the application of softened clay to the forehead, whiskey or the occipital part of the patient's head.
• You can try rubbing the temporal region of the balm gold star. Its components allow you not only to relax, but also have sedative properties, which allow you to stop pulsating pain in the temples.
• If you do not have a tablet at hand, but the headache is getting worse, it's worth trying a cotton swab dipped in ammonia, rubbing for one to five seconds of whiskey. Pain must lose its intensity, and then go completely.

But it should be clarified once again that it is not recommended to treat temporal arteritis by alternative means. The methods described above for the relief of discomfort are good only for relieving pain symptoms, but they do not relieve the patient of the source of the problem. Therefore, mandatory specialist consultation and a full examination is necessary. Only a certified doctor is able to correctly diagnose and conduct adequate therapy. And it is with him that one should consult about the use of a prescription of alternative medicine to relieve the attack of a headache and improve the general condition of the patient.

Prevention of temporal arteritis

The recommendations of primary measures to prevent the development of the disease in question are very problematic, since modern medicine does not possess sufficient knowledge about the nature and sources of the pathological changes that lead to the disease under consideration. Secondary prevention of temporal arteritis includes a lifelong finding of a patient on immunosuppressants and steroid hormones. To relieve the same headaches, a person can easily find the most effective for him specifically the method of alternative medicine. But in this case, it is not superfluous to consult with your doctor.

Prognosis of temporal arteritis

The distant and near future of a person suffering from Horton's syndrome directly depends on the timeliness of seeking help from a neurologist. If the diagnosis was made on time and adequate therapy was performed, the prognosis of temporal arteritis may be quite favorable. Adhering to the recommendations of his attending physician, the patient continues to live a full, familiar life for him.

If, at the time of the diagnosis, the process was started, the disease can provoke the development of quite serious complications that do not always respond to treatment therapy, do not lend themselves to regression, leading the patient to disability.

Nature has created our body "wise." And if you often have a headache, do not take self-medication, taking the first pill that fell under your arm. It should be understood that frequent pain symptoms our body signals about harmful changes that disrupt its normal functioning. If the diagnosis of temporal arteritis is put on time, then the patient's body will undergo the least damage, and the subsequent life of the patient, when implementing the recommendations of a specialist, will not differ much from the life of a healthy person. If a person is ignored pain symptoms, he may in the near future to face the fate of the disabled. Therefore, it is worthwhile to pay attention to your health and seek advice from a qualified specialist on time.