Pain points

Diagnostic pain points are symptomatic points, the definition of which can contribute to clarifying or revealing the disease, its location and nature. They need to be distinguished from the diffuse soreness of muscles, subcutaneous tissue, etc.

Depending on the tissues studied pain points are determined in those parts of the body where the nerve or vessel, which is in a pathological condition, can be pressed against the bone; they are also determined by stimulation of deep tissues (fasciae, places of attachment of muscles to bones) and internal organs.

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Pain points in the head and neck

• painful points of exit I, II, III branches of the trigeminal nerve - with neuralgia of this nerve, sinusitis, meningitis and meningitis, arachnoiditis (absent from coma);
• Vascular pain points of Greenstein: at the inner corner of the orbit - with phlebitis and thrombophlebitis of veins of the face; behind the ears in the region of the occipital bumps - with vasomotor pathologies of cerebral vessels, meningitis;
• painful points in the temple area above the zygomatic process - with arteritis and sympatalgia of the face, leptomeningitis;
• painful points in the mastoid process, in front and down from the tragus of the ear - with neuritis and neuralgia of the facial nerve, otitis, mastoiditis;
• painful points at the base of the skull above the first cervical vertebra in the place of the occipital nerve exit - with neuralgia of these nerves, cervical osteochondrosis, meningitis, tumors of the cerebellar zone;
• painful points of spinous processes of the cervical vertebrae, intervertebral discs, paravertebral - with osteochondrosis, hernias of intervertebral discs;
• painful points of the vertebral artery on the line connecting the apices of the mastoid process and the spinous process of the second cervical vertebra - with pathology of the vertebral artery and cardialgia of various genesis.

Pain points in the shoulder region and arms

• at the outer edge of the sternocleidomastoid muscle - with cervical osteochondrosis;
• under the collarbone in the middle third - with cervical osteochondrosis, staircase and first rib syndrome, humeroscapular periarthritis;
• in the region of the coracoid scapula of the scapula - with humeroscapular periarthritis and cervical osteochondrosis;
• on the anterior surface of the shoulder joint - with stenocardia, myocardial infarction, cardialgia;
• on the inner surface of the shoulder along the nerve-vascular trunk - with Raynaud's disease, the pathology of the brachial artery and its trunks, irritation of the distal branches of the ulnar nerve (inflammation and injury of the hand and forearm), irritation of the stellate cervico-thoracic node located in the fork between the outer and the inner branches of the carotid artery (compression, trauma, inflammation);
• supraclavicular and subclavian pain points of Erb, receding from the edge of the sternum by 2 cm - with plexitis;
• along the peripheral nerves of the hand - with neuritis and irritations of the branches with perineural inflammations and tissue traumas.

Pain points in the chest and abdomen

• spinous processes of thoracic vertebrae and paravertebral - at the level of intervertebral discs - with osteochondrosis, chondropathies, intervertebral hernias, juxtramedullary tumors;
• in the intercostal spaces along the parotid, axillary and peri-chest lines - with intercostal neuralgia, chest trauma, pleural cavity pathology;
• Sternberg, 2-3 cm above the navel and somewhat to the right - with irritations of the solar plexus - with solyarites, more often due to mesadenitis, or reflex solaralgia; approximately 5-7 cm from the navel along the line connecting the navel with the right axillary cavity - with local pancreatitis in the head region of the pancreas;
• paravertebral painful points of Boas at the level of X-XII thoracic vertebrae and Openchovsky in the region of spinous processes of VIII-X thoracic vertebrae - with ulcers, cancer and other pathologies of the stomach;
• the anterior point of Boas at the intersection of the rectus abdominis and the right costal arch - with cholecystitis and duodenal ulcer;
• McBurney below the navel by 2 cm and to the right by 1-2 cm - with mesadenitis and reflex solaritis, more often with appendicitis; At the intersection of the line between the navel and the ileal wing with the rectus abdominis - with appendicitis;
• Ortner on the lower edge of the costal arch on the right - with diseases of the liver and gallbladder;
• Mussie over the clavicle, between the legs of the sternocleidomastoid muscle, - cholecystitis, subdiaphragmatic abscess and pathology, accompanied by irritation of the diaphragmatic nerve;
• Gerbsta at the transverse process of the third lumbar vertebra on the left - with peptic ulcer;
• Kümmel, located 1 cm to the right and down from the navel, - with appendicitis;
• Lantzava, 5 cm from the right anterolateral upper iliac bone on the line connecting both awns - with appendicitis;
• McBurney in the middle of the awning-umbilical line - with appendicitis;
• Munro at the point of intersection of the outer edge of the right rectus abdominis with the awning-umbilical line - with appendicitis;
• the Shoffar zone (choledochocampanic) is 5-7 cm above the navel on the right and left of the median line.

Pain points in the pelvic region and legs

• in the place of exit of the femoral nerve in the middle of the inguinal fold - with neuritis and neuralgia of this nerve;
• pain points Ball - lateral spinous processes, in the lumbar spine, in the scallop of the posterior upper ostium of the ilium, in the middle of the crest of this bone, in the ischial tuber, in the middle of the posterior surface in the lower third of the femur, in the popliteal fossa, behind the fibula, external ankle, at the rear of the foot - with lumbosacral radiculitis and radiculoneuritis;
• pain points Tara - with pressure on the spinous processes of the IV-V lumbar vertebrae, in the iliac-sacral region, in the region of the transverse processes of the IV-V lumbar vertebrae - in the lumbosacral radiculitis, radiculalgia, radiculoneuritis;
• Dejerine in the spinous process of the sacral vertebra - in the lumbosacral radiculitis and radiculalgia;
• Bekhterev in the middle of the sole - with radiculitis, the appearance or strengthening of pain in the lower back;
• Schüdel - with radiculitis pain with percussion or pressure on the spinous processes of the vertebrae;
• Mayo-Robson on the anterior-inner surface of the lower third of the left tibia - in acute pancreatitis there is an increase in pain in the epigastrium.