Georg Ivanovas From Autism to Humanism - systems theory in medicine

4. Systemic Basics - 4.8 Autopoiesis

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c) the visce-neuro-muscular system and specific trigger points

The visce-neuro-muscular system shows some further traits of a structurally determined inner condition. Low back pain has many different patterns according to the muscles involved. The pain of the M. longissimus might be triggered by a tendinosis in the thoracic area (as seen in the illustration), whereas the felt pain is in the lumbar or sacral region (Bergsmann/Bergsmann 1988). That is, the felt pain and its origin are found in different places. In such cases a CT or an x-ray of the lumbosacral region will not provide any useful information. It might even lead to a wrong diagnosis and to an inappropriate therapy if alterations like spondylophytes or a discus prolaps are found by accident in the examined area.

As pain makes the related neurons hyperexcitable a slight stimulus is able to provoke and maintain a state of pain (Marx 2004). That is, there is local positive feedback mechanism where the pain increases the activation of certain neurons creating more pain. Every physician knows such self-maintaining states of pain.

Two characteristics are important in this context

  1. The symptom (the pain) is triggered by an irritation in a different part of the body
  2. The problem might spread out involving different anatomical structures and physiological processes.

Through the viscero-neuro-muscular organisation of the peripheral nervous system (illustration) skin, muscles, nerves and inner organs are functionally coupled. A disturbance, like a hyperexcitation in a certain region might influence the functionally related structures. Thus, a tendomyosis in the thoracic region might disturb to some extend the function of the related inner organs like the lung or the heart. Through the projected pain in the lumbar or sacral region the intestines and the pelvic organs might be impaired. As this interrelation is not a one way mechanism (from muscle or nerves to inner organs) the dysfunction of an inner organ or even the skin might create a neuro-muscular excitation, as well. The result is an integral disturbance involving tendons, muscles, nerves, inner organs, the skin and/or the humoural secretion.

That is, seemingly different problems are related through structure and organization. They create a pattern. This pattern can only be understood when the physician has an according neurophysiological knowledge and a theory about organisation. If not, the pattern falls apart. What remains is a deliberate (autistic) picture of unrelated symptoms.

In the described ‘Latissimus-case’ unspecific therapies like massage, warm or cold peloids or bodily exercise are able to heal a lot of the unrelated ‘specific diseases’.

But there is also a more tailored treatment. A method based on the understanding of the functional anatomy of the peripheral nervous system is the so-called neural therapy. It maintains that a lot of diseases can be improved or treated just by infiltrating certain trigger points with a local anaesthetic. By that the whole viscero-neuro-muscular complex might recover from the circulus vitiosus of hyperexcitation, pain and tension. For example, stress, tachycardies, constipation and/or menstrual pain might vanish just by infiltrating the trigger points of the M. longissimus.

That is, understanding the principles of structure and function often enables a physician to stimulate certain points of intervention (as the trigger points) to induce a complex reaction of the whole organism which eventually leads to an improvement of health.

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