This paper reports a case of musculoskeletal chronic pain and evaluates the serviceability of the approarch of psychosomatic orthopedics to musculoskeletal chronic pain with secondary fibromyalgia due to Sjogren's syndrome. There are many so-called musculoskeletal life-related diseases, i. go, degenerative spondylosis, osteoporosis, osteoarthritis, neck-shoulder-arm syndrome, rheumatoid arthritis, etc. The patient suffers from a functional somatic syndrome that includes fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome and the symptom called ‘painful depression’ that consists of the complex of pain and depressive state. However many of orthopaedic physicians have an inclination to interpret ‘psychogenic’ as ‘mere fancy’ or ‘exaggerated’. The orthopedic physician that does not suspect the psycho-social background of the patient's pain can make a good relationship with the patient, because the physician treats the psychosomatic patient as organic disease.
Patients ; Pain ; musculoskeletal ; seconds ; Approaches

Prevention ; System ; Use of ; Approaches ; Medical Errors

Basal ganglia are an area where cerebral haemorrhage occures frequenthy. Recently our knowledge of the brain and its function increases rapidly, but this knowledge is not much used in rehabilitation yet. Parallel neural networks (Hikosaka, 1999) are a model of sequential procedures learning, and basal ganglia perform an important function in it. Using this model, we designed a rehabilitation approach and applied it to a patient with left putamen hemorrhage. In the early stage, we promoted passive movement of her paralysed arm and fingers in the spatial coordinates with her eyes opened. Afterwords, we guided her to motor leaning in the motor coordinates with somatic sensation with her eyes closed. We intended to integrate the spatial coordinates and motor coordinates, by which we encouraged her to move her arm and fingers with her eyes opened after her recognition of motion perception improved. Her motor paralysis of fingers in particular improved by rehabilitation, which lasted about 1.5 month. We recognized some improvement in her arm, but it was slightly insufficient than her fingers. We considered that a difference in the degree of improvement occurred because she could not confirm enough on her shoulder in the early stage.
Fingers, unit of measurement ; Neural Network Simulation ; Rehabilitation aspects ; Arm ; Approaches