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In medicine, tenderness is pain or discomfort when an affected area is touched. [1] It should not be confused with the pain that a patient perceives without touching. Pain is patient's perception, while tenderness is a sign that a clinician elicits.
Peritonitis is inflammation of the localized or generalized peritoneum, the lining of the inner wall of the abdomen and cover of the abdominal organs. Symptoms may include severe pain, swelling of the abdomen, fever, or weight loss. One part or the entire abdomen may be tender. Complications may include shock and acute respiratory distress syndrome.
Trigger finger, also known as stenosing tenosynovitis, is a disorder characterized by catching or locking of the involved finger in full or near full flexion, typically with force. There may be tenderness in the palm of the hand near the last skin crease. The name "trigger finger" may refer to the motion of "catching" like a trigger on a gun. The ring finger and thumb are most commonly affected.
Fibromyalgia is a medical syndrome which causes chronic widespread pain, accompanied by fatigue, waking unrefreshed, and cognitive symptoms. Other symptoms can include headaches, lower abdominal pain or cramps, and depression. People with fibromyalgia can also experience insomnia and a general hypersensitivity. The cause of fibromyalgia is unknown, but is believed to involve a combination of genetic and environmental factors. Environmental factors may include psychological stress, trauma, and certain infections. Since the pain appears to result from processes in the central nervous system, the condition is referred to as a "central sensitization syndrome".
Tension headache, stress headache, or tension-type headache (TTH), is the most common type of primary headache. The pain usually radiates from the lower back of the head, the neck, the eyes, or other muscle groups in the body typically affecting both sides of the head. Tension-type headaches account for nearly 90% of all headaches.
Tension myositis syndrome (TMS), also known as tension myoneural syndrome or mindbody syndrome, is a name given by John E. Sarno to what he claimed was a condition of psychogenic musculoskeletal and nerve symptoms, most notably back pain. Sarno described TMS in four books, and stated that the condition may be involved in other pain disorders as well. The treatment protocol for TMS includes education, writing about emotional issues, resumption of a normal lifestyle and, for some patients, support meetings and/or psychotherapy.
Courvoisier's principle states that a painless palpably enlarged gallbladder accompanied with mild jaundice is unlikely to be caused by gallstones. Usually, the term is used to describe the physical examination finding of the right-upper quadrant of the abdomen. This sign implicates possible malignancy of the gallbladder or pancreas and the swelling is unlikely due to gallstones.
Blumberg's sign is a clinical sign in which there is pain upon removal of pressure rather than application of pressure to the abdomen. It is indicative of peritonitis. It was named after German surgeon Jacob Moritz Blumberg.
Waddell's signs are a group of physical signs, first described in a 1980 article in Spine, and named for the article's principal author, Professor Gordon Waddell (1943–2017), a Scottish Orthopedic Surgeon. Waddell's signs may indicate non-organic or psychological component to chronic low back pain. Historically they have also been used to detect malingering in patients with back pain. While testing takes less than one minute, it has been described as time-consuming and alternatives have been proposed.
An abdominal examination is a portion of the physical examination which a physician or nurse uses to clinically observe the abdomen of a patient for signs of disease. The abdominal examination is conventionally split into four different stages: first, inspection of the patient and the visible characteristics of their abdomen. Auscultation (listening) of the abdomen with a stethoscope. Palpation of the patient's abdomen. Finally, percussion (tapping) of the patient's abdomen and abdominal organs. Depending on the need to test for specific diseases such as ascites, special tests may be performed as a part of the physical examination. An abdominal examination may be performed because the physician suspects a disease of the organs inside the abdominal cavity (including the liver, spleen, large or small intestines), or simply as a part of a complete physical examination for other conditions. In a complete physical examination, the abdominal exam classically follows the respiratory examination and cardiovascular examination.
Costovertebral angle (CVA) tenderness is pain that results from touching the region inside of the costovertebral angle. The CVA is formed by the 12th rib and the spine. Assessing for CVA tenderness is part of the abdominal exam, and CVA tenderness often indicates kidney pathology.
Trochleitis is inflammation of the superior oblique tendon trochlea apparatus characterized by localized swelling, tenderness, and severe pain. This condition is an uncommon but treatable cause of periorbital pain. The trochlea is a ring-like apparatus of cartilage through which passes the tendon of the superior oblique muscle. It is located in the superior nasal orbit and functions as a pulley for the superior oblique muscle. Inflammation of the trochlear region leads to a painful syndrome with swelling and exquisite point tenderness in the upper medial rim of the orbit. A vicious cycle may ensue such that inflammation causes swelling and fraying of the tendon which then increases the friction of passing through the trochlea which in turn adds to the inflammation. Trochleitis has also been associated with triggering or worsening of migraine attacks in patients with pre-existing migraines.
Counterstrain is a technique used in osteopathic medicine, osteopathy, physical therapy, massage therapy, and chiropractic to treat somatic dysfunction. It is a system of diagnosis and treatment that uses tender points, which are produced by trauma, inflammation, postural strain, or disease, to identify structures to manipulate. The manipulation uses light pressure to decompress the local nociceptors and mechanoreceptors responsible for the sensation of pain, returning central sensitization to its normal state. This technique extends Strain-counterstrain, a technique inhibits the reflexes by putting the tissues in a position of ease directly opposite to that of the reflex. Strain-counterstrain is also known as the Jones technique,, and spontaneous release by position. Counterstrain was developed by Lawrence Jones in 1955 and was originally called “Spontaneous Release by Positioning,” before being termed “strain-counterstrain.”
Greater trochanteric pain syndrome (GTPS), a form of bursitis, is inflammation of the trochanteric bursa, a part of the hip.
Pubic symphysis diastasis is the separation of normally joined pubic bones, as in the dislocation of the bones, without a fracture that measures radiologically more than 10 mm. Separation of the symphysis pubis is a rare pathology associated with childbirth and has an incidence of 1 in 300 to 1 in 30,000 births. It is usually noticed after delivery but can be observed up to six months postpartum. Risk factors associated with this injury include cephalopelvic disproportion, rapid second stage of labor, epidural anesthesia, severe abduction of the thighs during delivery, or previous trauma to the pelvis. Common signs and symptoms include symphyseal pain aggravated by weight-bearing and walking, a waddling gait, pubic tenderness, and a palpable interpubic gap. Treatment for pubic symphysis diastasis is largely conservative, with treatment modalities including pelvic bracing, bed rest, analgesia, physical therapy, and in some severe cases, surgery.
In medicine, Carnett's sign is a finding on clinical examination in which (acute) abdominal pain remains unchanged or increases when the muscles of the abdominal wall are tensed. For this part of the abdominal examination, the patient can be asked to lift the head and shoulders from the examination table to tense the abdominal muscles. An alternative is to ask the patient to raise both legs with straight knees.
Markle's sign, or jar tenderness, is a clinical sign in which pain in the right lower quadrant of the abdomen is elicited by the heel-drop test.
A phoenix abscess is an acute exacerbation of a chronic periapical lesion. It is a dental abscess that can occur immediately following root canal treatment. Another cause is due to untreated necrotic pulp. It is also the result of inadequate debridement during the endodontic procedure. Risk of occurrence of a phoenix abscess is minimised by correct identification and instrumentation of the entire root canal, ensuring no missed anatomy.
Lépine's sign is one of the medical signs of gallbladder disease. It is positive when effleurage with crooked third finger at the point of the gallbladder projection to anterior abdominal wall elicits pain. It is not to be confused with the following:
The human abdomen is divided into quadrants and regions by anatomists and physicians for the purposes of study, diagnosis, and treatment. The division into four quadrants allows the localisation of pain and tenderness, scars, lumps, and other items of interest, narrowing in on which organs and tissues may be involved. The quadrants are referred to as the left lower quadrant, left upper quadrant, right upper quadrant and right lower quadrant. These terms are not used in comparative anatomy, since most other animals do not stand erect.
Heel tap sign, also called heel-jar or jar tenderness, is a clinical sign to identify appendicitis. It is found in patients with localized peritonitis. With the patient supine the right heel is elevated by 10-20 degrees is hit firmly with palm of the examiner's hand.
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