자율신경 이상, 치료해도 계속 아픈 진짜 이유 [건강한겨레]

A 40-year-old man sought medical help due to recurring symptoms for two months. He experienced palpitations, chest tightness, insomnia, loss of appetite, and poor digestion. His anxiety grew as the symptoms multiplied. He visited the nearest emergency room seeking treatment. Upon receiving the diagnosis of autonomic nervous system imbalance, he began therapy.

Despite receiving treatment for anxiety and sleep disorders from the mental health department, including precision examinations, medication, and psychological counseling, his symptoms persisted. He consulted the primary physician to uncover the root cause. He revisited his life before the symptoms began, noting excessive work, insufficient sleep, occasional alcohol consumption, and starting a strength training routine in May.

As the weather grew hotter, his symptoms intensified. The patient didn't mention headaches, so the physician probed further, revealing that he had frequently experienced headaches and was previously diagnosed with tension headaches at another hospital. The current headache was not the most challenging symptom; therefore, the patient hadn't connected his past tension headaches with his current condition.

Tension headaches are not merely a painful condition; patients may also experience autonomic nervous system imbalance even when they don't have a headache. Research shows that autonomic nervous system changes can be observed in heart rate, blood pressure regulation, and the standing response. Issues such as nausea, vomiting, and changes in digestive function are also frequently associated with tension headaches.

It is likely that these symptoms can all be attributed to tension headaches alone. However, in this patient's case, it is essential to consider that his palpitations, insomnia, and digestive issues could all be manifestations of tension headaches combined with other factors like sleep deprivation, overexertion, heat, and alcohol consumption.

Autonomic nervous system imbalance is not a single disease but rather a symptom that can appear in various diseases and states. Therefore, treatment requires two approaches: first, managing each symptom that troubles the patient, such as palpitations, blood pressure fluctuations, insomnia, and digestive issues. However, this should not be the end.

Simultaneously, it is crucial to identify the underlying cause of autonomic nervous system imbalance and associated diseases. Examples include diabetes-associated autonomic nervous system disorders, Parkinson's disease, autoimmune diseases, and endocrine disorders. Additionally, the close relationship between tension headaches and autonomic nervous system function abnormalities should not be overlooked in neurology clinics.