MRI RESEARCH OF THE CAUSES OF PAIN SYNDROMES IN THE BACK AND OSTEOCHONDROSIS OF THE SPINE

The aim of the study was to search for organic changes in the tissues of the spine that are the cause of pain syndromes in the back and spine. With the help of MRI, the state of the muscular corset of the spine was diagnosed and the violations found were compared with the localization of pain syndromes in the back and the localization of dystrophic manifestations in the vertebrae and intervertebral discs. In 70 patients who underwent MRI examinations of areas with pain syndromes in the back, it was shown that osteochondrosis of the spine is preceded by spastic conditions of the intervertebral muscles, leading to disruption of trophism of the vertebrae and intervertebral discs, as well as to the development of pain syndromes.

MRI RESEARCH OF THE CAUSES OF DYSTROPHIC PROCESSES IN THE SPINE

The aim of the study was to search for organic changes in the tissues of the spine, which are the cause of pain syndromes in the back and spine. Method. MRI was used to diagnose the condition of the muscular corset of the spine and conditions of the identified disorders with the localization of pain syndromes in the back and the localization of dystrophic manifestations in the vertebrae and intervertebral discs. Results. In 70 patients who underwent MRI of areas with pain syndromes in the back, it was shown that dystrophic manifestations in the spine are preceded by spastic conditions of the intervertebral muscles, leading to disruption of trophism (nutrition and regeneration) of the vertebrae and intervertebral discs, as well as the spine, the development of pain syndromes. The localization of spastic conditions of the intervertebral muscles coincides with the areas in which people experience pain, caused, according to most neurologists, by osteochondrosis of the spine. Osteochondrosis of the spine as a dystrophic process is a consequence of the spastic conditions of the muscles that cause disturbances in the trophism of the vertebrae and intervertebral discs. Conclusions: Spinal osteochondrosis is not a disease, but an irreversible dystrophic process in the vertebrae and intervertebral discs. The reasons for the development of dystrophic processes and back pain are spastic conditions in the intervertebral muscles.

Ultrasound-guided Hydrodissection of Sural Nerve for Foot Pain

Background: Sural nerve entrapment is an impor­tant but infrequent cause of pain. The sural nerve provides sensation to the posterolateral aspect of the leg, lateral foot and fifth toe. Sural nerve entrapment can be challenging to treat and can cause significant limitation. We present a case of sural nerve entrapment resistant to conservative management that was effectively treated by percutaneous ultrasound guided hydrodissection of the sural nerve. Case Report: A 57 year old male came with complaints of pain and tingling sensation on both lower limbs with 50% decrease in sensation to touch (right > left) in lateral aspect of both foot. The patient had tried several conservative modalities with no success. We performed percutaneous ultrasound guided hydrodissection of the sural nerve and the patient reported complete improvement in his pain. Conclusion: Percutaneous ultrasound guided hydrodissection of the sural nerve, is a safe and effective treatment for patients with sural nerve entrapment that does not respond to conservative therapy. However, studies are needed to elucidate its effectiveness and safety profile.

Does MRI Knee in Those over 50 Years with Knee Pain in Osteoarthritis Alter Management? A Retrospective Review

Knee osteoarthritis (OA) is a significant cause of pain and disability worldwide. Imaging provides diagnosis, prognostication, and follow-up. Radiographs are first line, useful, and inexpensive. Magnetic resonance imaging (MRI) can detect additional features not seen on radiograph, but it is of questionable usefulness in the management of knee OA. Our aim was to investigate the usefulness of MRI in the workup of knee OA and whether MRI alters management in knee OA. A retrospective review was performed of consecutive MRI knees performed for knee pain in those over 50 years. Clinical information and documentation of management plan pre- and post-MRI were collected. Assessment was made whether the MRI results influenced the final management plan. Of the 222 MRI knees included for study, the majority (62.2%) had not had a recent radiograph. OA was reported in 86.9% of radiographs and 89.6% of MRI. On MRI, the most prevalent finding was tearing/abnormality of the medial meniscus, seen in 47% of MRIs overall, increasing to all in severe OA. MRI assisted with management in 9.5% of all (21/222) patients, and changed management plans in 23% of those that had documented management plans prior to the MRI (6/26 patients). MRIs can guide tailored management in knee OA and are useful for surgical planning; however, they should only be ordered in certain cases, and a radiograph should always be performed first. MRI should be considered if symptoms are not explained by OA alone or the appropriate treatment option requires MRI.

Kinesiophobia, fear of fall, neuropathic pain and navicular drop in rheumatoid arthritis- a correlation study

Background: Rheumatoid arthritis (RA) is one of the most common chronic health conditions and a leading cause of pain; joint damage and disability. Fear of fall and kinesiophobia are associated with activity limitations in RA patients because of pain and stiffness which affects the quality of life. Kinesiophobia and fear of fall are associated with pain. The pathogenics and chronicity of RA can lead to neuropathic pain. Hence the aim of this study was to assess pronation of foot and evaluate if there is any correlation between fear of fall, kinesiophobia and neuropathic pain in patients with rheumatoid arthritis.Methods: Subjects in the age group of 30-50 years were included after passing the EULAR criteria and were assessed for navicular drop by using the navicular drop test. Later they were assessed for fear of fall, kinesiophobia and neuropathic pain using fall efficacy scale, Tampa scale and LANSS questionnaire respectively.Results: Significant co-relation was found between kinesiophobia and fear of fall (p value =0.0046) and there were non-significant co-relations between all other factors.Conclusions: Participants with RA showed significant navicular drop where left subtalar joint was more affected than right. According to the LANSS score subjects showed lower concerns of neuropathic pain. Maximum number of subjects displayed high concerns of kinesiophobia and fear fall which proves the significant association between the factors.

GAMBARAN KEJADIAN DISMENORE PADA REMAJA PUTRI DI FAKULTAS ILMU KESEHATAN UNIVERSITAS PASIR PENGARAIAN

Dysmenorrhea is a painful condition that occurs during menstruation that can interfere with activities, causing pain in the lower abdomen, which spreads to the lower back and legs. The incidence of dysmenorrhea is experienced by young women around the world on average. The cause of pain is due to an imbalance of the hormone progesterone in the blood. Several factors triggering the occurrence of dysmenorrhea include the first menstruation at an early age, endocrine factors, psychological disorders, allergic, long menstrual periods, heavy menstrual blood flow, smoking, a history of obesity and alcohol consumption. Efforts to overcome dysmenorrhea can be done by non-pharmacological and pharmacological methods. This study aims to describe the incidence of dysmenorrhea in adolescent girls. This study used a descriptive survey method with a questionnaire that was distributed via google form to 73 students of the Faculty of Health Sciences, Pasir Pengaraian University. The results showed that the average menarche at the age of 13-16 years was 39 people (53.43%), the most experienced dysmenorrhea was 52 people (71.23%), the efforts made to reduce dysmenorrhea with rest were 35 people. (47.95 %) and 38 people (52.05%) who tried to reduce the feeling of dysmenorrhea, respondents used drugs to reduce dysmenorrhea, namely 26 respondents (35.62%). The conclusion of this study is that the average age of menarche for adolescent girl is 13-16 years, the majority experience dysmenorrhea, most of the adolescent girl make efforts to reduce dysmenorrhea pain with non-pharmacological and pharmacological methods.

O Disco Intervertebral da Coluna Lombar. Qual o Efeito do Exercício Físico?

Pain in the lumbar spine is very common in sports. Pathology of the intervertebral disc is a frequent cause of pain and changes in sports performance. The authors present the anatomy of the intervertebral disc and the impact of physical exercise on its structural quality.

Effects of a physiotherapist-led approach based on a biopsychosocial model for spinal disorders: protocol for a systematic review

IntroductionLow back pain and neck pain are among the most common musculoskeletal disorders, and their related medical costs are rising every year. Many interventions are based on the biopsychosocial (BPS) model since the cause of pain is more multifaceted. Physiotherapists have increased opportunities to perform multidisciplinary interventions alone in clinical practice due to a lack of understanding of the model and its cost. Therefore, physiotherapist-led interventions using the BPS model are important and require an updated report summarising their effectiveness. Thus, the purpose of this study will be to summarise and synthesise the effects of physiotherapist-led interventions using the BPS model for spinal disorders.Methods and analysisWe will search the Web of Science, CENTRAL, MEDLINE, PsycINFO, CINAHL and PEDro electronic databases, using a date range from inception to September 2021. We will include only randomised controlled trials for patients diagnosed with spinal disorders who received physiotherapist-led interventions based on the BPS model. The search will be limited to English-language publications. Pain intensity and disability are the primary outcomes. Secondary outcomes are any psychological factors. We will examine the short-term, medium-term and long-term effects, and a subgroup analysis will be conducted, if possible, to investigate the role of additional physiotherapist training.Ethics and disseminationThis study is exempt from ethical approval because it involves publicly available documents. The findings will be submitted for publication in a relevant peer-reviewed journal.PROSPERO registration numberCRD42021258071.

Incidental finding of hereditary multiple osteochondroma causing ischiofemoral impingement

Ischiofemoral impingement (IFI) has been described in the medical literature as a cause of hip pain. IFI occurs due to an abnormal contact or reduced space between the lesser trochanter and the lateral border of the ischium and is an often unrecognised cause of pain and snapping in the hip. Association of multiple exostoses and a skeletal dysplasia characterised by an abnormal modelling of bone metaphysis and osseous deformities is highly characteristic of this disease. Consequently, multiple exostoses may narrow the ischiofemoral space and cause impingement and pain, even in the absence of malignant transformation. Surgical excision of exostosis of the lesser trochanter is a safe and effective method of treatment for patients with IFI. We present a case of left hip pain with incidental finding of hereditary multiple osteochondroma causing IFI and discuss the predisposing factors and review of literature.