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Zygapophyseal joint pain (~40%) Cervical disc pain (~40%) Combined ZA joint and disc pain (~20%) Systemic causes such as rheumatoid arthritis, ankylosing

This article is a stub. See physiotherapy protocol by Roberta Ainsworth for massive rotator cuff tears. Subacromial Pain Syndrome Subacromial Bursa Injection

fibromyalgia patients had definite SFN, compared to 3% in the control group. See Manuel et al for a summary. Some central sensitisation framework proponents

and inactivated. They are vital for the generation of action potentials (See also Basic Neurophysiology and Channelopathies and Chronic Pain). Disease

It is often described as a self limiting condition. A “wait and see” approach can see improvement within one year . A third of patients have prolonged

pelvis innervation. This article is a general overview of spinal cord anatomy. See nociception and basic neurophysiology for a more detailed overview on neurophysiology

40-50% of patient with fibromyalgia meet the diagnostic criteria for SFN. See also: Basic Neurophysiology Small fibre neuropathy results from damage to

This article is still missing information. Neurons are cells derived from the same embryonic tissue as skin, namely the ectoderm. They are highly differentiated

spontaneous pain, and only assesses superficial sensitivity rather than deep pain. See figure for clinical correlates. Dynamic Mechanical Allodynia Dynamic mechanical

This article is still missing information. Neuropathic pain is pain that is caused by a demonstrable lesion or disease of the somatosensory system. Typically

while looking for any back or rib cage abnormalities such as a rib hump. See video on Adams test Seated Adam's test: Non-structural causes can be assessed

under 50. Remembering that BPPV comes on with neck movements, it is easy to see how a misdiagnosis of "cervical vertigo" can be made when there is a history

when it comes to medial branch neurotomy, but the procedure can be repeated. See review by Russo et al. Traditionally it has only been used to treat chronic

Fluoroscopic guidance is safer than ultrasound due to the inability on ultrasound to see ventral to the Sacrococcygeal disc space where the bowel in located. However

different clinical syndromes because of the different mutational effects See also: Basic Neurophysiology Ion channels are integral membrane proteins that

aleotoric processes (See article on uncertainty). A single "unifying diagnosis" of central sensitisation may not apply here. Here we see the opposing aphorisms

abdomen, the nerve bifurcates into the lateral and anterior cutaneous branches. See also: Post-Hernia Repair Chronic Pain The injection can have diagnostic and

This article is still missing information. This article reviews surgical options for chronic low back pain, radicular pain, and lumbar spinal stenosis

amyotrophy is also known as Parsonage-Turner syndrome and brachial neuritis. See older open access review, and two newer closed access reviews. Neuralgic Amyotrophy

at six months. Surgery The main options are arthrodesis and trapeziectomy. See https://www.youtube.com/watch?v=i7_iHbFVtHA for more information. Tenti S

the wrist can become unstable and lead to post-traumatic osteoarthritis. See also: Hand and Wrist Biomechanics The carpal bones give stability to the wrist

This article is a stub. Familial episodic pain syndrome (FEPS) encompasses a group of non-inflammatory, paroxysmal pain syndromes primarily affecting the

This is ported content from WikiEM It is subject to the compatible CC-BY-SA license. Suspicion of septic arthritis Suspicion of crystal arthropathy Evaluation

page outlines the regional anaesthetic technique. For carpal tunnel syndrome see carpal tunnel injection. Useful for lacerations across multiple fingers/palm

medial to lateral and advance until the needle tip is close to the nerve. See Palamar et al for a review on technique. Patient in position of comfort allowing

This page or section deals with a topic that is not widely recognised or accepted. Please use your clinical judgement and note that this is not necessarily

inflammation is simply a superimposed phenomenon on tendon degeneration. See Fakoya and colleagues for a detailed discussion and literature review on the

motor neuron signs such as weakness, spasticity, Babinski or Hoffman sign. (see video on Hoffmans sign) The reflexes are asymmetric which either means that

of sternoclavicular instability and pain. See Sternoclavicular Joint Anatomy for a review of the anatomy See also: Sternoclavicular Joint Anatomy The Sternoclavicular

This article is still missing information. The coccyx (plural: coccyges) is the series of rudimentary vertebrae forming the caudal termination of the vertebral

This article is still missing information. Interobserver reliability is the agreement between two observers on the findings of a given diagnostic test

This article is still missing information. Myelopathy is term that describes a spinal cord lesion that is confined to a discrete level, for example from

however only the outer surface of the Os peroneum can be assessed (but it can see displacement). It can however assess the tendons such as for tears and tenosynovitis

groups can work through them allowing isolated movements and we see less asymmetry. We see increasing synergy and coordination of the deep stabilising system

Written by: Dr Jeremy Steinberg – created: 12 April 2021; last modified: 8 May 2022 This page is probably complete! It is awaiting peer review The sternoclavicular

This article is still missing information. During an experiment two samples are compared which each are supposed to represent two populations. Errors can

that is what we see with single medial branch blocks for facet joint pain, due to the placebo effect. To overcome this we need to see at minimum a second

and so it can be helpful to distinguish it from cervical radicular pain. (See also Cervical Spine Pain Definitions and Radicular Pain and Radiculopathy

access is not always straightforward and failure to enter the joint is common. See Sacroiliac Joint Precision Treatment for more information about precision

This article is a stub. See Willard et al for a free open access article on the thoracolumbar fascia. Lumbar Fat Herniation Willard et al.. The thoracolumbar

large osteophytes, and gross deformity of the femoral head and acetabulum. See Radiopaedia for a collection of x-ray cases. MRI is more specific, and much

intravascular Slowly inject anesthetic and extend the infiltration laterally Please see Highland EM U/S Guide for videos and tutorials Residual Paresthesia due to

arthritis and promote synovitis, pannus growth, and cartilage/bone destruction. See also: Cartilage Biomechanics The ability of synovial fluid to lubricate the

postyield regions Fracture occurs when the ultimate strength is reached. See also: Material Properties Elastic Behaviour Isotropic materials: elastic properties

stub. This article focuses on chronic pain following traumatic brain injury. See open access article by Irvine et al. Global incidence of TBI is 106 per 100

lateral to the facet joint, medial to lateral, into the pseudoarthrosis. See images by Chen and colleagues. Transitional Vertebral Anatomy Chen, Zhi-Jia;

This article is a stub. See open access article. Yang, Guang; McGlinn, Evan P.; Chung, Kevin C. (2014-07). "Management of the stiff finger: evidence and

This article is a stub. Sacroiliac Joint Dysfunction Laslett et al.. Diagnosis of sacroiliac joint pain: validity of individual provocation tests and composites

fascia iliaca, infiltrate a small volume of the anaesthetic solution. Should see the fascia lift up off of the nerve. Continue to infuse anaesthetic. Confirmation

Sacroiliac ligament pain (interosseous or dorsal ligaments) Mechanical Locking Hypermobility Osteoarthritis Following Lumbosacral fusion Fracture Tumour

This article is a stub. See open access review by Leider et al. Leider, Joseph D.; Derise, Olivia C.; Bourdreaux, Kyle A.; Dierks, Gregor J.; Lee, Christopher;

This article is a stub. See Lam et al for an open access review on ultrasound guided nerve hydrodissection, a technique primarily used to treat certain

(cervical rib arising from C7). See Konin et al for an open access review on the lumbosacral transitional vertebral (LSTV) anatomy. See Furman et al for a practical

approach to numbness. For a more specific approach in the presence of pain see Pain Oriented Sensory Testing. Main article: Spinal Cord Anatomy Part or all

This article is a stub. See kunam et al for an open access review. There are six patterns of deficit in the spinal cord: Ventral cord syndrome Central

This article is a stub. Assess for localised tenderness over the medial epicondyle with the elbow flexed at 90°, and for pain on resisted pronation of

The point of contact is called the motor end plate, and it is here where we see cellular communication between the nervous system and skeletal muscle. The

Osteoarthritis - joint space narrowing, subchondral sclerosis and cysts, osteophytes. Capsule hypertrophy is often prominent and can mimic neoplasm. Posttraumatic

This article is a stub. The suprascapular nerve supplies sensation to most of the shoulder joint, especially the superior and posterior regions. Various

This article is a stub. Piriformis Syndrome

This article is a stub. See open access article by Smith et al for ultrasound-guided aspiration, fenestration, and injection for the treatment of baker's

article is a stub. Patients usually respond well to one steroid injection. See Pourcho et al for a free access review.. The topics of sternoclavicular joint

Osteoarthritis Osteonecrosis Crystal-induced (Gout, Pseudogout) Gonococcal arthritis, arthritis-dermatitis syndrome Nongonococcal septic arthritis Malignancy

joint itself is anomalous and only found is approximately 10% of individuals. See open access article by Singh et al Singh et al.. Symptomatic coracoclavicular

This article is a stub. Thoracic facet joint pain is felt in the parasagittal region and doesn't cross the midline. Thoracic Zygapophyseal Joint Pain Patterns

This article is still missing information. The supratrochlear nerve is a terminal cutaneous branch of the frontal nerve. The frontal nerve arises from

This article is still missing information. Occipital region of the scalp close to the midline. The posterior root of C3, otherwise known as the the Third

lumbarisation of S1, sacralisation of L5, fusion of the coccyx, and spina bifida (see Transitional Vertebral Anatomy). The sacrum is wedge shaped with concave anterior

This article is a stub. The distal biceps tendon insertions on the radial tubercle just distal to the raidal head. It supinates the forearm and is a secondary

This article is a stub. Proximal patellar tendinopathy is much more common than distal. In some cases there may be a rheumatological cause with insertional

This article is still missing information. Oral exam Head/chin deviations C curve occurs due to hypomobility, the mandible deviates to the involved side

This article is a stub. Glyceryl Trinitrate is a treatment for Tendinopathy. It is applied to the degenerative area and may enhance collagen synthesis

This article is a stub. A consensus approach to the MSK examination in children was developed by Foster et al in 2011. The open access consensus document

This article is still missing information. The lesser occipital nerve (LON) is commonly injected alongside the greater occipital nerve for headache disorders

This article is a stub. A genicular nerve injection can be used to treat knee osteoarthritis pain with or without steroid. The addition of steroid provides

on the assessment and treatment of all forms of dizziness, for that please see the external resources section below. The aim is rather to provide a basic

See reviews by Tofts et al, Colombi et al, and Kumar et al Generalised Joint Hypermobility Hypermobility Spectrum Disorder or Hypermobile Ehlers Danlos

enthesis (plural entheses) is the interface between tendon/ligament and bone. See also about the myotendinous junction, the connection between muscle and tendon

more than 2 cm behind the posterosuperior corner of the S1 vertebral body See Huec et al for a free open access article on this topic, from an orthopaedic

Ulnocarpal stress test ECU subluxation 1st CMC OA – CMC grind test, shuck test, see progressive adduction with hyperextension A consensus approach to the MSK

This article is a stub. From Manchikanti Main article: Lumbar Radicular Pain In 1993 Nitta et al looked at dermatome patterns by doing fluoroscopically

This article is a stub. Bone consists of two forms: woven and lamella Woven and lamellar bone are organised structurally into trabecular (spongy or cancellous)

This article is still missing information. The auriculotemporal nerve is a branch of the mandibular nerve (V3) that runs with the superficial temporal

This page or section deals with a topic that is not widely recognised or accepted. Please use your clinical judgement and note that this is not necessarily

impact on diagnostic error, as premature closure can lead to misdiagnosis (See Diagnosis). Aleatoric uncertainty is chance uncertainty. It includes uncertainly

This article is a stub. Coronal balance is one of the features that needs to be assessed on long spine radiographs obtained for spinal deformity, particularly

into 1-3 ascending branches which nearly reach the superior nuchal line. See Kim et al for a review of the anatomy The third occipital nerve can be blocked

the stability and functionality of the overall musculoskeletal system. Also see closely related article Fibrous Connective Tissues. Fascia is distinct from

This article is a stub. Infection, uncontrolled coagulopathy, joint prosthesis, poor response to previous injections. Allergy to eggs or feathers is a

This article is still missing information. The peroneal tendons are located in the lateral compartment of the leg behind the lateral malleolus. Peroneus

discussed knee biomechanics, for a discussion on the anatomy of the joint see Knee Joint. The knee motion is more complex than a simple hinge. The contours

approach to weakness. The examination of the motor system is covered elsewhere (See Motor System Examination) When evaluating weakness the following distinction

circumferential lost of perineural fat signal with compression of the nerve root See also: Radicular Pain and Radiculopathy Radiculopathy occurs when conduction

This article is still missing information. Report writing is the process by which the clinician summarises the salient features of the patient's condition

This article is a stub. Physical inactivity is a primary cause of most chronic diseases, including musculoskeletal diseases. The components of an exercise

This article is a stub. The ischiofemoral space is bounded by the ischial tuberosity medially, the lesser trochanter of the femur laterally, the femoral

section deals with a controversial topic. Please use your clinical judgement. See Hauser et al for a free open access systematic review from 2016.The most commonly

This article is still missing information. This article deals with the treatment of lumbar facet joint pain when diagnosed by a precision diagnosis technique

from the muscle filaments to the collagen fibres of the adjoining tendon. See also about entheses, the connection between tendon/ligament and bone. Muscles

evidence to support the use of medicinal cannabis in Musculoskeletal Medicine. See Cogan for a recent cutting open access review on the controversies of this

This article is still missing information. This page or section deals with a topic that is not widely recognised or accepted. Please use your clinical

This article is still missing information. The intertarsal joints include the three cuneonavicular joints, the intercuneiform joints, the cuboideonavicular

This article is still missing information. Intrapartum injuries to the lumbosacral plexus generally involve the lumbar part of the plexus. This is due

This article is still missing information. Main article: Ankle Joint Anatomy The ankle joint, or tibiotalar joint, is a hinged synovial joint. It is created

This article is a stub. Conus medullaris syndrome is caused by injury to the conus medullaris and lumbar nerve roots. It is a subset of the Incomplete

cranial dorsal root, and spread to the intermediate and lateral branches. See Kimura et al for a free open access article on the technique. The lumbar dorsal

supply to the buttocks. This article covers inferior cluneal nerve entrapment. See also the more common superior cluneal nerve entrapment, as well as middle

discussion of the clinical syndrome and the anatomy are discussed elsewhere (See Lateral Femoral Cutaneous Nerve Entrapment and Lateral Femoral Cutaneous Nerve

such as the MMP family, whose expression is controlled by various cytokines (see Fibrous Connective Tissues, and Synovial Joints). Osteophytes are simply adaptive

Weakness Facioscapulohumeral Dystrophy Proximal Weakness Myotonia Congenita See more Small Fibre Neuropathy Sodium Channelopathies Channelopathies and Chronic

This article is still missing information. This article describes some important concepts for the safe and effective use of spinal needles during fluoroscopic

This article is a stub. The biomechanical problems in those with rotator cuff tendinopathy and those with subacromial pain syndrome are fundamentally the

This article is still missing information. TMC joint injection may be indicated with failure of first line treatments to treat chronic pain e.g. fromosteoarthritis

to as adhesion molecules. They bind chondroblasts to type II collagen. We see an interaction between the cells that produce the matrix and the matrix components

judgement and note that this is not necessarily standard practice in NZ. See open access review by Henderson et al. Henderson et al.. Neurological and

Written by: Dr Jeremy Steinberg – created: 12 March 2023; last modified: 23 March 2023 This article is still missing information. Primary erythromelalgia

This article is still missing information. The extensor hood stabilises the extensor tendon at the MCPJ, whereas the dorsal extensor apparatus stabilises

This article is still missing information. This article discusses the prostanoid biosynthesis pathway and cyclooxygenase enzymes. It is relevant to the

This article is still missing information. Achilles tendon injuries are a common problem in both active and sedentary individuals of all ages. There are

This article is still missing information. Greater femoral trochanteric bursa injections under ultrasound-guidance ensures the injectate is accurately

This article is still missing information. Long head of biceps brachii (LHB) tendon sheath injections under ultrasound-guidance ensures accurate delivery

This article is still missing information. Articular nociceptors are primary afferent neurons that innervate the joints and signal noxious stimuli. In

extremities. The ball and socket configuration allows for stability and mobility. See also: Hip Joint The acetabulum is not completely spherical due to the acetabular

chronic pain, especially Neuropathic Pain and Nociplastic Pain. See also Numbness. See also: Nociception Peripheral transmission follows transduction.

have a very short wavelength which gives it certain properties. You can't see it, it passes through things, and it ionizes all matter. In a biological system

This article is a stub. Autism spectrum disorder (ASD) is a developmental disability characterized by social and communication impairments, restricted

This article is still missing information. Joint mobilisation refers to a therapeutic passive motion of a painful or dysfunctional peripheral or axial

This article is still missing information. Reduced mineralisation of bone matrix (osteoid) is the cardinal feature of all osteomalacic syndromes. Rickets

This article is a stub. Lidocaine was the first clinically used amide local anesthetic in 1948. It is widely used because of its potency; rapid onset;

This article is still missing information. Hyperkyphosis, an excessive curvature of the thoracic spine, is a condition that primarily affects older adults

other C5-innervated muscles, with also a spread to C4 and C6 muscles (Also see Deep Somatic Pain). Twitch Response: A local twitch response can occur which

movement e.g. from contractures and joint disease), and strength testing. See the article on the myotomes for the segmental innervation of the muscles The

ability of the body to resorb the calcific deposits with corticosteroid. See open access review by Catapano an colleagues. Tendoninopathy Myotendinous

cause is found), family planning, and participation in clinical trials. (See also Diagnosis) Overseas there are many sponsored genetic testing programs

This article is still missing information. Postisometric relaxation (PIR) combines manual medicine and self-rehabilitation. It is a technique that treats

This article is still missing information. A rare disease is a condition that affects fewer than one in 2000 people. It is often reported that there are

This article is a stub. The atlas (C1) sits on the axis (C2) and the wear is borne through the lateral antlanto-axial joints. Apart from its weight-bearing

retrieved data. The medical history is complemented by the physical examination. See also the article on diagnosis. One view of goal of medical history taking

supply to the buttocks. This article covers middle cluneal nerve entrapment. See also the more common superior cluneal nerve entrapment, as well as inferior

least 300 conditions that can cause lower limb neurogenic and referred pain. See the article below for a summary. JA Louw. The differential diagnosis of neurogenic

This article is still missing information. Cervical Pain Maps for Medial Branch Blocks C1-2 C2-3 C3-4 C4-5 C5-6 C6-7 C0-3 Blank Grid Probabilities C1-C4

This article is still missing information. Paracetamol is a commonly used analgesic and antipyretic. In 1852 Anilide was acetylated to Acetanilide. The

compounding pharmacies There are many other studies that have been done, please see Obara et al. There is also research into the use of H3 antagonists as analgesics

medication and other individuals no medication. The researcher then looks to see how the blood pressure changes after receiving the new medication and performs

microdiscectomy. (See Lumbar Radicular Pain) Treatment for cervical radicular pain has included conservative therapy, transforaminal steroids, and surgery. (See Cervical

inability of the muscle to relax normally and are generally myogenic in origin. See also Leg Cramps. Muscle cramps are thought to arise from spontaneous ectopic

Written by: Dr Jeremy Steinberg – created: 3 March 2022; last modified: 17 April 2022 This article is still missing information. There is little research

This article is a stub. Electromyography (EMG) is the study of motor unit and muscle fibre electrical activity. They can be studied individually or collectively

This article is still missing information. Massage: There is very low to low quality evidence of benefit but it is not clinically meaningful (-0.6 to -0

This article is still missing information. The administration of local anaesthetic can be painful. There are many factors that influence pain. These are

Written by: Dr Jeremy Steinberg – created: 17 September 2021; last modified: 17 April 2022 This page is probably complete! It is awaiting peer review Bogduk's

cases are unknown), The sources of chronic low back pain are largely known (see Causes and Sources of Chronic Low Back Pain). History and examination are

infiltration, and so should not distend significantly with injection. If you see significant bugling then you are not in the correct plane. Infection is an

afterwards. This is called exercise induced hypoalgesia (EIH). Typically we see reduced pain sensitivity both close to the exercising muscle (local EIH),

This article is still missing information. Obesity is associated with lower limb and hand osteoarthritis, chronic pain, and disability. The rates of obesity

This article is a stub. Somatic referred pain is pain perceived in a region innervated by nerves coming from somatic structures other than those that innervate

This article is still missing information. The ligaments that surround the ankle act to limit plantarflexion and dorsiflexion, anterior and posterior movement

Written by: Dr Jeremy Steinberg – created: 23 August 2021; last modified: 17 April 2022 This page is probably complete! It is awaiting peer review Allodynia

This article is still missing information. Injection treatment of the ganglion impar with local anaesthetic with or without corticosteroid is a procedure

modern investigations, while ignoring the copious literature to the contrary. See Non-Specific Chronic Low Back Pain for complete discussion on this topic.

e. you are testing the toe phase of the stress-strain curve (see biomechanics below). See also: Fascia Irregular fibrous connective tissue is designed

discusses knee joint anatomy. For a discussion on biomechanics of the knee see Knee Biomechanics. The knee joint contains four bones: the femur, tibia, patella

in frequency with advancing age. Trauma This may be the most common cause (see epidemiology section for audit data). It mostly occurs by lifting in flexion

The structures are involved in anchoring the skin to the palm of the hand. See this video for a review of the anatomy. The patient may report difficulties

This article is still missing information. There is clear evidence that opioids are not effective for long term chronic non-cancer pain. In fact, patients

This article is still missing information. Rotator cuff calcific tendonitis can be treated with various techniques including ultrasound-guided barbotage

This article is a stub. See Cervical Pain Maps Cervical Discogenic Pain - Peng and Bogduk 2018 - 344 KB (f)

involves placing a needle through the sacral hiatus to reach the epidural space. See also: Sacrum, Coccyx The sacrum has five fused vertebrae and has a dorsal

Written by: Dr Jeremy Steinberg – created: 22 August 2021; last modified: 27 April 2022 This article is still missing information. Musculoskeletal examination

This article is still missing information. Measurement of LBP includes prevalence (the presence at any point in a defined period), the incidence of symptoms

leg is a non-specific finding In all subjects, pain abolished by lignocaine See also: Lumbar Medial Branch Blocks Lumbar zygapophysial joint pain cannot be

This article is a stub. See blog post Lateral ‘hip’ pain? Don’t always blame the glutes

acetabular anteversion. Acetabular version can vary greatly with pelvic tilt. (See Hip Radiograph) Labrum: The labrum is a fibrocartilaginous lip that encircles

imagining/making up your symptoms/going crazy.” Emphasize that it is common. “I see lots of patients with similar problems.” Emphasize reversibility. “Because

discussion of injection treatments and the anatomy are discussed elsewhere (See Lateral Femoral Cutaneous Nerve Injection and Lateral Femoral Cutaneous Nerve

lateral malleolus. Also assess for head alignment and spinal curvatures. (See also sagittal balance of the spine) In the coronal plane the line should bisect

is also variation to what is "normal" for the lumbar spine. With aging you see fairly uniform changes in the lumbar spine, and so normality changes with

(f) ESSR Knee Guidelines - 1.34 MB (f) ESSR Ankle Guidelines - 2.82 MB (f) See recommended terminology here.

2019.pdf - 1.12 MB (f) Unusual pain disorders - Sachau 2021.pdf - 1.7 MB (f) see section on SMD Literature Review Reviews from the last 7 years: review articles

post COVID event. This is a diagnosis of exclusion. On biopsy you should see primary inflammation , i.e. inflammatory cells invading the muscle fibres

This article is still missing information. Internal disc disruption is a condition that affects lumbar intervertebral discs and is the cause of pain in

cord segments. This article covers visceral and somatic referred pain. Also see the article on radicular pain which is a type of referred neuropathic pain

already on opioids there is no worsening of pain with ceasing their use. (See Opioid Deprescribing). Furthermore, there is no benefit compared to NSAIDs

discontinuity of a load-bearing tendon that can be partial or complete. Also see article on Calcific Tendinopathy, which is a different disease process. Tendinopathy

(common palmar digital, proper palmar digital) deep Median nerve (medial root): see above posterior cord subscapular (upper, lower) thoracodorsal axillary (superior

fluid as possible Send: cell count, culture, gram stain, crystal analysis See joint-specific page for procedures Arthrocentesis: shoulder Arthrocentesis:

This article is still missing information. A variety of radiofrequency procedures have been developed for the treatment of proven sacroiliac joint pain

This article is still missing information. A variety of radiofrequency procedures have been developed for the treatment of discogenic pain. An ongoing

suggested by the "C-sign", "deep pointer sign", or "coordinate fingers" (see Figure 1) Ahuja, Vanita; Thapa, Deepak; Patial, Sofia; Chander, Anjuman; Ahuja

patient cutting multiple nerve roots above to determine the superior border. See Downs et al on the history of dermatome maps. Bolk 1898 and Herringham 1886

with Prostaglandins and Cyclooxygenase Enzymes. All NSAIDs, except aspirin (see below), act as competitive reversible inhibitors of COX, thus reducing the

posterior abdominal wall, in which case the pain is not truly referred in nature. See also: Lumbar Pain Maps, Sacroiliac Pain Maps Somatic referred pain is referred

(common palmar digital, proper palmar digital) deep Median nerve (medial root): see above posterior cord subscapular (upper, lower) thoracodorsal axillary (superior

This article is still missing information. Several tests are used to assess a variety of parameters under the DNS concept: Compare individual postural

5 mSv. The additional cancer risk is based on the age of the individual. See XrayRisk.com The second hazard is creating a false sense of security. For

or there are contraindications then CT or CT myelogram are alternatives. See McNamee et al for an open access review of imaging. MRI can assess for cauda

classified based on their diameters, conductivity, and myelin properties. See table below. The largest Aα muscle afferent fibers are sometimes classified

wall and upper limbs (see Thoracic Pain Maps). The lower thoracic segments may refer to the lumbar spine and gluteal region (see Superior Cluneal Nerve

Meralgia paraesthetica Snapping Hip Syndrome Proximal Iliotibial Band Syndrome See complete list Medial pain Hip Osteoarthritis Adductor Related Groin Pain Nerve

that can occur from AC joint overload or less commonly from direct trauma. See also: Shoulder Biomechanics The clavicle is an S-shaped bone. The medial growth

point. Some practitioners bend the needle to allow for easier manipulation. (See Needlecraft for Fluoroscopy) Injection Connect a low volume extension tube

common cause of chronic heel pain, with a lifetime prevalence of up to 10%. See also: Foot and Ankle Biomechanics The deep plantar fascia, also known as the

This article is still missing information. See also: Tibiotalar Joint (Talocrural Joint), Foot and Ankle Biomechanics For stability the anterior talofibular

cancellous bone and the haversian canals. Within necrotic cancellous bone we see the production of osteoid on the scaffolding of the necrotic trabeculae. The

and strengthen the calf muscles daily. A separate trial compared wait and see versus heel raise inlay versus calf strengthening for 10 weeks and found no

menopause, fluoroquinolone antibiotics Main article: Hamstring Examination See also: Tendinopathy Reduce compression (excessive hip flexion) and energy storage

(common palmar digital, proper palmar digital) deep Median nerve (medial root): see above posterior cord subscapular (upper, lower) thoracodorsal axillary (superior

however in the long term cessation may be beneficial. Patience may be needed to see the benefits of smoking cessation on pain. and some of the harmful effects

the scalene and pectoralis minor muscles, and Cardiovascular conditioning See video lecture on method here, which is part of channel with multiple other

biceps tendon, surrounding neurovascular structures and articular cartilage. See also: Shoulder_Biomechanics#Glenohumeral_Joint The glenohumeral joint is a

(common palmar digital, proper palmar digital) deep Median nerve (medial root): see above posterior cord subscapular (upper, lower) thoracodorsal axillary (superior

of chronic post-traumatic neck pain because there is a proven treatment. See also: Category:Cervical Spine Anatomy The cervical disc are very different

information is highlighted, and this is called centre-surround inhibition (see Nociception) Suppression occurs with global stimulation of brainstem nuclei

The causes of radicular pain and radiculopathy are discussed elsewhere (See Lumbar Radicular Pain). The exact figures depend on the age (figure 1), but

disk There is significant motion at the ACJ during elevation of the humerus.(See Shoulder Biomechanics). Teece, Rachael M.; Lunden, Jason B.; Lloyd, Angela

Meralgia paraesthetica Snapping Hip Syndrome Proximal Iliotibial Band Syndrome See complete list Medial pain Hip Osteoarthritis Adductor Related Groin Pain Nerve

neurology practice. There are at least 15 different diagnostic criteria. See below for an example from the European Federation of Neurological Societies

"cervical spine." Acute pain: Pain <3 months Chronic pain: Pain > 3 months See also: Cervical Radicular Pain, Radicular Pain and Radiculopathy Definition

This article is still missing information. See Drakos et al for a brief review. First MTPJ integrity is related primarily to the joint capsule, collateral

well-defined calcified zone, tidemark, and closure of the epiphyseal plate. See also: Fibrous Connective Tissues, Synovial Joints Water content: increased

Pain Medicine Case Reports BMJ case reports Journal PM&R visual vignettes See Clinical Reasoning Articles for clinical reasoning practice. Patient Links

dexamethasone was injected. Cervical Retrolaminar Injection - Members Subpage See closed access article Hochberg et al.. A New Solution to an Old Problem: Ultrasound-guided

pronator muscles) but the validity of the MRI findings is controversial See Rinkel et al for a somewhat recent systematic review of the effectiveness

chronic cases can be challenging. A groin nerve block can be beneficial (see Ilioinguinal and Iliohypogastric Nerve Injection) with breaking the pain cycle

arm of the quadriceps. This leverage generates high joint reactive forces (see https://orthopaedia.com/page/Patellofemoral-disorders). As such, patellar

the greater trochanter, and (c) insertion sites for the abductor tendons See also: Tendinopathy Historically lateral hip pain was thought to be exclusively

(common palmar digital, proper palmar digital) deep Median nerve (medial root): see above posterior cord subscapular (upper, lower) thoracodorsal axillary (superior

specific itch receptors on peripheral nerve endings in the skin, unlike what we see with pain. It is thought that there may be such receptors in second order

common peroneal nerve is at risk for injury with proximal fibula fracture (see Figure 2). The extrinsic muscles of the foot originate in the lower leg. These

findings have to be differentiated from other conditions, see the differential diagnosis section. See a 2017 review of the classification criteria by Kuperus

A new less invasive technique known as Hansen repair has been described See a video of the technique here, and a webinar by Dr Hansen here. Vertical rib

tibial artery and vein, and tibial nerve all run through the tarsal tunnel. See cadaver videos: hereand here The tarsal tunnel is a tight space and so any

ventral aspect of the lumbar plexus. B: dorsal aspect of the sacral plexus. See abbreviations Lumbosacral Plexus Nerve Type Plexus Origin Lumbar Plexus: T12-L4

groups based on their exposure status. Cohorts are followed over time to see who develops the disease in the exposed and non-exposed groups. Cohort studies

tendinopathies of the midfoot are extensor and tibialis posterior tendinopathies. See Foot Pain Differential Diagnoses The injury was assessed as grade 2 by Nunley

this ring and run parallel to the femoral neck to feed the femoral head, see Figure 4. Healing of femoral neck fractures can be compromised by the lack

in pain that is unresponsive to other measures - NSAIDs, physical therapy (See Tendinopathy Management), time, etc. Joints Chronic inflammatory joint disease

reduces the normal range to 37.5°. Craniocervical flexion test (CCFT) (also see this video) Lie the patient in supine crook lying position with the head in

Before purchasing expensive rocker shoes a darco wedge shoe can be trialed to see if this approach will help. For patients with minor calf shortening but a

by the “too many toes” sign. This test is positive if the practitioner can see more than the fifth and part of the fourth toe. Inspection and palpation over

treatment is often required. The olecranon is the proximal-most part of the ulna (see Figure 1). The coronoid process anteriorly and the olecranon posteriorly together

people-year) = 0.00026 cases/people-year = 0.26 cases/1000 people-year We can see then that with either method we arrive at the same answer of 0.26 cases/1

injections, piriformis tenotomy, and sciatic nerve release. See review by US physiotherapist here See Marin et al for a recent open source review Closed access