Introduction: Piriformis syndrome (PS) is a neuromuscular condition with a special combination of several characteristic manifestations mainly highlighted by gluteal pain(1). Others may involve pain in the lower back area down to buttocks, paraesthesia, numbness and limitations to some weight-bearing activities like walking for long periods, standing and sitting to some degrees(1-5). Other symptoms may also include: the sciatic notch tenderness, swelling, sexual dysfunctions and splayfoot with a dominant external rotation in supine lying indicating tightness of the muscle(6). In general, four primary manifestations had the highest tendency to be found as was reported by a recent systematic review. These include: posterior buttock pain, increased sciatica symptoms with sitting, tenderness over the greater sciatic notch and positive results of Piriformis muscle tension tests
She has elbow range of motion actively from 15 to 150 degrees. She is exquisitely tender to touch throughout the medial elbow and distal forearm. There are some trophic skin changes consistent with her diagnosis of complex regional pain syndrome. She has subtle weakness of the intrinsic function in her hand. There is a 2 point discrimination of 8mm and ulnar nerve distribution, 4 mm in the median nerve distribution.
Pain is located in the low back and left leg, rated as 4/10. There is associated numbness to the left thigh and foot, and pins and needles sensation to the left foot. He continues with Percocet with 80% help with use. CURES was very consistent and appropriate.
Range of motion is limited with flexion and extension of 20 degrees limited by pain. Spurling test is positive. Sensation is diminished C5-C6 bilaterally. Diagnoses are cervical strain, bilateral C5-C6 cervical radiculopathy, and diminished sensation, C6 reflex bilaterally.
This is a 42-year-old female with a 2/7/2015 date of injury. A specific mechanism of injury has not been described. DIAGNOSIS: low back pain; Lumbago with sciatica right side; Myalgia 12/01/15 follow-up visit identified lower back pain. Patient rates the pain as 7/10. The pain is characterized as burning.
This article presents a case report about a 31 year old male patient, a teacher at a university, who started experiencing mid back pain after weightlifting one day.3 About 3 hours after weightlifting, the patient began to feel sharp back pain, at levels T4-T8. His pain began to worsen that night causing muscle spasms of his paraspinal muscles, with intermittent radiating pain to his lateral thorax and chest.3 This patient had been diagnosed with thoracic facet injuries in the past, and just assumed it was that.3 However, after the pain did not subside the patient went to his physician who claimed the patient was just having muscle spasms and needed myofascial release.3 However, a radiograph was also done that revealed end plate degenerative changes at T7-T8.3 The patients clinical evaluation revealed muscle spasms of the paraspinal muscles between T3-T12, tenderness to palpate between T6-T8, full shoulder ROM, 5/5 shoulder muscle strength, and normal distal pulses and sensations.3 The patient was diagnosed with thoracic pain and muscle spasms and was give muscle relaxants and exercises for myofascial release.3 Three days after the physician visit, the patient decided to do some walking, to work on his cardio, and experienced mild shortness of
She states that the pain is progressively getting worse. Objective findings revealed pain in the lumbosacral region, more in the sacroiliac joint. Positive findings on fortin finger flexion test. There is limited lumbar flexion. The patient is subsequently diagnosed with lumbar sacral spondylosis; sacroiliac joint arthritis; and low back pain.
Symptom Characteristics Pre-surgery, Susie suffered from numb toes and pain down her leg, post-surgery Susie lost the use of her legs and suffered from extreme pain in her legs and hip and numb lower legs. Pre-surgery her symptoms are an annoyance and post-surgery she was in a wheelchair and unable to walk or stand, drive and work. She suffered 24/7 with pain and medication only briefly lessening the pain. 6. Conceptualization of disease: The 5 components a.
There is a 4.5mm generalized disc bulging and redundancy of the disc annulus with impingement of existing L5 nerve roots at neural foraminal level, right greater than left. Per the medical report dated 09/29/16, patient complains of back pain, rated as 8/10, radiating to both lower extremities, worse with standing and walking. Per the medical report dated 11/10/16, the
SI joint field ache could or will not be in reality coming from the SI joint. It usually is strictly established on this discipline (the buttock) or it should radiate down the leg reasonably. It could be burdened with myofascial style discomfort within the paraspinal muscle tissues, piriformis, or gluteal muscle mass. Different sufferer issues that can mimic SI joint affliction include intervertebral discs which have tears in the outer element (annulus), or possibly arthritic and painful aspect joints that have ache that radiates into the buttock vicinity. All of those can cause cause suffering to appear in the equal field, as a result, deciding the special pain generator(s) can take some critical intellectual gymnastics.