Introduction PIVD stands for prolapsed intervertebral disc. It occurs due to the outgrowth of the disc. This outgrowth is the nucleus pulposus that seeps through a shred in the annulus fibrosus. It is also called slipped or herniated disc. It occurs in four stages: 1. Bulging: initially, when the disc cannot get back to its original state, after being stretched and retains a tin bump at one end of the disc. 2. Protrusion: post bulging, the bump becomes very prominent and the substance starts to spill out of the disc. 3. Extrusion: the jelly (nucleus pulposus) has entirely spilled out and is sticking out of the fibres. 4. Sequestration: the material strats breaking off and moves in the surrounding area. Anatomy PIVD is a pathology allied …show more content…
The pain in and around the vertebrae can occur due to skeletal anomalies such as inflammation and degeneration. The thoracic discs are barel affected because of PIVD, the upper two cervical space, coccyx and sacrum do not contain any disc. So, they aren’t at risk. The causes of PIVD vary depending upon age, heredity and lifestyle. It can be caused due to birth defects, during adolescence, over stretching in sports, extensive manual labour, weight lifting, obesity, prolonged sitting etc. Clinical features The signs and symptoms of disc herniation can range from mild to severe pain in areas like neck, shoulder, lower back, etc even radiating to the arms, legs and even the chest. Cervical disc herniation is majorly responsible for numbness, pain and weakness in the neck, head, arms, shoulders and hands along with a tingling sensation. While lumbar disc herniation affects the lower back along with dull or shooting pain in the buttocks, thigh and groin by dint of the perennial nerve. This will further radiate to the foot. If the sciatic nerve gets affected, it leads to sciatica. When the femoral nerve gets affected, it causes a numb and tingling sensation in both lower limbs. Diagnosis and …show more content…
Forward flexion test: to check if there’s radiating pain or not 5. Hyperextension test: to check if there’s lumbar strain 6. To palpate if there’s tenderness 7. Gluteal stretch: to check if the piriformis is affected 8. Femoral stretch test: to check if the nerve is impinged 9. Gait pattern: I. Due to conditions like spasticity and contractures the hip range of movement decreases and causes the hip to slightly excessively flex during the gait cycle.\ II. Due to hip abductor weakness, the patient acquires trendelenburg gait. Imagery diagnosis 1. X-ray: it done to check if theres a decrease in height of the disc, sclerosis, hypertrophy, etc 2. CT-scan: it gives a detailed and more elaborate anatomic view of the spine 3. MRI-scan: it helps in detecting the cuts and tears through multiple tissue layers 4. EMG study: detects whether a nerve is impinged or not Treatment Medical management • OTC drugs: medicines that are safe to be take without prescription, if the pain is shooting/excruciating For example: ibuprofen, naproxen, etc • Narcotics drugs: to produce analgesic effect. Example: oxcodone • Nerve pain medication: pain relievers and anti depressants, to reduce nerve pain. Example: gabapentin, pregabalin, tradamol,
An MRI was performed of the lumbar spine. The examination found no significant extra
Patient denies any complications and new complaints associated with epidural steroid injection procedure; however, he states that approximately 5 days after the injection procedure, he felt a sharp shooting pain down the posterior aspect of both legs to the feet to the feet when lying on his back with his feet on the floor. Otherwise, he reports ongoing axial lower back pain and weakness with no significant radicular symptoms at this time. He reports only mild relief with use of over-the-counter ibuprofen. In addition, he reports of moderate pain located at the low back which describes as an aching, continuous and sharp pain. He rated his pain as 5/10 in severity at the time of visit.
2. EMG/NCV studies consistent with peripheral motor and sensory neuropathies, from October 2008 12/15/15 Progress Report described that the patient has ongoing low back pain. He was last seen on 10/28/15. The patient stated that his current medication regimen has been helpful. He rated the pain 9/10-scale level, which is brought down to 6/10-scale level with the medications.
QEP Scripts for Two Recordings – Audio for Musculoskeletal System; “OK, Team! We have a new patient in Room 3B who is being admitted with a progressive (gradual, advancing) decrease in mobility (movement) of his back and legs, and increase in pain located in the lumbosacral (lower back above the tailbone of the spine) area. The patient’s Primary Care Provider has sent along Computed Tomography scans (CT, a rotating x-ray emitter, detailed internal scanner) showing spinal stenosis (narrowing of the spine causing pressure on the nerves and spinal cord causing lower back pain.) and decrease of the normal lordosis (abnormal curvature lower spine, excessive inward curvature of the spine) in the thoracic vertebrae (upper and middle back). Lumbosacral
Sacroiliac joint dysfunction is found in 15 to 30% individuals with low back pain.1 Sacroiliac joint dysfunction can be a result of acute trauma, heavy lifting, prolonged bending, torsional strain, fall on to the buttocks and motor vehicle accidents. Chronic and repetitive shear or torsional forces associated with sports like golf, bowling, skating may also result in sacroiliac joint dysfunction. Prolonged sitting or lying on the affected side, more weight bearing on the affected side during walking or standing, forward bending with knees extended may also predispose a person to sacroiliac joint dysfunction.3 Mechanism of dysfunction: Dysfunction occurs mostly when a person lifts something in a forward flexed position or stands in lordotic posture. Due to this, line of gravity shifts anterior to the acetabulum which creates rotational force in extension around
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.
Per pulmonary function tests, his condition was stable. Degenerative disc disease lower back and neck, lower back pain. Degenerative joint disease right knee. Right and left knee scope in 2008, right knee scope in 07/2010, decreased range of motion bilateral knees. Independent with activities of daily living.
Ami Brown of Alaskan Bush People has been dealing with a health issue and now Ami is actually sharing what is going on with her. Radar Online spoke exclusively with Ami and she shared the details of what is going on with her health right now. Her husband Billy Brown has been dealing with a bit of health issues as well as it was recently shared that he is having seizures. Things have been rough on Ami Brown recently and she has been dealing with a lot of pain in her neck and back. Now Ami Brown is finally sharing exactly what is going on with her health after seeing the doctor.
They can also do a physical exam to check for your areas of tenderness and range of motion. Your doctor may advise you an X-ray to ensure your pain is not linked to any other kind of injuries or degenerative ailments like arthritis. Other tests, such as magnetic resonance imaging (MRI) and computed tomography (CT) scans will let your doctor to check any inflammation or damage of the soft tissues, spinal cord, or
His doctor recommended the applicant to have acupuncture and physical therapy. He said that there has not been any discussion of surgeries or injections. He takes Naprosyn three times a week. He claims that he began having radiating pain into his knee since he started treating at Southland Spine. He claims this pain occurs three times per month.
Overuse can also result from powerful activities involving either forward moving or sitting and continuous activity of the lower limbs like running or bicycling especially with lack of stretching and strengthening exercises. In these cases, impingement of the sciatic nerve is a high possibility especially in conditions where the Piriformis size is increased by 40%. Some studies have shown some involvement of the Pedundal nerve as well presented with symptoms of incontinence in addition to groin tingling and numbness(13). Furthermore in advanced case, unilateral weakness of several hip muscles supplied by nerves arising from the sacral plexus (e.g. Gluteus Maximus, Medius & Minimus, Tensor Fascia Lata and Quadrates Femoris) was associated with chronic stages of Piriformis syndrome. This could explain the decreased internal rotation range of motion in ipsilateral hip joint with increased severity and continuity of the
Introduction Kyphosis is a spinal disorder involving an excessive outward curve that causes an abnormal rounding of the upper back. It occurs when the spinal bones (vertebrae) in the upper back (thoracic spine) become wedge-shaped and cause deformity. Kyphosis is sometimes called dowager's hump, hunchback, or roundback. It is most common among elderly people, but can happen at any age. There are four main types of kyphosis: Postural kyphosis.
Further testing of undiagnosed neck pain can include X-ray evaluation, CAT scan,
Our spine is one of the delicate organ of nervous system, as it protects the central nervous system of human body, as well as the main support for the body to stay upright. It comprises of small bones placed one over the other which provides flexibility for movement. The upper part of spine is terminated in the skull. This region where the spine is attached to the skull is called the cervical region or neck. Pain in the neck or cervical pain is one of the diseases that are found very often in the entire world.