Piriformis Syndrome Case Study

Unfortunately, I have experienced the most common form of back pain, sciatic nerve pain. OUCH! The sciatic nerve is the longest nerve in the body (1) and is comprised of two nerves, “tibial and common fibular—bound together by a common sheath of connective tissue. It splits into its two divisions, usually at the knee. Injury to the sciatic nerve results in sciatica, pain that may extend from the buttock down the posterior and lateral aspect of the leg and the lateral aspect of the foot” (1). Sciatic pain has a range, “from a mild ache to a sharp, burning sensation or excruciating pain. Sometimes it can feel like a jolt or electric shock. It can be worse when you cough or sneeze, and prolonged sitting can aggravate symptoms. Usually only one side of your body is affected” (2).

On examination of the back, there is tenderness upon palpation midline of the lower lumbar and sacral region. Posture shift is to the left.

I have not been able to participate in athletics nearly as much as I would have liked. I started running track in the spring of my seventh grade year. I performed surprisingly well and decided to participate in cross country the next fall. I spent the summer training and preparing for the season, and it definitely showed. I ran in the varsity race for my first cross country meet ever. I was an eighth grade girl who was running the same workouts as the junior and senior boys. My team won the conference meet and I won all conference honors. We went on to place second at the section meet, which earned us a place at the state meet. I earned all section honors myself and missed going to state as an individual by only a few places. At the state meet,

The patient has completed physical therapy, time, rest, medications, chiropractic care, and acupuncture with no alleviation of the pain. Significant pathology on the MRI is noted with degenerative disk disease, neural foraminal stenosis and a nerve root impingement in the cervical spine.

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

As per office notes dated 7/19/16, the patient complains of chronic low back pain at the localized curvature. There is radiating pain, which is increased since the fall. There is limited range of motion. Pain is exacerbated with walking, standing, and sitting. The patient had post lumbar surgery on August 2015. 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. Treatment plan includes diagnostic bilateral sacroiliac joint injection under ultrasound guidance. Then if the patient received good relief, then she is to proceed with sacroiliac joint radiofrequency ablation. A course of physical therapy would be appropriate since she has not had any physical therapy for increasing range of motion since her surgery 8/4/2015. Plan also includes weaning off opioid

whether or now not you lead a bodily energetic subculture, a sedentary one, or someplace in between, you might frequently understand how important it is that your knees be functioning comfortably and be soreness free. The knees absolutely serve plenty of capabilities. Not completely do these endure the load of the physique; the knees are additionally essential for almost any movement. As such, it comes as no surprise that knee joint agony is a typical predicament, experienced by means of contributors of all a while, sizes, and origins.

The patient used a four poster walker after the spinal surgeries in 2010 and then graduated to a cane after hardware removal in late 2012. He is now taking Norco 5 mg 4 times daily. He has not had any physical therapy in the last two years and does not recall being given home exercise program from physical therapy. He is not doing home exercises. He has not had any epidural steroid injections and chiropractic treatment for the last two years. He does have a TENS unit, which he uses intermittently. As of this report, the first surgery helped him 10%, and the second surgery had no benefit. On examination of the lumbar spine, standing range of motion is 20 degrees. Straight leg raising is 80 degrees on the right, and 90 degrees to the left. There is diminished right heel/toe walking/raising. Patient is only able to do heel-to-toe raising about 0.25 inch off the ground. His gait is broad based. Tandem is not possible. He uses a cane. There is an obvious limp. During examination, he leans to the left to unload the right side and fidgets and changes positions every 5-10 minutes. Hip exam shows positive Patrick’s test and trochanteric percussion on the right. Knee reflexes are 1-2. Ankle reflexes are absent. Motor shows 4/5 weakness, 60-80% of normal, in the right

This is a 63-year-old male with a 10/06/1978 date of injury. He fell between two walls and injured his left knee.

The patient can perform the following activities but it always caused pain: lift heavy items; grasp items; sleep; and sit for prolonged periods.

These provide proprioceptive information on movement as the skin is stretched at various points along the ROM (Gregg 1994 p15 ass)

It was also noted that the office will give a new lap slip. It was also noted that the patient is scheduled for a repeat caudal epidural steroid injection. Physical examination revealed that the cervical spine has decreased range of motion; tenderness to palpation at the paraspinal muscle; spasm at the bilateral cervical trigger point, bilateral trapezius rigger point, and bilateral rhomboid trigger point. There is also bilateral tenderness to palpation of facet joints C5-C7, positive Spurling’s test, foraminal compression test. Physical examination of the lumbar spine revealed decreased range of motion on all planes; tenderness to palpation at the lumbar paraspinous area; tenderness to palpation over the lumbar spine; bilateral straight leg raise; bilateral knee extension weakness, bilateral lumbar radicular sign, and spasm noted. Assessment includes spondylosis without myelopathy or radiculopathy, lumbosacral region; radiculopathy, lumbar region; cervical disc disorder, unspecified, cervicothoracic region; radiculopathy, cervical region; other cervical disc displacement, unspecified cervical region; other cervical disc displacement, lumbar region; testicular

On examination of the cervical spine, there is tenderness at the left paraspinal. Palpation revealed left-sided muscle spasms.

Plantar flexors strength is 5/5 on the left, diminished and with pain on the right.

Reverse palmaris longus was first described by Captain John T. Morrison in 1916 as an incidental post amputation finding [11].It may cause compartment syndrome in the Carpal tunnel and Guyons canal. The patient will present with pain and edema in the wrist region. This is an occupational hazard in people whose work involves repetitive wrist movements as it will result in hypertrophy and cause compression of median nerve and or ulnar nerve. This makes the modern day computer professional particularly vulnerable. Symptomatic patients presenting with a palpable volar swelling should be examined for variations in the palmaris longus. In an asymptomatic subject a hypertrophied muscle will obstruct and result in hazy interpretation of radiological assessment of this region. Difficulties in endoscopic procedure and electro myographic studies may also result from such a reversal