Sciatica Indicates Sevirity of LBA

-
Following article is Extracted from paper of folowing author(s):
Selim AJ, Ren XS, et al. The importance of radiating leg pain in assessing health outcomes among patients with low back pain. Results from the Veterans Health Study. Spine, Feb. 1998;23(4), pp470-74.
Patients with sciatica may suffer significantly more disability than patients with lower-back pain alone. For this reason, evidence of nerve root irritation should be taken into account in the assessment of patients with low-back pain. Four hundred twenty-eight patients were studied to determine a method of categorizing patients with low-back pain, by combining patient reports of radiating leg pain with the results of straight-leg-raising tests. Results demonstrated that this method worked well in identifying patients with different levels of low-back-pain intensity.
Patients were placed into four groups: 1) report of low-back pain alone; 2) report of low-back pain radiating into the thigh; 3) report of low-back pain radiating below the knee with negative straight-leg-raising tests; and 4) report of low-back pain radiating below the knee with positive straight-leg-raising tests.
The method also seemed to correspond well with differences in health-related quality of life scores and disability days which were assessed during the course of the study. The study method of categorizing patients with low-back pain appears to be a practical approach to characterizing low-back pain. It may be important for future research to develop a case-mix adjustment for low-back pain based on factors that determine both the pain intensity and the extent of radiating leg pain.

Comments

Post a Comment

Popular posts from this blog

Entrapment of medial calcaneal nerve (MCN)

-
Image
Peripheral nerve entrapment is a rare, but important, cause of foot and ankle pain that often is underdiagnosed and mistreated. A peripheral nerve may become entrapped anywhere along its course, but certain anatomic locations are characteristic (2). The medial calcaneal nerve (MCN) The Tibial nerve is called the planter nerve in the sole. The tibial nerve passes to the sole of the foot takes a turn on the medial side of the calcaneum is called MCN. The medial calcaneal nerve arises from tibial nerve of the inner side of the ankle, perforates the laciniate ligament, travels downwards passing below the bony projection on the inner side of the ankle, and supplies the skin over the medial aspect of the heel. Hence it is the most important nerve for heel sensations. MCN have 2 branches. The anterior branch dominate the cutaneous sensation of the anterior part of the medial calcaneal and heel weight loading field, while the posterior branch dominate the sensation of the posterior an
Read more

Review of Labral Tears of shoulder

-
Image
The glenoid labrum of the shoulder has extensive anatomic variation but appears to be important for contributing to shoulder stability and for increasing the depth of contact between the glenoid labrum and the humeral head. Tears of the labrum are commonly seen in association with other pathologic entities, such as instability and rotator cuff tears, and treatment of the labral pathology may be incidental to treatment of the other more significant pathology. However, conditions isolated to the labrum do occur and can be a significant source of shoulder problems. Effective treatment of these lesions may result in significant improvement in the patient's symptoms (4). Labral lesions are difficult to diagnose, and special diagnostic studies and, frequently, arthroscopy are required. How much we can rely on clinical tests is a question. Shoulder complaints are frequently recurrent. Instability might cause some of these complaints (3). History taking and clinical tests are commonly used
Read more

Differential diagnosis of Anatomic (Radial) snuffbox pain: It is not always DeQuervain’s tenosynovitis.

-
Image
Tendon, Bone & Ligament causes: 1. DeQuervain’s tenosynovitis: Swelling of tendon of APL (Abductor pollicis longus) & extensor pollicis brevis at lateral wrist near anatomic snuff box.  The primary complaint is radial sided wrist pain that radiates up the forearm with grasping or extension of the thumb. The pain has been described as a “constant aching, burning, pulling sensation." Pain is often aggravated by repetitive lifting, gripping, or twisting motions of the hand. Swelling in the anatomical snuff box, tenderness at the radial styloid process, decreased CMC abduction ROM of the 1st digit, palpable thickening of the extensor sheaths of the 1st dorsal compartment and crepitus of the tendons moving from the extensor sheath may be found upon examination. Other possible findings include weakness and paresthesia in the hand. Finkelstein’s diagnostic test will present positive provoking the patient’s symptoms. If left untreated, the inflammation and progressive narro
Read more