Back and Pelvic Pain

Back and Pelvic Pain

  • Fred Bagares added an answer:
    Can anyone cite a good article that reviews the pathophysiology and/or neuroscience regarding pain associated with menstruation?
    I'm thinking specifically about back pain but any article on the topic would be great.
    Fred Bagares · Midwestern University
    Thank you very much!
  • Panayot Tanchev added an answer:
    Is it possible to have sex when experiencing back pain?
    This is a frequently asked question of patients (especially male ones).
    Panayot Tanchev · Medical University of Sofia
    Yes, Dr. Gielen, this a very useful reading. Regards
  • Gopal Nambi added an answer:
    Any suggestions for new areas of exploration in physiotherapy for non specific low back pain.
    Lower pack pain is the common musculo-skeletal problem that everyone is facing in day to day life. Finding the exact diagnosis and proper management for the above symptom is a big deal for all the health professionals.
    Gopal Nambi · C.U. Shah Medical college
    Thank you so much for your valuable suggestions.
  • Panayot Tanchev added an answer:
    What are behind Modic changes?
    While Modic changes are familar with most spine doctors, what is this phenomenon reflect? What exactly causes them?
    Panayot Tanchev · Medical University of Sofia
    To Dr. Duntsch: You state that MC on MRI are a common phenomenon "linked with low back pain". Is that always so ? I think there are patients with MC who are absolutely symptomless. On the other hand, you are right that "the etiology of MC remains poorly understood" . The clinical significance of MC is not clear.
  • Panayot Tanchev added an answer:
    Can herniated nucleus pulposus be cleaned by the body in some cases?
    Many studies have indicated that the immune cells, which infiltrate around the degenerated disc, could impact the situation. While these immunocytes can cause damage such as inflammation, can they also clean the herniated nucleus pulposus and reduce nerve root stress? At least to some degree?
    Panayot Tanchev · Medical University of Sofia
    Dr. Duntsch, You present a valuable collection of studies which contributes to the understanding of damaged NP. Anyway, pro duomo suo (spinal surgery), I would say that a massive extruded or sequestered NP prolapse causing acute neurologic deficit corresponding to the niveau of the prolapse is an absolute indication for surgical decompression with or without restoration of NP (nucleoplasty or similar).
  • Panayot Tanchev added an answer:
    Does diagnosis affect therapy treatment?
    When I see patients I really try to not look at any imaging or notes until I evaluate them first. I personally feel it adds too much bias into the picture and I don't want it to affect my clinical judgment. Are there any studies that show whether or not knowing the diagnosis changes the approach? It's obviously different here in the US because a diagnosis has to be coded by somebody so it's hard to be truly blind. Are there studies out there that look at whether being blinded to diagnosis affects treatment / therapy approach?
    Panayot Tanchev · Medical University of Sofia
    This question strives to complicate the general diagnostic and therapeutic algorithm. I would recommend to follow the classic formula which works for thousands of years: "Qui bene interrogat bene diagnostic, qui bene diagnostic bene curat". Unfortunately, many doctors of today look at the MRI-pictures, then at the CT-images, then at the X-rays, and at the end ask the patient about complaints, perform inspection, palpation, percussion, auscultation, etc. This is a vicious approach.
  • Sergio Lerma Lara added an answer:
    Why there is a prevalence of hamstring tightness in subjects with anterior pelvic tilt?
    In anterior pelvic tilt, lower cross syndrome exists, where hipflexors and spinal extensors get shortened while abdominals and hip extensors lengthen. This is what theory explains, but contradictorily I had seen hamstring shortening in subjects with anterior pelvic tilt. Can somebody clear this up for me?
    Sergio Lerma Lara · Hospital Infantil Universitario Niño Jesús
    We used to add kinematic and kinetic data for decission making. If you are familiar with Dynamic Muscle Length graphs psoas or rectors femoris spasticity or contracture could be in relation with "false hamstrings thigthness". Try with Modified Popliteal Angle test. (Keenan,WN et al. J Ped Othop, 2004). In other populations neural tissue tension mut be taken in consideration (SLR test).
  • Arnold YL Wong added an answer:
    Can the results of physical examination predict the clinical outcomes of patients with low back pain?
    Based on my literature search, it is apparent that depression and fear avoidance are the most important predictors for the development of chronic low back pain while the results of medical imaging or physical examination do not contribute much to the prediction of clinical outcomes of patients with low back pain. Have you read any articles that support the roles of physical factors (morphology or physical exam) in predicting the clinical outcomes of patients with low back pain?
    Arnold Wong · University of Alberta
    You are welcome

About Back and Pelvic Pain

To facilitate discussion on issue of prevention, diagnosis and treatment of acute and chronic lumbar and lumbopelvic pain.

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