Tag Archives: sciatica

The large majority of the bodys joints, including the elbow, are capable of producing what are known as accessory movements, small sliding and gliding movements occurring inside a joint which a person cannot perform on their own. Accessory movements are vital for the normal use of a joint and are easily disrupted, limited or abolished by trauma or postural bodily misuse. The elbow accessory movements are very limited in size and consist of a small sideways gapping of the joint, which does not make a large difference to the ability to achieve various positions with the hand but does increase functional ability. Continue reading

The ankle is a very particular joint, commonly referred to as a mortise joint. It hinges backwards and forwards whilst we are walking and also gives the sideways support to allow us to hold our balance in moving and unstable conditions. The ankle hinge connects the foot to the lower leg and allows transmission of the forces of the bodyweight across it and onto the mobile and propulsive platform of the foot. In the lower leg the tibia makes up most of the upper part of the ankle with the fibula contributing a small amount towards the outside. Continue reading

Connecting across the two major bones of the navicular and the calcaneus and running under the talus is the spring ligament, a strong band-like structure which braces the foot arch. The weight of the body presses down to flatten the arch and the spring ligament holds between the two bones, becoming tauter as more weight is applied. Due to its great strength the spring ligament is adapted to manage the high forces generated by activities such as running, hopping or jumping, which are too vigorous for the musculature to able to hold the arch in place. The muscles contribute to arch maintenance but at a longer term lower level. Continue reading

If the joint is thought to be the pathology causing the symptoms the clinician will have to decide the likely process. Of the three major diagnostic categories one is arthritis of an inflammatory cause, involving the synovial joint linings and the bone-ligament and bone-tendon junctions (the entheses). The function and structure of a joint can be affected by arthritic changes not of an inflammatory nature, secondary to meniscal or articular cartilage damage or caused by other joint changes which can be from a number of causes. Continue reading

The shoulder is a very special joint. It allows a very great degree of movement to occur at the important junction between the torso and the arm. Notionally a ball and socket joint, the shoulder has been modified so this structure is much less clear than in the hip. The top of the arm bone or humerus is expanded into a large rounded knuckle which is like a ball but the socket is different. Unlike the deep hip socket which holds the head of the femur, the shoulder socket is very small in comparison to the head and very shallow. Continue reading

Joint pain can be caused by many different processes which include degeneration of the articular cartilage, infection, inflammation, trauma and deposition of crystals. Distinguishing one type of joint diagnosis from another is mostly made by taking a history and examining the joint, as this process is able to narrow down the options well. Once a provisional diagnosis is made then investigations are typically used to confirm the diagnosis and are less useful in trying to look for a cause without a narrow range of options. Clinicians try first to establish the source of the joint symptoms and then the potential underlying pathological process. Continue reading

As the individual nerve roots emerge from the neck they join together and separate in a complex fashion in an area called the brachial plexus, running down from the neck to the axilla where the individual arm nerves emerge. Nerves are very vulnerable structures and can be injured in gunshots, direct blows, knife attacks and traction injuries, which involve a sudden stretch. The results can be very disabling, with a chronically painful arm the patient is not able to move or use very well. Recovery is very variable and many patients have to cope with a less than useful arm. Continue reading

In industrialised countries back pain problems limit physical abilities in people under forty-five years more than any other pathology. Chronic covers a problem persisting beyond three months, which is a typical healing time for bodily soft tissues which may be affected by the injury. There is a biological purpose to acute pain syndromes, to prevent us from continuing with an activity which is causing tissue damage and to force us to take care of the injury until it heals. Chronic pain syndromes have none of this useful biological function and appear to be without use. Continue reading