Archive for July, 2007
Low back pain | Toe Dorsiflexion (extension)
July 27, 2007 5:07 pmFriday, July 27, 2007
Patients with lower back pain due to irritation of the L5 nerve roots may have difficulty with dorsiflexion of the ankle and toes. Patients may also suffer from pain in the toes especially on pulling the toes upward. With such a movement, toe muscles may actually go into spasm with the toes in extension.
Weakness of toe extension will also produce difficulty in lifting the toes high off the floor when walking on the heels.
Testing the strength of the extensor hallucis longus is commonly performed for detection of presence of L5 nerve root irritation. The examiner tries to press down on the interphalangeal joint of the great toe while the patient tries to resist this movement by pulling into dorsiflexion.
Muscles which perform dorsiflexion of the toes are:
- extensor digitorum longus (deep peroneal nerve, L5, S1)
- extensor hallucis longus (deep peroneal nerve, L5, S1)
- extensor digitorum brevis. This muscle extends all the toes the metatarso- pharyngeal joints except that of the little toe. (deep peroneal nerve, L5, S1) © 2007 copyright all rights reserved
www.stopmusclepain.com Low back pain| toe dorsiflexion
Photograph showing toe extensors and the extensor hallucis longus (below)
Low back pain| foot eversion
July 20, 2007 10:17 amFriday, July 20, 2007
Patients with lower back pain secondary to nerve root irritation especially of the S1 nerve root can have pain on turning the foot and ankle outward away from the midline of the body (foot eversion). Foot eversion is always accompanied by plantarflexion also of the foot.
Tightness due to spasm in the muscles that perform foot eversion leads to pain during this movement. You can feel the tendons of the peroneus longus and brevis as they travel behind the lateral malleolus (this bone is easily felt at the outer aspect of the ankle).
Muscles which perform foot eversion are:
- peroneus longus (L5, S1 through the superficial peroneal nerve)
- peroneus brevis (L5, S1 through the superficial peroneal nerve)
- peroneus tertius (L5, S1 through the deep peroneal nerve)
© 2007 copyright all rights reserved www.stopmusclepain.com Low back pain| foot eversion
Photograph showing the ankle and foot everters (see below)
foot eversion, low back pain, lower body topics, pain, peroneal muscles, peroneal nerve
Muscle pain relief|foot and hand massage
July 15, 2007 8:04 pm
Sunday, July 15, 2007
Foot and hand massage has the potential to assist in pain relief. Massaging the feet and hands stimulates the mechanoreceptors that activate the "nonpainful" nerve fibers, preventing pain transmission from reaching consciousness.
The following study showed that a 20-minute foot and hand massage (5 minutes to each extremity), provided 1 to 4 hours after a dose of pain medication reduced pain perception and sympathetic responses among 18 postoperative patients.
The patients rated pain intensity and pain distress using a 0 to 10 numeric rating scale had decreases in pain intensity from 4.65 to 2.35 (t = 8.154, p <.001) and in pain distress from 4.00 to 1.88 (t = 5.683, p <.001). Statistically significant decreases in sympathetic responses to pain (i.e., heart rate and respiratory rate) were observed although blood pressure remained unchanged.
The authors concluded that foot and hand massage appears to be an effective, inexpensive, low-risk, flexible, and easily applied strategy for postoperative pain management. (Wang HL. Keck JF. Foot and hand massage as an intervention for postoperative pain. Pain Management Nursing. 5(2):59-65, 2004 Jun).
Here is a story of one of my patients with chronic pain who unwinds from the effects of the long day by having a foot massage.
http://www.youtube.com/watch?v=Ugr2fhYhCaI
© 2007 copyright all rights reserved www.stopmusclepain.com Muscle pain relief| foot and hand massage
hand and foot massage, lower body topics, muscle pain relief, muscles, pain, self care topics, upper body topicsLow back pain| foot inward turning (foot inversion)
July 6, 2007 12:47 pmFriday, July 06, 2007
Patients with lower back pain due to irritation of the L5 and S1 nerve roots may have difficulty with turning the foot inward toward the midline (inversion). Usually with foot inversion, the sole of the foot is turned toward the midline of the body.
Muscles that turn the foot inward are primarily supplied by the L5 nerve roots. The foot inverting muscles supplied by the posterior tibial nerve (L5, S1) include:
- tibialis posterior
- flexor digitorum longus
- flexor hallucis longus
- gastrocnemius (medial and lateral)
- soleus
These muscles in addition to foot inversion also cause plantar flexion of the foot.
The foot inverting muscles supplied by the deep peroneal nerve include:
- tibialis anterior (L4, L5)-
extensor hallucis longus (L5, S1)
These muscles in addition to foot inversion also cause dorsiflexion of the foot.
© 2007 copyright all rights reserved www.stopmusclepain.com Low back pain| foot inversion
Photograph showing the ankle and foot inverters (see below)
inversion, low back pain, lower body topics, muscles, pain, peroneal nerve, plantar flexion, posterior tibial nerve
