Nerve Pain

Nerve Pain - Radicular Pain

Symptoms;

• Severe pain in the neck and arm
• Pain will be easily aggravated and sharp/stabbing when irritated
• Constant background dragging, nagging, horrible pain
• Pins and needles and tingling in the arm - this will be in specific fingers. If it’s in the whole hand then this is nerve involvement but it indicates a Brachial Plexus irritation rather than a specific nerve root

What causes Radicular Pain?

Radicular pain from the neck is caused when one of the nerves from the neck is being irritated to a significant amount. Nerves have a huge ability to cause pain as they themselves are the communication and pain pathways of the body. The nerves from the neck supply the sensation, reflexes and muscle strength to the upper arm. The most important differentiation when you experience symptoms like this is whether the nerve is being irritated alone or if it has been irritated enough to affect it’s ability to function. This will lead to sensory deficit (loss of touch sensation), weakness and reflex loss. Therefore it is extremely important that you have your upper limb neurology assessed if you are experiencing these symptoms. This has a huge impact on how likely you are to respond to treatment and whether or not you would require surgery. Conservative treatment is the first approach utilised in these cases. If you are suffering from this condition, when we see you at our clinics we will undertake treatment whilst simultaneously referring you for MRI scans.

Can Radicular Pain be treated?

Yes. The first option should always be conservative care. Surgery in the neck is a significant procedure with significant risks and would only be undertaken in non-responsive cases. Conservative care must be specific and appropriate. When you are in so much pain, our initial goal is to relieve any irritation to the nerves and reduce your pain. This means addressing the arm pain first. We have a number of techniques that are gentle and specific in conjunction with a lot of home advice and specific, gentle exercises at regular intervals.

VERY IMPORTANT

If you experience lower limb or body symptoms in addition to the above then you need to contact your GP immediately. Should you experience leg or foot numbness or loss of control of your bowels or bladder then you need to call an ambulance.

Ankle/foot pain

Anterior Talo-Fibular Ligament ATFL Sprain

The ATFL is the most common ligament affected in the “classic” ankle sprain. It is on the outside of the ankle; the lateral aspect. Lateral ankle sprains account for 85% of all ankle sprains. The ATFL is the weakest ligament in the lateral ligament complex and therefore the one most commonly injured. The mechanism for this is the foot twisting inwards, most commonly in a “toes down” position.

Ankle sprains commonly cause acute or sharp pain at the time of injury and afterwards. With damage to the ligaments, heat, swelling, redness and bruising are also common. Pain with weight bearing on the affected ankle is common. 

Not only are Acute Lateral Ankle Ligamentous Sprains (ALALS) common, they are also commonly associated with long term problems. A large proportion of patients with ALALS experience recurrences and persistent symptoms after their initial ankle injury. Therefore undertaking expert examination, treatment and appropriate strengthening is key to both managing your injury short term and avoiding recurrence long term.

If you require more information or would like to book an appointment then please call the clinic today.

 

Retrocalcaneal Bursitis

Retrocalcaneal bursitis is an inflammation of the bursa that sits between your achilles tendon and your heel bone. Bursas are fluid filled sacs that protect tendons and other structures from being rubbed and irritated by adjacent bones. Inflammation of this bursa can cause pain at the back of the heel.

This is most commonly caused by overuse injuries such as running or from wearing shoes that are hard or tight around the heel. These may occur in association with Gout, Rheumatoid Arthritis or other Inflammatory Arthropathies.

Retrocalcaneal Bursitis responds well to conservative treatment including advice, manual therapies and exercises. The use of steroid injections has been associated with Achilles Tendon rupture in cases and may be contraindicated.

If you require more information or would like to book an appointment then please call the clinic today.

Achilles Tendonopathy

The achilles tendon is one of the largest tendon in the body and is commonly affected. The pain in the ankle is often worse when you wake up in the morning but often warms up and eases over a period of time. You may find that you can still perform the activities you wish but the Achilles feels very stiff and sore initially, and again warms up. This injury used to be called tendonitis, which implies the tendon is inflamed, more recently it has been proven that it is not an inflammatory condition but a degenerative one. Therefore it is now called tendonopathy. This means that you actually need to exercise the tendon and rest is not good for long-term health.

To address Achilles Tendonopathy you need two things. A correct diagnosis and an appropriate management programme. This will look at your footwear, your strength and foot / lower limb mechanics.

It is very important to avoid putting off treatment. The longer you leave this problem to brew and progress the more difficult it is to settle, so our advice to you is get early intervention and comply with your programme. Our goal is to get you back to activity as soon as possible and keep you there! 

If you require more information or would like to book an appointment then please call the clinic today.

Syndesmosis Sprain

Also referred to as a high ankle sprain the mechanism is slightly different to the customary ankle sprain. The method of injury in this case often involves your foot being placed firmly on the floor and a twisting motion occurs. The twist then causes the ankle joint to open slightly and can cause a tear to the ligaments. Often the pain is then felt when you place your foot on the floor, which causes stress to the ligaments again. There is also often a restriction in how high up on your toes you can get.

Treatment

The treatment often goes against what you think in this case. The goal is too tighten your ankle joint. The pain associated with this condition is often due to excessive movement of the joints in the ankle.

Therefore exercises to stiffen it are usually required. Mobilising joints around the ankle and into the foot also assist.

If you require more information or would like to book an appointment then please call the clinic today. 

Plantar Fasciitis/Fasciopathy (policemans heel)

This is the most common cause of pain under the heel. Rather than achilles pain which is at the back of the heel, plantar fascia pain occurs directly under the heel. It can feel like you have a stone in your shoe but then usually increases to sharp and stabbing pain particularly first thing in the morning. The pain usually eases with movement even though it can be very stiff and sore initially.

Treatment

Once you have been assessed your practitioner will advise you of the best possible route towards recovery.

This type of injury can take a long time to fully recover, but 90% respond well to conservative care combining manual therapies and specific exercise programmes. Sometimes the hardest thing to do is remain committed to the exercises for the time it takes.

If you require more information or would like to book an appointment then please call the clinic today. 

Morton's Neuromas

This injury is classically an irritation of the plantar nerves, which pass under the foot. You usually feel pain between the 3rd and 4th toes. There can also be pins and needles in the foot and toes. The pain is caused by the nerve becoming inflamed and not settling adequately so it remains slightly swollen.

Treatment

If the neuroma becomes too big surgery is sometimes required, however, this is rare. This condition can be associated to previous sciatica, as it is part of the same nerve. It is also caused by a weakness in the foot or calf.

If you require more information or would like to book an appointment then please call the clinic today.