Few times now I’ve had people come in with fever and neck pain, one time altered mental status on top of it. Kernig/brudzinski negative but neck feels pretty stiff and not much up/down range of motion when I examine it. I ask the neurologist to come by to help with the LP (the way it usually gets done at this little community hospital) and they say that LP is not indicated because the neck pain is musculoskeletal on exam. Granted they have some cspine disease on the imaging but I feel like I’m missing something . Can you reliably tell on exam the difference between nuchal rigidity and msk neck pain that you can defer an LP even with the meningitis triad present ? If so how? At other hospitals I’ve worked at the LP would be done already by the ER in a patient like this. I tried a few literature searches and asked other people but I’m not getting anywhere. Thanks for any insight you have.
I'm a new herbalist planning to grow my own garden this spring, and I'm starting to put together formulas for use while also working out of books like the Modern Herbalists Dispensary and Herbal Medic.
I haven't had much luck finding formulas online (my searches seem to all bring up single-use herbs) and I wanted to see if maybe some more experienced herbalists could help me.
The formula I'm working on is for musculoskeletal pain (lower back and joints) caused by suspected Edlers-Dahler syndrome. I'd want it to work mainly as an analgesic without being a sedative, and have been going back and forth on whether an infusion or a salve of some sort would be better suited.
The current formula I have:
Solomon's Seal - key herb. Anti-inflammatory, can be used both internally and topically.
Cramp bark - supporting herb. Antispasmodic.
Black cohosh - supporting herb. Antispasmodic, mildly analgesic, reduces joint inflammation
Ginger - balancing herb. Potent anti-inflammatory.
I've created a video on the patiophysiology of different myopathies w MCQs as a part of the Rapid Review series for the USMLE on my youtube channel
I hope this helps you! :)
TL;DR - Do you get relief from tight pecs or improved posture while using the VB?
Hi guys,
I would say that I have mild to moderate pectus. I think it may look a little less than it really is because I have a more spread out, valley-like variation that starts higher up than most but I'll attach a photo and you can say what you think.https://imgur.com/a/JICyjl9
(this also makes me wonder if the VB would be as effective for this type of pectus?)
Anyways visually my pectus doesn't bother me at all and I've been a competitive athlete my whole life so I don't think it's affecting my breathing or heart (although it would be great if there was some performance boost to be gained by fixing it)
The real reason I'm here though and considering the VB is because I suffer from almost chronic myofascial pain in the form or knotted up and sore traps and levator scapulae. I have issues with internally rotated shoulders, improper shoulder range of motion and lots of neck pain.
A lot of this was caused by poor posture so I've been going to the gym for the past 4 years to strengthen and stretch the appropriate muscles to improve my posture. I recently bought u/StrongClock's book and almost everything detailed inside (other than the VB) I was already doing or I was doing something with a similar effect.
Anyways what I mentioned above helped a lot and I'm in a lot less pain now than I was 4 years ago and my posture has improved a lot too. I'm still not perfect though but I feel like my pectus is holding me back from getting any better than I currently am, my pecs are always tight no matter how much I stretch them and I feel like they are always pulling my shoulders forward and rounding my upper back. My hunch is that the muscle fibers simply have further to travel with the depressed sternum and that is what is causing all of this. You can't build perfect posture off of a fundamentally broken base.
So what I'd like to know is if any of you have similar issues and after a VB session do you immediately feel that you have better posture or that your pecs aren't as tight since your sternum is no longer as depressed. Wondering if this would help me or not.
Thanks,Gabe
Any of you folks have luck getting SC for things like knees and back without it being in your STRs? Like you were Airborne Infantry and years later you feel like your 80 when you’re still in your 30s?
Hi Just wanted a medschool opinion on what is harder to learn: visceral anatomy or musculoskeletal anatomy? Also I'm guessing people tend to find visceral more interesting?
Non-native English speaker here.
Fitness parameters only measure cardiovascular parameters and musculoskeletal functioning. Such as how fast you can run, how much weight you can lift, how much you can stretch etc. They do not measure the functioning of any other organ system, such as how your liver or kidneys or pancreas is doing, or how your blood vessels are doing etc.
There also does not seem to be any widely available tests that anyone can do to figure out how well their organs are working. I mean sure there are tests, but those are only prescribed by doctors after you develop a problem or symptom and then only if its necessary to make a diagnosis.
Can someone tell me why there aren't any fitness type tests for all the organ systems of the body?
Just came back from a hip/back/knee/tendons C&P; it was a bunch to cover in one hour. Overall, it went well, but looking back, I have a couple "things I'm not sure about". I just want to relate these to you for some feedback or insights.
Overall, there wasn't really enough time to cite how all of the claims affect me. I articulated a couple ways the back affects me, but no time was spent on how the knee could contribute to the back e.g. poor lifting mechanics, military occupation, etc. Same for hip. Another point is in regard to knee measurements. While I stated that my knee had pain at lock-out and during weight-bearing, she never took a measurement during weight-bearing (only standing knee flexion). She didn't even want to look at the knee.
In comparison, at my hearing C&P, the audiologist used some great questions, and she was able to dig out ways that my hearing could have been affected while serving and how it affects me now. In comparison, today's evaluator spent very little time and effort doing this. Dunno, while some of these issues might be in the claim, it just doesn't feel like I wasn't given enough time to state my case.
Do you have any insights as to hhow thourough a C&P chould be? If this is normal? If I should be concerned and file a form?
Thanks, Rumbly
For questions and reading
About 6 months ago my chest started to hurt when I coughed, I smoke a lot and assume it was from coughing too much. It went away after a bit, but I had a depressive episode that had me smoking a lot more than normal and coughing quite a bit.
It’s been a couple months since the pain came back, still on my right side, but this time it isn’t the same, it hurts when I breath deeply depending on my position, and hurts worse with exercise, or even when moving from sitting to walking around for a bit.
I went to emergency and they did a EKG and said it was great, did a chest X-ray and blood tests to rule out clotting and cancer.
I often get pain when reaching to grab things, and that feels muscular but their is no tenderness on the surface. The pain is across my right breast usually focused just under my nipple. It occasionally radiates to the back or farther to the front depending on my position.
I’m 22, only smoked for 2 years. Currently quitting as this anxiety about my health isn’t allowing for it anymore.
I'm getting a lot of questions from musculoskeletal system wrong in my uworld first pass I used first aid and bnb but some questions are from topics not covered in either.
What resource should I use?
I'm 25 y/o male that's been having complaints that are believed to at least be contributed to by pelvic floor dysfunction. I saw a urologist who did an exam, said for the most part things appear normal but did notice some tightness in pelvic floor on rectal exam. Advised doing some exercises and let him know if it gets worse and he'll refer me to PT.
I did get hit in a moderately serious MVA a few years ago where I think I failed to realize what a seat belt can cause problems when you are hit at moderate speed and it totals your car (please wear one though!). I dealt with some numbness in my genital and rectal area for a while shortly after, and rare incontinence for a while. I'm in regular PT for chronic neck and back issues.
Symptoms include:
-Several UTI's which are supposed to be infrequent in men
-ED that I believe started out as positional but is now in any position
delayed ejaculation/loss of sensation that is now inability to reach orgasm or ejaculate at all for weeks at a time
-slower stream
-chronic constipation where it feels like something is getting ‘stuck’ or there’s a stricture in my colon. On occasion getting into a different position to go helps move things along.
-I stopped masturbating b/c it ends up causing pain (penis, suprapublc, shaft, and bladder) for a day or two after attempting to (and I can't reach orgasm). Eventually, sildenafil stopped producing much of a result.
I do sit too much, which I know isn't helping so I'm trying some general stretches. I know that’s a lot of complaints and don’t want to hit a provider with them all at once. A specialist said it may be outlet dysfunction, but per them it’s usually seen in women. I'm okay with whatever therapy at this point.
Anyone else have a similar experience, or have experience with all of this stuff going on? How did you get a referral and any tips on finding a PFPT?
It's appreciated!
Beyond the pelvis I mean. Just wondering.
Hey all! Looking for some insight into my recent experiences with my doctors. Thanks in advance!
I am 27 years old and very healthy and in shape. In 2019 I ran a marathon and continue to be very active both outside and in the gym. Over the last year, I started noticing shortness of breath and over the last 6 months, I started getting chest pain (sometimes on exertion, almost always after drinking alcohol). The chest pain sometimes radiates to my shoulder blade and neck.
I knew something was not right so after a few EKGs and chest X-rays, an echo finally showed that I had a BAV. They saw the valve, but the only thing out of the ordinary was trace to mild regurgitation.
The nurse practitioner and my general physician said that this is likely the reason for shortness of breath and chest pain. However, due to how 'healthy' my heart showed in the echo, they said to just do annual checkups to monitor.
This frustrated me, as I want to get rid of these symptoms and feel normal again. I got a second opinion with a cardiologist yesterday and he said there is no way that my symptoms are caused by BAV because there is no stenosis. He said that mild regurgitation couldn't possibly cause shortness of breath and chest pain.
What do you all think? Should I get another opinion? Is it true that the only way you have symptoms is if the valve is stenotic? The doctor essentially told me it was musculoskeletal and sent me on my way. When asked what to do about my symptoms, he told me to get a massage.
Thanks so much in advance for any input!
edit: highlighted BAV
During the Olympic games I was asked a lot about taping, which reminded me it has been a while since I looked at the evidence for taping, so I started my search.
Luckily it did not take long, because I found a map review published in 2019 that summarized the evidence from 41 systematic reviews and 127 RCTs. These studies were published between December 31, 2007, to October 31, 2019, however, I continued the search and found additional systematic reviews and/or meta-analyses which I mention after the results of the map review.
These are the results of the map review categorized by the quality of evidence and summary of evidence. Click here to see the evidence grading table.
High-Quality Recommendation for Taping By Condition
Chronic Low back Pain:
- Kinesiotaping is recommended by high-quality evidence for patients with chronic low back pain.
- Note: I found a meta-analysis published in November 2019 (after the map review) that found low-quality evidence for the short-term effect of kinesiotaping on pain reduction and disability improvement for chronic LBP patients. This meta-analysis included 11 RCTs and 785 participants.
Knee Osteoarthritis
- Rigid Taping is recommended by high-quality evidence for patients with knee OA.
- Note: I also found 5 reviews not included in the map review, 2 of which concluded that the evidence does not support the use of taping (elastic/kinesio) for knee OA, while the other 3 found a positive effect for taping on Knee OA pain and function.
High-Quality Evidence that Discourages the use of Taping
Non-Specific neck pain
- Kinesio taping is discouraged to treat non-specific neck pain.
- Note: I couldn’t find other reviews or clinical trials that were not included in the map review on NS-NP KT or other methods. so for now, maybe we shouldn’t use KT for non-specific neck pain!
Moderate Quality Evidence that taping is Favorable
- Rigid tapping is favorable for subacromial Impingement by moderate-quality evidence.
- KT is favorable for Acute low back pain by moderate-quality evidence.
- KT is favorable for Diastasis recti abdominins.
- KT and McConnell Taping is favorable for Knee Osteoarthritis.
Moderate Quality Evidence that taping unfavorabl
... keep reading on reddit ➡Hi! I've recently been diagnosed with hypermobility and I have a hypermobility spectrum disorder (HSD) however I'm not sure what yet, as over the past few months I've began to suffer from leg pain in my joints and frequently my leg will just go limp and give way on me with a twinging pain in my hip joint. Walking, running, driving, standing etc. seems to make it worse. I've only just turned 20 and im struggling to walk a simple 10 minutes or stand for longer than 20. Even sleeping/lying down sets off my joints.
I've been told that exercise such as swimming and cycling are excellent for helping strengthen hypermobile joints/muscles as it doesnt apply too much pressure to the joint. That being said, I was planning to joint a swim team even before my leg became a problem as I'm a lifeguard and have loved water ever since I was a child competing in galas. I want to professionally swim again, but I'm not sure if it'll help me or make my joints worse.
The issue is, I find strokes like breaststroke painful for my knee caps as they constantly crack and feel like they're going to dislocate with each rotation. When I have to perform "life saving leg kicks" (sideways breast stroke) when doing my lifeguard training, it causes me a lot of pain.
Does anyone have hypermobility or musculoskeletal issues on the subreddit and has swimming helped?
Thank you!
A chiropractor I know mentioned that you can help other non-musculoskeletal issues through chiro adjustments. Such as helping w constipation because he claims that the nerves from the spine run to the digestive system. I might add that he says this in an indirect way. He does not bring people in, claiming that he can fix their diabetes or whatever, but he is saying that indirectly, your other issues can be resolved sometimes. Is this not true? Because I’ve heard a lot of people looking down on the “fix-it-all” chiropractors. And I don’t know where the line is from into approaching that “fix-it-all” chiropractic mentality.
I've created a video on the patiophysiology of different myopathies w MCQs as a part of the Rapid Review series for the USMLE on my youtube channel
I hope this helps you! :)
