The main diagnoses treated in my office of physical medicine and rehabilitation are back and neck pain of various origins, tendonitis, arthritis and other joint problems, post-traumatic revalidation and complications due to fractures or sprains, neuritis and neuralgia, muscle ailments and osteoporosis. As a specialist, I make a complete functional assessment of the patient in order to allow an optimal therapeutic orientation. What are the causes of lower back pain? These are osteoarthritis of the joints of the spinal vertebrae, disc protrusions, herniated discs, muscle contractures, accident, osteoporosis, organic disease, etc. For everyone, the right dose and the choice of physical activities bring its share of benefits. Among these are muscle strength and flexibility. It also improves sleep and a feeling of well-being. This reduces pain via a release of opiates, beta-endorphins, by our own body. Prescribing a program of strengthening and stretching exercises could help improve physical condition, without increasing the pain. The important thing is to properly intensify the exercise program. We can also modify the program according to the evolution of the condition if necessary. Lumbar radiculopathy, often known as sciatica, is a series of symptoms including back pain and lower limb pain from the lumbar nerve roots. In addition to pain, patients may experience numbness, weakness, and loss of reflexes. The causes of lumbar radiculopathy are disc herniation, foraminal stenosis, tumor, osteophytosis and, rarely, infection. The lumal spinal stenosis is the consequence of a congenital or acquired narrowing of the vertebral canal. The patient has the pain and weakness of the legs when walking. This neurogenic pain is called intermittent spinal claudication. Pain in the lower limbs comes from the lumbar nerve roots. The patient may experience numbness, weakness and abolition of reflexes. Causes of the lumbal spinal stenosis include protrusion or disc herniation, arthropathy of the posterior facet joints, as well as thickening and deformation of the yellow ligaments. A neurosurgical emergency is when there is compression of the lumbar spinal nerve roots. The consequence is a lumbar myelopathy or a tail syndrome with motor deficit of the lower limbs and intestinal and bladder symptoms. The large dorsal muscle syndrome is related to the development of myofascial pain syndrome, mostly owing to repetitive strain injuries of the muscle due to activities such as the energetic use of weight machines, or tasks that require a forward and upward movement, as well as closed muscle trauma. Myofascial pain syndrome is a chronic pain syndrome that affects a specific point or region of the body. The diagnosis is based first on the identification of myofascial trigger points in physical examination. Cervicobrachial neuralgia manifests as neurogenic neck pain and upper limb pain from the cervical nerve roots. The patient may experience numbness, tingling, paraesthesia in the region of the affected nerve root(s), weakness, and loss of upper limb reflexes. Causes include a herniated disc, foraminal stenosis, a tumor, osteophytosis and, rarely, an infection. Cervical facet syndrome consists of ill-defined, dull pain in the neck, head, shoulder and proximal upper limb that radiates without waiting for a particular dermatome. Lateral or bilateral, it is exacerbated by flexion, extension and lateral inclination of the cervical spine. We also treat fibromyalgia of the cervical musculature, interspinous cervicodorsal bursitis and brachial plexopathy. Rotator cuff tendonitis occurs when the tendon is overused as a result of frequent repetition of incorrectly performed gestures, too rapid variation in the intensity of an effort imposed on a poorly prepared joint (due to lack of strength or endurance). Very often, there is an imbalance between the muscles that "pull" the shoulder forward (which are generally strong) and the muscles at the back (which are weaker). This imbalance brings the shoulder into an improper position and causes additional stress on the tendons, making them more fragile. The imbalance is often accentuated by poor posture. "Shoulder impingement syndrome" (SIS) is descriptive and refers to the pinching of the tendons and the bursa of the rotator cuff between the bones (in the subacromial space). In the most acute cases, SIS combines inflammation of the rotator cuff tendons (tendinitis) and inflammation of the serous bursa near these tendons (bursitis). The main risk factor for SIS are repetitive gestures at or above the shoulder during professional activity or playing a sport (including swimming, throwing, tennis, weight-lifting, golf, volleyball and gymnastics). The predisposition to SIS increases with age. Deltoid muscle syndrome is a myofascial pain syndrome. Stretching lesions or a shock to the muscle by flexion-extension and lateral movements during the practice of sport, or repetitive strain injuries due to professional activities that require carrying loads for a long time. Elbow Disorders: Anconeous Muscle Syndrome and Supinator Muscle Syndrome are painful myofascial syndromes that are most often caused by repetitive strain injuries of the muscle due to activities such as ironing, using a screwdriver, handshakes or digging. We also treat arthropathy of the elbow and post-traumatic affection of the elbow. Hand conditions: carpal tunnel syndrome is a common condition, often overlooked. It occurs when the median nerve that crosses the wrist is compressed in its canal, the carpal tunnel. Compression affects the sensory and motor function of the hand, which can cause numbness, pain, inability to perform certain movements. In the majority of cases, the disease is bilateral, i.e. it affects both hands. Osteoarthritis of the thumb, or rhizarthrosis, accounts for about a third of cases of osteoarthritis. Often of professional origin, it affects women more than men, and in particular those over the age of 50. It is particularly painful and disabling. Rhizarthrosis can be accompanied by tendinitis. A genetic field is not to be excluded. Repeated movements are a well-known cause: typing on a computer keyboard, cooking, sewing, writing, tinkering, cleaning, playing certain sports... Symptoms: repetitive movements become very painful, driving or dressing, opening a door or a bottle, combing your hair or cleaning up can seem overwhelming. A stiff thumb may appear (especially at the base), severe pain at the base of the thumb. In the long term, one can observe a deformation of the finger which retracts towards the inside of the hand. Fibromyalgia is a condition that is characterized by chronic musculoskeletal pain, which is often accompanied by symptoms such as severe fatigue, sleep disturbances, headache, depression, or joint stiffness. Scientists cannot determine its etiology, because this pathology presents a very large number of different symptoms. Current treatments offer a better quality of life to suffering patients, without neglecting the psychological aspect of their condition. Osteoporosis is a chronic disease that weakens the bones. When the destruction of bone tissue takes precedence over its formation, its total mass decreases. The consequence is an increased risk of fracture. Osteoporosis is particularly common in women after menopause, but can also affect men. Fortunately, solutions exist to prevent and treat osteoporosis.
