Questions FEB. 10.

2010
Article ID: 6957 Title: Bone spurs Name: Sheila Weingartner Section: Topics A-Z Category: Bone Spurs Question: I had bone spurs on the bac o! my heel" but no# it !eels li e they are on the bottom o! my heel and ma es #al ing pain!ul$ What can I do and could this happen% Age: &&-'( years )ender: *emale Painful Heel !ur The heel spur is the conse+uence o! a long term ,lantar *asciitis #hich is produced by in!lammation o! the insertion on the heel o! the plantar !ascia -a !ibrous layer that supports the plantar arch muscles and ligaments." causing remar able heel pain that alters your normal daily acti/ities$ It is the most common cause o! heel pain in 0S$ Initially the pain tends to decrease #ith #al ing but gets #orse throughout the day as acti/ity increases$ The pain #orsens by #al ing bare!oot on hard sur!aces or #al ing up stairs$ The causes o! ,lantar *asciitis are: aging" heel !at pad thinning" too lo#-arched or too high arched !oot" #ea ness o! the cal! muscles" leg-length discrepancy" #al ing or running #ith inappropriate shoe type on poor cushioned sur!aces" a change in the #al ing or running routine$ The suggested strategy to treat conser/ati/ely plantar !asciitis #ith heel spur #ould be: physical therapy aimed to stretch the muscles o! the cal! and !oot" using ice pac s a!ter the e1ercise routine to decrease in!lammation and pain" relati/e rest -a/oiding acti/ities that reproduce the heel pain." use o! anti in!lammatory drugs -e1ample: 2Ad/il3. and replacement o! #orn-out shoes by ade+uately cushioned shoes$ *or cases that do not respond to the conser/ati/e treatment" the corticosteroid in4ection on the site may be considered and i! still there is no signi!icant impro/ement" Surgery might be considered$ Article ID: 6971 Title: 5ight shoulder pain Name: Ine6 Berry Section: Topics A-Z Category: ,ain 7anagement Question: I ha/e ,ain in the right shoulder" mo/ing do#n my right arm and into the muscles$ I Cannot pull right arm to the bac or put on my hip$ It !eels sti!!" and I8m a!raid to !orce it$ What can I do be!ore I see my doctor and What other in!ormation is important !or my doctor to no# so he can help diagnose it$ What is the best imaging test !or shoulder pain% Age: &&-'( years )ender: *emale

$ Both are closely related$ :S=-@ is traditionally associated #ith oro!acial -mouth and !ace.N> Question Name: Bryan 7oberly Section: Se1 ? Beauty Category: )enital :erpes Question: :ello$ I ha/e 4ust been diagnosed #ith the :S=-@ on my genital area$ I #as prescribed =altre1$ The doctor I /isited said that more than li ely I #ont ha/e another occurrence and i! I do it shouldnt be too bad$ 7y +uestion though is I am married ho# #ill that a!!ect my se1 li!e !rom no# on$ Is it o ay to ha/e unprotected se1 #ith my #i!e as long as I ha/e no symptoms% Age: A&-B( years )ender: 7ale Current 7edication: =altre1 Her!es Infection: Pre'ention There are t#o types o! :erpes =irus: herpes simple1 /irus type @ -:S=-@. genital shedding and to !urther reduce . and type A -:S=-A. disease" #hile :S=-A is traditionally associated #ith genital disease$ :S= is transmitted by close personal contact" and in!ection occurs /ia inoculation o! the /irus into susceptible mucosal sur!aces -eg" oropharyn1" cer/i1" con4uncti/a. or through small crac s in the s in$ 5eacti/ation is more common in :S=-A in!ection than in :S=-@ in!ection$ :o#e/er" in indi/iduals #ith no symptoms /iral shedding in sali/a or genital secretions may occur in @C-AC o! in!ected persons and may be as high as &C in the !irst !e# months a!ter ac+uisition o! the in!ection$ 5esearch studies sho# that daily anti/iral therapy can be gi/en to reduce episodes o! asymptomatic -in indi/idual #ith no symptoms.the-art diagnostic tool !or a !ull e/aluation o! the shoulder$ Article ID: 6979 Title: :S= . is the state-o!.ne an1iety attac or pressure #ent up "oul#er Pain: $otator %uff &en#initis There are se/eral causes o! shoulder pain< one o! the most common is the 5otator Cu!! tendinitis and this seems to correspond #ith the description that you made o! your pain$ The rotator cu!! is a group o! tendons that support the shoulder $ These tendons can be in4ured during li!ting" #hen playing sports #ith a lot o! thro#ing" a!ter repetiti/e use o/er a long time or su!!er degenerati/e changes #ith the aging process$ The important in!ormation !or your doctor is as !ollo#s: your age" occupation" detailed description o! the pain" onset" locali6ation" type" se/erity" timing" #hat acti/ities or positions increase the pain%" is it constant%" ha/e you tried any treatments or per!ormed any diagnostic test to date%" 7agnetic resonance imaging -75I.Current 7edication: No medication 9no#n Allergies: Weather related$ 5unny nose and sni!!les 7edical :istory: Basic good health$ .

Title: Should my doctor be doing more% Name: Nathan Clar Section: Topics A-Z Category: Bac .the ris o! transmission< ho#e/er" it is unclear ho# long this should be administered$ Although not easily applicable to oral-oral contact" barrier protection using late1 condoms is recommended to minimi6e e1posure to genital :S= in!ections$ Article ID: 6990 Title: Spinal stenosis Name: Dolores Ilaria Section: Topics A-Z Category: =ertigo Question: 7y E& yr old husband has had spinal stenosis !oryears and no# he has great di!!iculty #al ing and eeping his balance$ Surgery is not an option$ Is there anything that can help him% Age: &&-'( years )ender: *emale (on)*&er+ !inal tenosis: %onser'ati'e treat+ent ..atients #ith spinal stenosis o!ten bene!it !rom conser/ati/e treatment such as physical therapy program that includes: !le1ion e1ercises that decrease the stress on the spine and increase the si6e o! the spinal canal" stationary cycling" and the use o! heat" cold or ultrasound to control the pain" along #ith anti-in!lammatory drugs$ It could be bene!icial the use o! a rolling #al er" #hich pro/ides some stability and promotes a !le1ed posture" this allo#s the patient to #al longer distances$ The local corticosteroid in4ection may be considered !or patients #ith spinal stenosis #ho sho# limited response to oral medication and physical therapy$ Article ID: 70.ain Question: I am a /et #ho sustained a bac in4ury #hile in ira+$ I ha/e been through e/ery conser/ati/e method o! pain control and nothing has #or ed$ 5ecently I had an 75I done o! my lumbar area$ A!ter the test I #ent to see my pro/ider and he said that all the !indings #ere normal$ :ere is #hat the !indings actually said: There is a some#hat mottled appearance #ith thic ened area o! so!t tissue posterior to the FB-F( /ertabral bodies and inter/ertebral disc space le/els$ This appears to be e1tradural and could represent ossi!ication o! the posterior longitudinal at these le/els$ There does not appear e/idence o! signi!icant thecal sac e!!acement$ I! these are !lo# /oids" a rare paraganglioma is also on the di!!erential$ I did some reasher on the ossi!icaton o! the longitudinal and the paraganglioma$ 7y +uestion is" should my doctor be doing more to !ind out i! I do actually ha/e this tumor% Age: A&-B( years )ender: 7ale Current 7edication: gabapentin !le1oril cele1a lonopin tra6adone 9no#n Allergies: dimetapp morphine benadryl ati/an codiene .

7edical :istory #as le!t blan $ Depending on the si6e and locali6ation o! the paraganglioma surgery can be considered to a/oid ner/e compression" according #ith the description o! the 75I is not sure that there is in !act paraganglioma neither ossi!ication o! the posterior ligament$ The report o! the 75I is not conclusi/e$ The suggested strategy #ould be: as !or a second opinion o! a spine surgeon$ .

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