Carpal tunnel syndrome

August 23, 2016 by Sian Smale

Carpal tunnel syndrome is the most common entrapment neuropathy of the upper limb and often considered in the differential diagnosis of thoracic outlet syndrome and cervical radiculopathy. Understanding the cardinal clinical signs is paramount in assessment as there is no set criteria for diagnosis. This blog explores the presentation, assessment and neurodynamic treatments for this condition.

Deciphering the driving mechanisms in chronic low back pain

September 24, 2015 by Sian Smale

When it comes to discussing the diagnosis of low back pain (LBP) there are times when it is really hard to put a label on pain because it is hard to say is it one specific thing. Such a blurry diagnosis. In fact 85-90% of people with LBP are in this category making the blurry diagnosis the majority. The O'Sullivan system is a framework that aims to identify the main drivers and mechanisms of pain and dysfunction. Where movement is associated with pain, the classification considers if the movement is protective or maladaptive? This blog is all about this framework, breaking it down step by step, to help others see how using this classification system makes a complex pain disorder less complicated.

Reducible discogenic low back pain

March 20, 2015 by Sian Smale in Clinical reasoning, Pain mechanism, Case Study, Low back pain, Discogenic pain, Pain education, Patient education

A previous blog has explored the initial assessment of acute lower back pain presenting with radicular leg pain. This is a sequel post which explores the management pathway from day 1-3 on a patient with discogenic low back pain with radicular leg pain. It specifically focuses on when I chose to retrain lumbar flexion range of movement and the steps taken.

A mechanism-based approach to clinical reasoning of pain.

April 04, 2014 by Sian Smale

The clinical reasoning process for pain is complicated, particularly as there is no gold standard assessment for pain. Smart and collegues interview experiences musculoskeletal physiotherapists and pain physicians to determine which symptoms and clinical signs are indicative of nociceptive, neuropathic and central sensitisation pain, and their clinical utility and accuracy in diagnosis.

A Tribute to Max Zusman

January 13, 2014 by Alicia Rayner

Max provided a succinct article to "inform (musculoskeletal physiotherapists') clinical reasoning and decision-making process and smooth the way for mutual understanding with fellow orthodox health care professionals

Clinical presentation of neuropathic pain.

January 10, 2014 by Sian Smale

This blog highlights the key messages from Nee and Butlers article (2006) on the clinical presentation of neuropathic pain. It outlines both the presentation of nerve trunk pain and dysesthetic pain.