People use their hands for just about anything – cooking, eating, driving, holding things, working, etc. Hands make daily tasks and routines easier. Most people don’t realize the importance of their hands until they experience pain or a tingling sensation that prevents them from doing their usual routines.

Wrist pain is usually the most common complaint. Affected areas will present specific symptoms such as dull pain, sharp pain, tightness in the area, or a sensation of pins and needles. There are many causes of pain that occur in the hands. Due to the complex structure that makes up the fingers, wrists, and hands; determining the root cause of the pain entails a comprehensive medical history, physical inspection, and diagnostic imaging tests.

Here are the four causes of wrist and hand pain:

De Quervain’s Tenosynovitis / Wrist Tendinitis

De Quervain’s Tenosynovitis is one of the top conditions that cause wrist and hand pain. Its presenting symptom is pain on the side of the thumb and wrist. It is also considered as Wrist Tendinitis as a result of a repetitive or sudden injury to the wrist.

Women appear to be more affected by De Quervain’s Tenosynovitis than men. This condition is also called “mommy’s wrist” due to a higher prevalence in new mothers and postpartum moms. This is associated with repetitive motion of holding and picking up a baby combined with hormonal fluctuations that result in fluid retention and swelling around the joints after giving birth.

Pain is usually felt around the thumb and its nearby wrist structures where two thumb tendons occupy the same space.

Peripheral Neuropathy

Neuropathy, often popularly called ‘peripheral neuropathy’ is the dysfunction or damage of the nerves in your body. It is an indication of a problem occurring in the peripheral nervous system. Neuropathies will usually start in your hands and feet but will also manifest in other body parts.

Common signs and symptoms of Neuropathy include ‘pins and needles’ sensation, numbness,  sharp pain, changes in sensation, loss of coordination, muscle weakness or twitching, paralysis, abnormal heart rate, excessive sweating, problems with bladder, digestion, and bowels.


Arthritis is the most common cause of wrist and hand pain for people age 40 and older. Although the wrist is the least affected part when it comes to arthritis compared to other joints of the body, arthritis on the wrist can occur as a result of wear and tear or a history of wrist joint injury. When a tear in the wrist ligaments happens, bones form in an unusual pattern. This abnormal movement causes the cartilage breakdown. The cartilage acts as a cushion between the two bones in a joint. When the cartilage breaks down, bones rub each other that causes bone spurs which is one aspect of arthritis.

Symptoms include swelling, stiffness, loss of normal range of motion, and pain in the affected part.

Carpal Tunnel Syndrome

Carpal tunnel syndrome is a prevalent condition among office workers who are always using the computer. This condition is a result of a compressed or squeezed median nerve.

The median nerve is located in the middle of the wrist and travels to the hand. It is surrounded by flexor tendons and tissues. When the surrounding structures become swollen, the tunnel becomes narrowed putting pressure on the median nerve. This pressure causes numbness, tingling, pain, and weakness in the hand.

When to see a doctor

You need to see a doctor when the symptoms of wrist and hand pain prevent you from doing your activities of daily living. The doctor will perform a physical examination, thorough medical history, and diagnostic procedures to determine the cause of pain in your wrist or hand. The doctor will prescribe medication, surgery, and may recommend physical therapy for advanced cases.


Stress is your body’s response to threat, demand, or pressure. When you feel a threat to your physical, emotional, or psychological being, your body’s defenses switch to automatic response known as the ‘fight or flight’ response or the ‘stress response’. It is a built-in mechanism that reacts to protect your body and being from real or imagined threats.

Sometimes, recurring stress can cause a buildup of worrying thoughts that could often lead to anxiety. Anxiety is your body’s response to stress. It is a feeling of fear or worries about what’s to come.

Causes of Stress

Each person is surrounded by countless life stressors that can trigger stress responses and anxiety. Common external and internal stressors are the following:

External Causes of Stress

  • Major life changes, death of a loved one
  • Work or school demands
  • Relationship troubles
  • Financial problems
  • Being too busy with so many things
  • Family life

Internal Causes of Stress 

  • Negative outlook in life
  • Inability to accept uncertainty
  • Rigid mindset, lack of flexibility
  • Negative self-talk
  • Perfectionism/unrealistic expectations
  • All-or-nothing attitude

When working properly, the “fight or flight” response will help you stay focused, alert, and full of energy. For example in a situation where you need to defend yourself or avoid accidents, your body will respond automatically to protect yourself from imminent danger.

Chronic Stress

Continuous stress or too much exposure to stressors can leave you feeling overwhelmed and that may suddenly sneak up on you. People don’t realize the amount of stress they’re going through until they suddenly feel choked up with too many demanding events in their lives. This stress build-up can eventually lead to physical, emotional, and psychological health breakdown over a course of time if left unchecked.

Ways to Manage Stress and Anxiety

A person who is overwhelmed by a lot of life stressors can react tremendously with little tiny stressors. When you are too overwhelmed with stress and anxiety, even the simplest of things like dealing with your partner or kids can become a burdensome toil on your part. Even if you are simply running late in light traffic causes your temper to blow up. You easily get irritated and out of focus with little distractions.

Here are ways to decrease anxiety and stress whenever you feel overwhelmed in certain situations:

Calm your body and your brain

A calm mind and body relieve stress by lowering the stress hormone called cortisol and it also lowers your blood pressure. To calm your mind and body, listen to slow music, take a meditative walk, eat nutritious food, get adequate sleep, engage in social activities, do some routine exercise like yoga, and be present in the present. Be mindful of your thoughts and feelings of the moment.

Always practice these calming techniques even if you are not in a stressful situation. The more you apply these techniques, the easier you can employ them when you are facing a challenging situation.

Get therapy

There are many kinds of therapy you can seek out when you are overwhelmed with stress and anxiety. Occupational therapy will help you transition from your daily work routines to your new normal. A qualified therapist is an effective partner in your support system. They nurture and guide you in applying life skills that help you in calming your mind and body.

In a long-term facility, older people get stressed out when they feel overwhelmed with the thought of their diseases or disorders. Practicing these mind and body relaxation techniques can help them in their memory care and physical therapy if there are bodily disorders that can stress them out. Their therapist and caregivers can assist them in dealing with day to day tiny stressors with guided techniques in calming the mind and body.



The human body changes every minute of every day. It constantly creates, destroys, and rejuvenates the body cells. There are constant processes that the body needs to undergo to live continuously. As the body ages, there are expected changes in the physical, mental, and emotional aspects of each person.

The most common expectation of aging is the physical function. Hearing and eyesight may not be as sharp as it was before. Physical movements may not be as flexible as a decade before. Also, in the cognitive part, reacting to daily situations may not be as accurate as before. Seniors may understand things differently than the usual stuff they are used to encounter every day. Speech changes in Seniors can significantly affect the way they communicate with the people around them. And not surprisingly, speech changes can happen to the senior population too.

Changes in physical attributes of speech

The muscles in the larynx and the vocal cords work hand in hand in producing sound. Just like in many areas of human health, aging can jumpstart an avalanche of bodily changes, including changes in speech among seniors. The body parts responsible for producing voice may start to weaken, and vocal cords are losing its elasticity.

If you feel there are changes in your speech recently or have observed in someone else, it is essential to know the causes of this condition and what you can do about it.

Aging and its effects on speech

Aging can bring many physical changes in the body. It is not clearly understood why the body ages. As a person ages, the body loses its elasticity and flexibility. The muscles become weaker, and this includes the muscles lining in the jaw and throat. Along with the throat, muscle weakness is the changes in the tissues and glands in the body. This could greatly affect the speech of the elderly leading to shaky, hoarse, and modified pitch.

Other disorders and diseases could also affect speech along with the aging body. For example, if a person has Parkinson’s Disease, Dementia, or Stroke, these conditions are directly proportional to the changes in a person’s ability to talk and communicate. Certain medications, injury, and underlying causes may be to blame.

Signs of speech changes in seniors

Changes in the speech may not be easy to recognize in the early stage of aging. Sometimes, changes in speech may just be mistaken as a result of flu, cough, and sneezing. The telltale signs of speech changes in Seniors include:

  • Changes in cognition
  • Difficulties participating in a conversation
  • Difficulty producing certain sounds or saying certain words
  • Difficulty swallowing
  • Hoarseness and changes in pitch
  • Loss of hearing

If you feel any of these signs or if you observe them in your loved ones, you may want to set an appointment with your Geriatric Doctor to diagnose the underlying cause of the speech changes properly. If you are worried about you or your loved one’s deteriorating speech, see your doctor for speech problem treatments appropriate for you or your loved one’s condition.


The foot is considered one of the most frequently used parts of the body. It is through the foot a person can stand, walk, run and move accordingly. The foot is composed of several small bones that allow movement and weight-bearing.

Several problems can occur in the foot which may result in pain, immobilization, difficulty in walking, and can be worsened with every step. There are several causes of foot pain. Here are 7 of the most common causes of foot pain while walking.

1. Plantar Fasciitis

Plantar Fasciitis is the inflammation of the plantar fascia. This is a group of thick connective tissue that is located across the bottom of the feet.

The pain may be described as stabbing pain at the bottom of the foot and gets worst when walking or standing. It usually occurs first thing in the morning. It is the cause of foot pain while walking for an estimated 15% of foot problems.

2. Morton’s Neuroma

Morton’s Neuroma is the thickening of a group of tissues surrounding a nerve that runs from the ball of the foot to the toes. This usually develops as a result of injury, nerve irritation, or trauma. This condition places pressure on the toes making the person feel that there is always a marble or a rock inside the shoe.

The pain may be described as a tingling sensation on the ball of the foot that radiates to the toes. Sometimes, the person with Morton’s Neuroma will report numbness or burning in the foot especially while walking.

3. Metatarsalgia

Metatarsalgia is the painful inflammation of the ball of the foot.

The pain presents as a sharp burning and aching pain on the ball of the foot. Tingling and numbness can also be present. The pain is located on the ball of the foot just behind the toes. The symptoms are highly similar to Morton’s Neuroma. The doctor may perform an Xray to rule out underlying causes.

4. Tendinitis

Tendinitis is the inflammation of the thick and fibrous cords called ‘tendons’ that connect the foot muscles to the bones. The three most common tendon inflammations are the Achilles Tendinitis, Extensor Tendinitis, and Peroneal Tendinitis.

The pain may be described as an ache in the back of the heel or the leg with little to moderate stiffness or tenderness in the foot.

5. Hallux Vagus

Hallux vagus, also known as ‘bunions’ occurs when the big toe tilts toward the other toes. This toe misalignment causes a bony prominence or a bump on the inside of the foot right at the base of the big toe.

The pain can be described as a burning sensation, particularly in the big and second toes. The pain can worsen when the person is wearing closed or restrictive shoes. The person may also report swelling, redness, and numbness in the foot.

6. Arthritis

Several types of bone and joints arthritis can affect the foot including the ankles, toes, heels, and ball of the foot.

Osteoarthritis can cause degradation of the cartilage of the feet. The cartilage acts as the protective cushion between two bones rubbing each other. Osteoarthritis leads to stiffness in the feet particularly the toe region down to the heel.

Rheumatoid arthritis is an autoimmune condition that destroys the ligaments, cartilage, and tendons surrounding the different bones of the feet. The pain is presented as dull combined with joint swelling, redness, warmth, and stiffness.

7. Heel Spur

A heel spur is an abnormal bony-like growth located between your heel bone and your foot arch. This condition causes pain, redness, and swelling. The pain is radiating throughout the entire foot especially during walking, running, jogging or any other physical type of activity.

When to See A Doctor?

If the pain increases as time goes by and it starts to hamper your daily activities, it is better to set an appointment with a doctor or an orthopedic specialist.

One or more of these causes of foot pain will prompt you to see a doctor. Your doctor will perform a physical exam on the affected area. They may also perform several diagnostic procedures to rule out the underlying cause of foot pain.



“Dance until you drop.” as one famous line says. The aging process is one that can be challenging, but doesn’t have to be.

As first scientifically proposed by a German biologist Dr. August Weismann, the body is like a mechanical system that is going to break down with use over the years. The wear and tear theory of aging asserts the effects of aging causes progressive damage to the body cells over time until it functions less than the normal.

In the medical field, the legally elderly age is 65 years old. From this age, a person can experience several body changes. Amongst all these are joint body pain and symptoms associated with illnesses of hypertension, diabetes, etc.

Accompanying the aging process may be a gradual decrease in muscle mass and strength. Functional impairment can be a result of putting some risks to older adults.

Causes of leg weakness in the elderly

  • Sarcopenia. It is a degenerative condition associated with aging where muscle mass gradually declines, resulting in muscle weakness of the extremities. Physically inactive people tend to lose muscle mass by 3-5%. The elderly have the highest risk of acquiring this condition, and it is one of the most causes of incidents of falls and fractures among older adults.
  • Vitamin D deficiency. Older people would likely develop Vitamin D deficiency due to decreased dietary intake, diminished sunlight exposure, reduced skin thickness, impaired intestinal absorption, and impaired hydroxylation in the liver and kidneys. Vitamin D is proving to develop muscle strength among the elderly.
  • Inflammation. The body typically responds to a reconstruction of the damaged cells right after an injury. Chronic inflammatory illnesses, such as rheumatoid arthritis, are believed to decreased muscle mass and leg weakness.
  • Diabetes and Hypertension. These two medical conditions can lessen blood perfusion in the body. Diabetes can cause peripheral neuropathy damaging the nerves in the legs and feet while hypertension can increase blood pressure in the arteries of the extremities, causing leg weakness.

Effects of leg weakness

● Risk of falls and fracture. Handrails all over the bathroom are needed to reduce any injury to the elderly. We can use assistive devices like walkers to prevent damage as well.
● Functional impairment. Muscle weakness and fatigue are a result of limited mobility. A caregiver can help assist an elderly cope with daily activities.

Preventing leg weakness

  • Exercise the legs. The sit to stand chair exercise works well for seniors with weak legs and allows them to improve their balance. Participate in a simple daily routine activity to eliminate too much of physical inactivity.
  • Control your weight. Weight gain can affect joints of the legs. The more overweight you are, the higher the risk of developing osteoarthritis and leg weakness.
  • Elevate legs. It can promote good circulation among the rest of the body and prevents swelling. Elevating the legs by putting a small pillow can ease tired feet.
  • Vitamin D supplement. The recommended supplement of vitamin D for the elderly is 1000 IU/day. It can lessen not only muscle problems but also the risk of cardiac illnesses.f
  • The right diet. Fresh fruits and vegetables, including berries and green leafy veggies. Meat and fish products also provide protein for muscle improvement.


Baby boomers, those who are born between 1946 and 1964, are aging and with this fact, the number of dementia cases is rising. The need for memory care services is also expected to rise. According to the projections from World Alzheimer’s Report and RAND Corporation, the number of people with dementia will possibly double or even more by the year 2040. The demand for quality memory care services will rise sharply over the coming decades. The baby boomers generation is creating a surge of people needing treatment for dementia cases. Fortunately, the senior care industry is adept at accepting the change and meeting the demands. According to Senior Housing News, new and existing communities are ready and equipped in the development of memory care units.

Deciding to put a loved one in a memory care community

People with Alzheimer’s disease and Dementia sufferers need specialized and comprehensive care. Deciding to put your loved one in a memory care unit can be a difficult decision but the benefits outweigh the consequences. Memory care services offer more than assisted living, it gives seniors the quality of life they need with their condition.

Why you need memory care services

Memory Care Services are more expensive than traditional assisted senior living. It offers particular programs and features specifically for Dementia sufferers.

Memory Care Programs often include the following services:

  • A secure environment where they can safely wander around preventing elopement incidents.
  • A low staff-to-resident ratio
  • Color-coded hallways and building design that help seniors to navigate the premises easily and reduce their anxiety
  • Sensory-based programming
  • Can accommodate people in their early, middle or late stages of the disease

Effective Assisted Living with Memory Care Services can deliver improvements in the quality of life of the resident. Through effective services and efficient treatments, the family will observe the following indications of improvement in the quality of life of their loved one:

  • Reduced number of medications
  • Negative medication side effects
  • Reduced incidents of injuries and falls
  • Decreased number of ER visits
  • Fewer incidents of violent behaviors
  • Improved independence and Social Interaction
  • Improved body nutrition and Decreased vitamin deficiencies
  • Residents are functioning at a higher level
  • Increase sense of happiness
  • Improved or maintained mental functions of about 75% of residents in six months

The role of family in memory care

The role of the family is important in determining how their loved one lived before coming to the center. Once families decide to bring their loved one to memory care services, the memory care team will work with them to get the necessary information about the new resident:

  • Who they are
  • What are their life experiences
  • What has brought them a sense of success and purpose

Individualized programs help dementia sufferers to practice their interests, hobbies, and experiences unique to each one. The memory care communities work hand in hand with the families to help their loved ones create meaning and purpose even at their current state.


As people age, they don’t only get wiser – they also become more prone to fractures from common accidents such as falls. Based on statistics, 1 out of 3 adults (aged 65 and up) falls each year in the United States. The bad news is, most of these accidents could be fatal. As a matter of fact, 8,000 accidents were fatal to American seniors in 1995.

What are the common fractures for seniors?

In most cases, the patient is subject to hospital admission due to trauma. The older the age, the higher the likelihood of hospitalization. Accidents such as falls cause fractures, especially in the high-risk areas of the body such as the following:

  • Hip – Hip fracture is a common type of fragility fracture and is often associated with the highest mortality among seniors. Apart from falls, older adults who have low vitamin K and vitamin D levels are also at risk.
  • Thighbone – Fracture in this area is typically sustained in high-impact trauma, such as dangerous falls or car crashes.  Damage occurs to the thigh bone once a large amount of force hits it.
  • Pelvic bone – This happens when a strong force breaks the bony structure of the pelvis. Typical causes are falls, pedestrian accidents, motor vehicle collisions, or a vehicle crash injury.
  • Spine – Spine fracture is also known as a broken back. Immediate, high-impact trauma normally brings spinal cord injury.
  • Upper arm bone – This usually results from a fall when an arm is outstretched.
  • Forearm – This can affect one or two of the forearm bones. Aside from falls, a direct force from an object causes this fracture.
  • Hand – Hand fracture occurs when one of the bones in the hand breaks, usually caused by a fall, twisting injury, crush injury, or collision in sports.
  • Leg/ankle bones – This is typically brought about by falls, sports injuries, and motor vehicle accidents.

Are all fractures equal?

While some fractures do cause severe occurrences such as permanent disability and death, others may not be fatal and the patient can fully recover by means of physical therapy.

What factors increase the likelihood of getting fractures?

Senior citizens who experience the following are at a higher risk of getting fractures caused by accidents:

  • Eye problems such as cataracts and myopia
  • Joint and muscle issues such as arthritis
  • Nervous system disorders such as sciatica
  • Lack of balance and gait such as Parkinson’s disease
  • Sleepiness, usually brought about by medication

How can fractures be prevented?

Fractures don’t have to happen in the first place. Here are some measures you can help an elderly do to prevent accidents right before they happen.

  1. Engage in physical activity to improve mobility, flexibility, and strength.
  2. Limit sleep-inducing medicines especially during the daytime, if possible.
  3. Seek appropriate treatment for medical conditions such as those stated above.
  4. Install safety modifications like metal handles, maintain good lighting, and clear all possible obstacles around the residential area.

Seniors are at a higher risk of getting fractures. But with proper care and supervision, our beloved elderlies can live a longer, fracture-free life.

What To Do

For those who have had a fracture and need rehabilitation, look to Strides Maplewood in Sauk City WI.  Our physical therapy and occupational therapy department can help you to return to normal life.


What is congestive heart disease?

Congestive heart disease, or also known as congestive heart failure (CHF), is a progressive condition that takes place when the heart muscle can’t pump blood efficiently to meet the body’s needs.

Because of various potential causes, blood flows much slower than usual and heart pressure increases. Consequently, the heart cannot pump sufficient oxygen and nourishment that is needed by the body. The heart chambers stretch to allow more blood circulation, or it becomes rigid and thick. For a while, this helps maintain the blood flowing, but eventually, it weakens the heart muscles and become incapable of pumping properly.

What are the types of congestive heart disease?

There are two common types of CHF: the left-sided CHF and the right-sided CHF.

Left-sided congestive heart disease

The most prevalent form of CHF happens when blood is not correctly pumped out to the body by the left ventricle. The two classes of left-sided CHF are:

  • Systolic heart failure – This arises if the left ventricle doesn’t contract properly, thereby reducing the amount of blood pressure to circulate.
  • Diastolic failure – This occurs when the left ventricle muscle becomes rigid and the heart doesn’t fill up with blood.

Right-sided congestive heart disease

This happens when it is difficult for the right ventricle to pump blood into the lungs. Blood recoils back in the blood vessels, causing fluid or water retention in the lower limbs and other essential organs.

What causes congestive heart disease?

There are several possible causes of CHF, the most common are:

  • Heart attack – This is due to a blocked coronary artery that stops the blood circulation for the heart, leading to scarring of the heart’s muscle.
  • Coronary artery disease (CAD) – This is an artery disease that reduces blood flow.
  • Cardiomyopathy – This is heart muscle damage caused by infections or abuse of alcohol and drugs.
  • Conditions that cause heart strain – Conditions such as hypertension, diabetes, valve disease, renal disease, thyroid disease, or congenital heart defects can result in heart failure.

What are the signs or symptoms of congestive heart disease?

CHF symptoms can be persistent (chronic), or it comes and goes (acute). Symptoms could be mild or severe. The symptoms may include:

  • Lung congestion – This is caused by fluid in the patient’s lungs that results in breathing difficulty. It can also be the root cause of wheezing or hacking cough.
  • Fluid retention – This is caused by affected kidneys that results in edema and bloating.
  • Nausea and lethargy – This happens due to lesser blood to organs, muscles, and brain.
  • Irregular or rapid heartbeats – This occurs due when the heart beats faster than normal.

How is congestive heart disease diagnosed?

If the patient is experiencing the symptoms, he or she will be referred to a cardiologist. The cardiologist then will order diagnostic tests to get a complete understanding of your present condition.

  • Electrocardiogram (EKG) – This device checks for abnormalities in the heart’s rhythm.
  • Echocardiogram (ECG) – This determines if there is poor blood circulation, muscle damage, or the heart doesn’t function normally.
  • Magnetic Resonance Imaging (MRI) – This displays heart damage.
  • Stress test – This shows heart performance under different stress levels.
  • Blood tests – These check abnormalities of blood cells or if there infections present.
  • Cardiac catheterization – This displays blockages in the coronary arteries.

What is the outlook for people with congestive heart disease?

With the right care, heart failure may not stop you from doing the things you enjoy. If extended medical care is advised, there are nursing home facilities that will cater to patients with CHF.


Calcaneal Spurs – What Are They?

Calcaneal spurs, also known as heel spurs, are bony outgrowths that form on the calcaneal tuberosity or the heel bone. Calcaneal spurs that occur beneath the soles are called plantar heel spurs which are commonly associated with Plantar fasciitis. Those that are found at the back of the heel are called dorsal heel spurs which are also linked to Achilles tendinopathy.

The Anatomy

The calcaneal tuberosity area is composed of many muscles including the Soleus, Abductor Digiti Minimi, Abductor Hallucis, Gastrocnemius, Flexor Digitorum Brevis, Extensor Digitorum Brevis, Extensor Hallucis Brevis, and Quadratus Plantae; and the plantar fascia  that exert an adhesive friction on the tuberosity (rounded heel bone) and nearby regions of the heel especially with abnormal or excessive pronation.

An inferior calcaneal spur, also known as a plantar heel spur, is located on the lower aspect of the heel which is situated superior to the plantar fascia insertion. It develops as a response to plantar fasciitis over some time and may also be associated with ankylosing spondylitis especially in children.

A posterior calcaneal spur, also known as a dorsal heel spur, grows on the back of the heel at the attachment of the Achilles tendon. It is often bulky and easily palpable through the skin and may need to be surgically removed as part of the treatment of insertion Achilles tendonitis.

Causes of Spurs

The causes of calcaneal spurs are often the result of repetitive trauma to the foot. One of the common causes of Calcaneal Spurs is Plantar fasciitis; the inflammation of a thick band of tissue underneath the foot that stretches from the toes to the heel. When the foot goes through consistent pressure to the plantar fascia ligament, it produces small rips and breaks close to its attachment.

To repair the injury, the body reacts with inflammation (plantar fasciitis) which causes the symptoms to occur. Calcium deposits start to gather in the space where there is ripping created. Generally, this does not affect a person’s daily activities.  Over time, the minerals build up on the bottom of the heel bone to form a calcaneal spur or heel spur. When the mineral buildup reaches a considerable form, the person feels pain surrounding the spur.

People who are prone to developing calcaneal spurs are those who have overpronation feet, have heavyweight problems and those who are frequently wearing high heels.

Symptoms of Spurs

Stabbing pain is the first symptom of Calcaneal Spur. The person feels a sharp piercing pain in the bottom of the foot near the heel that worsens in intensity after prolonged periods of rest. Patients may report severe heel pain a few steps after getting up in the morning. Also, patients may refrain from putting their weight on the affected heel. Prolonged standing or rising up after sitting for a while may also trigger the pain. Walking, running, lifting heavy objects can intensify the pain.

Diagnostic Procedures

The doctor may take note of the patient’s history and perform a physical examination. An x-ray can often establish the diagnosis. Other diagnostic adjuncts can also rule out calcaneal spurs including radiology and sometimes but rarely, doctors perform an MRI to be definitive.


Piriformis Syndrome – What Is It?

What is Piriformis Syndrome?

The Piriformis Syndrome is a neuromuscular disorder that occurs when the piriformis muscle compresses the sciatic nerve and causes abnormal symptoms in the area. When sudden spasm occurs, it causes discomfort such as numbness and pain to the buttocks area or sciatic nerve.

In definition, the piriformis muscle is a small, flat, band-like muscle located deep in the buttock area. The muscle starts at the lower part of the spine and connects to the upper part of each thighbone.

Piriformis muscle is essential to the lower body part movement because it supports the hip joint. It lifts and rotates thighs away from the body, which allows a person to walk or shift weight from one foot to the other, and at the same time, being able to maintain balance.

On the other hand, the sciatic nerve is long, thick, and a major nerve in the body, which extends from the lower end of the spinal cord and goes through the piriformis muscle. It goes down behind the leg’s back, and branches off into smaller nerves that end in the feet.

What causes Piriformis Syndrome?

In an anatomical position, the piriformis muscle serves as not only the thigh at the hip joint’s lateral (external) rotator but also the pelvis at the hip joint’s contralateral rotator. However, if the leg is flexed to around 60 degrees and above, the piriformis muscle switches from being the thigh’s lateral rotator into a medial (internal) rotator.

The piriformis muscle meets the sacroiliac joint, which acts as its stabilizer. Since piriformis syndrome happens when piriformis muscle tightens, any movement or posture that requires piriformis contraction increases the muscle’s baseline tone and contributes to the discomfort or pain when piriformis syndrome occurs.

One of the primary causes of piriformis muscle tightening is when it contracts to normalize a painful or dysfunctional sacroiliac joint. Dysfunctional sacroiliac joint conditions may include hypomobility, hypermobility, macro trauma, recurred microtrauma which causes irritation or inflammation to the concerned join, or sprain.

The most common cause of the piriformis muscle’s tightening would be likely to be either pain or hypermobility if the patient has a chronic posture of lateral thigh rotation, which leads to shortening or hardening of the piriformis muscle.

Piriformis muscle tightening may happen when patients drive their vehicles with the foot on the gas pedal, but the heel is placed on the front of the break. Another cause of piriformis syndrome is a patient’s repeated pattern of crossing their legs, where ankles are on the other side of the knee.

What are the signs or symptoms of Piriformis Syndrome?

  • Pain
  • Tingling
  • Pain that may go from the back part of the body to the foot
  • Recurring pain
  • Severe pain when attempting to do specific movements that require the use of legs (a few examples of which are climbing stairs, running, walking, bending)

Who can treat Piriformis Syndrome?

Doctors or other healthcare professionals who may help treat or address piriformis syndrome include physical therapists occupational therapists, orthopedists, osteopathic physicians, physical therapists, sports medicine doctors and chiropractors.

What are the risk factors concerning Piriformis Syndrome?

For patients involved in sports activities, injuries may include the following:

  • Inflammation (due to overuse or sprain)
  • Trauma (blunt buttock trauma)
  • Hematoma
  • Scar formation

And those who develop the above mentioned near the piriformis muscles may also be at risk of the following:

  • Cysts
  • Pseudo-aneurysms
  • Tumors

What tests do healthcare professionals often diagnose those with piriformis syndrome?

While there are no definitive tests for this neuromuscular disorder, doctors may ask the patient during a physical examination if they experience pain or palpitation when moving the concerned body part in specific directions.

Since piriformis syndrome usually causes sciatica and lower back pain, healthcare professionals perform tests to eliminate other causes of sciatic nerve compression like back sprains, herniated discs, lumbosacral spondylolisthesis, spinal stenosis, and many more.

X-rays may rule out any bone fracture, while CT Scans, MRI (Magnetic Resonance Imaging), Electromyography (EMG), Neurography or Electrophysiologic tests, or injecting on the piriformis muscle’s trigger points with anesthetics like lidocaine, may help the physician on-charge determine if the symptoms present is caused by piriformis syndrome or other health concerns like herniated disc and others.

Is it possible to avoid Piriformis Syndrome?

Preventing piriformis syndrome is possible if an individual avoids overuse or trauma to the lower back or gluteal muscles. With proper flexibility training, exercise, and proper stretching, the recurrence of piriformis syndrome may also be avoided if the concerned individual commits to such a lifestyle.