Patient: Description of condition (onset, main symptoms, hospital visited, etc.): My father, 61 years old, noticed pain in the back of his left thigh after squatting several times in the morning in early April 2011. There is no improvement and it is showing signs of aggravation. There is no pain when sitting, walking is limited, and the pain improves after squatting or lifting the leg to stretch when walking. He was diagnosed with sciatica at the orthopedic clinic of Changning Central Hospital on June 1, and no other tests such as radiographs were performed. He took blood circulation and pain relief capsules and loxobuprofen tablets orally as prescribed by the doctor. No improvement. I would like to get a doctor’s advice on what caused the sciatica, whether it is an injury to the hamstrings or muscles, or the root cause in other areas. Whether further examination is needed and how to treat and recuperate. Thank you very much. Shanghai Ruijin Hospital, Department of Anesthesiology, Ma Wei: According to the medical history you provided, it can be basically judged that your father is a pear-shaped muscle syndrome, the cause is due to intense or incorrect squatting exercise, when the squatting position jerked up when the injury to the pear-shaped muscle led to muscle membrane rupture or tendon junction part of the rupture, causing the pear-shaped muscle hemorrhagic edema, hypertrophy, degeneration and contracture, compression of the sciatic nerve caused by the syndrome mainly pain symptoms. The pain is characterized by no pain when sitting or standing at rest, but the pain increases when walking and leads to walking limitation, or the pain increases when the feet are together and the affected limb is externally rotated, the pain is increased when the lower limb is elevated within 60 degrees, but the pain decreases after continued passive elevation over 60 degrees, and the pain decreases when squatting, etc. are the pain characteristics of the pear-shaped muscle syndrome, and the general imaging examination is often negative. Through the review of the medical history and physical examination can basically diagnose this disease, in the treatment, the acute phase is stressed to bed rest, your father’s medical history has been 2 months, in addition to pay attention to rest, avoid squatting or walking for a long time and other sports, you can also do physical therapy such as our hospital’s ultra-laser irradiation, if there is a clear pressure point, you can also do a local block injection of anti-inflammatory pain relief solution to relieve pain, I hope my answer I hope my answer will make you satisfied! Patient: Thank you very much, doctor. I would like to ask, will this disease completely eliminate the pain if I rest at home? The old man is worried that the pain will worsen or become irreversible. Since it is not particularly convenient to go to the hospital, would it be beneficial if physical therapy, such as heating by baking lamp irradiation, is given at home. Would some rheumatic pain relief cream help. Thank you very much. If I go to Ruijin Hospital, which department should I register for. Thank you. Ma Wei, Department of Anesthesiology, Ruijin Hospital, Shanghai: The effect of conservative treatment is still possible as long as you pay attention to bed rest and do some physical therapy, etc. Whether the pain can be completely eliminated should be further observed. It has a significant pain relief effect on soft tissue pain caused by strain. If you come to our hospital, you can directly register for the special anesthesia clinic (pain clinic), and then we will decide how to treat the situation!
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