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Ankle Sprain FAQs

A sprain is a tear of a ligament.
Ligament tears can vary from very
minor - a few fibres stretched - to
complete tears of the entire
ligament. The most common type of sprain is a lateral ankle sprain, where the ligaments on the outer part of the ankle joint are sprained. The most important part of treatment for ankle sprains is physiotherapy supervised rehabilitation to restore strength and balance. Sometimes people with many years of ankle instability from an old injury that was never properly rehabilitated can recover with a good physiotherapy programme.

Clavicle Fracture FAQs

Fractures of the collar bone
(clavicle) are common and seen in
all age groups. Most are due to a
fall onto the shoulder. Clavicle
fractures are divided into medial, mid-shaft and lateral fractures, in which mid-shaft are the most common (80%). Non-operative treatment has traditionally been the norm for treating mid-shaft, operative treatment is indicated for severely displaced, comminuted ('shattered') fractures, especially if associated with high-energy trauma. Almost all displaced lateral clavicle fractures should be operated, as they have a very high rate of non-union, and the non-unions are very difficult to treat. Medial clavicle fractures are not very common (2%).

Lumbar Spinal Stenosis FAQs

Lumbar spinal stenosis most
commonly causes cramping, pain or
pins & needles in one’s legs; but
it can also cause: back pain; loss
of sensation in the legs; and sometimes problems with bladder or bowel function. Lumbar spine (low back) degeneration is the most common cause. Many people may ignore the early symptoms of spinal stenosis, believing that the pain and stiffness they experience are a normal part of aging. Most patients are recommended non-operative treatment for at least 6 weeks. Surgical treatment will be advised if the patient is not responding well.

Bunions FAQs

Hallux valgus is the medical term
for “bunions”, which refers to
the abnormal angulation of the big
toe towards the second toe. Severe
hallux valgus can lead to recurrent inflammation and pain over the bunion due to the repeated friction with shoe wear, difficulty in fitting shoes, second toe or other lesser toe deformities due to overcrowding, and calluses on the sole. There are more than a hundred hallux valgus operations described in the medical literature, but no one operation has proved itself to be the best. The exact operation performed depends on an individual’s particular combination of problems.

Achilles Tendinopathy FAQs

Achilles tendinopathy refers to
diseases of the Achilles tendon,
which often caused by degenerative
problems with combination of
intrinsic and extrinsic factors. This article will focus on non-insertional Achilles tendinopathy. Non-operative treatments are often preferred over conservative treatment which echoes the histological evidence of a degenerative disease process that has poor capacity for healing.

Haemorrhoids: Management update and a word of caution

There are three cushions present in
the normal anal canal, which
contribute 10 15-20% anal closure
pressure and are important for both
flatus and faecal continence. Haemorrhoids occur when these vascular cushions become congested and swollen, and when the condition becomes severe, they can prolapsed out of the anal canal. There are various treatments to Haemorrhoids, in which stapled haemorroidopexy is commonly used nowadays.

Chronic Pain after Ankle Injury

Ankle injuries are one of the most
common sports injuries, accounting
for 10-20% of injuries in different
sports. Ankle injuries can be
divided into: soft tissue (ligamentous/joint capsule) injury, bone injury (fracture/contusion), or combined. Soft tissue injuries (ankle sprain) are far more common than fractures (80% vs. 10%). Most ankle sprains heal without persistent pain or chronic disability after conservative management (RICE and physiotherapy), but 20-40% of patients have persistent problems. Two common sources of chronic pain and disability are ankle impingement and persistent ankle instability. Both ankle impingement and persistent ankle instability are usually treated non-surgically first, if the symptoms are not relieved after a period of time, patients can undergo ankle arthroscopy, a well established procedure which has fewer complications and quicker recovery.

Diagnosis of Low Back Pain FAQs

Accurate diagnosis of back pain
isn’t always easy. The human
spine is very complex, so it can be
difficult to pinpoint the exact
cause of low back pain or other symptoms. Additionally, other factors, like depression, anxiety, or stress, can contribute to the symptoms of back pain. MRI scanning is safe and produces outstanding images of the spine, but, unfortunately, it doesn’t show ‘pain’, therefore, in more complex cases of back pain it can often be very helpful to inject X-ray dye and local anaesthetic into the back to identify, and in some cases, treat, the painful structures.

Biological Knee Replacement (BKR) FAQs

Biological Knee Replacement (BKR)
involves repairing a badly damaged
knee with natural tissues instead
of replacing the entire knee with a
metal and plastic Total Knee Replacement (TKR). In theory the BKR should not ‘wear out’, because it really consists of returning the knee to its uninjured state and giving it a second chance. Essentially repairing, reconstructing or replacing each structure that is broken in the knee. Exactly what is needed will vary between individuals. At best, it could give one a near-normal knee, and allow one to play sport.

Interventional Pain Management

Pain is a multidimensional
experience. Chronic pain differs
from acute pain in that it lasts
for more than 3-6 months, and there
may not be obvious tissue injury leading to the pain. The pathway leading from stimulus to perception may be sensitised. There is often associated depression. Management of chronic pain therefore requires a holistic multi-disciplinary approach. In addition to pharmacological treatment, psychosocial support, physiotherapy and operative treatment, interventional techniques may benefit some patients by defining the pain generator and offers prolonged relief.