EP. 071: Nerves Under Pressure - A Deep Dive into Entrapment Neuropathies with Annina Schmid
12/07/24 • 50 min
In this episode of the PhysioTutors podcast, Dr. Annina Schmid, a specialist in musculoskeletal physiotherapy and a professor of pain neurosciences at Oxford University, discusses entrapment neuropathies, focusing on conditions like carpal tunnel syndrome and cubital tunnel syndrome. She explains that these conditions occur when nerves are compressed or irritated as they pass through narrow anatomical spaces, leading to symptoms such as pain, tingling, numbness, and sometimes motor changes like weakness. The conversation covers common types of entrapment neuropathies, diagnostic challenges, and distinctions between peripheral and nerve root entrapment. Dr. Schmid emphasizes the importance of pattern recognition, detailed patient assessment, and understanding the anatomical and neurological aspects of each case. Dr. Schmid also delves into the importance of deep clinical phenotyping and precision physiotherapy, highlighting the need for detailed understanding of patient presentations and individualized treatment approaches. She discusses the potential benefits and mechanisms of neurodynamic treatments and other interventions, stressing that education and managing patient expectations are crucial. The discussion touches on the role of advanced imaging techniques like ultra-high field MRI in diagnosing and treating entrapment neuropathies, and the significance of surgical intervention in severe cases. The episode concludes with Dr. Schmid's takeaways for clinicians, emphasizing the need for careful diagnosis, patient education, and innovative research approaches.
Content
00:00 Intro
00:48 What are entrapment neuropathies?
01:48 Typical presentations
02:45 Does Piriformis syndrome exist?
05:10 Causes and Riskfactors of PNE
07:23 Differential diagnosis
13:00 How reliable is dermatome examination
15:25 What is Deep Clinical Phenotyping?
20:20 What is Precision Physiotherapy?
24:37 Effects of Neurodynamics
26:49 Effectiveness of other Interventions
31:35 Interface treatment
34:40 When to refer for surgery
36:48 Nerve repair
41:25 Ultra High Field MRI Explained
44:48 Three Take Aways
47:03 Annina's Closing Thoughts
48:13 Contact Info
49:39 Outro
Bonus Material
Download the referenced transcript including PubMed Links and a high-resolution infographic on this episode as part of your Physiotutors membership on the Physiotutors App.
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In this episode of the PhysioTutors podcast, Dr. Annina Schmid, a specialist in musculoskeletal physiotherapy and a professor of pain neurosciences at Oxford University, discusses entrapment neuropathies, focusing on conditions like carpal tunnel syndrome and cubital tunnel syndrome. She explains that these conditions occur when nerves are compressed or irritated as they pass through narrow anatomical spaces, leading to symptoms such as pain, tingling, numbness, and sometimes motor changes like weakness. The conversation covers common types of entrapment neuropathies, diagnostic challenges, and distinctions between peripheral and nerve root entrapment. Dr. Schmid emphasizes the importance of pattern recognition, detailed patient assessment, and understanding the anatomical and neurological aspects of each case. Dr. Schmid also delves into the importance of deep clinical phenotyping and precision physiotherapy, highlighting the need for detailed understanding of patient presentations and individualized treatment approaches. She discusses the potential benefits and mechanisms of neurodynamic treatments and other interventions, stressing that education and managing patient expectations are crucial. The discussion touches on the role of advanced imaging techniques like ultra-high field MRI in diagnosing and treating entrapment neuropathies, and the significance of surgical intervention in severe cases. The episode concludes with Dr. Schmid's takeaways for clinicians, emphasizing the need for careful diagnosis, patient education, and innovative research approaches.
Content
00:00 Intro
00:48 What are entrapment neuropathies?
01:48 Typical presentations
02:45 Does Piriformis syndrome exist?
05:10 Causes and Riskfactors of PNE
07:23 Differential diagnosis
13:00 How reliable is dermatome examination
15:25 What is Deep Clinical Phenotyping?
20:20 What is Precision Physiotherapy?
24:37 Effects of Neurodynamics
26:49 Effectiveness of other Interventions
31:35 Interface treatment
34:40 When to refer for surgery
36:48 Nerve repair
41:25 Ultra High Field MRI Explained
44:48 Three Take Aways
47:03 Annina's Closing Thoughts
48:13 Contact Info
49:39 Outro
Bonus Material
Download the referenced transcript including PubMed Links and a high-resolution infographic on this episode as part of your Physiotutors membership on the Physiotutors App.
Download the Free App now
Follow our Podcast on:
Previous Episode
EP. 070: From Resistance to Commitment - Achieving Behavior Change in Therapy with Serena Simmons
In this episode of the Physiotutors podcast, Kai interviews Serena Simmons, a seasoned psychologist with over 30 years of experience, about behavioral change and patient buy-in in healthcare. Serena highlights the challenges that healthcare providers face due to the lack of psychological training in their initial education, which often leaves them unequipped to effectively promote behavioral change in patients. She emphasizes the importance of understanding both the practitioner's and the patient's psychology to foster meaningful interactions and facilitate change. Serena discusses the significance of the patient-provider relationship, suggesting that building trust and rapport is crucial, and that understanding and addressing the patient's intrinsic motivations can lead to better adherence to treatment plans.
Additionally, Serena offers practical advice for healthcare providers, such as spending more time understanding the patient's emotional reasons for seeking treatment and creating small, achievable milestones to reinforce progress. She also stresses the importance of self-awareness and communication skills for practitioners, recommending further education in human psychology and decision-making processes. Serena's insights underscore the need for a holistic approach that combines psychological understanding with clinical expertise to improve patient outcomes. The episode is rich with strategies for enhancing patient engagement, compliance, and overall effectiveness in physiotherapy and other healthcare practices.
Content
00:00 Intro
02:00 Barriers to behavior change
05:19 How to identify psychological factors impeding recovery
08:15 How to create rapport
14:27 Everything starts with you
18:30 How to strengthen your bond with a patient
24:24 How to uncover a patient's "why"
33:40 The benefit of hands-on treatment
35:13 Motivational Interviewing
39:10 My patient doesn't do exercises
46:06 How to secure buy-in
51:09 Recommended reading
53:30 Serena's closing thoughts
54:10 Contact info
54:35 Outro
Bonus Material
Download the referenced transcript including PubMed Links and a high-resolution infographic on this episode as part of your Physiotutors membership on the Physiotutors App.
Download the Free App now
Follow our Podcast on:
Next Episode
Exploring the Cosmos of Low Back Pain: From Astronauts to Everyday Life with Daniel Belavy
In Episode 72 of the Physiotutors podcast, we interview Dr. Daniel Belavy, a professor with a prolific research background in muscle, bone, and joint health, specifically focusing on low back pain. The discussion explores various aspects of back pain research, including disk herniations in astronauts, the role of mechanical loading in disk health, and the challenges of classifying non-specific low back pain.
Dr. Belavy shares insights from his studies on physical exposure and spine postures, contextual effects in treatment, and exercise training for back pain. He emphasizes the importance of understanding how treatments work to optimize clinical care and highlights the ongoing quest to identify subgroups and optimal exercise prescriptions for back pain. The episode underscores the complexity of back pain and the multifactorial elements influencing it, advocating for continued research and collaboration in the field.
Content
00:00 Intro
00:57 Disc Herniations in Astronauts
04:08 Discs need (de-)loading
08:04 Is there a U-curve for loading?
10:15 NSLBP Classification Challenges
19:20 SI Joint Pain Classification Challenges
24:30 Physical Exposures and Low Back Pain
29:04 Physical Function/Activity and Low Back Pain
31:40 Contextual Effects in Low Back Pain
40:09 How to harness contextual effects in treatment
41:21 Which type of exercise is best for LBP
47:01 Exercise variables and pain reduction
50:29 Daniel's closing thoughts
53:00 Contact info
55:52 Outro
Bonus Material
Download the referenced transcript including PubMed Links and a high-resolution infographic on this episode as part of your Physiotutors membership on the Physiotutors App.
Download the Free App now
Follow our Podcast on:
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