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Proximal diabetic neuropathy, also known as diabetic amyotrophy, is a complication of diabetes mellitus that affects the nerves that supply the thighs, hips, buttocks and/or lower legs. Proximal diabetic neuropathy is a type of diabetic neuropathy characterized by muscle wasting, weakness, pain, or changes in sensation/numbness of the leg.
Botulinum toxin, or botulinum neurotoxin (commonly called botox), is a neurotoxic protein produced by the bacterium Clostridium botulinum and related species. [24] It prevents the release of the neurotransmitter acetylcholine from axon endings at the neuromuscular junction, thus causing flaccid paralysis. [25]
This includes eliminating tight fitting clothing and tight belts, losing weight, avoiding activities that aggravate symptoms, and physical therapy to stretch the muscles and tendons present along the course of the lateral femoral cutaneous nerve. [3] [5] [4] Medications can be used for symptomatic treatment. [5]
The innominate bones join in the front of the pelvis to form the pubic symphysis, and at back of the sacrum to form the sacroiliac (SI) joints. Each innominate bone (ilium) joins the femur (thigh bone) to form the hip joint; thus the sacroiliac joint moves with walking and movement of the torso. [9]
The Thomas test is used to detect excessive tightness of the iliotibial band. In this test the patient holds the unaffected leg to their chest while the examiner straightens and lowers the other leg to a horizonal position, inability to fully straighten and lower the leg indicates excessive band tightness. [13] [14] [15]
This is most common in middle-aged women and is associated with a chronic and debilitating pain which does not respond to conservative treatment. Other causes of trochanteric bursitis include uneven leg length, iliotibial band syndrome, and weakness of the hip abductor muscles. [1]
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