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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]
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.
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 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]
If these are ineffective, the definitive treatment is steroid injection into the inflamed area. Physical therapy to strengthen the hip muscles and stretch the iliotibial band can relieve tension in the hip and reduce friction. The use of point ultrasound may be helpful, and is undergoing clinical trials. [8]
Iliocostal friction syndrome, also known as costoiliac impingement syndrome, is a condition in which the costal margin comes in contact with the iliac crest.The condition presents as low back pain which may radiate to other surrounding areas as a result of irritated nerve, tendon, and muscle structures.
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