Needle Injury To Sciatic Nerve

Sciatic Nerve Pain Stretches Exercises Ask Jo

Hey y'all, it's Jo and my assistantwith me today is Bailey again. And today I'm going to be talking about your piriformis.So lots of times I hear people say they've got that sciatic nerve, well actually everybodyhas a sciatic nerve, but you can have pain coming from that nerve, and a lot of timesthat piriformis muscle is causing the pain. So we're gonna show you some stretches tostretch out your piriformis and hopefully get rid of that sciatic nerve pain. Alrightlet's go on to our backs. Here we go. I think we're gonna maybe move Bailey out of the way.In the first stretch for your piriformis is a pretty simple one. A lot of pictures youmay get from your therapist will actually

show one leg down, I actually like for youto have it staying up so you can prop your foot over it. So your gonna make almost likea figure 4 with your legs and then what you're gonna do, the side that's hurting, so my leftside is hurting, I'm gonna cross that leg over. And what I'm gonna do is I'm gonna bringmy knee with my opposite hand towards my shoulder over here. So I'm pulling this leg up and acrossmy body. And what you wanna do same kind of thing with all the stretches, you wanna pulland you wanna feel a stretch under there. Soon as you feel a really good stretch youwanna hold it for 30 seconds. So remember up and across the body. Just coming up isnot gonna get that piriformis stretch. But

coming up and across the body like I'm tryingto bring that knee towards my shoulder. Holding it there for about 30 secondsa real 30 seconds.And then coming back down and you wanna do that 3 times. Now the next one to do, sometimesthis is a little harder for people, but what your gonna do is your gonna keep that samefigure 4, and what your gonna do is your gonna take your hands and on the opposite side thatit's hurting, so the hurting side is still up crossed over it's still my left side. I'mgonna take my hands and put them underneath my thigh, and I'm gonna bring my leg up, andI'm gonna pull until I feel that stretch underneath there. Now some people might have a hard timegrabbing on to their leg here, so again you

can use your belt, or your dog leash and putit under, around your leg, and pull up towards you like this. Same kind of thing, you wantto hold that stretch for 30 secondsbye Bailey, we'll see you later and then 3 times each.Alright, so now you're gonna bring that down getting it nice and stretched. For those ofyou that need a stronger stretch, those might not be stretching it out quite as much, whatI'm gonna have you do is I'm gonna have you turn over. And what your gonna do is the sidethat's hurt again, my left side, I'm gonna bring my leg up across. Now as you can see,this is something you have to be pretty high level, pretty flexible to do, but it's gonnaget a fantastic stretch. So your gonna put

your knee over across your body, and bringyour body down. So it's almost that same concept, you're bringing that knee towards the oppositeshoulder, but what you're doing now, is you're using your body weight to bring it down. Youcan stretch that back leg as far as you can. You can bring your arms down, but that kneeis essentially going towards that opposite shoulder. 30 second stretch, 3 times each.Alright and there you have it. Those were your piriformis stretches. So if you had somepressure on that sciatic nerve, hopefully that will loosen it up a little bit. So ifyou like my hair, or if you like the stretches, please click quot;likequot; and leave me a comment.And if you'd like to see some more stretch

tutorials, or if you'd like to go see some educationaltutorials, please go to AskJo . And remember, Be Safe. Have Fun. And I hope youget to feeling better y'all!.

Saphenous and Sural Nerve Injury Following Laser How to Avoid

Saphenous Nerve and Sural nerve injuries area potential complication of all endothermal treatments both endovenous laser and radiofrequencyablation. This presentation discusses this problem. It is mainly of concern to s,nurses and vascular technologists, but members of the public mainly also find it of interest.My own interest in this subject was stimulated by colleague and friend Ted King in Chicago.Ted has done a lot of al research on the saphenous nerve and sural nerve and theiranatomical relationship to the great saphenous vein and the small saphenous vein. Ted haskindly helped to direct my reading of the medical literature and he has generously sharedthe findings of his own research that was

presented to the European Venous Forum inJune 2010. Nerve injury may occur in over a third oflaser treatments of the great saphenous vein and nearly one in twenty small saphenous veintreatments. A recent study from Germany has even suggestedthat saphenous nerve injury is more likely after endovenous laser than after surgicalstripping. The study authors have proposed that in some cases the nerve may have beeninjured by the needle during administration of the tumescent local anaesthetic.Here are the mechanisms by which the nerve might possibly be injured. Firstly, the nervemight injured by the needle during the cannulation

of the vein itself. This is probably veryrare but it is possible that the nerve could be transected by the needle. Similarly, aneedle stick injury might occur during the administration of local anaesthetic causinga neurotemesis. Finally, the thermal ablation could cause the direct transfer of heat energyto the nerve causing a thermal neuropraxia a burn injury.These are the possible strategies to avoid nerve injury. Firstly, the nerve and veincan be imaged in transverse section to identify a site of cannulation where the nerve andvein are sufficiently far apart to minimise the risk of thermal energy transfer. Secondly,the vein and nerve can be imaged in transverse

section during the cannulation to ensure thatthe vein is cannulated directly and that the needle tip does not impinge on the nerve.Thirdly, the nerve, vein and needle tip can be kept in view during tumescent anaestheticadministration by scanning in transverse section at all times. Lastly, the needle should bewithdrawn immediately and the thermal ablation terminated immediately if pain is felt inthe sensory distribution of the nerve at risk. In fact, performing these treatments underlocal anaesthetic is much safer than under general anaesthetic for this very reason.When pain occurs, the treatment should be terminated or the needle withdrawn, makingthe possible risk of nerve injury less likely.

Here you can see that the saphenous nerveand the great saphenous vein are very close and in contact in the distal calf. The twolie within the saphenous fascia superficial to the tibia. In this case the nerve liesanterior to the vein. This would not be a good site for cannulation. Even if the needletip is kept in view and the vein is cannulated cleanly by which I mean the needle tip isnot allowed to stray near the nerve, it is likely that the nerve would be injured byadministration of local anaesthetic fluid. As this tutorial clip shows, distally the nerveand vein and nerve are in contact as the probe moves more proximally, the vein and nerveare separated by 10mm or more. The vein can

be easily identified by the fact that it collapsesflat with pressure from the transducer probe. The probe is moved proximally and distally. Here once again we can see the probe moving more distally, and the vein and the nervecoming into contact with each other the vein collapsing on pressure.Here is the appearance of the Sural Nerve in relation to the small saphenous vein. Theanatomy and ultrasound appearance of the sural nerve have been very nicely described by Ricci.This tutorial clip shows that further proximally the vein and nerve are separated by 10mm ormore. As the probe moves more distally, the vein and the nerve are in close contact. Thevein here is collapsing on light pressure

Leave a Reply