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Wang Cheng Lin
Orthopedics
About me
Having worked in orthopedic clinical practice for over ten years, he is a committee member for the Asia-Pacific Foot and Ankle Chinese District.
Proficient in diseases
Specializes in treating foot and ankle injuries and diseases.
Voices
Do you need to take an X-ray for plantar fasciitis?
Patients with plantar fasciitis need to have imaging done, as many people with plantar fasciitis also develop heel spurs. Therefore, imaging can be used to check if the patient has heel spurs. In addition to imaging, it is also necessary to perform color ultrasound or MRI. These examinations can reveal local edema in the plantar fascia, indicating some damage to the plantar fascia, and even the presence of aseptic inflammation. It is also necessary to combine the patient's medical history, physical examination, and clinical signs to diagnose plantar fasciitis comprehensively. However, imaging is a very necessary part of the examination process.
Is the ankle pain due to gout or rheumatoid arthritis?
In clinical practice, the first reason for ankle pain is rheumatic or rheumatoid arthritis, which mainly involves the synovium of the joint in the early stages, causing synovial hyperplasia and effusion leading to pain. The second cause is gout, which is due to dietary habits, such as frequent consumption of greasy or seafood-based foods, and a preference for beer, leading to increased uric acid levels and gout. The third cause is osteoarthritis in middle-aged and elderly people, which leads to degeneration of joint cartilage and pain. The fourth cause is sprains, which can lead to damage to cartilage and ligaments within the joint, causing pain. To determine whether ankle pain is caused by gout or rheumatic arthritis, one can simply visit a hospital for a checkup, such as a uric acid test to see if there is a significant increase in gout uric acid levels. If the uric acid level is significantly elevated, it is likely caused by gout. Additionally, one can check for a rheumatism panel to see if the anti-O test is positive; if it is, it may suggest that rheumatic factors are causing the pain.
How is plantar fasciitis treated?
The treatment of plantar fasciitis currently is divided into two methods in clinical practice. The first method is conservative treatment, which includes rest, avoiding strenuous exertion and excessive weight-bearing walking. It can be managed with physical therapy, massage, acupuncture, physiotherapy, and local block injections. If conservative treatments do not improve the condition or even if the pain progressively worsens over more than half a year, severely affecting daily life, surgical treatment may be necessary. The objectives of surgical treatment are firstly to release the plantar fascia and secondly to remove bone, as a significant portion of patients with plantar fasciitis also have heel spurs; therefore, the surgical procedure involves the removal of these bone spurs to alleviate the pain.
Plantar fasciitis clinical symptoms
The clinical manifestation of plantar fasciitis primarily involves pain on the inner side of the foot when bearing weight, particularly severe during excessive weight-bearing activities. This pain can significantly affect your posture while walking and has a substantial impact on daily life. Currently, there are two main treatments used clinically. The first is conservative treatment, which mainly involves rest, local injections, electrotherapy, magnet therapy, and acupuncture to alleviate the pain. If conservative treatment fails to yield results after more than six months and the pain progressively worsens, surgical treatment becomes the only option. Surgical treatment includes releasing the plantar fascia, removing bone spurs, and eliminating inflammatory tissue around the plantar fascia to relieve pain.
Can acupuncture be used for lumbar muscle strain?
Yes, and the effect of acupuncture is very good for the treatment of lumbar muscle strain. At the same time, it should also be known that the treatment of lumbar muscle strain is not just about acupuncture treatment. The most important thing is that the cause of lumbar muscle strain is due to fatigue, and the main cause of the disease must be removed to cure the disease fundamentally. Therefore, patients with lumbar muscle strain, in addition to acupuncture, must pay attention to rest and avoid fatigue. If after the acupuncture, the pain is relieved, and then you continue to do heavy physical work, the lumbar muscle strain will recur and will become increasingly severe. Therefore, in general, after acupuncture, it is still recommended to avoid fatigue and pay attention to rest.
Plantar fasciitis symptoms
The main symptom of plantar fasciitis is pain on the inner side of the foot when bearing weight and walking, which severely affects weight-bearing walking. Over time, this pain during weight-bearing walking can turn into what is known as rest pain, which is pain in the foot even when it is not bearing weight. The treatment of plantar fasciitis is currently divided into two parts in clinical practice. The first part is conservative treatment, which mainly involves massage, acupuncture, electrotherapy, magnet therapy, and occlusive methods to relieve the symptoms of foot pain when bearing weight. If this conservative treatment is ineffective and the pain worsens, severely affecting weight-bearing walking, surgical treatment may be necessary. The goals of surgical treatment are, firstly, to release the plantar fascia, and secondly, to remove heel spurs, as a significant number of patients with plantar fasciitis also have heel spurs. Thus, the aim of surgery is to release the plantar fascia and remove the heel spur to alleviate the pain during weight-bearing walking.
Can a lumbar crush fracture cause paralysis?
Whether a lumbar burst fracture will cause paralysis mainly depends on the severity of the comminution and whether the fracture fragments protrude into the vertebral foramen, compressing the nerves. If it is simply a comminuted fracture and the fragments do not protrude posteriorly and do not compress the nerve roots, then it will not cause paralysis of the lower limbs. However, if the fracture fragments protrude backwards and compress the spinal nerves, or even damage the spinal nerves, the patient may experience complete loss of muscle strength and sensation in both lower limbs. In this case, emergency surgery is required to relieve this compression and reduce the pressure on the nerves, thereby alleviating the symptoms. If lower limb paralysis occurs, long-term oral medication to nourish the nerves is needed to help the nerves gradually recover. Therefore, whether a fracture can cause paralysis mainly depends on whether the nerve is compressed by the fracture fragments. If there is compression, it will result in complete loss of muscle strength and sensation in the patient's lower limbs. (Please take medication under the guidance of a professional physician.)
Is a comminuted fracture of the iliac bone serious?
Iliac fractures are assessed based on the severity of the fracture. Generally, there are two types of iliac fractures. The first type is a linear fracture. If this linear fracture does not involve the joint surface and is a simple, non-severe linear fracture, a plaster cast can be sufficient for complete recovery, usually within about two months. The second type is a comminuted fracture, where the fracture ends affect the joint surface; in such cases, surgical treatment may be required to restore the smoothness of the joint and stabilize the fracture pieces, with a recovery time generally ranging from two to three months. Therefore, a comminuted patellar fracture is generally very serious and typically requires surgery. This is because comminuted patellar fractures are likely to lead to the most common form of post-traumatic arthritis, resulting in pain during activity later on.
Differences between Osteoarthritis and Rheumatoid Arthritis
Osteoarthritis is commonly seen in middle-aged and elderly people, primarily due to long-term joint wear, leading to degeneration of the cartilage in the joints, causing symptoms of pain, swelling, and discomfort in movement. In contrast, rheumatoid arthritis often begins in younger individuals and is linked to genetics and viral infections, primarily being an autoimmune disease. It is characterized by positive rheumatoid factor, including elevated erythrocyte sedimentation rate and C-reactive protein. Additionally, the treatment methods for these two diseases are different. Osteoarthritis can mainly be managed with massage therapy, injections of sodium hyaluronate, and oral nonsteroidal anti-inflammatory drugs to alleviate symptoms. Rheumatoid arthritis, on the other hand, might require the use of immunosuppressants, steroids, or nonsteroidal anti-inflammatory drugs to relieve pain. Importantly, rheumatoid arthritis commonly affects the small joints of the fingers, whereas osteoarthritis most frequently affects larger joints, such as the knee, highlighting the fundamental differences between the two conditions. (Note: The answers provided are for reference only. Medications should be taken under the guidance of a professional physician, and self-medication should be avoided.)
Can osteoarthritis be treated with moxibustion?
The primary cause of osteoarthritis is degeneration, which can lead to damage, wear, and tear of cartilage within the joints, as well as the formation of excessive osteophytes and bone spurs around the joints. These changes cause symptoms such as knee pain, swelling, and difficulty walking. There are many treatment methods available, the most common of which include oral medication, rest, physical therapy, and moxibustion, all of which can help alleviate symptoms. However, these treatments only provide relief from the symptoms of osteoarthritis and do not cure the condition. If a cure is needed, surgical treatment, such as total knee replacement, may be necessary to fully recover. Conservative treatments like moxibustion can help relieve pain and reduce swelling, but they only offer relief and do not cure the condition. Therefore, while moxibustion can alleviate pain from knee arthritis, it cannot cure it.