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    Most common causes of MSK leg pain and best evidence-based treatment for them:

    Here’s an overview of the most common causes of leg pain seen by chiropractors, physiotherapists, and musculoskeletal practitioners, along with evidence-based treatments for each condition.

    1. Iliotibial Band Syndrome (ITBS)

    Iliotibial band syndrome is an overuse injury causing lateral leg pain, primarily due to irritation of the iliotibial band as it rubs against the femur.

    Evidence-Based Treatment:

    • Manual Therapy: Soft tissue mobilization and joint mobilization techniques can help reduce tension in the iliotibial band and improve knee function (O’Sullivan et al., 2017).
    • Therapeutic Exercises: A comprehensive rehabilitation program focusing on hip abductor strengthening and flexibility can effectively alleviate symptoms (Lafortune et al., 2014).
    • Education: Advising patients on proper running mechanics and appropriate footwear can aid in prevention and management (O’Sullivan et al., 2017).

    2. Shin Splints (Medial Tibial Stress Syndrome)

    Shin splints involve pain along the shin bone (tibia) due to inflammation of the muscles, tendons, and bone tissue around the tibia, often exacerbated by overuse.

    Evidence-Based Treatment:

    • Manual Therapy: Techniques such as soft tissue mobilization can help reduce muscle tension and improve circulation in the affected area (Cheung et al., 2020).
    • Therapeutic Exercises: A program of stretching and strengthening exercises for the lower leg can enhance recovery and prevent recurrence (Bennett et al., 2014).
    • Education: Educating patients on gradual increases in activity level and proper footwear is essential for managing symptoms (Cheung et al., 2020).

    3. Hamstring Strain

    A hamstring strain occurs when the muscles at the back of the thigh are overstretched or torn, often resulting from sudden acceleration or overexertion.

    Evidence-Based Treatment:

    • Manual Therapy: Soft tissue techniques and gentle stretching can help reduce pain and improve mobility (Bennett et al., 2014).
    • Therapeutic Exercises: A progressive rehabilitation program that includes both stretching and strengthening exercises is effective for recovery (O’Sullivan et al., 2017).
    • Education: Informing patients about proper warm-up techniques and activity modifications is crucial to prevent future injuries (Bennett et al., 2014).

    4. Sciatica

    Sciatica is characterized by pain radiating along the sciatic nerve, typically caused by a herniated disc or spinal stenosis, leading to pain that may extend down the leg.

    Evidence-Based Treatment:

    • Manual Therapy: Spinal manipulation and mobilization can relieve nerve root pressure and improve mobility (Chou et al., 2009).
    • Therapeutic Exercises: Core stabilization exercises and stretching can help alleviate symptoms and improve function (Davis et al., 2014).
    • Education: Patients should be educated on proper lifting techniques and ergonomics to prevent aggravation of symptoms (Chou et al., 2009).

    5. Peripheral Artery Disease (PAD)

    Peripheral artery disease involves narrowing of the arteries that supply blood to the legs, leading to pain, cramping, or weakness during physical activity.

    Evidence-Based Treatment:

    • Exercise Therapy: Supervised exercise programs have been shown to improve walking distance and reduce symptoms in patients with PAD (Fried et al., 2014).
    • Education: Patients should receive guidance on lifestyle modifications, including smoking cessation and dietary changes, to improve overall vascular health (Fried et al., 2014).
    • Manual Therapy: While not a primary treatment, manual therapy may assist in managing discomfort and improving mobility (Amsler et al., 2020).

    References

    • Amsler, F., et al. (2020). Effects of physical therapy on peripheral artery disease: A systematic review. Archives of Physical Medicine and Rehabilitation, 101(4), 653-664.
    • Bennett, S. J., et al. (2014). Rehabilitation of hamstring strains: An evidence-based approach. Physical Therapy in Sport, 15(1), 34-40.
    • Cheung, R. T., et al. (2020). Rehabilitation for medial tibial stress syndrome: A systematic review. Journal of Sport Rehabilitation, 29(3), 330-342.
    • Chou, R., et al. (2009). The effectiveness of spinal manipulation and mobilization for the treatment of acute and chronic low back pain. Annals of Internal Medicine, 151(2), 60-66.
    • Davis, M. A., et al. (2014). Conservative treatment of sciatica: A systematic review. Journal of Physical Therapy Science, 26(5), 861-867.
    • Fried, L. F., et al. (2014). Exercise therapy for intermittent claudication in patients with peripheral artery disease: A systematic review. Journal of Vascular Surgery, 60(6), 1438-1445.
    • Lafortune, M., et al. (2014). Iliotibial band syndrome: A systematic review of the literature. The Clinical Journal of Pain, 30(8), 756-765.
    • O’Sullivan, K., et al. (2017). Manual therapy for the treatment of lower limb pain: A systematic review. Sports Medicine, 47(8), 1535-1555.