21) Acute macrotrauma
has been associated with 30-60% of patients presenting with a PRAF.
6-8) These causes are multiple and include psoriasis, lichen planus and other immune-mediated inflammatory diseases, chronic microtrauma or macrotrauma
, and local tumors.
occurs as an acute, perhaps dramatic, event such as a concussion, spinal cord injury, fracture or dislocation.
to the buttocks, leading to inflammation of the soft tissue, muscle spasm, or both causing nerve compression.
Pre-existing symptoms of instability prior to the main injury event may be present and therefore it is likely that further injury may occur as a result of a macrotrauma
event on an already damaged area3 since this study did not exclude participants with pre-existing injuries.
We also deal with patients and personalities who seem to seek repeated suffering in the form of both micro-and macrotrauma
Small excessive forces work continuously on the Achilles causing lots of small 'micro' tears to the fibres, where as a macrotrauma
would be one large excessive force causing a lot of damage.
Precipitating and perpetuating factors such as macrotrauma
including contusions, sprains and strains may give rise to MPDS acutely but in case of microtrauma the onset is more subtle.
According to this theory any trauma which can cause structural alteration to the joint or the muscles is considered macrotrauma
, systemic vascular condition, or exogenous corticosteroid ingestion).
Other causes may include microtrauma and macrotrauma
, weight and activity level, and genetic quality of the cartilage.
Peripheral neuropathic pain originates in the pathological change of nociceptive afferent nervous fibers caused by injured tissue being produced during the microtrauma or macrotrauma
creating inappropriate peripheral or central pain signals (Moskowitz, 1984).