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STRESS FRACTURE AKIN TO METAL FATIGUE
Dear Dr. Donohue: The term "stress fracture" bothers me. It seems that it is a fracture, but not really a fracture. Is it a break in the bone or not? I see references to stress fractures in your column now and then, and it is not clear what is meant. Do stress fractures show on X-rays? How long before you can use the limb again?
-- J.N.
Stress fractures are breaks in a bone surface. If not allowed to heal, a stress fracture can develop into a thorough break across a bone.
Stress fractures have their origin in misuse or overuse of the bone. Improper running mechanics can contribute.
In some ways, a stress fracture is comparable to what occurs when you bend any pliable object. For example, if you bend and rebend a piece of metal often enough, eventually the repetitive force forms a surface fracture and ultimately a complete break.
A stress fracture calls for rest of the stressed limb and an evaluation of the particular activity or exercise involved. Depending on a stress fracture's severity, it requires from four to 12 weeks of rest.
Early on, in the first week or so, a stress fracture might not be visible on X-rays. But it shows up clearly on a bone scan.
Dear Dr. Donohue: Many years ago, I started taking vitamin E because I heard it was good for your complexion. After some time, I noticed that my leg cramps had disappeared. When I stopped the vitamin, the cramps came back. Of course I started the vitamins again, and have been cramp-free since. Just a response to your recent item.
-- Mrs. W.T.
Another testimonial to vitamin therapy. There is, I must restate, no proof that your vitamin E dosage prevents leg cramps, but I learned years ago not to argue with success, even someone else's.
We will hear from both sides of the E controversy in the future, I am sure.
Dear Dr. Donohue: We recently heard of a "Nervous Leg Syndrome Support Group." I wonder if it would help my wife. When she lies in bed at night, her feet jerk spasmodically, less than once a minute. It seldom awakens her. It seems to me watching her that it should drain her energy. I don't want to sleep separately after all these years of marriage.
-- G.L.
I would get a proper diagnosis before joining a support group.
There are a number of drugs to use for nervous leg syndrome. They include baclofen, clonazepam and temazepam.
There is no specific test to diagnose nervous leg syndrome. The doctor usually relies on the patient's description. You should go along for the visit. The patient's bed partner is usually the better witness.
Restless leg syndrome, a similar phenomenon, causes a creepy-crawly sensation that is relieved by getting up and moving about.
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