Presented at the 2013 AAPM Annual Meeting« Back

Lax Lower Extremity Pain Syndrome (LLEPS)

Jason Siefferman, MD, jsiefferman@gmail.com¹, (1) Mount Sinai School of Medicine, New York, New York

Introduction: Lax Lower Extremity Pain Syndrome (LLEPS) describes a collection of painful conditions affecting the back and lower extremity united by a common pathophysiologic process. The painful conditions have been well-described as individual entities occurring in isolation, but a single unifying process has yet to be described. Description: In LLEPS, laxity and weakness in the lower extremity lead to postural changes which alter the kinetic chain and increase biomechanical stress on certain structures. Painful conditions attributable to LLEPS may include lumbar facet arthropathy, sacroiliitis, trochanteric bursitis, piriformis strain, iliotibial band syndrome, patellofemoral syndrome, ankle degeneration, plantar fasciitis and metatarsalgia. Treatment: Physical thearpy may be prescribed to address postural changes due to weakness and laxity with the goal of optimizing biomechanical forces along the kinetic chain. Medical or interventional management of pain is also essential for effective participation in physical therapy. Conclusions: Recognition of LLEPS as a clinical syndrome provides a framework for understanding the pathophysiologic process underlying many common pain complaints. Identification of these clinical features may improve diagnostic accuracy and allow for more a comprehensive treatment plan. References: 1) Kosashvili, Y., et al., The correlation between pes planus and anterior knee or intermittent low back pain. Foot Ankle Int, 2008. 29(9): p. 910-3. 2) Waryasz, G.R. and A.Y. McDermott, Patellofemoral pain syndrome (PFPS): a systematic review of anatomy and potential risk factors. Dyn Med, 2008. 7: p. 9. 3) Fredericson, M. and K. Yoon, Physical examination and patellofemoral pain syndrome. Am J Phys Med Rehabil, 2006. 85(3): p. 234-43. 4) Wearing, S.C., et al., The pathomechanics of plantar fasciitis. Sports Med, 2006. 36(7): p. 585-611. 5) Eichenseer, P.H., D.R. Sybert, and J.R. Cotton, A finite element analysis of sacroiliac joint ligaments in response to different loading conditions. Spine (Phila Pa 1976), 2011. 36(22): p. E1446-52.

Funding: None