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Should You Give Injectables a Shot for Osteoarthritis Pain?

Should You Give Injectables a Shot for Osteoarthritis Pain?

(ĐTĐ) – A number of injectables, including corticosteroids and hyaluronic acid, are now available to treat painful knee osteoarthritis. Finding relief from knee pain can be a trying experience for the nearly 27 million Americans who live with osteoarthritis. Non-steroidal anti-inflammatory drugs (NSAIDs) help many, but these medications can have serious side effects, including ulcers and serious gastrointestinal bleeding. What’s more, supplements such as glucosamine and chondroitin, which were once hailed as miracles, have not always lived up to their…

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Corticosteroid Injections of Joints and Soft Tissues

Corticosteroid Injections of Joints and Soft Tissues

Introduction Use of cortisone injections in the treatment of muscle and joint inflammatory reactions is becoming increasingly popular. First popularized by Janet Travell, MD, muscle injections are a remarkably effective adjunct to pharmacologic and physical therapies and are safe and easy to perform. Joint injections, while technically more difficult to perform, also can be of great benefit in the patient’s recovery. The purpose of this article is to introduce the basic principles of muscle and joint injections. Mechanism of Inflammation …

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Coccyx Injections

Coccyx Injections

Coccyx pain (coccydynia) apparently occurs far less commonly than lumbosacral pain. Coccydynia can be a severe and persistent pain, causing significant suffering, frustration, and functional limitations (199). These patients often have a history of coccyx trauma (e.g., from a fall or childbirth) resulting in contusions, fractures, dislocations, or other injuries. However, other cases are idiopathic. Typical symptoms include focal tailbone pain, particularly worse with sitting and sometimes immediately worse upon going from sit-to-stand (199). Careful screening should seek to exclude…

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Metatarsal Joint Injection

Metatarsal Joint Injection

Tiếng Việt >> Indications This injection procedure is used to diagnose and treat Morton’s metatarsalgia and Morton’s neuroma. Techniques After informed consent is obtained, the patient is positioned for optimal access to the dorsal aspect of the foot. The metatarsal joint interspaces are palpated for swelling and tenderness. The patient is prepared in a standard aseptic fashion over an area large enough to allow palpation of landmarks, and sterile technique is used throughout the procedure. A 1-in. (2-cm), 25-gauge needle…

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Metatarsophalangeal Joint Injection

Metatarsophalangeal Joint Injection

Tiếng Việt >> Indications Metatarsophalangeal joint injection is a useful procedure in the treatment of joint inflammation secondary to rheumatoid arthritis. Techniques After obtaining informed consent, the patient is positioned for optimal access to the dorsal surface of the foot. The metatarsophalangeal joints are palpated for swelling and point tenderness. The patient is prepared in a standard aseptic fashion over an area large enough to allow palpation of landmarks, and sterile technique is used throughout the procedure. Light traction is…

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Sacroiliac Joint Injection

Sacroiliac Joint Injection

The sacroiliac (SI) joint can be a significant source of low back pain (141–143). Etiologies of SI pain include spondylo arthropathy, crystal arthropathy, septic arthritis, trauma, and pregnancy diasthesis (144). In addition, SI joint dysfunction (pain from a biomechanical disorder without a demonstrable lesion) has been proposed as a possible etiology of SI pain (145). Among patients with chronic low back pain, a study using a single block technique of the SI joint with a local anesthetic, estimated the prevalence…

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Plantar Heel Fascia Injection

Plantar Heel Fascia Injection

Tiếng Việt >> Indications Plantar heel fascia injection is used to treat inflammation at the insertion of the long plantar ligament at the anterior aspect of the calcaneus, secondary to chronic overuse disorder or spondyloarthritides. Techniques After informed consent is obtained, the patient is placed in the prone position with the feet extending over the end of the examination table. The plantar aspect of the heel is palpated in the area of the attachment of the plantar fascia to the…

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Zygapophyseal Joint Injection

Zygapophyseal Joint Injection

Introduction The prevalence of lumbar zygapophyseal joint (Z-joint) pain has been reported to be approximately 6% in a primary care setting (94). However, in a tertiary spine center, lumbar Z-joint pain has been reported to range from 15% in younger individuals (96) to 40% in older populations (98) with chronic low back pain. In individuals with chronic neck pain after a whiplash injury, Z-joint pain occurred in approximately 50% of patients (99,100). More recent literature examining 500 patients has reported…

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Retrocalcaneal Bursa Injection

Retrocalcaneal Bursa Injection

Tiếng Việt >> Indications Retrocalcaneal bursa injection is a useful therapeutic procedure for bursitis secondary to repetitive overuse disorder or rheumatoid arthritis. Techniques After informed consent is obtained, the patient is situated in the side lying position. The lateral malleolus and the Achilles tendon are palpated. The patient is prepared in a standard aseptic fashion over an area large enough to allow palpation of landmarks, and sterile technique is used throughout the procedure. A 1½-in. (4-cm), 23- to 25-gauge needle…

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Subtalar (Talocalcaneal) Joint Injection

Subtalar (Talocalcaneal) Joint Injection

Indications Subtalar joint injection is used to treat inflammation secondary to rheumatoid arthritis and other inflammatory arthritides. Techniques After informed consent is obtained, the patient is placed in the prone position with the feet extending over the end of the examination table and the foot flexed to about 90 degrees. The location of the subtalar joint, about 1 to 2 cm distal to the tip of the lateral malleolus and posterior to the sinus tarsus, should be palpated and marked….

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