Industrial Medicine and Acute Musculoskeletal Rehabilitation. 6. Upper- and Lower-Limb Injections for Acute Musculoskeletal Injuries and Injured Workers

Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, NJ 07103, USA.
Archives of Physical Medicine and Rehabilitation (Impact Factor: 2.57). 04/2007; 88(3 Suppl 1):S29-33. DOI: 10.1016/j.apmr.2006.12.013
Source: PubMed


This self-directed study module focuses on the use of corticosteroids and other injections in the treatment of lateral epicondylitis, de Quervain's tenosynovitis, carpal tunnel syndrome, Achilles' tendinitis, and plantar fasciitis. It is part of the study guide on industrial rehabilitation medicine and acute musculoskeletal rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. OVERALL ARTICLE OBJECTIVE: To review the medical literature to help clinicians make treatment decisions regarding corticosteroid and other injections in the upper and lower limbs in injured workers.

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  • Chapter: The wrist
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    ABSTRACT: Injections at the wrist region are frequently performed in musculoskeletal practice. Prior to injection at the wrist or any site, the physician should perform a careful history and a physical exam to hone in on the source of the patient’s presenting symptoms. The literature provides a variety of descriptions regarding how to perform various injections for various procedures, and variable degrees of evidence regarding their effectiveness (Table 8.1).
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    ABSTRACT: This case study was conducted to evaluate the conservative management of a patient presenting with right sided wrist and thumb pain diagnosed as De Quervain's tenosynovitis/tendinopathy. A 49-year-old female warehouse worker and recreational cyclist with right-sided De Quervain's tenosynovitis/tendinopathy that began after a long-distance cycling trip. Treatment included ultrasound, soft tissue and myofascial release therapy, tool assisted fascial stripping or "guasha", acupuncture, mobilizations and kinesiology taping. Home advice included icing, rest, wrist bracing, elevation and eccentric rehabilitation exercises. The positive outcome was a complete resolution of the patient's complaint. This case demonstrates how De Quervain's disease is a challenging condition to treat with conservative methods and can be aggravated with new exacerbating factors as treatment continues. In this case, the addition of the active care (including eccentric exercises and self-care) helped to reinforce the passive care given in the office and accelerate the recovery.
    Preview · Article · Jun 2012 · JCCA. Journal of the Canadian Chiropractic Association. Journal de l'Association chiropratique canadienne
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    ABSTRACT: De Quervain's disease is a painful stenosing tenosynovitis of the first dorsal compartment of the hand affecting the tendons of the abductor pollicis longus and extensor pollicis brevis, caused mainly by overuse. Conventional treatments include rest, immobilisation, oral anti-inflammatory drugs, corticosteroid injection and even surgery, but none of these is established as clearly effective. Acupuncture is rarely mentioned and the points suggested are rather general-regional, tender and ah shi points. Tendinopathy is almost always associated with problems in the relevant muscles and this paper calls attention to the correct identification and needling of the affected muscles, in order to increase the specificity of acupuncture treatment.
    Preview · Article · Dec 2013 · Acupuncture in Medicine