The biceps brachii is a muscle in the upper extremity that is comprised of two heads, a short head and long head. The biceps muscle functions to flex the elbow and forearm. It also is responsible for shoulder flexion, supination of the forearm and hand (turning the palm upward) as well as stabilization of the shoulder. Tendonitis describes an inflammation of the tendon at its insertion junction with the boney attachment site. Tendonopathy describes a general condition that affecting the tendons not functioning properly. Biceps tendonopathy is common in throwing athletes and may be in combination with rotator cuff tendonpathy. Common symptoms may include pain, swelling, or impaired performance. Tendonitis can occur at any of the muscle insertion points. If the tendonopathy is severe enough the long head of biceps tendon may rupture. Treatments may vary depending on the location and amount of pathology present. Salem Pain & Spine Specialists can help diagnose and treat your pain.
Subacromial refers the space in the shoulder between the acromion of the scapula and head of the humerus. The rotator cuff muscle, supraspinatus travels through this space and is often the culprit in shoulder pain associated with either bursitis or tendopathy. Bursitis is the inflammation of one or more bursae. The bursae are fluid-filled sacs that cushion and pad bony prominences, allowing muscles and tendons to move freely over the bone. When bursitis occurs movement of the inflamed area becomes difficult and painful typically during or after an activity. Symptoms vary from local joint pain and stiffness, to burning pain around the region of the inflamed bursa. Bursitis can be easily treated with cortisone injection and anti-inflammatory pain medication along with strengthening exercises. Other causes of bursitis may include infection. Septic bursitis may require antibiotic therapy.
Shoulder pain commonly affects the rotor cuff muscles. The “rotator cuff” refers to a group of muscles that help stabilize the shoulder and connect the upper arm (humerus) to the shoulder blade (scapula) allowing the humerus to rotate. The muscles are; supraspinatus, infraspinatus, teres minor and subscapularis. These muscels come together to form a common tendon. Partial thickness tears most commonly affect the supraspinatus portion of the tendon. It is important to remember that shoulder pain is not proportional to the size of the tear on imaging. Partial thickness tears may heal with guidance of therapy to help specifically strengthen the weak muscles and these patients are good candidates for non-operative management. Patients who do not respond to non-operative treatment may be considered for surgery. As with many overuse injuries prevention is the best way to minimize further problems. Good preventive techniques include healthy life style, good posture that emphasizes proper biomechanics of the shoulder girdle, regular exercises to maintain strength and flexibility. If there are signs of overuse or inflammation utilizing rest,ice, anti-inflammatory medications and joint injections to help speed the healing process prior to beginning a strengthening program. Tendonitis describes an inflammation of the tendon at its insertion junction with the boney attachment site. Tendonopathy describes a general condition that affecting the tendons not functioning properly. Common symptoms may include pain, swelling, or impaired performance. Tendonitis can occur at any of the insertion points. Treatments may vary depending on the location, level of athletic activity and amount of pathology present.
The AC joint is the junction of the acromion of the shoulder blade and clavicle (collar bone). AC joint arthritis is common and in many patients is managed with non-operative treatment. A “shoulder separation” is a traumatic disruption in the ligaments that stabilize the AC joint. There are different classification sytems that grade the tears, mostly depending on which ligaments are involved and the stability of the joint. Most separations do not require surgery, but may predispose to arthritis like conditions later. Osteoarthritis is the most common type of joint disease, also known as degenerative arthritis. It is result of gradual loss or breakdown of the cartilage in the joint contributing to narrowing of the joint space, resulting in abnormal biomechanics and inflammatory joint disease which results in the formation of bone spurs and bone cysts. Many sufferers of osteoarthritis experience disabling pain that keeps them from participating in routine activities. There are many causes, such as natural process of aging, trauma, infection, autoimmune diseases (i.e. lupus, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis and seronegative spondylarthropathy) or crystal deposition. At Salem Pain & Spine Specialists there are many treatment options available for the various types of arthritis.
– Glenohumeral Arthritis Glenohumeral refers to the shoulder joint. The shoulder is capable of a wide range of motion and when functioning smoothly the shoulder is incredibly diverse in it movements. Depending on the severity of arthritis at the Glenohumeral joint, the motion may be compromised. According to Waldman Textbook of Pain Management (2011) osteoarthritis is the most common cause of shoulder pain and functional disability. Osteoarthritis is the most common type of joint disease, also known as degenerative arthritis. Conservative treatments include NSAIDs (anti-inflammatory medications), rest, ice or heat, physical therapy and interarticular joint injections It is result of gradual loss or breakdown of the cartilage in the joint contributing to narrowing of the joint space, resulting in abnormal biomechanics and inflammatory joint disease which results in the formation of bone spurs and bone cysts. Many sufferers of osteoarthritis experience disabling pain that keeps them from participating in routine activities. There are many treatment options available for the various types of arthritis. There are many causes, such as natural process of aging, trauma, infection, autoimmune diseases (i.e. lupus, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis and seronegative spondylarthropathy) or crystal deposition.
Adhesive capsulitis is a gradual severe restriction in range of motion affecting the shoulder joint. The capsule surrounding the joint becomes stuck and fibrotic which affects the fluid like movement of the shoulder. There are three phases; the early phase is called freezing phase, next is frozen and last is thawing. The early phase is severely painful, because movement is still permitted, then gradually it becomes less painful as the range of motion gradually is lost. The pain in the frozen phase changes to a dull ache and function is severely limited and in the thawing phase motion may start increasing as the pain starts to decrease. The lack of movement in the shoulder causes the muscles to atrophy (weaken) and the weakness causes an alteration in the joint mechanics. Careful exam and assessment of the shoulder with clinical tests can indicate the diagnosis of adhesive capsulitis. It is important to rule out more serious conditions that may be also associated with shoulder pain.
Who is affected with adhesive capsulitis? Women are more frequently affected compared to men. The exact cause is unknown, however is thought to be linked to autoimmune component. Maske estimates a 3-5% incidence of adhesive capsulitis in the general population and 20% in secondary adhesive capsulitis with diabetic patients. Type I diabetic have an estimated lifetime risk of developing adhesive capsulitis of 40% There are other systemic diseases also associated with adhesive capsulitis and it may also be the result of prior trauma and reluctance to move the shoulder joint which then develops into adhesive capsulitis.
What can Salem Pain & Spine Specialists do to help adhesive capsulitis? Treatment is primarily aimed at restoring the range of motion first. This can often be done with a simple injection, however the treatment doesn’t stop here. In order to get the best outcome, the remaining treatments are coordinated with physical therapy in order to maintain the newly restored motion and develop proper shoulder mechanics. This includes postural correction, stretching and strengthening the supporting muscles in a graduated fashion under supervision of a physical therapist in order to maintain this balance.
Suprascapular neuritis is an often overlook cause of shoulder pain. Those at risk are individuals who participate in a large amount of overhead activities as a function of specific tasks in your career or your sport. Athletes that demand upper quarter strength such are tennis, baseball, basketball, swimming, volleyball and weight lifting are at risk. The suprascpular nerve lies in the groove (suprascapular notch) of the scapula. A disruption in shoulder mechanics (rotator cuff tears and labrum tears) can also increase the risk for pain associated with suprascapular nerve. Compression of the suprascapular nerve can cause the supraspinatus and infraspinatus muscles to weaken and atrophy. This is termed backpack palsy and is common in backpackers or military persons who carry heavy backpacks. Backpack palsy may also affect other nerves of the posterior cord of the brachial plexus including the long thoracic nerve and axillary nerve. A thorough exam by a specialists who understands shoulder mechanics and disorders of the nervous system (such as PM&R Physical Medicine and Rehabilitation) is important to exclude other causes of shoulder pain. There are treatments available for shoulder pain associated with suprascapular neuritis that can restore your function.
Cubital tunnel syndrome describes entrapment of the ulnar nerve at the elbow. Chronic pressure on the ulnar nerve can cause pain from the elbow radiating to the hand. The function of the nerve may also be affected, either the sensory or motor function or both. Nerve conduction studies are often ordered to identify if the nerve is not functioning properly. Other conditions the must be differentiated form ulnar neuropathy are; medial epicondylitis, cervical (C7 or C8) radiculopathy. At Salem Pain & Spine Specialists we are Physical Medicine and Rehabilitation specialists and understand nerve, muscle and joint disorders and can you help formulate a treatment plan.
The lateral epicondyle of the elbow is the common attachment site for the wrist extensor muscles of the forearm. Lateral epicondylitis is an over-use injury where the muscle has tension overload and results in microscopic tears of the extensor muscles of the forearm. It is involved in activities that require repetitive forearm pronation and wrist flexion or high torque wrist turning or hand grasping activities. Commonly in baseball pitchers, golf, tennis, racquetball, football, javelin and weight lifting. Tendonitis describes an inflammation of the tendinous insertions at the junction to bone. Tendonopathy describes a general condition that affecting the tendons. Common symptoms may include pain, swelling, or impaired performance. Tendonitis can occur at any of the insertion points. Treatments may vary depending on the location and amount of pathology present. Differential diagnosis of other painful elbow conditions include; elbow arthritis, gout, rheumatoid arthritis, olecranon bursitis, golfer’s elbow, radial tunnel syndrome and cervical (C6 or C7) radiculopathy.
Treatment options? Conservative treatments include anti-inflammatory medications (NSAIDs), stretching and strengthening the wrist extensor muscles and review of biomechanics to correct potential causes. If these options do not alleviate the pain, bracing or a steroid injection may be recommended.
The medial epicondyle of the elbow is the common attachment site for the wrist flexor muscles of the forearm. This is an over-use injury where microscopic tears occur at the forearm flexor group at the attachment site causing inflammation and can be painful. Tendonitis describes an inflammation of the tendinous insertions at the junction to bone. Tendonitis describes an inflammation of the tendinous insertions at the junction to bone. Tendonopathy describes a general condition that affecting the tendons. Common symptoms may include pain, swelling, or impaired performance. Tendonitis can occur at any of the insertion points. Treatments may vary depending on the location and amount of pathology present. Differential diagnosis of other painful elbow conditions include; elbow arthritis, gout, rheumatoid arthritis, olecranon bursitis, tennis elbow, ulnar neuropathy and cervical (C6 or C7) radiculopathy.
Treatment options? Conservative treatments include anti-inflammatory medications (NSAIDs), stretching and strengthening the wrist extensor muscles and review of biomechanics to correct potential causes. If these options do not alleviate the pain, bracing or a steroid injection may be recommended.
Carpal Tunnel Syndrome is a compressive neuropathy where there is entrapment of the median nerve at the wrist under the carpal ligament in the carpal tunnel. The median nerve travels with nine flexor tendon through the carpal tunnel. Physical Medicine and Rehabilitation physicians (Physiatrists) or Neurologists with additional training in electrodiagnostic studies can do special testing called a nerve conduction study. The purpose of this test is that it is an extension of the physical exam and provides more detailed information on the severity of nerve damage from the compression. There are conservative options such as bracing and steroid injections that can be tried if the compression is not too severe. In some case with severe compression you may be recommended for surgical release of the carpal ligament. Please ask your physician if any of these treatments are suitable for you.
The Carpal Metacarpal joint is located at the base of the thumb and is the most commonly involved arthritic joint in the hand. A hypermobile joint may contribute to the arthritic changes. Osteoarthritis is the most common type of joint disease, also known as degenerative arthritis. It is result of gradual loss or breakdown of the cartilage in the joint contributing to narrowing of the joint space, resulting in abnormal biomechanics and inflammatory joint disease which results in the formation of bone spurs and bone cysts. Many sufferers of osteoarthritis experience disabling pain that keeps them from participating in routine activities. There are many treatment options available for the various types of arthritis. There are many causes, such as natural process of aging, trauma, infection, autoimmune diseases (i.e. lupus, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis and seronegative spondylarthropathy) or crystal deposition.
Treatment options? Conservative treatments include anti-inflammatory medications (NSAIDs) or review of biomechanics to correct potential causes. If these options do not alleviate the pain, bracing to rest the joint or a steroid injection may be recommended. In severe cases of instability surgery may be recommended.
Trigger finger is an inflammation of the tendons (tenosynovitis) of the finger, specifically the superficial and deep flexor tendons at the A1 pulley. Tenosynovitis can impede smooth movement of the tendon because of edema, fibrosis, stenosis and thickening of the tendon sheath. The inflamed tendon causes an engorgement distal to the pulley and as the tendon travels through this pulley is becomes stuck causing a snapping sensation or “triggering” where the finger feel stuck in flexed position.
Treatment options? Conservative treatments include anti-inflammatory medications (NSAIDs) or review of biomechanics to correct potential causes. If these options do not alleviate the pain, bracing to rest the tendon or a steroid injection may be recommended. In severe cases surgical release may be recommended.
DeQuervain’s Tenosynovitis is an inflammation of the tendons (tenosynovitis) of the thumb in the first extensor compartment. Common symptoms may include pain, swelling, or impaired performance. Tenosynovitis can impede smooth movement of the tendon because of edema, fibrosis, stenosis and thickening of the tendon sheath. The involved tendons are the abductor pollicis longus and extensor pollicis brevis of the thumb. This is a repetitive injury involved in activities pinching the thumb alongside wrist movement in the radial or ulnar planes. There are many potential causes such as trauma, autoimmune diseases of periodic inflammation (i.e. rheumatoid arthritis, psoriatic arthritis and seronegative spondylarthropathy) pregnancy or crystal deposition. A thorough physical exam must be completed by a physician trained in musculoskeletal disorders to rule other causes of wrist or hand pain. Differential diagnosis of radial wrist pain is long and includes CMC arthritis, intersection syndrome, Wartenburg’s syndrome (superficial radial neuritis), carpal fracture (scaphoid, trapezium), scapholunate instability, flexor/extensor carpi radialis rupture or radial styloid fracture.
Treatment options? Conservative treatments include anti-inflammatory medications (NSAIDs) or review of biomechanics to correct potential causes. If these options do not alleviate the pain, bracing to rest the tendon or a steroid injection may be recommended. In severe cases surgical release may be recommended to decompress the tendon.
Trochanteric bursitis refers to lateral “hip pain”. Bursitis is the inflammation of one or more bursae. The bursae are fluid-filled sacs that cushion and pad bony prominences, allowing muscles and tendons to move freely over the bone When bursitis occurs movement of the inflamed area becomes difficult and painful typically during or after an activity. Symptoms vary from local joint pain and stiffness, to burning pain around the region of the inflamed bursa. Bursitis can be easily treated with cortisone injection and anti-inflammatory pain medication along with strengthening exercises. Other causes of bursitis may include infection. Septic bursitis may require antibiotic therapy. The causes of trochanteric bursitis may be due to weak abduction muscles that move the thigh to the side away from the body, result of leg length discrepancies, (scoliosis, after joint replacement or congenital growth deformities) or in runners with coexisting IT band tendonitis or gluteus medius tendonopathy.
Treatment options? Conservative treatments include anti-inflammatory medications (NSAIDs), strengthening the muscles of the hip and thigh or review of biomechanics to correct potential causes if orthotics might be indicated. If these options do not alleviate the pain, a steroid injection may be recommended.
Osteoarthritis is the most common type of joint disease, also known as degenerative arthritis. It is result of gradual loss or breakdown of the cartilage in the joint contributing to narrowing of the joint space, resulting in abnormal biomechanics and inflammatory joint disease which results in the formation of bone spurs and bone cysts. Many sufferers of osteoarthritis experience disabling pain that keeps them from participating in routine activities. Hip arthritis pain is manifested in the groin with weight bearing
There are many treatment options available for the various types of arthritis. There are many causes, such as natural process of aging, trauma, infection, autoimmune diseases (i.e. lupus, rheumatoid arthritis, avascular necrosis, psoriatic arthritis and seronegative spondylarthropathy) or crystal deposition. Infectious causes may be septic arthritis.
Treatment options? Conservative treatments include a healthy lifestyle, weight loss, smoking cessation, anti-inflammatory medications (NSAIDs) therapy to strengthen any muscular deficiencies and review of biomechanics to correct potential causes. If these options do not alleviate the pain, interarticular steroid injection may be recommended. If these options are not helpful, surgical consultation may be recommended.
Iliopsoas is actually two muscles, the iliacus and psoas. These muscle together are responsible for hip flexion. With a shortened muscle either from spasm or strain there may be an audible snapping with hip flexion/extension movments. Bursitis is the inflammation of one or more bursae. The bursae are fluid-filled sacs that cushion and pad bony prominences, allowing muscles and tendons to move freely over the bone. When bursitis occurs, movement of the inflamed area becomes difficult and painful typically during or after an activity. Symptoms vary from local joint pain and stiffness, to burning pain around the region of the inflamed bursa. Bursitis can be easily treated with cortisone injection and anti-inflammatory pain medication along with strengthening exercises. Other causes of bursitis may include infection. Septic bursitis may require antibiotic therapy or surgical drainage if there is an abcess.
Treatment options? Conservative treatments include a healthy lifestyle, weight loss, smoking cessation, anti-inflammatory medications (NSAIDs) therapy to stretch the psoas and strengthen the back muscles and review of biomechanics to correct potential causes. If these options do not alleviate the pain, a steroid injection may be recommended.
Meralgia paresthetica refers to the entrapment or pinching of the nerve that supplies feeling to the upper outer part of the thigh. This can be caused by trauma or direct pressure. Patients typically complain of a burning sensation or numbness in the lateral thigh. Oftentimes, this condition simply goes away with time.
Meralgia Paresthetica, was first described in 1878. This condition is considered to be due to either compression or injury to the lateral femoral cutaneous nerve near the anterior superior iliac spine as it passes through or under the ilioinguinal ligament.
Tendonitis describes an inflammation of the tendinous insertions at the junction to bone. Tendonopathy describes a general condition that affecting the tendons. Common symptoms may include pain, swelling, or impaired performance. Tendonitis can occur at any of the insertion points. The gluteus medius is a muscle that moves the thigh to side away from the body (abduction) as well as rotation of the hip inward (medially). If there is weakness of gluteus medius the gait pattern is altered, the trunk lurches toward the weak side during stance in order to reduce the effort required of the weak abductors. This is called Trendelenburg gait.
Treatment options? Conservative treatments include a healthy lifestyle, weight loss, smoking cessation, anti-inflammatory medications (NSAIDs) therapy to correct muscle imbalances and review of biomechanics to correct potential causes. If these options do not alleviate the pain, a steroid injection may be recommended.
The piriformis muscle is located in the gluteal region and is primarily an external rotator of the hip. When the hip is flexed is abducts the hip. Lumbar radiculopathy irritates the pirformis muscle. In approximately 20% of the people piriformis muscle is split by the sciatic nerve, more commonly the peroneal division. True neurogenic priformis syndrome is rare, however piriformis muscle related pain is more common. Common causes are direct trauma, hematoma formation, muscle spasm, posterior approach for hip replacement and muscle stretch and weakness. Pain is felt deep in the muscle belly in the buttock, may radiate to the limb and is sometimes described as “hip pain.”
Treatment options? Conservative treatments include weight loss, smoking cessation, anti-inflammatory medications (NSAIDs) therapy to correct muscle imbalances and review of biomechanics to correct potential causes. Accupuncture is also useful for muscle related pain and may be beneficial. If these options do not alleviate the pain, a steroid injection may be recommended. In spasticity cases Botox may be recommended.
Osteoarthritis is the most common type of joint disease, also known as degenerative arthritis. It is result of gradual loss or breakdown of the cartilage in the joint contributing to narrowing of the joint space, resulting in abnormal biomechanics and inflammatory joint disease which results in the formation of bone spurs and bone cysts. Many sufferers of osteoarthritis experience disabling pain that keeps them from participating in routine activities. There are many treatment options available for the various types of arthritis. There are many causes, such as natural process of aging, trauma, infection, autoimmune diseases (i.e. lupus, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis and seronegative spondylarthropathy.) or crystal deposition.
Treatment options? Conservative treatments include a healthy lifestyle, weight loss, smoking cessation, anti-inflammatory medications (NSAIDs) therapy to strengthen any muscular deficiencies and review of biomechanics to correct potential causes. If these options do not alleviate the pain, viscosupplementation injections may be recommended. This is a very effective treatment option for knee arthritis. If there is no improvement despite conservative measures surgical consultation for joint replacement may be recommended.
Pes anserine (goose’s foot in Latin) is the junction of the tendons and / or bursae of the Sartorius, Gracilis and Semitendinosus muscles at the medial knee. Bursitis is the inflammation of one or more bursae. The bursae are fluid-filled sacs that cushion and pad bony prominences, allowing muscles and tendons to move freely over the bone. When bursitis occurs, movement of the inflamed area becomes difficult and painful typically during or after an activity. Symptoms vary from local joint pain and stiffness, to burning pain around the region of the inflamed bursa. Bursitis can be easily treated with cortisone injection and anti-inflammatory pain medication along with strengthening exercises. Other causes of bursitis may include infection. Septic bursitis may require antibiotic therapy.
The plantar fascia is composed of dense fibrous layers of connective tissues along the sole, the plantar surface, of the foot. These fibrotic bands of tissue help support the foot, with repetitive stresses with abnormal loads there can be micro tearing and inflammation.
Contributing factors involved in plantar fasciitis are obesity, shoes with poor support or runners who change the training surface or mileage too quickly.
Treatment options? Conservative treatments include a healthy lifestyle, weight loss, smoking cessation, anti-inflammatory medications (NSAIDs), stretching Achilles tendon to maintain flexibility, review of biomechanics to correct potential causes, foot orthotics to correct deficiencies and provide support, night splints. If these options do not alleviate the pain, a steroid injection may be recommended.
Hallux rigidus was first described in 1887 by Davies-Colley and refers to pain and stiffness at the great toe that may be a result of abnormal mechanics and eventual arthritis at the metatarsalphalangeal joint. Osteoarthritis is the most common type of joint disease, also known as degenerative arthritis. It is result of gradual loss or breakdown of the cartilage in the joint contributing to narrowing of the joint space, resulting in abnormal biomechanics and inflammatory joint disease which results in the formation of bone spurs and bone cysts. Many sufferers of osteoarthritis experience disabling pain that keeps them from participating in routine activities. There are many treatment options available for the various types of arthritis. There are many causes, such as natural process of aging, trauma, infection, autoimmune diseases (i.e. lupus, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis and seronegative spondylarthropathy.) or crystal deposition.
Myofascial pain syndrome (MPS) is a chronic pain sensation that can occur the muscles of the head, face, neck, trunk or limbs, it may have been previously diagnosed as fibromyalgia. MPS can be the result imbalances in the musculoskeletal structure or result of an injury.
In order to arrive at this diagnosis, the patient must exhibit the following criteria:
This is a simple “in office procedure” and can give excellent relief for of the myofascial pain or headaches of myofascial origin and soft tissue damage. A mixture of anesthetics are injected into the muscle trigger point, which helps to relieve muscle spasms. Trigger Point Injections are not painful, and may be repeated on an occasional basis. Your doctor may also recommend a combination of different services in order to help the patient gain better function and mobility which are all effective tools once the pain has been resolved. Examples may include physical therapy, ASTYM, spinal manipulation, massage therapy or other various treatments.
Epidural steroid injections (ESIs) are a common treatment option for some types of cervical, thoracic, arm, low back and/or leg pain. ESIs have been used for low back pain since the 1950s and are still an important part of the non-surgical management of low back pain and sciatica.
The goal of an ESI is to provide the patient with pain relief. Sometimes the injection alone provides the patient with great relief. Your doctor may also recommend a combination of different services in order to help the patient gain better function and mobility which are all effective tools once the pain has been resolved. Examples may include physical therapy, spinal manipulation, massage therapy or other various treatments.
The main goal of the epidural injection is to shrink the swelling in bulging or herniated discs, and to decrease any inflammation that surrounds the disc and the spinal nerve. This is a common procedure. Because of the low risk and low incidence of any significant problems or side effects, this is felt to be a reasonable procedure to pursue when traditional conservative therapy for disc pain has failed to provide improvement. A large percentage of patients upon whom this procedure is performed will get complete resolution of symptoms; a small percentage may experience no real improvement at all. Additional injections have additive effect and are often recommended if only partial relief has been achieved. If there is improvement from the steroid epidural, it likely will occur over the next several days to two weeks. The improvement should not be expected immediately. Patients are advised to rest on the day of the epidural, although bed rest, while preferable, is not required. By the next day, previous activities can be resumed. An occasional patient will feel such significant relief that they are tempted to resume various strenuous activities. They are cautioned not to do this, however. It is generally advised to gradually increase activity to full function which may be coordinated with physical therapy or other physical training once the injections have been completed.
Patients are usually seen within a couple weeks after the procedure for a follow-up exam to evaluate their response.
Side effects and adverse reactions are rare but include fluid retention, “puffiness” and rarely, acne, and a possible “spinal headache”. The incidence of a spinal headache is approximately 1 in 1,000, and occurs in a patient about once every year. Proper precautions are utilized before and during these procedures to minimize the risk. Other rare potential risks include: worsening of symptoms, bleeding, infection, backache, steroid side effects, bowel or bladder dysfunction, hematoma, cord compression, paralysis, neurological damage or impairment, or death.
Radiofrequency Ablation is the treatment of choice for many painful areas of spine weather it is a result of arthritis or a painful nerve. Radiofrequency can offer more long term relief of the cervical, thoracic or lumbar region or peripheral nerves. It is minimally invasive, using specialized equipment and needle with a probe to deliver high-frequency radio waves and heat to eliminate the sensation of the pain form its source. There are different methods to deliver this electric energy, either by pulsed (cooled) or heat (continuous) modes. In pulsed radiofrequency the nerve is pulsed to eliminate the painful aspect and the nerve continues to function.
ASTYM is a physical therapy technique used to help in the remodeling of new collagen at the local inflammation site to increase stretching, strengthening and functional activities. This has been demonstrated to be of benefit in many inflammatory conditions such as patellar tendonitis, plantar fasciitis, lateral epicondylitis, tibial fasciitis. ASTYM can cause bruising or discolorations which can be tender to the touch following treatment and may require multiple applications. Anticipated response may require a few treatments. Usually, the pain associated with ASTYM will decrease over time as the increased muscle tone begins to resolve. However, the pain may increase before it gets better and it is very important to keep stretching to the point of pull but not pain, as directed by the physical therapist.
Disclaimer: This information is for informational purposes and educational purposes only. This information does not constitute medical advice and is not intended to be a substitute for professional medical advice. You should always seek the advice of a physician or other qualified health care provider.