1/8. Low power laser therapy and analgesic action.OBJECTIVE: The semiconductor or laser diode (GaAs, 904 nm) is the most appropriate choice in pain reduction therapy. SUMMARY BACKGROUND DATA: Low-power density laser acts on the prostaglandin (PG) synthesis, increasing the change of PGG2 and PGH2 into PG12 (also called prostacyclin, or epoprostenol). The last is the main product of the arachidonic acid into the endothelial cells and into the smooth muscular cells of vessel walls, that have a vasodilating and anti-inflammatory action. methods: Treatment was performed on 372 patients (206 women and 166 men) during the period between May 1987 and January 1997. The patients, whose ages ranged from 25 to 70 years, with a mean age of 45 years, suffered from rheumatic, degenerative, and traumatic pathologies as well as cutaneous ulcers. The majority of patients had been seen by orthopedists and rheumatologists and had undergone x-ray examination. All patients had received drug-based treatment and/or physiotherapy with poor results; 5 patients had also been irradiated with He:Ne and CO2 lasers. Two-thirds were experiencing acute symptomatic pain, while the others suffered long-term pathology with recurrent crises. We used a pulsed diode laser, GaAs 904 nm wavelength once per day for 5 consecutive days, followed by a 2-day interval. The average number of applications was 12. We irradiated the trigger points, access points to the joint, and striated muscles adjacent to relevant nerve roots. RESULTS: We achieved very good results, especially in cases of symptomatic osteoarthritis of the cervical vertebrae, sport-related injuries, epicondylitis, and cutaneous ulcers, and with cases of osteoarthritis of the coxa. CONCLUSIONS: Treatment with 904-nm diode laser has substantially reduced the symptoms as well as improved the quality of life of these patient, ultimately postponing the need for surgery.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
2/8. Electrodiagnostic medicine.Electrodiagnostic testing examines the physiologic integrity of the peripheral nervous system. However, such testing should represent only one part of an electrodiagnostic consultation in which the entire clinical context, including the history, physical examination, laboratory studies, and electrodiagnostic testing, is considered as a whole. Although each electrodiagnostic laboratory establishes its own normal values for nerve conduction studies and needle EMG, these values should not be used in isolation. The electrodiagnostic consultation can help narrow an otherwise broad differential diagnosis, confirm a suspected diagnosis, or help define a confusing clinical picture.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
3/8. Medial epicondylitis caused by injury to the medial antebrachial cutaneous nerve: a case report.A 35-year-old man who had chronic elbow pain due to medial epicondylitis received a steroid injection into the medial epicondyle. This was followed immediately by increased pain and symptoms of dysesthesia in the distribution of the medial antebrachial cutaneous nerve. On surgical exploration 9 months later, the nerve was found to lie directly over the medial epicondyle and appeared to have sustained an injection injury. This report draws attention to the fact that because the posterior division of the medial antebrachial cutaneous nerve may lie directly over the medial epicondyle, it may be at risk of direct injury if injections are given into the epicondyle.- - - - - - - - - - ranking = 7keywords = nerve (Clic here for more details about this article) |
4/8. Radial tunnel syndrome: a spectrum of clinical presentations.A variety of symptoms associated with 15 cases of resistant tennis elbow and resistant radial tunnel pain are described. These included sensations of popping, paresthesias, and paresis. The duration of symptoms averaged 2.3 years before a definitive diagnosis of radial tunnel syndrome was made. Two unique anomalies were contributing factors in the radial nerve entrapment; one case demonstrated a completely tendinous proximal border of the extensor carpi radialis brevis and the other a bifid extensor carpi radialis brevis origin. Excellent pain relief, elimination of popping, and improvement of the paresthesias and paresis was achieved by release of the radial tunnel in cases unresponsive to conservative treatment.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
5/8. tennis elbow. Anatomical, epidemiological and therapeutic aspects.Five studies of tennis elbow are presented. Epidemiological studies showed an incidence of tennis elbow between 1 and 2%. The prevalence of tennis elbow in women between 40 and 50 years of age was 10%. Half of the patients with tennis elbow seek medical attention. Local corticosteroid injections were superior to the physiotherapy regime of Cyriax. Release of the common forearm extensor origin resulted in 70% excellent or good results one year after operation and 89% at five years. Anatomical investigations and nerve conduction studies of the Radial Tunnel Syndrome supported the hypothesis that the Lateral Cubital Force Transmission System is involved in the pathogenesis of tennis elbow.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
6/8. tennis elbow.The term "tennis elbow" usually refers to lateral epicondylitis, but the same symptoms can be caused by pathologic processes in the elbow. In fact, most cases of this common condition are caused by occupational stress rather than racket sports. patients complain of elbow pain when the wrist is extended against resistance or during repetitive actions with the wrist and elbow extended. The condition is thought to be caused by a lesion at the origin of the common wrist extensor mechanism, at or very near the lateral epicondyle of the humerus. Differential diagnosis includes inflammatory, arthritic and nerve entrapment syndromes. Prompt conservative treatment has a high success rate. Patient education, use of a tennis-elbow band and physical therapy play key roles in the management of acute symptoms and in the prevention of recurrence. Surgical intervention is required only when other treatment fails.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
7/8. ulnar nerve injury at the elbow after steroid injection for medial epicondylitis.We describe an accidental injury to the ulnar nerve at the elbow following steroid injection for medial epicondylitis in a patient with undetected recurrent dislocation of the nerve. The chalky substance found on exploration to intermingle with the nerve fascicles was removed and the nerve was placed under the flexor-pronator mass. After surgery, complete resolution of the epicondylar pain was noted, along with significant improvement in two-point discrimination of the ulnar digits. We recommend clinical assessment of the ulnar nerve location prior to injection to avoid injury. Should recurrent dislocation of the nerve be diagnosed, injection should be given cautiously, preferably with the elbow in an extended or semiflexed position.- - - - - - - - - - ranking = 10keywords = nerve (Clic here for more details about this article) |
8/8. Industrial rehabilitation medicine. 3. Case studies in upper extremity cumulative trauma disorders.This self-directed learning module highlights new advances in this topic area. It is part of the chapter on industrial rehabilitation medicine in the Self-Directed Physiatric education Program for practitioners and trainees in physical medicine and rehabilitation. This section contains three case studies discussing nerve, joint, and soft tissue pathology and work disability due to upper extremity pain. New areas of interest covered in this section include the controversy regarding the work causality of upper extremity disorders, a detailed review of the impact of upper quadrant postural dysfunction on symptom perpetuation, and the assessment and nonsurgical management of thoracic outlet syndrome.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |