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Conditions which may benefit from prolotherapy are:
Complications are uncommon but do occur, and include pain or discomfort around the injection site, numbness of the skin in the same area, increased pain from muscle spasm in the injection area, permanent nerve pain, allergies or reactions to the medication and infection.
People worry they will injure or over strain the joints as they are unable to feel them after the nerves have been heat damaged. This has not been found to occur, even with the very large number of these procedures which have been performed. There is a small chance, less than 5%, that the pain will worsen after the procedure. This may be due to increased irritation of a partially damaged nerve, which was not completely destroyed. Treatment with medication can help this and it usually goes away in several months.
The next day, the patient can return to regular activities, with care. The neck or back is often very sore over the next one to four days, caused by muscle spasm and irritability while the targeted nerves are dying from the heat damage over the next one to two weeks. Resting for a few days before resuming normal activities is normal, with painkilling medication given as appropriate.
Radio frequency denervation is performed under fluoroscopy (a form of live x-ray). It is important to be sure that the placement of the needle is accurate, to damage the correct small nerve and avoid unintended consequences.
Patients are advised to avoid driving and strenuous activities for the day of the procedure, and to continue taking their normal medications except aspirin or other blood-thinning medications.
An intravenous line is inserted so that relaxation drugs can be given as required and the patient asked to lie face down on the x-ray table.
A local anesthetic is given to the area of skin where the procedure is to be performed. Fluoroscopy, which is live x-ray guidance, is used to place the needle alongside the medial or lateral branch nerves. A small electrical charge is passed through the needle to check it is in the right area next to the nerve. This stimulation should bring on the patient’s typical pain and make the back muscles twitch.
The target nerves are then anesthetized to minimize the pain while the lesion is being made, and repeated as often as the number of nerves to be treated. The whole thing takes from 30-90 minutes.
Users of functional knee braces and neoprene sleeves have similar recoveries from anterior cruciate ligament reconstruction, according to new research presented recently at the 2007 Annual Meeting of the American Orthopedic Society for Sports Medicine.
Pilates is an exercise program that focuses on the core postural muscles that help keep the body balanced and are essential to providing support for the spine. In particular, Pilates exercises teach awareness of neutral alignment of the spine and strengthening the deep postural muscles that support this alignment, which are important to help alleviate and prevent back pain.
The Pilates exercise program
Pilates is an exercise system named after its originator, Joseph Pilates. Mr. Pilates developed this system in the early 1900’s to improve his health and to support the health of fellow World War I internees. Later, he incorporated the resistance of springs into rehabilitation programs for hospitalized patients, and then translated the use of springs into machines and created the unique equipment now used in the exercise system.
Important principles of the Pilates exercise program include:
· Use of mental focus to improve movement efficiency and muscle control
· Awareness of neutral spine alignment, or proper posture, throughout the exercises
· Development of the deep muscles of the back and abdomen to support this posture
· Use of breath to promote mental focusing and centering
· Creating length, strength, and flexibility in muscles
Electrodiagnostic tests generally have two components: An electromyogram (EMG) and a nerve conduction study (NCS). These tests evaluate the physiology and functioning of the nerves and muscles and give information that complements the findings provided by x-rays and other scans. They cannot measure the pain that you may be experiencing but do give information about past or current damage to nerve fibers and how that damage affects muscles.
Epidural steroid injections for rehabilitation
In general, an epidural steroid injection is used to help provide pain relief to enable patients to progress with their rehabilitation. Individuals who have less back pain and feel more comfortable are generally able to work on the active therapies—such as stretching, strengthening/pain relief exercises and low impact aerobic conditioning—that are critical in rehabilitating the lower back and helping prevent (or minimize) future episodes of low back pain.
Several common conditions—including a lumbar disc herniation, degenerative disc disease, and lumbar spinal stenosis—can cause severe acute or chronic low back pain and/or leg pain. For these and other conditions that can cause chronic pain, an epidural steroid injection may be an effective non-surgical treatment option.
What will happen to me during the procedure?
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