Bulletin of the NYU hospital for joint diseases
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Three percent of all biceps tendon ruptures occur at the distal aspect, where the tendon inserts into the radial tuberosity. Distal bicep tendon ruptures typically occur in middle-aged males after an eccentric extension load is applied to the elbow. Patients usually complain of a sudden, sharp, and painful tearing sensation in the antecubital region, with a palpable defect. ⋯ Partial ruptures are significantly less common and initially can be treated conservatively. Chronic tears are more difficult to treat because of possible tendon retraction and poor tissue quality. Tendon grafts using semitendinosus, fascia lata, hamstring, Achilles (calcaneal), or flexor carpi radialis have been successfully used for length restoration in these cases.
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Fibromyalgia is a chronic syndrome of diffuse musculoskeletal pain with tenderness at specific locations, often associated with persistent fatigue, cognitive and mood disorders, joint stiffness, and insomnia. Understanding the pathophysiology of fibromyalgia and the establishment of effective treatments have been complex endeavors that have not yielded simple answers. ⋯ These findings have led to the use of new therapies that have shown beneficial effects on symptoms. This review discusses ideas that have become accepted as well as novel associations under consideration in regard to the pathogenesis of fibromyalgia and the current and emerging therapeutics for its treatment.
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Bull NYU Hosp Jt Dis · Jan 2010
The effectiveness of tricyclic antidepressants on lumbar spinal stenosis.
Tricyclic antidepressants have not been explicitly studied in the conservative treatment of lumbar spinal stenosis. A retrospective chart review was conducted in a subset of patients with chronic low back pain and lumbar spinal stenosis managed with low dose tricyclic antidepressants. Of 26 patients, 20 reported improvement in back pain. ⋯ Patients with both leg and back pain reported improvement in greater proportion than patients with back pain alone. According to this study tricyclic antidepressants appear to be effective in controlling lumbar spinal stenosis symptoms in this patient population. Tricyclic antidepressants need to be further analyzed in randomized controlled studies as a means to conservatively manage lumbar spinal stenosis with stratification based on location of pain.