Clinical rheumatology
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This overview is based on the over 30 years of performing arts medicine experience of the author, an orthopaedic surgeon who devoted his professional life entirely to the prevention, diagnostics, and treatment of dancers' and musicians' injuries. After a short introduction on the specific demands of professional dance and music making, it describes some general principles of orthopaedic dance medicine and causes of injuries in dancers. The relation of dance injuries with compensatory mechanisms for insufficient external rotation in the hips is explained, as well as hypermobility and the importance of 'core-stability'. ⋯ In overuse injuries, relative rest supported by 'mental practice' is effective. The specific orthopaedic musicians' medicine section deals with some common injuries of the neck and upper extremities, like (posture related) cervicobrachialgia, and thoracic outlet syndrome. An important group of causes of musicians' injuries form the entrapment neuropathies (especially ulnaropathy), osteoarthritis of the hands and hypermobility.
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Compared to elite athletes, elite performers, especially musicians and dancers, invariably lack expert medical backup even though their needs are just as great as the sportspeople. In some countries, this is now being realised and addressed. It is hoped that a new MSc in Performing Arts Medicine, recently introduced in the UK, will go some way towards correcting this, and its syllabus has provided the catalyst for this themed issue.
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Clinical rheumatology · Mar 2013
Randomized Controlled TrialThe effect of dry needling in the treatment of myofascial pain syndrome: a randomized double-blinded placebo-controlled trial.
The objective of this study was to test the hypothesis that dry needling is more effective than sham dry needling in the treatment of myofascial pain syndrome (MPS). This was a prospective, double-blinded, randomized-controlled study conducted in an outpatient clinic. Thirty-nine subjects with established myofascial trigger points were randomized into two groups: study group (N = 22) and placebo group (N = 17). ⋯ When VAS scores were compared between the groups, the first assessment scores were found to be similar, but the second and third assessment scores were found to be significantly lower in the dry needling group (p = 0.034 and p < 0.001, respectively). When SF-36 scores of the groups were compared, both the physical and mental component scores were found to be significantly increased in the dry needling group, whereas only those of vitality scores were found to be increased significantly in the placebo (sham needling) group. The present study shows that the dry needling treatment is effective in relieving the pain and in improving the quality of life of patients with MPS.
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Clinical rheumatology · Mar 2013
Randomized Controlled TrialTramadol/acetaminophen combination as add-on therapy in the treatment of patients with ankylosing spondylitis.
This study aimed to determine the safety and efficacy of tramadol 37.5 mg/acetaminophen 325 mg combination tablets (Ultracet®) in patients with ankylosing spondylitis (AS). This was a 12-week, randomized, double-blind, placebo-controlled study. Sixty patients with active AS according to the Modified New York Criteria were enrolled. ⋯ The tramadol 37.5 mg/acetaminophen 325 mg combination tablet (Ultracet®) might has additional effect to nonsteroidal anti-inflammatory drugs in the treatment of patients with ankylosing spondylitis. It showed marginal benefit in pain and disease activity. However, a slight increase in minor adverse events was noted.