Pain physician
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Ice hockey is a competitive sport and ice hockey injuries can be influenced by many physical and psychological factors. Young ice hockey players are especially vulnerable to injury due to their relative lack of experience and rapid physical growth during their juvenile years. Up to now there has been no survey of the physical, psychological, and environmental etiological factors based on the Korean high school ice hockey players population. ⋯ The multiple aspects of this etiological factor analysis showed modest results. However, based on our results, in order to reduce the long-term implications of youth ice hockey injuries and associated public health costs, comprehensive efforts, including psychological and environmental factor modification, should be put in place.
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We report a new technique for pulsed radiofrequency (PRF) of the entire nerve supply of the knee as an option in treating osteoarthritis (OA) of knee. We targeted both sensory and motor nerves supplying all the structures around the knee: joint, muscles, and skin to address the entire nociception and stiffness leading to peripheral and central sensitization in osteoarthritis. Ten patients with pain, stiffness, and loss of function in both knees were treated with ultrasonography (USG) guided PRF of saphenous, tibial, and common peroneal nerves along with subsartorial, peripatellar, and popliteal plexuses. ⋯ The sustained pain relief and muscle relaxation enabled the patients to optimize physiotherapy thereby improving endurance training to include the daily activities of life. We conclude that OA knee pain is a product of neuromyopathy and that PRF of the sensory and motor nerves appeared to be a safe, effective, and minimally invasive technique. The reduction of pain and stiffness improved the knee function and probably reduced the peripheral and central sensitization.
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Interlaminar cervical epidural steroid injections (ic-ESI) are safe and effective treatment options for the management of acute and chronic radiculopathy, spinal stenosis, and other causes of neck pain not responding to more conservative measures. However, the procedure inherently lends itself to possible spinal cord injury (SCI). Though reports of such events have been documented, the clinical presentation of patients with needle puncture SCI varies. ⋯ Though most cases of devastating outcomes, such as hemiplegia and death, have been reported during cervical transforaminal epidural injections and rarely with ic-ESI, it is important to understand the symptoms and potential pitfalls of performing any cervical epidural injection. Cervical epidural malpractice claims are uncommon, but exceed those of steroid blocks at all the levels combined, demonstrating the need for improved awareness of potential complications in ic-ESI. Here, we will describe an unusual presentation of a spinal cord injection during an ic-ESI procedure.
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The causes of upper extremity radicular pain or neck pain are varied, often involving disc herniation, spinal stenosis, or spondylosis. Cervical transformaminal epidural steroid injection (C-TFESI) is a common treatment for such pain. However, its efficacy conceivably may depend on needle-tip placement, linking the degree of pain reduction achieved to the pattern of contrast dispersion. ⋯ C-TFESI is an effective treatment for cervical radicular pain that is refractory to conventional conservative remedies. However, therapeutic response to C-TFESI and dispersion pattern of injected contrast failed to correlate in this study.