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The role of physiotherapy for musculoskeletal disorders in primary care
Published in Maneesh Bhatia, Tim Jennings, An Orthopaedics Guide for Today's GP, 2017
If there is concern over the specific diagnosis or failure to improve over 12 weeks, then further advice and exercise prescription/progression may be required via physiotherapy. Consideration of adjunct therapies such as shock-wave therapy or autologous blood injection is also useful.
Chronic joint pain
Published in Peter R Wilson, Paul J Watson, Jennifer A Haythornthwaite, Troels S Jensen, Clinical Pain Management, 2008
Tanya Baqai, Ali Jawad, Bruce Kidd
Although evidence for inflammation is lacking in most soft-tissue disorders of the forearm and hand, locally injected steroids have been widely used and appear to provide better results than either placebo or local anesthetic alone.158 The best evidence for the efficacy of corticosteroid injections has come from studies in patients with tennis elbow where treatment produces good shortterm benefits, but no improvement in outcome at one year.161[II] Other suggested therapies for which some evidence exists include the use of botulinum toxin,162[II] autologous blood injection,163[III] topical nitrates,164[II] and acupuncture.165[I] Unfortunately, relapse is common, with between 15 and 50 percent of patients with lateral epicondylitis having further symptoms and about 40 percent having prolonged discomfort over the next five years.158[II] Surgery gives good results in the short term, but symptoms may recur.166
Injection therapies for patellar tendinopathy
Published in The Physician and Sportsmedicine, 2020
Dry needling is the repeated passing of a needle through the abnormal part of the tendon to stimulate an inflammatory process. It has been hypothesized that dry needling can cause the disruption of collagen fibers in the tendon leading to internal bleeding [41]. Granulation tissues are formed as part of the inflammatory process. The autologous blood containing rich growth factors can help tendon healing by inducing cell proliferation, collagen regeneration, and promoting the synthesis of angiogenic factors [42,43]. Autologous blood injection was reported effective in the management of chronic heel pain [44], lateral epicondylitis [45], and Achilles tendinopathy [46]. For these reasons James, Ali [41] investigated the effectiveness of a autologous blood injection and dry needling combination in PT. There was a positive impact on the VISA-P score and the patients returned to their normal activity level following the treatment. However, the authors recommended further investigation of this method due to the lack of a control group in the study. In a pilot study Resteghini, Khanbhai [47] examined the effectiveness of autologous blood injection in chronic patellar tendinopathy. A significant improvement was reported on the McGill pain questionnaire, VAS scale, and VISA-P score in subjects who received the autologous blood injection. However, the evidence regarding the efficacy of autologous blood injection is still inadequate.
22q11.2 microduplication syndrome and juvenile glaucoma
Published in Ophthalmic Genetics, 2018
Federico Di Matteo, Paolo Bettin, Giulia Ferrari, Marina Fiori, Carlo Ciampi, Emanuela Manfredini, Alessandro Rabiolo, Francesco Bandello
At subsequent follow-up examinations, the IOP reached 28 mmHg in RE. Since deep sclerectomy in LE had failed previously, the patient underwent trabeculectomy in RE. Once again, persistent hypotony developed, with visual acuity of <20/200, IOP 4 mmHg and macular folds. The same treatment was administered for 2 months, with no significant improvements. Autologous blood injection (ABI) was therefore performed, resulting in an increase in both visual acuity and IOP within 2 weeks.