Efficacy of Trigger Point Injections in Patients with Lumbar Disc Hernia without Indication for Surgery

Study DesignProspective comparative study.PurposeTo investigate the efficacy of gluteal trigger point (TP) injections with prilocaine in patients with lumbosacral radiculopathy complaining of gluteal pain.Overview of LiteratureTP injections can be performed using several anesthetic agents, primarily lidocaine and prilocaine. While several studies have used lidocaine, few have used prilocaine.MethodsA total of 65 patients who presented at the polyclinic with complaints of lower back pain with lumbar disc herniation (based on physical examination and magnetic resonance imaging) and TPs in the gluteal region were included in this prospective comparative study. Group 1 comprised 30 patients who were given TP injections, a home exercise program, and oral medications, and group 2 comprised 35 patients who were only treated with a home exercise program and oral medications. The patients' demographic data, Oswestry Disability Index (ODI) scores, and Visual Analog Scale (VAS) scores were recorded, and these data were evaluated at 1- and 3-month follow-ups.ResultsThe ODI and VAS scores of both groups significantly decreased initially and at the follow-up examinations, but the decreases were more marked in group 1.ConclusionsWe obtained better results with TP injections than only a home exercise program and oral medications in patients with radiculopathy and TPs in the gluteal region

Effects of microprocessor-controlled prosthetic knees on self-reported mobility, quality of life, and psychological states in patients with transfemoral amputations

Objective: This study aimed to determine the effects of the microprocessor-controlled prosthetic knee (MPK) joint on self-mobility, body perceptions, depression, and quality of life in patients with unilateral transfemoral amputations (TFAs)

Comparison of the short-term results of single-dose intra-articular peptide with hyaluronic acid and platelet-rich plasma injections in knee osteoarthritis: a randomized study

Introduction/objectives Intra-articular injections may be useful in terms of pain and functional status, in knee osteoarthritis (OA). Besides hyaluronic acid (HA) and platelet-rich plasma (PRP), peptide molecules recently begin to be used. The aim of this study was to compare the efficacy of intra-articular peptide Prostrolane (R) (CAREGEN Co. Ltd.) injection with that of the HA and PRP in the persons with OA. Method Fifty-four patients with OA were included in this prospective, randomized study. Patients were randomized into three groups as intra-articular HA, peptide, and PRP groups. Paracetamol was permitted three times a day to all groups. All the patients were evaluated by the Western Ontario and McMaster Universities Arthritis Index (WOMAC), Health Assessment Questionnaire (HAQ), and visual analogue scale (VAS) at rest and during movements. Measurements performed at the baseline, after the first week of injection, and at the first and third months of follow-up. Results Mean age was 55.8 +/- 8.9 years. Forty-four (81.6%) were women. A week after the injections, rest and movement pain severity was measured by VAS decreased significantly in all the study groups (p 0.05). WOMAC pain, stiffness, function, and total scores were improved significantly in all the groups a week after the injections (p < 0.05). Improvement continued at the third month control; however, the improvement in the WOMAC pain score was significantly better in the peptide group at the third month control (p < 0.05). The decrease in the rest and movement pain was continued for 3 months except the HA group's rest pain. There were no differences among the groups for all measurements, except for the WOMAC pain score at 3 months after treatment, which was significantly lower in the peptide group. Conclusion As a result, pain relief and functional improvement were obtained after the intra-articular HA, peptide, and PRP injections in OA, and decrease in pain was better in the peptide group

Effects of platelet-rich plasma on the clinical outcomes and cartilage thickness in patients with knee osteoarthritis

Abstract. BACKGROUND: The interest in biological treatments that have the potential to modify cartilage biology has gradually increased in recent years. OBJECTIVE: The aim of our study was to investigate the effects of intra-articular platelet-rich plasma (IA-PRP) injections on the femoral cartilage thickness, pain, functional status, and quality of life of patients with knee osteoarthritis. METHODS: A total of 71 patients (109 knees) with knee osteoarthritis who were administered IA-PRP injections twice with two-week intervals were included in this study. The resting and activity pain values measured using a Visual Analogue Scale (VAS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, the Lequesne index scores, and the quality of life scores measured using Short Form-36 (SF-36) were recorded before treatment and at 1 month, 3 months, and 6 months after treatment. The femoral cartilage thickness was measured via ultrasonography before treatment, and at 3-month and 6-month follow ups. Obtained results were analyzed by the Wilcoxon signed rank test. RESULTS: The mean age of the patients was 47.4 10.4 years old. The resting and activity pain scores were significantly decreased at 1-month, 3-month and 6-month follow ups when compared to the pre-injection values (p &lt; 0.05). Significant reductions were found in the Lequesne index and WOMAC pain, stiffness, and function scores at 1, 3, and 6 months (p &lt; 0.05), while a significant increase was detected in the third month scores when compared to the first month. Significant improvements were determined in the physical functioning, physical role, pain, general health, and emotional role sub-scores during the 6- month period (p &lt; 0.05). However, there was no significant difference with regard to the cartilage thickness at the follow ups (p &gt; 0.05). CONCLUSIONS: The results of our study indicated that the IA-PRP injections improved the pain, stiffness, physical functioning, and quality of life of knee osteoarthritis patients; however, they did not seem to affect the cartilage thickness during the 6-month follow up period. Keywords: Cartilage, intra-articular injection, knee, osteoarthritis, platelet-rich plasm

Efficacy of Trigger Point Injections in Patients with Lumbar Disc Hernia without Indication for Surgery

Study Design: Prospective comparative study

Ultrasound-guided cervical selective nerve block: A case series

BACKGROUND: Cervical radiculopathy is characterized by pain, numbness, tingling, and weakness, mostly in an affected extremity, reflecting compression of a nerve in the neck is compressed or irritated where it emerges from the spinal cord. Diagnosis requires a detailed anamnesis, physical examination, and imaging. Physical therapy, exercise, medical therapy, and injections are the preferred treatments, but injections into the cervical region are only indicated if conservative treatment is ineffective

Cross-training effect of chronic whole-body vibration exercise: a randomized controlled study

Purpose: To determine whether unilateral leg whole-body vibration (WBV) strength training induces strength gain in the untrained contralateral leg muscle. The secondary aim was to determine the potential role of spinal neurological mechanisms regarding the effect of WBV exercise on contralateral strength training. Materials and Methods: Forty-two young adult healthy volunteers were randomized into two groups: WBV exercise and Sham control. An isometric semi-squat exercise during WBV was applied regularly through 20 sessions. WBV training was applied to the right leg in the WBV group and the left leg was isolated from vibration. Sham WBV was applied to the right leg of participants in the Control group. Pre- and post-training isokinetic torque and reflex latency of both quadricepses were evaluated. Results: The increase in the strength of right (vibrated) knee extensors was 9.4 +/- 10.7% in the WBV group (p = .001) and was 1.2 +/- 6.6% in the Control group (p = .724). The left (non-vibrated) extensorsvibrated) knee extensors w4 +/- 8.4% in the WBV group (p = .038), whereas it decreased by 1.4 +/- 7.0% in the Control (p = .294). The strength gains were significant between the two groups. WBV induced the reflex response of the quadriceps muscle in the vibrated ipsilateral leg and also in the non-vibrated contralateral leg, though with a definite delay. The WBV-induced muscle reflex (WBV-IMR) latency was 22.5 +/- 7.7 ms for the vibrated leg and 39.3 +/- 14.6 ms for the non-vibrated leg. Conclusions: Chronic WBV training has an effect of the cross-transfer of strength to contralateral homologous muscles. The WBV-induced muscular reflex may have a role in the mechanism of cross-transfer strength

Efficacy of ultrasound-guided suprascapular nerve block treatment in patients with painful hemiplegic shoulder

ObjectiveThe aim of this study was to evaluate the efficacy of ultrasound-guided suprascapular block treatment in patients with painful hemiplegic shoulder whose pain was not reduced after conservative treatment.DesignThe patients were those whose hemiplegic shoulder pain was not reduced by standard conservative treatment prior to discharge. The study group (n=21) included patients who had undergone an ultrasound-guided suprascapular nerve block (SSNB). The control group (n=21) were patients who had not undergone SSNB. Both groups undertook home exercise programs. All patients were evaluated at 1week and 1 and 3months after the discharge. Evaluations included shoulder range of motion (ROM), Visual Analog Scale (VAS) for pain, EQ-5D-3L for quality of life, the Modified Ashworth Scale (MAS), and Brunnstrom staging.ResultsThe shoulder ROM significantly increased in the SSNB group at 1-3months, when compared with the baseline value. The shoulder ROM significantly decreased (p?0.05) in the control group at 1-3months, when compared with the baseline value. The pain VAS and EQ-5D-3L scores significantly decreased (p?0.05) after treatment in the follow-ups at 1month in the SSNB group. The control group showed no change from the baseline scores (p?0.05). The MAS scores and Brunnstrom staging did not differ between the two groups.ConclusionThe ultrasound-guided SSNB is a safe and more effective treatment than conservative treatment for painful hemiplegic shoulder. Further studies are needed to compare ultrasound-guided and non-guided suprascapular blocks as treatments for hemiplegic shoulder pain

Comparison of the functional and cardiovascular effects of home-based versus supervised hospital circuit training exercises in male wheelchair users with chronic paraplegia

Objectives: The aim of this study was to compare the efficacy of home-based upper extremity circuit training exercises (CTEs) with supervised hospital program in male patients with traumatic complete paraplegia