The Acupuncture Handbook Of Sports Injuries Pain Pdf To ExcelUniversity of Maryland Medical Center. Introduction. Tendinitis happens when a tendon - - which attaches muscle to bone - - gets inflamed. You feel pain and tenderness right outside a joint. It often happens as a result of repetitive movements. Acute or sudden tendinitis may become chronic or long- lasting if it is not treated. People get tendinitis most often in the shoulder (rotator cuff tendinitis), elbow (tennis elbow or golfer's elbow), wrist and thumb (de Quervain's disease), knee (jumper's knee), ankle (Achilles tendinitis), and hip. ![]() Calcific tendinitis, which happens when calcium deposits build up in a joint, often happens in people who have a chronic disease, such as diabetes. In most cases, you can treat tendinitis with rest and physical therapy. Signs and Symptoms. Swelling. Tenderness. Pain that gets worse when you move the affected limb. Warmth and redness. A crackling sound, called crepitus What Causes It? Tendinitis can happen because of: Overuse, undertraining, or poor technique in sports. Repetitive movement in some jobs, such as typing. Health psychology is concerned with understanding biological, psychological, and social factors that are involved in physical health and prevention of illness. What is a TENS Machine? TENS is an abbreviation of Transcutaneous Electrical Nerve Stimulation. Transcutaneous means "across the skin". In simple terms, a tens. Lumbar strain is a commonly wielded diagnosis (Depalma 2011, Houglum 2001) for mechanical low back pain but is without anatomical or histologic evidence.(Depalma 2011. Falling. Lifting or carrying heavy objects. Extreme or repeated injury Your risk for tendinitis may be higher if you have any of the following health issues: Overweight, due to increased pressure on tendons, ligaments, and bones. Inflammatory conditions, such as Reiter syndrome or ankylosing spondylitis. Autoimmune disorders, such as type 1 diabetes. ![]() Certain infections What to Expect at Your Doctor's Office. Your doctor will give you a physical examination and may take x- rays and other diagnostic tests. Treatment Options. Your doctor may prescribe pain relievers or steroid injections. Treatment also may include ice, rest, or keeping the area still, such as with a sling. Massage, strengthening exercises, or physical therapy may help. Some studies show that high energy shock wave therapy improves symptoms and pain associated with tendinitis. If you have severe tendinitis that is not healing from other treatments, you may need surgery. Drug Therapies. Nonsteroidal anti- inflammatory drugs (NSAIDs). NSAIDs such as ibuprofen (Advil, Motrin) and naproxen (Aleve), reduce pain and inflammation. There are also prescription NSAIDs. NSAIDs may increase the risk of stomach bleeding. Lidocaine or corticosteroid injections into the tendon. Our Founder Pete Egoscue. Pete Egoscue, an anatomical physiologist since 1978, is the creator of the Egoscue Method for safe, effective, and permanent relief from. We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we. Books and Chapters by Myopain Seminars Faculty - Books Co-edited by Jan Dommerholt - Manual Therapy for Musculoskeletal Pain Syndromes. These cannot be used for weight- bearing tendons because of the risk of rupture. Colchicine. For calcific tendinitis, when calcium builds up in the joint. Complementary and Alternative Therapies. Ice, especially right after the injury. Rest. Massage. Immobilizing the affected limb (slings, splints). Flexibility and strengthening exercises after the inflammation goes down. Physical therapy, such as range- of- motion exercises. Ultrasonography. High- frequency sound used to heat an area and increase circulation. Transcutaneous electrical nerve stimulation (TENS). Electricity used to help relieve pain. Nutrition and Supplements. Bromelain. This enzyme that comes from pineapples reduces inflammation. Bromelain may increase the risk of bleeding, so people who take anticoagulants (blood thinners), such as warfarin (Coumadin), clopidogrel (Plavix), and aspirin should not take bromelain without first talking to their doctors. People with stomach ulcers should avoid bromelain. If taken with antibiotics, bromelain may increase the levels of antibiotic in the body, which could be dangerous. Turmeric is sometimes combined with bromelain because it makes the effects of bromelain stronger. Vitamin C. To aid in healing, increase immune function, and reduce inflammation. Vitamin C supplements may interact with other medications, including chemotherapy drugs, estrogen, warfarin (Coumadin), and others. Calcium and magnesium. To aid healing of connective tissues and muscles. If you have any underlying medical conditions, especially heart conditions, such as high or low blood pressure, COPD, or others, you should not take calcium or magnesium supplements without your doctor's supervision. Vitamin A. For immune function and healing. DO NOT use if you are or may become pregnant. Vitamin A interacts with a number of medications, including some that are available over the counter. Some of these interactions can be dangerous. Ask your doctor before taking vitamin A. Vitamin E and essential fatty acids, such as fish oil or evening primrose oil to reduce inflammation. Vitamin E may interact with a number of medications. Vitamin E, fish oil, and evening primrose oil may increase the risk of bleeding. If you take blood thinners, ask your doctor before taking any of these supplements. Herbs. Herbs help strengthen and tone the body's systems. As with any therapy, you should work with your doctor to diagnose your problem before starting treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, make teas with 1 tsp. Steep covered 5 to 1. Drink 2 to 4 cups per day. You may use tinctures alone or in combination as noted. Tell your doctor if you are pregnant or nursing before using any herbal products. Turmeric (Curcuma longa). For pain and inflammation. Turmeric is sometimes combined with bromelain, because it makes the effects of bromelain stronger. Turmeric may increase the risk of bleeding, so people who take anticoagulants (blood thinners), such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin should not take turmeric without first talking to their doctors. Willow bark (Salix alba). Willow acts similar to aspirin. DO NOT take white willow if you are also taking aspirin or blood- thinning medications. DO NOT take willow bark products if you are allergic to aspirin or salicylates. Willow should not be given to children under the age of 1. Licorice (Glycyrrhiza glabra). To reduce inflammation. DO NOT take licorice if you have high blood pressure, edema, or heart failure; hormone- sensitive cancers such as breast, prostate, ovarian, or uterine cancer; diabetes; kidney disease; liver disease; or if you are taking corticosteroids prescribed by your doctor. Licorice interacts with a number of medications. So to be safe, ask your doctor before taking licorice if you take any other medications. The following herbs may also help reduce inflammation, although they have not been tested for tendinitis. Cat's claw (Uncaria tomentosa). Has been used traditionally for pain relief. DO NOT take cat's claw if you take medicine for high blood pressure or blood- thinning medications. Cat's claw may stimulate the immune system, and might interact with drugs taken to suppress the immune system, or be inappropriate for people with autoimmune disorders. Cat's claw may also lower blood pressure, so if you take medication for high blood pressure you run the risk of your blood pressure dropping too low. Devil's claw (Harpagophytum procumbens). Has been used traditionally to relieve pain. Devil's claw may increase the risk of bleeding, especially if you also take blood thinners, such as warfarin (Coumadin). It can interact with diabetes medications and other drugs. It can have negative effects on people with heart problems, such as high blood pressure or low blood pressure. DO NOT take Devil's claw if you have gallstones. Talk to your doctor before taking it. Boswellia (Boswellia serrata). Boswellia may increase the risk of bleeding, so tell your doctor before taking it if you also take blood- thinning medication. Homeopathy. Homeopathic remedies for tendinitis include creams or gels. Arnica cream by itself, or in combination with Calendula officinalis, Hamamelis virginiana, Aconitum napellus, and Belladonna, applied 3 to 6 times a day, speeds healing and reduces discomfort. For acute (sudden) injuries, always start with Arnica. Orally, the dose is usually 3 to 5 pellets of a 1. X - 3. 0C remedy every 1 to 4 hours until the symptoms improve. Bryonia. For pains that are worse with the slightest motion or when jarred. The pain feels worse with cold and better with heat. Phytolacca. For tendinitis where the pain is focused at the insertion of the tendons and feels worse with heat. Rhus toxicodendron. For tendinitis that is worse in the morning. Rhododendron. For tendinitis that gets worse with barometric changes. Many naturally- oriented doctors use injectable homeopathic medications, including Traumeel, which has shown promise in reducing inflammation in some studies. Physical Medicine. Orthotics or heel lifts and shoe correction, for Achilles tendinitis. Elbow strap and small (2 lb.) weights, for tennis elbow. Contrast hydrotherapy, or alternating hot and cold applications. After the first 2. Castor oil pack. Apply oil to a clean, soft cloth, cover in plastic wrap, and apply to the affected area. Place a heat source over the pack, and let sit for 3. Acupuncture. The National Institutes of Health has reported that acupuncture may help treat tennis elbow. In addition, two studies looking at the effect of acupuncture on tendinitis found that acupuncture provides better pain relief than placebo. Acupuncturists say that people with tendinitis frequently have a primary deficiency in the liver meridian, with a relative excess in the gallbladder meridian. In addition to needling treatment on the liver meridian and the supporting kidney meridian, treatments using moxibustion, a technique in which the herb mugwort is burned over specific acupuncture points may also be included. Needling and moxibustion may also be directly applied to painful areas and related sore points. A technique known as balance method acupuncture may be effective in treating many musculoskeletal problems, including tendinitis. Chiropractic Care. Although no well- designed studies have looked at chiropractic care for treating tendinitis, chiropractors commonly treat this condition with ultrasound, electrical muscle stimulation, manual trigger point therapy (applying firm pressure by hand on a trigger point for several seconds and then stretching the muscle afterward), and massage. People with stiff joints may also receive joint manipulation. University of Maryland Medical Center. Description. An in- depth report on the causes, diagnosis, treatment, and prevention of the most common form of arthritis. It is the most common form of arthritis. Risk Factors. Older age. Osteoarthritis usually occurs in older adults. Women. Osteoarthritis occurs more often in women than in men (although among those younger than age 4. Obesity. Being overweight increases the risk of developing osteoarthritis. Joint injuries. Sports injuries or occupational repetitive stress can lead to osteoarthritis. Symptoms. Symptoms of osteoarthritis begin gradually and worsen slowly over time. Osteoarthritis pain is generally described as: Aching or stiffness. Worsening during activity and improving when at rest. Occurring intermittently. Causing a grating sensation when the joint is moved. Bony growths can occur on the margins of joints. Diagnosis. Osteoarthritis is usually diagnosed based on a physical exam and the results of x- rays. In some cases, the doctor may take a sample of synovial fluid from the joint. Treatment. There is no cure for osteoarthritis, but treatment can reduce pain and improve flexibility, joint movement, and quality of life. Treatment options include: Lifestyle modifications and non- drug approaches such as exercise, weight loss, and physical therapy. Medications, including mild pain relievers such as acetaminophen, corticosteroid injections, and hyaluronic acid injections. Surgery may be considered for severe osteoarthritis that is not helped by other treatments. New Guidelines. In 2. American College of Rheumatology (ACR) released updated recommendations for drug and non- drug treatment of hand, knee, and hip osteoarthritis. Key points include: The recommendations emphasize the early use of non- drug treatments, especially aerobic, aquatic, and resistance exercise. Overweight patients are encouraged to lose weight. While not strongly recommended, the ACR considers tai chi, acupuncture, and transcutaneous electrical stimulation (TENS) appropriate options for some patients. For patients older than 7. ACR recommends skin- applied (topical) NSAIDs instead of oral NSAIDs. For older patients, topical NSAIDs pose less risks for stomach bleeding and other side effects. These products contained menthol, methyl salicylate and, in a few cases, capsaicin. The FDA recommends not applying bandages or heating pads to areas treated with these products. If you see signs of blistering or burning, stop using the product and seek medical help. These warnings also apply to topical NSAID products that contain trolamine salicylate. Introduction. Osteoarthritis, also known as degenerative joint disease, is the most common form of arthritis. In this disorder, a joint loses cartilage, the slippery material that cushions the ends of bones, over time. Osteoarthritis is a chronic disease of the joint cartilage and bone, often thought to result from . Joints appear swollen, are stiff and painful, and usually feel worse with increased use throughout the day. The tissue that lines the joint can become inflamed, the ligaments can loosen, and the muscles around the joint can weaken. The patient feels pain and movement limitations when using the joint. Specific parts of the joint, the synovium and cartilage, provide these functions. Synovium. The synovium is the tissue that lines a joint. Synovial fluid is a lubricating fluid that supplies nutrients and oxygen to cartilage. Cartilage. The cartilage is a slippery tissue that coats the ends of the bones. Cartilage is composed of four components: Water. Cartilage is composed mostly of water, which decreases with age. About 8. 5% of cartilage is water in young people. Cartilage in older people is about 7. Chondrocytes. These are the basic cartilage cells that are critical for joint health. Proteoglycans. These large molecules bond to water, which keeps high amounts of water in cartilage. Collagen. This essential protein in cartilage forms a mesh to give the joint support and flexibility. Collagen is the main protein found in all connective tissues of the body, including the muscles, ligaments, and tendons. The combination of collagen mesh and water forms a strong and slippery pad in the joint. This pad (meniscus) cushions the ends of the bones in the joint during muscle movement. Osteoarthritis: The Disease Process. Deterioration of Cartilage. Osteoarthritis develops when cartilage in a joint deteriorates. The process is usually slow. In the early stages of disease, the surface of the cartilage becomes inflamed and swollen. The joint loses proteoglycan molecules and other tissues. This joint then begins to lose water. Fissures and pits appear in the cartilage. As the disease progresses and more tissue is lost, the cartilage starts to get hard. As a result, it becomes increasingly prone to damage from repetitive use and injury. Eventually, large amounts of cartilage are destroyed, leaving the ends of the bone within the joint unprotected. Complicating the process are abnormalities in the bone around arthritic joints. As the body tries to repair damage to the cartilage, problems can develop: Clusters of damaged cells or fluid- filled cysts may form around the bony areas or near the fissures in the cartilage. Fluid pockets may also form within the bone marrow itself, causing swelling. The marrow, which runs up through the center of the bone, is rich in nerve fibers. As a result, these injuries can cause pain. Bone cells may respond to damage by multiplying, growing, and forming dense, misshapen plates around exposed areas. At the margins of the joint, the bone may produce outcroppings, on which new cartilage cells (chondrocytes) multiply and grow abnormally. Location of Osteoarthritis. Unlike some other types of arthritis, such as rheumatoid arthritis, osteoarthritis is less likely to involve many joints around the body or migrate from around one joint to another. Rather, it affects one or a few joints, often joints that have received extra wear. Osteoarthritis affects joints differently depending on their location in the body. It is common in joints of the fingers, feet, knees, hips, and spine. It sometimes occurs in the wrist, elbows, shoulders, and jaw, but it is not as common in these locations. Causes. The exact causes of osteoarthritis are not known. Scientists think that osteoarthritis likely develops from a combination of factors, including genetic susceptibility to joint injury. Aging Cells. The body's ability to repair cartilage deteriorates with increasing age. Although osteoarthritis generally accompanies aging, osteoarthritic cartilage is chemically different from normal cartilage of the same age. As chondrocytes (the cells that make up cartilage) age, they lose their ability to make repairs and produce more cartilage. This process likely plays an important role in the development and progression of osteoarthritis. Genetic Factors. Osteoarthritis tends to run in families. Genetic factors may be involved in about half of osteoarthritis cases in the hands and hips, and in a somewhat lower percentage of cases in the knee. Several genes that might contribute to an inherited risk are under investigation. Inflammatory Response. The inflammatory response is an overreaction of the immune system to an injury or other assault in the body, such as an infection. This response causes specific immune factors, called cytokines, to gather in injured areas and cause inflammation and damage to body tissue and cells. The inflammatory response plays an important role in rheumatoid arthritis and other muscle and joint problems associated with autoimmune diseases. Inflammation probably plays at most a minor role in the early stages of osteoarthritis and is more likely to be a result - - not a cause - - of the disease. However, inflammation may contribute to the progression of osteoarthritis and in its chronic nature. The effects of the inflammatory response in osteoarthritis are likely to be different, and less severe, than those in rheumatoid arthritis. Joint Injury. Joint damage from injuries or recurrent stress to the joint is often the starting point in the osteoarthritis disease process. Osteoarthritis sometimes develops years after a single traumatic injury to or near a joint. Patients with knee injuries may be up to five times more likely to have osteoarthritis in the injured knee than those without injuries, and patients with hip injuries may be more than three times more likely to develop arthritis in the injured hip. Proper treatment of injuries, such as surgical repair of ligament tears in the knee with a strong rehabilitation approach, may help prevent the development of osteoarthritis. Medical Conditions That Can Cause Osteoarthritis. Other causes of osteoarthritis include: Bleeding disorders that cause bleeding in the joint, such as hemophilia. Disorders that block the blood supply near a joint, such as avascular necrosis. Complications of persistent, inflammatory arthritic conditions, particularly chronic gout, pseudogout, or rheumatoid arthritis. Conditions that cause iron build- up in the joints, such as hemochromatosis. Anatomical abnormalities, such as mismatched surfaces on the joints, can become damaged over time. Legs of unequal length or skewed feet can cause jerky movement and may cause osteoarthritis. Risk Factors. Age. Osteoarthritis can affect people of any age, but it is much more common in older people. It rarely occurs in people younger than age 4. Gender. In people younger than 4. After age 4. 5, it develops more often in women. Some research suggests that women may also experience greater muscle and joint pain than men. Obesity. Obesity increases the risk for osteoarthritis. It also worsens osteoarthritis once deterioration begins. This higher risk is due to increased weight on the joints. Work and Leisure Factors. Because injuries can trigger the disease process, people whose work or leisure activities place them at risk for muscle and joint injuries may face a higher risk for osteoarthritis later on. Occupational Risks.
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