4. Therapeutic options in pain management

Dean, Bonnie Z.; Williams, Faren H.; King, John C.; Goddard, Mark J.

doi:10.1016/0003-9993(94)90374-3

Cited by 7 publications

(6 citation statements)

References 31 publications

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“…Cold therapy can be used as a valid therapeutic option in the treatment of several chronic conditions such as tendinitis, bursitis, trigger points and muscular spasms (19,70). In these conditions, cryokinetics is a model that can help during the early mobilization phase of the patient and make the physical activation easier.…”

Section: Cold In Chronic Soft Tissue Conditionsmentioning

confidence: 99%

“…The following diseases are therefore regarded as absolute contraindications to cryotherapy: Raynaud's phenomenon, cold allergy, cryoglobulinaemia, and paroxysmal cold hemoglobinuria. Relative contraindications include arthritic conditions, pheochromocytoma, anaesthetic skin, or a patient who is unresponsive due to cardiovascular disease (32,42,60,70).…”

Section: Contraindicationsmentioning

confidence: 99%

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Cryotherapy in sports medicine

Swenson¹,

Swärd²,

Karlsson³

1996

Scandinavian Med Sci Sports

309

197

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The use of cryotherapy, i.e. the application of cold for the treatment of injury or disease, is widespread in sports medicine today. It is an established method when treating acute soft tissue injuries, but there is a discrepancy between the scientific basis for cryotherapy and clinical studies. Various methods such as ice packs, ice towels, ice massage, gel packs, refrigerant gases and inflatable splints can be used. Cold is also used to reduce the recovery time as part of the rehabilitation programme both after acute injuries and in the treatment of chronic injuries. Cryotherapy has also been shown to reduce pain effectively in the post-operative period after reconstructive surgery of the joints. Both superficial and deep temperature changes depend on the method of application, initial temperature and application time. The physiological and biological effects are due to the reduction in temperature in the various tissues, together with the neuromuscular action and relaxation of the muscles produced by the application of cold. Cold increases the pain threshold, the viscosity and the plastic deformation of the tissues but decreases the motor performance. The application of cold has also been found to decrease the inflammatory reaction in an experimental situation. Cold appears to be effective and harmless and few complications or side-effects after the use of cold therapy are reported. Prolonged application at very low temperatures should, however, be avoided as this may cause serious side-effects, such as frost-bite and nerve injuries. Practical applications, indications and contraindications Effects of cryotherapyCryotherapy is assumed to retard haematoma formation due to capillary constriction and decreased blood flow. It is also assumed that cold reduces the inflammatory response after a soft tissue injury, by

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Section: Cold In Chronic Soft Tissue Conditionsmentioning

confidence: 99%

Section: Contraindicationsmentioning

confidence: 99%

Cryotherapy in sports medicine

Swenson¹,

Swärd²,

Karlsson³

1996

Scandinavian Med Sci Sports

309

197

View full text Add to dashboard Cite

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“…Geleneksel NSAİİ ile COX2 selektif NSAİİ arasında anlamlı fark olmamakla birlikte geleneksel NSAİİ daha fazla yan etkiye sebep olduğu bildirilmiştir [25]. Amerikan Ağrı Derneği'nin 2002'de yayınladığı tedavi kılavuzunda, kronik bel ağrısında orta düzeydeki ağrıların kısa süreli giderilmesinde asetilsalisilik asit (aspirin), ibuprofen, naproksen gibi NSAİİ'ın tercih edilebileceği bildirilmiştir [27,28]. NSAİİ'ın gastrointestinal ve renal yan etkileri dışında özellikle kardiyovasküler yan etkilerinin de olduğu ve arteryal kan basıncını arttırabildiği göz önünde bulundurulmalıdır.…”

Section: Asetaminofen Ve Nsai̇i̇unclassified

Chronic Discogenic Low Back Pain and Non-Surgical Treatment Methods: An Update

Yıldırım

2016

Dicle Med J

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Low back pain originating from intervertebral disc is described by two separate but related etiologies: disc herniation and discogenic pain. When other causes are excluded, prevalence of discogenic pain was reported to be between 17-42%. Diagnostic modalities include clinical examination, imaging, and discography and provocative discography remains to be the golden standard for diagnosis. Treatment methods include noninvasive approaches such as drugs, physiotherapy modalities, and multidisciplinary biopsychosocial rehabilitation; invasive approaches such as intradiscal treatments and epidural injections; and lastly surgical approaches such as fusion and artificial joint replacement. Evidence for drug treatment in chronic discogenic low back pain is limited to nonsteroidal anti-inflammatory drugs and opioids which are associated with many adverse outcomes. It has been shown that when noninvasive methods are used together with other modalities patients may obtain additional benefits. Evidence base is limited for many other physical and behavioral treatment methods like low back school and specific exercise programs. There is moderate evidence for epidural injections and poor evidence for intradiscal treatments. Evidence for surgical fusions and disc replacements are similar and it is not superior to multidisciplinary biopsychosocial rehabilitation or well-designed physical treatment. Multiple authorities have emphasized potential complications and limited the indication of surgical approaches to patients who do not response conservative treatments. In future, the most promising treatments seem to be multidisciplinary and long-term exercise programs and/or epidural injections. High quality randomized controlled studies with adequate sample sizes and long term follow ups should be designed in order to determine optimal treatment modalities.

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“…A associação simultânea de AINH entre si não resulta em efeito somatório de ação, decorrendo apenas em maior custo e maior incidência de efeitos colaterais (5).…”

Section: Analgésicos Antiinflamatórios Não-esteróides (Ainh) E Acetaminofenunclassified

“…Deveremos empregar sempre as menores doses efetivas, evitar os AINHs com alto nível de recirculação êntero-hepática (comoa indometacina), preferir salicilatos não-acetilados e utilizar protetores da mucosa gástrica em caso de antecedentes gástricos positivos (5) .…”

Section: Analgésicos Antiinflamatórios Não-esteróides (Ainh) E Acetaminofenunclassified

Dor mielopática pós-trauma raquimedular: manejo clínico e cirúrgico

Souza

1995

Acta Fisiátr.

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A dor mielopática é um tipo de dor central que se origina após lesão completa, incompleta ou subclínica das vias somato-sensoriais, especialmente do trato espinotalâmico. A dor é descrita como uma sensação de amortecimento desagradável, queimor ou "formigamento", freqüentemente de caráter constante, podendo apresentar períodos de exacerbação. Ocasionalmente são descritos dois tipos distintos de dor, uma de caráter crônico constante e outra intermitente e intensa com distribuição radicular ou por dermátomo, com característica de "choque". Freqüentemente este segundo tipo de dor está associado a comprometimento radicular concomitante ao comprometimento medular ou está localizado no nível da lesão medular, na área de transição da zona de sensibilidade normal para a comprometida.

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4. Therapeutic options in pain management

Cited by 7 publications

References 31 publications

Cryotherapy in sports medicine

Cryotherapy in sports medicine

Chronic Discogenic Low Back Pain and Non-Surgical Treatment Methods: An Update

Dor mielopática pós-trauma raquimedular: manejo clínico e cirúrgico

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