Der Orthopäde
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The specific minimal-invasive injection therapy is a key-procedure for cervical spine syndromes when performing a multimodal pain-therapy. Due to the exactly placed injections pain can be overcome. ⋯ The complex injection technique affords knowledge and expertise. The exact application and the specific complications are presented in detail.
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Minimally invasive injection therapy is an effective approach for the treatment of sciatica with less complications. This therapy is a sufficient option in cases without absolute indications for operation. The paper describes in detail the different injection techniques like spinal nerve analgesia, epidural dorsal/perineural injections, vertebral joint infiltrations, and radiculographies.
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The pharmacotherapy of musculoskeletal pain remains of high importance in Western countries. The present review concentrates on the use of acidic (nonsteroidal anti-inflammatory drugs) and nonacidic (paracetamol, selective cyclooxygenase-2 inhibitors) antipyretic analgesics in the therapy of musculoskeletal pain disorders with particular emphasis on the diverse pharmacokinetic properties and unwanted side effects of these substances.
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Nerve root blocks and epidural perineural injections are main part in the conservative treatment of degenerative spine diseases. These injections should be done without imaging because degenerative spine diseases - discogenic oder spinal stenotic - tend to recurrence and danger arises from too many imaging with cumulative ionizing radiation over the years, especially in younger people. ⋯ Repetitive periradicular injections desensitize the nerve root by local anesthetics and reduce its inflammatory swelling by steroids. The decompensated symptomatic deformity turns back into an asymptomatic compensated status.
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Organized orthopaedic pain management is a major part of successful patient treatment. Therefore pain management should start before surgery. Patients need to be informed about the operation and the subsequent procedures. ⋯ Supportive treatment approaches such as cryotherapy or transcutaneous electrical nerve stimulation (TENS) are useful in the post-operative period. Physiotherapy after surgery should be extended stepwise regarding the operative device and it is of particular importance to respect pain intensities. The post-hospital regimen for a continuous pain medication should be given to the orthopaedic specialist.