Physical medicine and rehabilitation clinics of North America
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Burns are ubiquitous injuries in modern society, with virtually all adults having sustained a burn at some point in their lives. The skin is the largest organ of the body, basically functioning to protect self from non-self. ⋯ Larger burns are associated with morbidity and mortality disproportionate to their initial appearance. Electrical and chemical burns are less common injuries but are often associated with significant morbidity.
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Phys Med Rehabil Clin N Am · Feb 2011
ReviewThe role of core stabilization in lumbosacral radiculopathy.
Lumbosacral radiculopathy is relatively common, and most cases resolve with appropriate conservative management. Along with pain control, the mainstay of treatment is a comprehensive rehabilitation program to correct for biomechanical factors that adversely affect spinal stability and predispose the patient to recurrent pain. ⋯ A comprehensive rehabilitation program includes postural training, muscle reactivation, correction of flexibility and strength deficits, and subsequent progression to functional exercises. This article reviews the current concepts regarding core stability and rehabilitation in lumbosacral radiculopathy.
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Phys Med Rehabil Clin N Am · Feb 2011
ReviewThe efficacy of lumbar epidural steroid injections: transforaminal, interlaminar, and caudal approaches.
Conservative management of low back pain includes the use of lumbar epidural steroid injections, which have become increasingly more popular in the last 20 years. The body of literature regarding the efficacy of these injections is vast, conflicting, and difficult to summarize. This article reviews the updated evidence for efficacy and the indications for these injections.
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Phys Med Rehabil Clin N Am · Feb 2011
ReviewEpidural steroid injections for cervical radiculopathy.
Epidural steroid injection (ESI) has been used to treat cervical radiculopathy for several decades. Generally, available studies demonstrate favorable results, although definitive evidence of efficacy is lacking. ⋯ In the cervical spine, where evidence of potential benefit is moderate and there is risk of major complication, non-interventional care is even more germane. This article reviews the available literature regarding risks and efficacy of ESIs for cervical radiculopathy, and aims to guide practitioners in treatment decisions for individual patients.
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Radiofrequency (RF) neurotomy is an interventional procedure used to alleviate certain types of low back pain. RF energy is used to thermally coagulate the specific nerves that transmit pain signals. Recent evidence has shown that this procedure demonstrates significant efficacy in relieving low back pain in lumbar zygapophysial joints, and research is ongoing to determine if pain relief for the sacroiliac joint is also possible. This article provides an evidence-based background for performing RF neurotomy, discusses the relevant anatomy, and highlights the indications and technique for lumbar and sacral RF neurotomy.