Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases
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Chronic pain disorders, including fibromyalgia and myofascial pain syndrome often do not respond adequately to standard therapy. The cases reviewed herein suggest the strain and counterstrain (SCS) technique, described in 1981 by Jones, may be helpful in reducing pain and improving function in patients with localized myofascial pain syndromes. This was a case study and retrospective review of 20 patients who had had chronic pain for an average of 2.7 years and were treated with SCS for pain relief. ⋯ Areduction in pain and an increase in function of 50%-100% occurred in 19 of 20 patients immediately after SCS therapy. Partial improvement was maintained for 6 months in 11 of 20 patients, and 4 were still pain free. We believe that SCS techniques should be considered and evaluated further as adjunctive therapy for patients previously unresponsive to standard treatment for myofascial pain syndrome.
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Hansen's disease is a chronic granulomatous disease of infectious origin. It has a worldwide distribution and a variety of clinical manifestations often involving the skin, nasal mucosa, and peripheral nerves. Lepromatous leprosy characterizes the condition of a large group of patients with little or no resistence to the infection. ⋯ However, Lucio's phenomenon is frequently fatal as a result of bacterial infection or sepsis, and both patients reported here died. We call attention to this particular and unusual skin manifestation of lepromatous leprosy, which can mimic rheumatic disease and other causes of vasculitis. This is especially likely to be unrecognized in nonendemic countries but cases will occasionally be seen in this age of extensive international travel.