MMW Fortschritte der Medizin
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For the treatment of back pain, behavioral modification, pharmacotherapy, non-pharmacological conservative treatment and surgical procedures are available. Systemic and metabolic disorders require specific treatment. Medication that may be considered includes non-opioid analgesics with or without an antiphlogistic action, opioid analgesics, muscle relaxants and antidepressants. ⋯ For myofascial pain, flupirtine is to be recommended because of its analgetic and muscle-tone-normalizing actions. Local anesthetic infiltration or nerve blocks are useful in blocking nociception with its pathophysiological sequelae. For chronic back pain, opioids and some antidepressants have a more favorable benefit-risk profile than NSAIDs.
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The subcutaneous injection of heating oil or other crude oil distillates are rare injuries. In the present case, a 26-year-old man injected heating oil subcutaneously into the left cubital region. ⋯ Subsequently, a mesh-graft was applied to the wound, which healed with no residual defects. The course of the present case, and the results of a review of the literature on similar occurrences involving mineral oil suggest early extensive debridement of such injuries.