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Issue title: Selected Proceedings from the 1996 Review Course in Pain Medicine and the 12th Annual Conference of the American Academy of Pain Medicine
Guest editors: Edward C. CovingtonGuest Editor and Richard LinchitzGuest Editor
Article type: Research Article
Authors: Fischer, Andrew A.*; 1;
Affiliations: V.A. Medical Center (117), 130 W. Kingsbridge Road, Bronx, NY, USA
Correspondence: [*] Corresponding author, Tel.: + 1 718 5791609 or + 1 516 8299337; fax: + 1 7185794082 or + 1 5168299337.
Note: [1] Associate Clinical Professor of Rehabilitation Medicine, Mt. Sinai School of Medicine (CUNY).
Abstract: This is a review of local anesthetic (LA) injections and infiltrations particularly combined with ‘needling’ for management of local musculoskeletal pain. New techniques are described including preinjection blocks (PIBs) which consist of blocking the sensory input from an area prior to giving an injection. PIBs prevent pain which would be caused by needle penetration of sensitive tissue. Needling and infiltration (N and I) with 1% lidocaine has been performed after PIB in 179 tender spots (TSs), trigger points (TrPs), and muscle spasms by the author, in 123 patients with the goal to relieve pain and promote healing. The immediate effect after the procedure as well as long-term results from 1 week to 7 months have been evaluated independently by a physiatrist experienced with injections (Dr. Tae Mo Chang). N and I extending over the entire taut band of abnormal muscle fibers, caused effective relief of pain and functional improvement in tender spots (TSs), trigger points (TrPs) and in muscle spasm caused by a variety of conditions including: acute and chronic sports and work injuries, motor vehicle accidents, muscle and ligament sprains (supraspinous, sacroiliac), overuse and repetitive stress syndromes, tennis elbow; local injuries or radicular irritation; and local inflammations such as bursitis, tendinitis, and osteoarthritis; and traumatic dystrophy, a type of reflex sympathetic dystrophy. Needling and infiltration of trigger areas and tender spots is effective treatment in several conditions. Pre-injection blocks allow the performance of the N and I of tender areas without pain.
Keywords: Trigger points, Injections, Preventive analgesia, Pain relief
DOI: 10.3233/BMR-1996-7205
Journal: Journal of Back and Musculoskeletal Rehabilitation, vol. 7, no. 2, pp. 107-117, 1996
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