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The Suprascapular Nerve &
Shoulder Pain How to Improve the Efficacy of Shoulder Injections |
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A Letter Released
to Physicians on March 8, 2008 Immediate Relief for Chronic Knee Pain Knee pain accounts for roughly
one-third of musculoskeletal problems seen in primary care.1 Exercise and lifestyle modification serve
as the conservative treatment of choice for many, and arthroplasty solves the
problem for thousands more. However,
for those who are too young, too old, too frail, or otherwise not recommended
for knee surgery, the private practice of Neal S. Taub, MD, ABPM&R has options that may be able to provide immediate,
long-lasting relief. One option for knee pain showing
very good results at Dr. Taub’s practice is
targeted neurolytic blocks using diluted
phenol. Nerve blocks around the knee are most commonly thought of as a form of anesthesia and
postoperative pain management for knee surgery, but practitioners should also
keep this option in mind for refractory chronic knee pain. Dr. Taub finds that 70% of patients receiving neurolytic
blocks for knee pain experience immediate relief even though this pain has
usually proved refractory to other treatments including intra-articular corticosteroids and viscosupplementation. Pain relief from one treatment lasts two to
four months. The injected nerves are not permanently damaged and typically return to normal
function. Your patients may have
repeated treatments as needed. Types
of knee pain often appropriate for nerve block treatments include arthritis, neuromata, patellofemoral pain syndrome, saphenous nerve entrapment, and spasticity related pain
and dysfunction. In addition, Dr. Taub makes nerve
blocks around the knee more effective by using ultrasound guidance. Two separate papers published just last
year suggest that ultrasound guidance for peripheral nerve blocks and femoral
nerve blocks works better than using anatomical landmarks and/or electrical
stimulation to localize nerves.2,3
Use of the less effective guidance techniques sometimes results in
multiple attempts to place the needle correctly, patient discomfort, and
patient frustration.2 As
with the shoulder, greater accuracy with nerve blocks around the knee
improves the pain relief result.3 Call Neal S. Taub, MD, Physiatrist for pain management & rehabilitation. |
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References 1.
Rosenblatt RA, Cherkin
DC, Schneeweiss R, Hart LG. The
content of ambulatory medical care in the 2.
Brull R, Perlas A, Chan V. Ultrasound-guided peripheral nerve
blockade. Curr Pain Headache Rep. 2007 Feb; 11 (1): 25-32. 3.
Casati A, Baciarello M, Di Cianni S, et
al. Effects of ultrasound guidance on the minimum effective anaesthetic volume required to block the femoral nerve. Br J Anaesth. 2007
Jun; 98(6): 823-7. |
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Home Stroke Rehabilitation About Neal Taub, MD What is a Physiatrist |
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