ABSTRACT
Frozen shoulder is characterized by pain in the shoulder and limitation of glenohumeral movement. The underlying pathologic changes in frozen shoulder are synovial inflammation with subsequent reactive capsular fibrosis. Capsular fibrosis is the ultimate course of frozen shoulder suffering from various causes irrespectively. Therefore, adhesions that are affecting the joint movement must be released. Most important diagnostic method is thoughtful history taking and physical examination, and ultrasonography is very valuable device of diagnosis and treatment. Interventional microadhesiolysis and nerve stimulation (IMNS) is effective to manage frozen shoulder patients. IMNS for frozen shoulder is composed of three release approaches. These are (1) subacromial, (2) posterior inferior capsular, and (3) subdeltoidal & subcoracoidal release and round needle can be used for each release. We report this experiences and recommand this technique for the treatment of frozen shoulder patients.
Subject(s)
Humans , Bursitis , Fibrosis , Inflammation , Joints , Needles , Physical Examination , Shoulder , Stress, PsychologicalABSTRACT
BACKGROUND: Cervical radicular pain can arise fromvarious structures, including spinal nerves, discs, zygapophyseal joints, ligaments, and myofascial connective tissue. However, no adequate experiments have been found regarding methods for the microadhesiolysis of adhesional connective tissue around the zygapophyseal joints and nerves. The first objective of this study was to ascertain the effect of fluoroscopy guided interventional microadhesiolysis and nerve stimulation (FIMS) on chronic cervical radicular pain caused by zygapophyseal joint dysfunction. The second objective was to identify the duration of pain alleviation, as well as commonly occurring regions for zygapophyseal joint dysfunction. METHODS: Twenty-eight patients were diagnosed with cervical radicular pain. The cervical zygapophyseal joints and adhesional structures around the cervical zygapophyseal joints were stimulated by adhesiolysis with a rounded needle; the procedure was performed once every second week. A visual analogue scale (VAS) for pain and neck range of motion (ROM) were used as indices for evaluating the degree of pain 1 and 3 months after completion of the procedures. A relief effect of FIMS was accepted when the VAS index decreased 50% compared with a previous VAS, and when there was absence of limitation of ROM. RESULTS: Among the patients, 52% showed zygapophyseal joint dysfunction in C5-6, 38% in C4-5, 7% in C2-3, and 3% in C6-7. After performing FIMS, the VAS index decreased in most of the patients after 1 and 3 months (92.8% and 75%, respectively), and treatment frequency was 2.7 +/- 1.2. There was no correlation between the number of FIMS procedures and the degree of VAS. CONCLUSIONS: FIMS is considered an effective modality in patients suffering from cervical radicular pain.
Subject(s)
Humans , Connective Tissue , Fluoroscopy , Ligaments , Neck , Needles , Range of Motion, Articular , Spinal Nerves , Zygapophyseal JointABSTRACT
BACKGROUND: Intramuscular stimulation (IMS) shows good results in the treatment of chronic pain patients who did not respond to other treatments such as oral analgesics, trigger point injection, nerve block and epidural steroid injection. Fluoroscopy Guided Interventional Musculoskeletal Adhesiolysis and Nerve Stimulation (FIMS) was used to stimulate the correct anatomic point using fluoroscopy. We present the results of FIMS in spinal stenosis. METHODS: 106 patients with ages ranging from 39 to 87 years were enrolled in this study. All the patients were postoperatively evaluated for the clinical outcomes such as numeric rating scale (NRS) for pain at 1 month, reduction in the analgesics dose, and the overall satisfaction rate. The patients considered to have received clinical benefit from FIMS were evaluated for the recurrence of pain by either a follow-up or telephone interview. RESULTS: FIMS reduced the level of pain compared with the pretreatment (P < 0.001). In addition, 61% of patients reported that they were satisfied. There were no procedural related serious complications. Three months after FIMS, there was continuing pain relief in 50% of the patients treated successfully. CONCLUSIONS: FIMS is a safe and effective treatment modality for spinal stenosis.