Shoulder pain is a common problem for which people often consult a doctor. The symptom is ambiguous, it may indicate a disease of the shoulder joint or muscle structure, at the same time, it signals a problem in a completely different part of the body or organ.
Pain in the shoulder can be caused by a simple strain of muscles, tendons or joints, but it can also indicate a more serious problem: heart disease, cervical spine or diaphragm. Patients are interested in how to deal with this symptom? Blocking pain in the shoulder joint with drug injections significantly helps in solving this issue.
Provoking reasons
The nature of shoulder pain is difficult to determine, since it is provoked by various pathological abnormalities. In addition, the symptom is divided into two types: internal and external.
Pain inside shoulder
Pain inside the shoulder can be caused by:
- degeneration or tear of the rotator cuff;
- unstable condition of the head of the humerus;
- excess calcium in the tendons of the shoulder;
- glenohumeral pathology;
- acromioclavicular disorder;
- excess calcium in the muscle structure, biceps;
- various types of infections (HIV, AIDS, etc.);
- fragmentation of the cartilaginous bag.
These reasons most often provoke pain inside the shoulder.
Pain on the outside of the shoulder
There are only a few reasons that can provoke pain on the outside of the shoulder:
- Referred pain. It is a “reflection” of pain in other parts of the body. The symptom may be caused by discomfort in the diaphragm, cervical spine or liver.
- Oncological lesion.
According to medical statistics, patients often seek help with referred pain, much less often with cancer.
Where can a shoulder block be performed in St. Petersburg?
MRI and ultrasound center RIORIT
Area:
Kalininsky
Metro:
metro station Grazhdansky Prospekt, metro station Devyatkino, metro station Prospekt Prosveshcheniya
Address:
St. Petersburg, Kalininsky district, st. Rustaveli, 66 lit. G
Telephone:
Equipment:
Siemens, open type
Schedule:
Around the clock
All addresses and prices in St. Petersburg
Neva Medical Center
Area:
Nevsky
Metro:
Obukhovo, Proletarskaya, Rybatskoye
Address:
St. Petersburg: Shlisselburgsky pr., 7A
Telephone:
Equipment:
MRI GE Signa Ovation HD 0.35T open type
Schedule:
9.00 — 22.00
| Therapeutic drug blockade of the spine and joints | from 2500 rub. |
Medical Center ENERGO on Engels Ave.
Area:
Vyborg
Metro:
Specific
Address:
St. Petersburg: Engelsa Ave., 33, bldg. 1
Telephone:
Equipment:
MRI GE Brivo MR355 1.5 T closed type
Schedule:
8.00 — 23.00
| Therapeutic drug blockade of the spine and joints | from 2260 rub. |
Medical center ENERGO on Leninsky Prospect.
Area:
Moscow
Metro:
Moscow
Address:
St. Petersburg: Leninsky pr., 160
Telephone:
Equipment:
MRI GE Healthcare Brivo MR355 1.5 T closed type
Schedule:
around the clock
| Therapeutic drug blockade of the spine and joints | from 2260 rub. |
Medical center Scandinavia near Pionerskaya metro station
Area:
Seaside
Metro:
Komendantsky Avenue, Pionerskaya, Staraya Derevnya
Address:
St. Petersburg: st. Ilyushina, 4/1
Telephone:
Equipment:
MRI GE Discovery MR750W 3T closed type
Schedule:
8.00 — 22.00
| Therapeutic drug blockade of the spine and joints | from 2150 rub. |
Multidisciplinary clinic Scandinavia on Liteiny
Area:
Central
Metro:
Vladimirskaya, Mayakovskaya, Vosstaniya Square
Address:
St. Petersburg: Liteiny Prospekt, 55
Telephone:
Equipment:
MRI General Electric Signa 1.5 T closed type
Schedule:
8.00 — 21.00
| Therapeutic drug blockade of the spine and joints | from 2150 rub. |
Medical Center NMC Scandinavia
Area:
Nevsky
Metro:
Lomonosovskaya
Address:
St. Petersburg: Narodnaya str., 21, bldg. 2
Telephone:
Equipment:
MRI Vantage Titan Toshiba 1.5T closed type
Schedule:
8.00 — 23.00
| Therapeutic drug blockade of the spine and joints | from 2150 rub. |
Medical Center MRI Center on Akademicheskaya
Area:
Kalininsky
Metro:
Academic
Address:
St. Petersburg: Grazhdanskiy pr., 84
Telephone:
Equipment:
MRI GE Signa Ovation 0.35T open type
Schedule:
8.00 — 21.00
| Therapeutic drug blockade of the spine and joints | from 2000 rub. |
City Clinical Oncology Dispensary
Area:
Kirovsky
Metro:
Avenue of Veterans
Address:
St. Petersburg: Veteranov Ave., 56
Telephone:
Equipment:
MRI Siemens Magneton Espree 1.5T closed type
Schedule:
8.00 — 21.00
| Therapeutic drug blockade of the spine and joints | from 2000 rub. |
Multidisciplinary clinic Admiralty Shipyards
Area:
Admiralteysky
Metro:
Baltiyskaya, Sadovaya
Address:
St. Petersburg: Sadovaya st., 126
Telephone:
Equipment:
MRI GE Signa HDx 1.5T closed type
Schedule:
8.00 — 21.00
| Therapeutic drug blockade of the spine and joints | from 2000 rub. |
St. Petersburg Research Institute of Phthisiopulmonology
Area:
Krasnogvardeisky
Metro:
Polytechnic
Address:
St. Petersburg: Politekhnicheskaya st., 32
Telephone:
Equipment:
MRI Toshiba Excelart Vantage 1.5T closed type
Schedule:
8.00 — 21.00
| Therapeutic drug blockade of the spine and joints | from 1800 rub. |
Medical Center Standard MRI on Ladozhskaya
Area:
Krasnogvardeisky
Metro:
Ladoga
Address:
St. Petersburg: st. Carla Faberge, 8, bldg. 2
Telephone:
Equipment:
MRI Siemens Magnetom Symphony 1.5T closed type
Schedule:
8.00 — 21.00
| Therapeutic drug blockade of the spine and joints | from 1800 rub. |
MRI in Vsevolozhsk Socialist St.
Area:
Kalininsky, Nevsky, Len. region
Metro:
Ladoga
Address:
Vsevolozhsk, st. Socialisticheskaya, 107
Telephone:
Equipment:
MRI Toshiba Vantage 1.5T closed type, CT Toshiba Alexion 16 slices
Schedule:
9.00 — 21.00
| Therapeutic drug blockade of the spine and joints | from 1750 rub. |
Federal State Budgetary Institution "Consultative and Diagnostic Center with Clinic"
Area:
Petrogradsky
Metro:
Krestovsky Island
Address:
St. Petersburg: Morskoy pr., 3
Telephone:
Equipment:
MRI Siemens Magnetom Avanto 1.5T closed type
Schedule:
8.00 — 21.00
| Therapeutic drug blockade of the spine and joints | from 1600 rub. |
FSBI "National Medical Research Center named after. V. A. Almazova"
Area:
Seaside
Metro:
Specific
Address:
St. Petersburg: st. Akkuratova 2
Telephone:
Equipment:
MRI Siemens Magnetom Trio A Tim 3.0T, MRI Siemens Magnetom Magnetom Espree 1.5 closed type
Schedule:
8.00 — 21.00
| Therapeutic drug blockade of the spine and joints | from 1550 rub. |
Children's Research and Clinical Center for Infectious Diseases (DNKCIB)
Area:
Petrogradsky
Metro:
Gorkovskaya, Petrogradskaya
Address:
St. Petersburg: st. Professor Popov, 9
Telephone:
Equipment:
MRI Philips Ingenia 1.5T closed type, CT Philips Ingenuity 128 slices
Schedule:
9.00 — 18.00
| Therapeutic drug blockade of the spine and joints | from 1500 rub. |
Medical clinic NDC-SPb on Entuziastov
Area:
Vasileostrovsky, Krasnogvardeysky
Metro:
Kupchino, Ladozhskaya
Address:
St. Petersburg: Entuziastov Ave., 33, bldg. 1, lit. A
Telephone:
Equipment:
MRI GE Signa Profile HD 0.2T open type
Schedule:
9:00 — 21:00
| Therapeutic drug blockade of the spine and joints | from 1500 rub. |
Medical Center NDC-SPB Lakhta
Area:
Seaside
Metro:
Komendantsky Avenue
Address:
St. Petersburg: Ispytatelev Ave., 39
Telephone:
Equipment:
MRI Siemens Magnetom Avanto 1.5T closed type
Schedule:
8.00 — 23.00
| Therapeutic drug blockade of the spine and joints | from 1500 rub. |
City Multidisciplinary Hospital No. 2
Area:
Vyborg
Metro:
Grazhdansky Avenue, Ozerki, Prospekt Prosveshcheniya
Address:
St. Petersburg: per. Uchebnyi, 5
Telephone:
Equipment:
MRI Siemens Magnetom Espree 1.5T closed type, CT Siemens SOMATOM Definition 16 slices, CT Siemens SOMATOM Definition AS 64 slices
Schedule:
around the clock
| Therapeutic drug blockade of the spine and joints | from 1500 rub. |
Center for Emergency and Radiation Medicine named after. Nikiforova
Area:
Seaside
Metro:
Komendantsky Avenue, Pionerskaya, Staraya Derevnya
Address:
St. Petersburg: st. Optikov, 54
Telephone:
Equipment:
MRI Siemens Magnetom Verio 1.5T closed type
Schedule:
8.00 — 20.00
| Therapeutic drug blockade of the spine and joints | from 1450 rub. |
Ear, Throat, Nose and Speech Institute
Area:
Admiralteysky
Metro:
Zvenigorodskaya, Pushkinskaya, Technological Institute, Frunzenskaya
Address:
St. Petersburg: st. Bronnitskaya, 9
Telephone:
Equipment:
MRI General Electric Signa Hdx 1.5T closed type, CT Somatom Emotion 16 slices
Schedule:
10.00 — 15.00
| Therapeutic drug blockade of the spine and joints | from 1450 rub. |
CT and MRI at the Bekhterev Research Institute
Area:
Nevsky
Metro:
Elizarovskaya, Obvodny Canal, Alexander Nevsky Square
Address:
St. Petersburg: st. Bekhtereva, 3
Telephone:
Equipment:
MRI Toshiba Vantage Excelart XGV 1.5T closed type, CT Philips BRILLIANCE 64 slices
Schedule:
9.00 — 17.00
| Therapeutic drug blockade of the spine and joints | from 1320 rub. |
St. Petersburg Clinical Hospital RAS
Area:
Vyborg
Metro:
Courage Square, Udelnaya
Address:
St. Petersburg: Thorez Ave., 72
Telephone:
Equipment:
MRI Siemens Magnetom Essenza 1.5T closed type
Schedule:
8.00 — 21.00
| Therapeutic drug blockade of the spine and joints | from 1300 rub. |
Multidisciplinary clinic MART
Area:
Vasileostrovsky
Metro:
Vasileostrovskaya
Address:
St. Petersburg: Maly pr. V.O. d 54, bldg. 3
Telephone:
Equipment:
MRI Siemens Espree 1.5 Tesla closed type
Schedule:
8.00 — 21.00
| Therapeutic drug blockade of the spine and joints | from 1100 rub. |
MRI and CT in Kupchino on Danube Ave
Area:
Frunzensky
Metro:
Kupchino, Moskovskaya, Obukhovo
Address:
St. Petersburg: st. Danube Avenue, 47
Telephone:
Equipment:
MRI Siemens Magnetom Essenza 1.5T closed type, CT Siemens Somatom Emotion 16 slices
Schedule:
9.00 — 22.00
| Therapeutic drug blockade of the spine and joints | from 1000 rub. |
Children's Clinical Hospital at St. Petersburg State Pediatric Medical University
Area:
Vyborg
Metro:
Vyborgskaya, Lesnaya
Address:
St. Petersburg: st. Litovskaya, 2a
Telephone:
Equipment:
MRI General Electric Signa HDx 1.5T closed type
Schedule:
8.00-19.00
| Therapeutic drug blockade of the spine and joints | from 1000 rub. |
North-Western State Medical University named after. I.I. Mechnikova, E.E. Eichwald Clinic
Area:
Central
Metro:
Chernyshevskaya
Address:
St. Petersburg: st. Kirochnaya, 41
Telephone:
Equipment:
MRI GE Signa Infinity 1.5T closed type
Schedule:
8.00 — 21.00
| Therapeutic drug blockade of the spine and joints | from 980 rub. |
MRI in Strelna
Area:
Petrodvortsovy, Len. region
Metro:
Avtovo, Leninsky Prospekt, Veteranov Avenue
Address:
Strelna, St. Petersburg highway, 48
Telephone:
Equipment:
MRI Siemens Magnetom Symphony 1.5T closed type
Schedule:
8.00 — 20.00
| Therapeutic drug blockade of the spine and joints | from 950 rub. |
Russian Research Institute of Traumatology and Orthopedics named after R.R. Vreden
Area:
Kalininsky
Metro:
Academic
Address:
St. Petersburg: st. Akademika Baykova, 8
Telephone:
Equipment:
MRI Philips Achievac 1.5T, MRI Siemens Magnetom Verioc 3T
Schedule:
8.00 — 21.00
| Therapeutic drug blockade of the spine and joints | from 750 rub. |
Clinical Hospital No. 122 named after L.G. Sokolov
Area:
Vyborg
Metro:
Prospect Education
Address:
St. Petersburg: Kultury Ave., 4
Telephone:
Equipment:
MRI GE Signa HDx 1.5T, MRI Siemens Verio 3T closed type
Schedule:
8.00 — 21.00
| Therapeutic drug blockade of the spine and joints | from 700 rub. |
Research Institute of Ambulance named after. Dzhanelidze
Area:
Frunzensky
Metro:
Bukharestskaya, Kupchino, International, Moscow Gate
Address:
St. Petersburg: st. Budapestskaya, 3
Telephone:
Equipment:
MRI General Electric Signa 1.5T closed type, CT Toshiba G 32 slices
Schedule:
8.30 — 16.00
| Therapeutic drug blockade of the spine and joints | from 600 rub. |
City Clinical Hospital No. 31
Area:
Petrogradsky
Metro:
Krestovsky Island
Address:
St. Petersburg: Dynamo Ave., 3
Telephone:
Equipment:
MRI Siemens Magnetom Essenza 1.5T closed type
Schedule:
8.00 — 21.00
| Therapeutic drug blockade of the spine and joints | from 550 rub. |
Elizabeth Hospital
Area:
Kalininsky
Metro:
Akademicheskaya, Civil Avenue, Ozerki, Polytechnic
Address:
St. Petersburg: st. Vavilovykh, 14
Telephone:
Equipment:
MRI Toshiba Excelart Vantage Atlas X 1.5T closed type, CT Toshiba Aquillion 64 slices, CT Toshiba Aquillion 16 slices
Schedule:
9.00 — 16.00
| Therapeutic drug blockade of the spine and joints | from 300 rub. |
Symptomatic manifestations
Shoulder pain has varied symptoms, as it is provoked by many causes:
- malignant formation and its characteristic symptoms, including weight loss, deformation of the affected area;
- if the cause of pain in the shoulder is infectious, erythema appears at the site of the lesion;
- fever, indicating an infection, inflammatory reactions or cancer;
- cramps, muscle convulsions;
- excessive mobility of the shoulder, often protrusion of the bone from the cartilaginous capsule;
- tingling, numbness, indicating problems with nerve endings.
Symptoms are unsystematic, occur sporadically, very rare symptoms are chronic or regular.
Diagnostics
To diagnose the cause of shoulder pain, it is necessary to conduct a two-stage examination of the patient: examination and questioning, hardware examination. After this, the doctor will be able to draw up a clinical picture and confirm the diagnosis.
The survey examines the patient's medical history, injuries that could cause shoulder pain in the future. The problem is not transmitted genetically or hereditarily, information about diseases of relatives is not required.
After the interview, it is time for inspection. Most of the causes of shoulder pain do not appear visually; instrumental and laboratory diagnostics are needed to clarify them.
The patient will have to undergo the following procedures:
- Get tested. It will not be possible to find out the cause of the pain, but it will be possible to determine its nature (infectious, inflammatory, as a result of injury).
- Ultrasonography. Visualizes the condition of tissues, muscles and tendons.
- MRI. Helps determine if there is soft tissue damage. If the cause of the pain lies in the cervical spine, an MRI will help find out.
- EMG. One of the methods of neurophysiology helps in situations where there is a suspicion of blockage of nerves or muscle function, or the cervical region is stiff.
After completing all stages of diagnosis and drawing up a clinical picture, the patient can proceed to treatment.
How to make an intra-articular block
The procedure is performed by a qualified doctor. The joint block is performed from the posterior, anterior or lateral surface of the joint. The syringe is filled with hydrocortisone and the selected anesthetic. The total volume of the drug is 4 milliliters. After this, the affected area is treated with an antiseptic. Using palpation, the medical worker determines the affected area, feels the injection site and moves the skin.
A thin needle is inserted to a depth of one and a half centimeters. The drug is administered gradually, as there is discomfort and pain. Gradually the needle moves into the joint cavity. When the needle has sunk to the full depth of the joint, the doctor injects the rest of the drug. During the procedure, the medical specialist periodically pulls back the syringe, making sure that no blood remains on the needle. If bloody discharge appears, we are talking about damage to the blood vessel.
After the anesthetic is administered, the affected area is sealed with a bandage. If the blockade is done at several points of the joint, several disposable syringes are used, on which the needle is changed.
Treatment
Depending on the nature of the pain, the underlying cause, and other factors, different types of treatment may be prescribed. In addition to drug therapy and medical intervention, home remedies for shoulder pain are often used:
- Less physical activity. Often, the root cause of what is happening is excess load. If you reduce them, the process of natural regeneration of the body starts, the likelihood of healing is small, but there is a possibility.
- Maintaining posture. Its violation leads to severe pain in the shoulder. Additionally, you can use orthopedic accessories: pillow and mattress.
- Do exercises with scapular retraction. A set of exercises can help restore mobility and mobility of the affected shoulder. In addition, the exercises are simple and can be done outside the home.
- Massage greatly relieves pain and helps partially restore mobility. You can massage your shoulder yourself, but after consulting a specialist.
- Treatment of diseases that provoke shoulder pain. If the cause is just a symptom or “reflection” of another disease, first of all you need to treat it and evaluate the results.
All of the above methods can help solve the problem, but there is no guarantee that it will work without blocking shoulder pain.
Old partial damage
Long-term partial damage to the tendon of the supraspinatus muscle of the shoulder can lead to a long-term limitation of the range of motion in the shoulder joint and the inability to perform full abduction of the upper limb. Treatment requires surgery.
Partial damage to the rotator cuff results in an increase in the length of the supraspinatus tendon over time. As a result, it becomes functionally inferior. The person cannot actively abduct the shoulder, although the amount of passive movement (performed by the therapist's hands) is usually maintained. The more the tendon is changed, the more pronounced the limitation in abduction of the limb.
If the tendon of the supraspinatus muscle of the shoulder is damaged, treatment is carried out using different methods:
- medial movement of the muscle to eliminate functional deficiency;
- osteotomy of the greater tuberosity and distal movement until physiological tension of the supraspinatus muscle is created in the state of shoulder abduction;
- lower wedge-shaped resection of the acromial process of the scapula, excision of the acromiocoracoid ligament to increase the subacromial space and eliminate pain (the ability to actively abduct the shoulder is not restored).
If a tear of the supraspinatus muscle of the shoulder occurs, treatment should be carried out as early as possible. It will be much more effective if, by the time of the operation, significant degenerative changes in the tissues and lengthening of the tendon have not yet occurred.
Blockade for shoulder pain
In combination with known treatment methods (physiotherapy, massage procedures, therapeutic physical education), shoulder pain blockade is often used. This is a technique based on eliminating pain to restore mobility and flexibility.
For blockade, injections of various drugs, such as Diprospan, are used. The medicine blocks the main symptom – pain, and in the shortest possible time.
The effect follows after a few days if the injection was performed correctly, according to all standards. If the doctor makes a mistake, another procedure may be required.
Basic principles of the treatment procedure
The drug procedure is based on blocking the muscles located near the joint. This allows you to prevent the destruction of shoulder tissue, stop inflammatory processes, and eliminate even the most acute pain. The drug solution is injected into the pathological inflammatory or destructive-degenerative focus. Direct delivery of the drug increases its clinical effectiveness and promotes the development of a better and significantly faster pharmacodynamic response.
An important advantage of blocking the shoulder joint with Diprospan or anesthetics is the versatility of the therapeutic effect of the therapeutic manipulation:
- the inflammatory process and associated pain syndrome are quickly relieved;
- skeletal muscles relax, painful muscle spasms and swelling are eliminated;
- metabolism is normalized, restoration of tissues damaged by pathology or injury is accelerated;
- the functional activity of the shoulder joint increases, including its mobility;
- trophism and innervation in the shoulder area improves.
When carrying out a therapeutic blockade, the active ingredient of the drug is localized directly at the site of the pathology, and penetrates into the systemic bloodstream in a minimal amount. The pharmacological load on the patient’s body is reduced, the likelihood of side effects is minimized, and the period of remission is extended.
Injection of anesthetics and analgesics into the affected joint.
Drugs used for blockade
The following drugs (groups of drugs) are used to block shoulder pain:
- Corticosteroids. Depending on the nature of the pain, short- or long-acting drugs (Dexamethasone or Hydrocortisone) are prescribed.
- Local anesthetics. Just painkillers, these include the drug Lidocaine.
- Hyaluronic acid. Reduces inflammation, nourishes joints with the right amount of substances, which also helps against pain.
- Radiosotopes, etc.
The list of medications is far from complete. For each patient, an individual drug is selected, to which, first of all, there is no allergy.
Rehabilitation after injury
Rehabilitation after this injury cannot be called quick: as a rule, it can take from 3 to 6 months. The load on the damaged joint must be accurately dosed so as not to disrupt the healing process.
Special exercises and restorative gymnastics are indicated as rehabilitation. Developing the joint should begin with passive movements. Active exercise may not be allowed until 6 weeks after surgery. Physiotherapy is prescribed to relieve tissue swelling and pain after surgery.
Contraindications to blockade
The administration of substances to relieve shoulder pain is contraindicated in the following cases:
- the infectious nature of the problems, injection can aggravate the process;
- the likelihood of infection as a result of the administration of the substance;
- open or closed fracture;
- too mobile joint;
- joint surgery performed or planned;
- the presence of an allergic reaction to the substances used;
- diabetes mellitus type 1 or 2;
- hemophilia.
If the patient has at least one contraindication, pain relief by injection is not considered as a possible treatment option.
Indications and contraindications
Drug blockades are used to quickly relieve pain and prevent shock in shoulder injuries - fractures, dislocations, ruptures of muscles, ligaments, tendons. For such injuries, the anti-inflammatory and decongestant effects of the drugs used are important. The following inflammatory and degenerative-dystrophic pathologies are the indications for the treatment procedure:
- glenohumeral periarthrosis;
- arthritis, arthrosis of various origins;
- non-infectious bursitis, synovitis;
- neuritis;
- contractures;
- tendinitis, tendovaginitis.
Shoulder joint blocks are not used if progressive fibrous changes are detected in the connective tissue structures located in the area of drug administration. Procedures are prohibited in case of decompensated reversible shock against the background of a deep circulatory disorder. Absolute contraindications to the blockade are necrosis or an infectious-inflammatory process in the area where the injection needle is inserted.
The procedure cannot be prescribed to a patient if he has been diagnosed with individual intolerance to the drug used. Shoulder blockade is not performed on patients under 12 years of age or on pregnant or breastfeeding women.
Possible side effects
Side effects occur in rare cases if the doctor made a mistake, the patient had an incompatibility with the drug being used, the dosage of the drug was incorrectly calculated, or two inappropriate drugs were mixed. As a result of this, the following problems may occur:
- infection due to a non-sterile medical device;
- increased pain;
- skin pigmentation;
- bleeding in cases where the patient has poor blood clotting;
- excess calcium in joints or muscles;
- violation of the integrity of the joint or cartilage;
- avascular necrosis.
Side effects do not necessarily occur. According to medical statistics, the chance of such an outcome is 3-5%.
Types of injections
Many drugs are used for injection. The wide range is due to the large number of patients; not everyone is suitable for a certain drug (allergies or other reasons).
The most common group of drugs are steroids if there are problems with the shoulder joint. Corticosteroids help restore the integrity of the rotator cuff, and intra-articular injections reduce pain.
Most often, steroids or lidocaine are used for relief. The medicine has a short duration of action, but it relieves the uncomfortable symptom well.
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03/19/2019 Thanks to Dr. Usenko N.S. for the consultation after the MRI of the shoulder joint! He calmly and professionally explained the results of the examination, made a diagnosis, answered all questions, relieved fears and gave recommendations for further treatment. I recommend
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01/15/2018 I am very grateful to all the employees for their attentive attitude towards people and the qualifications of a neurologist.
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04/28/2018 I underwent IV drips at this clinic. She came “crawling” and left dancing. High level of professionalism and skill. Now only here. I recommend to all.
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Indications for injection
Pain blockade by injection is not performed on every patient. Initially, doctors try standard, conservative treatment methods and only after them resort to relief. But the situation changes radically if there are indications for injection:
- the substance is introduced into the glenohumeral joint in the presence of spondyloarthrosis, capsulitis, rupture or degeneration of the rotator cuff;
- pain relief with Lidocaine is prescribed to those patients whose pain has become chronic or intensifies with any body movement;
- with bicipital tendinitis, the presence of degenerative processes in the muscle structure, destruction of cartilage tissue.
It is impossible to immediately begin treatment by blocking the pain syndrome; this may prevent the further development of symptoms. If this happens, the doctor will not be able to diagnose the cause of the problem and eliminate it. Pain can be relieved only after all diagnostic procedures have been completed, conservative treatment methods have been tried and drug therapy has been administered.
Treatment options for rotator cuff tears
The very first action of the doctor will be measures to relieve pain: usually, these are anti-inflammatory painkillers and ointments. It is recommended to completely rest the injured arm and fix it using a bandage or abduction splint. Applying cold, such as an ice pack, will help relieve swelling.
Surgery
A complete rupture of the cuff cannot heal on its own, and therefore immediate surgical intervention is required so as not to lose the motor function of the joint. In this case, it is important to perform the operation as early as possible, because an old injury leads to shortening of the muscle and the inability to stretch it to its original length. In such cases, it is very difficult to return the tendon to its place and will require a lot of effort from the surgeon. The optimal period for performing the operation is several months from the moment of rupture.
During surgery, the damaged tendon is stretched, attaching it to its original position, and also sutured, if necessary. All lifeless tissue that has undergone degeneration is removed so that the tendon can better adhere to the site of artificial attachment. Anchors are mainly used to attach the tendon. The anchor is screwed into the area of the bone where the soft tissue will subsequently be connected. The sutures attached to the anchor are passed through the rotator cuff and pulled to the bone using interrupted sutures. Thus, the sutures hold the tissue until the tear sites heal completely. Surgery to restore the function of the rotator cuff can be called quite complex and is performed through an incision.
Arthroscopic treatment
Arthroscopy is the most progressive method of surgical treatment of rotator cuff tears. It is performed without an incision by creating a special puncture with a diameter of 1-2 centimeters. A camera, an arthroscope, is inserted into the joint through the puncture cavity, allowing the surgeon to see a clear picture of the internal space of the joint. The image obtained from the surface of the arthroscope is transmitted to a screen, looking at which the surgeon carries out all the necessary manipulations and simultaneously controls them.
An operation performed in this way is most preferable, since healing occurs much faster, and the tissues surrounding the joint are practically not damaged during the intervention. After surgery, the patient's arm is immobilized for several weeks by applying a splint. This will protect against the possibility of re-rupture and allow the tissues to heal after surgery.