Ultrasound Guided
Ultrasound guided dry needling of chronic tendinopathyA number of different methods of
treating chronic tendinopathy has recently been presented. One of the methods that are increasingly experiencing greater interest is the "
dry needling" of the
chronic problems. (In some literature called
Ultrasound Guided Percutaneous pines Tenotomi)
In working
manual therapist and
acupuncture. For many years used dry needling as a method to treat
chronic tendon pathology, and has followed closely the research that has been presented on the site in recent years.
Muscle & Skeleton that examined the
use of ultrasound diagnosis in a
manual therapist practice. In this article, commented the need for
ultrasound as a guide to perform a
dry needling accurately and efficiently. Some researchers also call this method for a
percutaneous needle Tenotomi.
Recently used
ultrasound (U.S.) to guide the needle into the actual
tendon injury. The use of ultrasound has several obvious advantages. The
clinical diagnosis can be ensured by
UL. This avoids incorrect processing structure. At the same time ensures that the needles hit the U.S. jurisdiction in the
tendon.
Clinical trials are not good for determining where in the tendon injury is. Palpation is not a
safe diagnostic tool in this respect. Using UL is the investigator exactly the scene.
Chinese medicine and
acupuncture, and
western education in
physical therapy,
orthopedic medicine (
OMI) and
manual therapy. In
Chinese medicine have been published many articles in which "pepring" of the scene is
used as acupuncture. It is not known in most communities, when people first and foremost
envisions acupuncture as a method in which one uses a more global approach with pins.
By combining this method with the U.S. so we can go in and find where the
tendon injury is and treat accurately. By uses both
classical acupuncture needles and thin
injection needles in this treatment. The advantage of using an injection needle is that it is stiffer and can easily be inserted via eg the
thick layer of skin over the
plantar fascia. An
acupuncture needle tends to bend. In addition, an
injection needle a more potent "
cutting effect" that creates a somewhat larger "
trauma" and thus a larger internal bleeding in the tendon. The
advantage of an acupuncture needle is that the treatment is less painful. However, as mentioned earlier in this section as
acupuncture needle creates a
minor injury and one must often deal with more frequently to achieve the desired effect.
It perform 2-6 treatments with 1-2 week intervals in the treatment of chronic tendinopathy. During treatment with
injection needle he often waits two weeks between treatments, whereas with
acupuncture needles then you can / should deal with weekly. Often, only a few treatments may be enough to achieve the desired stimulation of the body to begin regeneration of
tendon injury.
As a
manual therapist had to treat patients without
local anesthetic. The
local anesthetic gives the therapist the ability to process longer so that you get stimulated whole tendon
injury on a treatment.
Without anesthesia, the patient will often not hold the entire treatment, so this must be carried out in several stages. One way which aids this problem if you do not have access to physician collaboration that
local anesthetic is to ask the patient to take
oral analgesics before treatment. This will possibly make the patient more susceptible to treatment. But he adds that all in all patients tolerated the treatment well without oral or
local analgesia.
Having used
tenotomi /
dry needling as a method for many years before he began using
U.S. guidance, able to compare the effects before and after UL - guidance. UL gives me the opportunity to make precise the treatment, he said. It is not just "touch and feel" as it is able to before. Used the U.S. as a
diagnostic and
counseling tool in the clinic for over 3 years.
Ultrasound diagnostics in combination with
acupuncture is an effective treatment for
tendon pathology and
bursitis.
Typical treatment areas is
lateral epicondylitis,
supraspinatus tendinopathy and
plantar fasciitis. But the method can be used on all
tendinopathy and
bursitis where the
medical history,
clinical tests and the U.S. together give you an answer about the structure that should be addressed. It emphasize that the U.S. alone is not an adequate tool to perform diagnostics. But with physiotherapy knowledge of testing, the group has everything it takes to be good at this method. Internationally, it was the often
radiology,
pediatric,
radiographers and
sonographer who used ultrasound abdomen and barren, but now holds it to be more focus on
skeletal muscle. Especially
rheumatology use ultrasound frequently to assess the extent and
localization of inflammation. There is now an increasing number of
physiotherapists,
manual therapists,
clinical orthopedic physical therapists and
chiropractors who use
ultrasound practice. And the group is growing. Encourage everyone with an interest in skeletal muscle injuries to use ultrasound guided
Percutaneous pines Tenotomi / dry needling as a treatment option for
bursitis and
tendinopathy.
Association for Clinical Orthopedic Medicine organizes an
annual anatomy, dissection and injection rate for
physical therapists and doctors at the preparations. This is an excellent way to familiarize themselves with the technique and a
natomy is required to use tenotomi as an
effective management tool.
Ultrasound with how had tested the treatment of
14 different tendon pathology with
ultrasound guided percutaneous needle tenotomi. Their
hypothesis was that treatment was equally effective even if you do not
inject cortisone for tenotomien. They got good results in his study, but since the study lacked blinding, large enough numbers and a control group, so the results should be tested in a larger study. The method was used to
treat lateral epicondylitis. This study was of higher quality, but the method they used was tenotomi followed by injection of cortisone to
control inflammation in the aftermath. The authors in this study even discussed the possibility of carrying out treatment without cortisone, and presented a h
ypothesis that it was mainly the needle damaging effect that initiated regeneration, and that cortisone had no active role. But you used when cortisone to control inflammation after treatment.
In light of recent studies on the effect of
Association for Clinical Orthopedic Medicine and cortisone their possible negative effects on healing after injury, is unsure of the need for cortisone. If the method of tenotomi is designed to create a new acute inflammation so that repair processes locally in the tissue is at it again, why would you then to inhibit this effect by
injecting cortisone? Some have argued that cortisone softens scar tissue, but remains more research.
