Best Treatment for Elbow Pain

Medi-Rehatek will introduce the best treatment for eblow pain today.

Elbow pain refers to the tendon tenderness and inflammation of outer elbow. The pain is caused by repetitive force on the muscles of wrist and fingers that stretch backwards. The patient feels pain in the outer elbow when gripping or lifting the object. Tennis elbow is a typical example of overwork syndrome. Studies have shown that the wrist extensor muscles, especially the wrist extensor carpi radialis brevis, which extends straight and puts forth your strength to the radial ,the tension is very large.The partial fiber on muscle and bones junction will have over-stretching to form a slight tear.

Treatment method

Rest and change activity patterns.

Appropriate rest is particularly important in the acute phase (severe redness, swelling, pain), but changing the pattern of activity is more important. Finding the cause of the injury, and then patients make the appropriate changes, who can slow down the disease. Studies have shown that tennis players suffer from tennis elbow, who reduce training intensity and scientific exercise, who can reduce 90% of the disease.

Physiotherapy.

Patients should be early to rest, local site can have hot compress.The affected limb is fixed with a triangular suspension in the chest. The elevation of affected limb and electrotherapy can control the inflammation.Physical therapy heals the tendon in a good environment.

Drug.

Anti-inflammatory drugs can help relieve pain and inflammation. Some people want to reduce the pain quickly, they choose to local steroid injection, but in fact it will cause a lot of harm to the organization, so it is not recommended to use.

Acupuncture and massage.

Acupuncture and massage produce stimulation to activate the elbow muscles through acupuncture points. The injured part can be messaged in different way like rub, press, straighten out, calm massage each day. It can relieve blood vessels and muscle spasms, relax the muscles and promote the blood circulation, repair tendons. Note that the action should be gentle massage, avoid fierce pull, so as to avoid secondary injury.

Topical Chinese herb.

External application of Chinese herbal medicine and wet wound pain cream as well as topical herb have a certain effect.It can remove rheumatism and dehumidify,relax the muscles and promote blood circulation to arrest pain.

Elbow brace.

In sports, the tennis elbow is mostly due to improper excessive force.In order to prevent the occurrence of tennis elbow, patient should have more activities om elbow and arm before the campaign activities. It is better to wear elbow brace in the forearm to ease the pressure on the elbow muscles.

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When will prosthesis be installed after amputation

Medi-Rehatek will introduce when prosthesis will be installed after amputation.

Many patients with amputation have this view, that prosthesis assembly needs to wait a long time after the amputation.The reasons for these patients with amputation who have limb edema without having the final shape. 

After the installation of prosthetic limb,the stump will shrink. Yes, that is right.Limb has edema after amputation, after the installation of prosthetic limb the residual limb will shrink.But amputees still should install the prosthesis as soon as possible.Before the first installation of temporary prostheses ,we need to promote the residual limb to have final shape, that will lay the foundation for the installation of a formal prosthesis.

In some places abroad, the patient's stump is installed with plaster socket after amputation surgery.The socket is connected to the prosthetic feet. The patient can walk out of bed as soon as practicing. Or waiting until the amputation wound is healing and stitches are taken out , patients need installation of artificial limbs as soon as possible.

At present, some prosthetic companies pick up the patients from hospital to install the prosthetic limbs, who does not promote the final shape of residual limb in that time.This is wrong to make patients wear the prosthesis formally. The stump will shrink fiercely after wearing prosthesis.

Even medical institutions should allow patients to wear bandages to promote the final type of residual limb. After the initial stereotypes, the patients need installing one or more prosthetic sockets .After 3 months when the shape of stump doesn’t change,patients can go to prosthetic company to replace prosthesis. 

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Avoid joint deformity after amputation

Medi-Rehatek will continue to introduce the best way to avoid joint deformity after amputation.

7, scar.

Surgical scar is inevitable. But also due to improper operation or inflammatory changes make line-like scar expansion, adhesions or contracture, a few people have physical scars who will produce keloids.

8, Skin diseases.

Common folliculitis and ringworm. It is mainly due to poor sanitary conditions of the residual limb.

9, Phantom sensation and phantom limb pain.

Patients may experience phantom sensation and phantom limb pain, that is, there is still the amputated limb that has the pain feelings. Phantom limb sensation and phantom limb pain are normal after surgery and they usually disappear after a few weeks or after prosthetic assembly. 

Patients can start tapping the affected limb after the wound is healing every 10-15 minutes, 1-2 times a day.Patients gradually increase the number of beats and strength, and the correct use of elastic bandage, can ease the phantom Limb sensation and phantom limb pain. 

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How to advoid joint deformity after amputation

Medi-Rehatek continue to introduce how to advoid joint deformity after amputation.

3,Reduce the stump pain

There are many causes of residual limb pain, but mainly in the following areas:

1) Surgery on nerve damage;

2) Limb blood circulation disorders;

3) The limb was cut off to cause the abnormal muscle tension;

4) Residual nerve has tumor;

5) Central nervous system injury.

The pain must be alleviated before prosthesis assembly.We must take surgery, medication, physical therapy, block therapy, acupuncture, injection or psychological treatment, etc. according to its cause. It avoids malignant pain to have formation of the foci in the brain center . Most can be cured, only a few patients are required surgery.

4, To protect the hygiene of the stump

Patients need to wash the stump with soapy water before bedtime daily.If using residual limb-specific care solution, patient can use body lotion to prevent better residual limb from infection.

5, stump sinus or ulcers

The formation of the sinus is mainly due to infection after there is a foreign body in deep wound, such as thick silk thread, sequestrum.Ulcers are mainly due to poor blood supply to the skin, and too many stump scar tissues, neurological disorders and other factors.The ulcers usually are in the load-bearing parts. Non-healing Wound will affect the prosthetic assembly, the treatment method is based on the condition, the elimination of foreign body, dealing with wound or re-amputation.

6, Residual bursitis

Occurrence of bursitis on the residual limb, if the bursitis often has the friction in the load-bearing parts, that will continue to become larger.It is difficult to subside, known as the abnormal synovial capsule. In general, there is no effect, such as synovial pouch is too large or infected, it needs treatment, while eliminating the cause of synovial fluid. 

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How to prevent joint deformity after amputation

Medi-Rehatek will introduce how to prevent joint deformity after amputation.

1, To maintain a good position.

To maintain the correct residual limb position in order to prevent residual limb joint contracture and deformity. As part of the muscle was cut after amputation, that can cause muscle imbalance, joint contracture. Such as: hip flexion, hip abduction, knee flexion, ankle plantar flexion, the results will affect the prosthesis alignment. Postoperative joint should be placed in functional position, and the joints should have early functional exercises to make sure that the joints are flexible without deformity.

 Put the pillow under the affected lower limb to reduce swelling after surgery.Then  the pillow should be removed to prevent joint contracture and deformation. Therefore, the thigh amputation patients should pay attention to extending the residual limb (hip extends backwards), as far as possible the stump is close to the middle position of the body (hip adduction).

Amputees can be prone position every 30 minutes twice a day.

Being Supine, patients should not raise the affected area or the residual limb height only just to feel comfort or to alleviate the pain. Put a pillow under the perineum to outreach the thighs.

Be careful about long-term use of wheelchairs, wooden crutch to lift the residual limb and other adverse posture.

Don’t separate the residual limb or increase waist height with pad.

Below -knee amputation patients should pay attention to the position of residual knee that should be placed in the extension position. Don’t  put pillows under the thigh or knee. Don’t lie on bed with knee flexion. Don’t sit on a wheelchair with knee flxion or place the stump on the handle of a crutch.

2, The elimination of residual limb edema.

Postoperative surgical trauma and insufficient muscle contraction,venous return disorder, which can cause residual limb edema. This swelling is temporary, it will disappear  after the residual limb circulation is reestablished. It usually takes 3-6 months.

The use of elastic bandage offers reasonable dressing to residual limb, which can reduce swelling and promote the final shape of stump.

 In recent years, the international use of postoperative artificial limb assembly, that is, on the operating table, the amputee is still awake after amputation surgery, who is fitted with temporary prosthesis. After one or two days amputees get out of bed to practice walking or other functional training. This method not only  greatly encourages the amputees psychologically ,but also accelerates final shape of the residual limb.It reduces affected limb pain and it is helpful for other pain.

There is also the use of environmental control therapy, that is, after the operation the residual limb without any dressing covered will be attached to  the transparent airbag that is connected with an air conditioner.And the stump practices walking. Container pressure can be adjusted so as to make residual limb contraction with final shape, to promote the early final shape of residual limb. 

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Treatment of congenital hip dislocation

Medi-Rehatek will introduce the treatment programs for the congenital hip dislocation:

Treatment of congenital hip dislocation in children, in principle, is the sooner the better, the treatment is different as age increases in principle.

1. For early dislocation less than 1 year, the treatment principle is to keep both hips in the frog-style position for a long time to ensure that the femoral head is completely into the acetabulum. The acetabular posterior edge and the femoral head have the normal development to joint stability without dislocation any more.Treatment is relatively simple, neither anesthesia, nor manual reduction, the effect is better. Put a wide diaper or triangular mat under the crotch, or use a frog-type brace to immobilize, make lower limbs to keep frog-style, it can be natural recovery for six months to a year.

2, 2-3-year-old children with hip dislocation need traction manipulation therapy and gypsum fixation, first we use traction to relax the affected muscle, under the anesthesia we use manual reduction, and we will pull out the femoral head back to normal levels, and we use frog-style gypsum or orthopedic brace to fix.It takes 9-12 months to achieve the satisfactory effect. As the human bone has a strong plasticity, children are in the progress of strong growth and development, the original poorly developed shallow acetabulum will be deepened and return to normal with the stimulation by femoral head.

3 - 4 -7 year-old children with obvious hip dislocation , secondary changes of bone and soft tissues are also obvious.It is difficult to return to normal to have manual reduction. Patients should take surgery. In principle, the acetabulum needs deepening or put a "cover" above it, so that the femoral head is no longer prolapseafter the manual reduction , while the implementation of osteotomy in the affected pelvis to stabilize the joint, postoperative application of plaster or orthopedic fixation.

4, More than 7-year-old children have long course of disease,their muscle ligaments have serious contracture that is difficult to have manual reduction. The femur needs shortening and then have reduction.We use gypsum or orthosis to stabilize after surgery.Surgical age can be extended to 12 years according to specific condition. 

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Congenital hip dislocation

Medi-Rehatek will introduce the congenital hip dislocation.

Congenital hip dislocation , also known as developmental hip dislocation or developmental hip dysplasia of the hip and hip hypoplasia, that are the most common deformities in children in China.The incidence rate is 4 ‰ , girls are more than boys, the left sides are more than the right sides. 

Bilateral dislocation is relatively rare, the disease has no obvious symptoms and signs at birth.The child's parents are not easy to find the disease in the early phase, they often find out when the child will be able to walk.They miss the best time to the treatment, leave the children with a lifetime disability and suffering.

The main pathology:

① Iliopsoas muscle tension, contracture, oppression of the acetabular entrance;

② The deformation of Joint capsule is gourd-like;

③ Femoral head and neck deformation, mainly femoral head is oval, short femoral neck,  anteversion angle of femoral neck increases;

④ Acetabular deformation, mainly acetabular fossa shallows, that is like triangular shape, acetabular index increases, the joint labellum involute;

⑤ Femoral ligament thickens and lengthens, articular cartilage degeneration and so on.

Clinical symptoms:

1, Both sides of the inner thigh skin have asymmetry wrinkles, affected skin wrinkles are deepened and increased.

2, Children perineum is widened, especially for  bilateral dislocation that is more obvious.

3, Patient’s hip have less activity, the activity is limited. Pedaling force is weaker than the sound side. The hip is often in the flexion position, can not be straight.

4, Patients with shorter limbs.

5,When patients have traction in lower limbs that have the bomb or snapping sound and sometimes patients will cry.

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