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Steroid injections for back pain can lead to bone loss, beware those with elbow pain, chronic pain, use Physiotherapy Winnipeg

Lately, many patients with chronic pain, including those with back pain, shoulder rotator cuff pain, elbow tendinitis pain or other chronic pain, have been asked by their family doctors ‘if they would prefer corticosteroid injections to physiotherapy?’

A Henry Ford Hospital, in Washington, D.C., study ( http://t.co/W3gj4dJt ) has found that postmenopausal women suffered significant bone density loss in their hip after they were treated with an epidural steroid injection for back pain relief.

Bone density loss after six months was six times greater when compared to the typical bone density loss seen in a year in a postmenopausal woman who doesn’t receive steroid injection, researchers said.

Shlomo Mandel, M.D., an orthopedic physician and the study’s lead author, said physicians should exercise caution prescribing an epidural steroid for select patients, suggesting that multiple injections may compromise bone strength.

“The findings of our study suggest that epidural steroid injections for back pain relief should be approached cautiously in patients at risk for bone fragility,” Dr. Mandel said.

“Physicians who do prescribe them should consider measures that optimize bone health such as calcium and vitamin D supplements and exercise as part of their patient’s treatment plan,” he added.

Back pain is one of the most common medical conditions in the United States, affecting 8 out of 10 people at some point during their lives. As people age, their spine ages with them, causing degenerative changes in the spine.

Patients are typically treated with anti-inflammatory drugs and physical therapy. If symptoms persist, an epidural steroid is often prescribed to alleviate pain and improve function. However, steroid use has been linked to diminished bone quality.

There has always been the link, and the questions concerning steroid injection and tendon or bone deterioration. One of the more famous cases was that of Joe Montana, Hall of Fame NFL quarterback and his elbow tendon rupture following multiple injections. Now there are not many of us that perform at this level, but chronic pain of any type can be debilitating and life altering. Please know your options and be aware of all the side effects associated with longterm medications; the list of side effects may outweigh any medical advantage.

If you are considering steroid injection as a form of treatment; ask your doctor about his/her experience in delivering such a treatment option. An orthopedic surgeon or experienced sportsmedicine doctor would be a wise choice.

Your Physiotherapist should be able to address your concerns about such a treatment option, and he/she should be able to provide treatment relevant to your pain trigger points and the appropriate exercise to assist in your longterm rehab.

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Sitting in Winnipeg; an Ergonomic approach to your Physiotherapy needs

Many people ask; ‘what do you treat most often Downtown?’, to that I reply; “mostly neck and back injuries, just from sitting all day at a workstation”.

Here’s where my 27 years of experience as a physiotherapist, who provides specific assessment, feedback, education and instruction in Occupational Ergonomics, or how we interact with our ‘work tasks’, benefits my patients of the grain, finance and legal hub of Winnipeg.

As a physiotherapist, I must assess your workstation and task challenges in order to understand your biomechanics that caused an injury or pain. I only use evidence based guidelines published, and reviewed annually (CSA link http://t.co/Su0MxsFy). Beware of those ‘weekend course’ assessors, quite frankly you will get what you pay for.

You, and your company can reduce repetitive strain complaints in your workplace with an ergonomic assessment at your specific, work site. I will assess problem areas and make recommendations for change to workstations, task organization and management, and your specific, body mechanics with a focus on employee participation, responsibility and behaviour change.

A worksite visit to understand your business and jobs will only provide a baseline for understanding the demands on workers. It will provide us with an ability to recommend modifications for ergonomic improvements and safe body mechanics training.

By providing immediate feedback; employees are able to participate and install immediate, habitual changes at work, home and play, that assist in improving compliance with safe work procedures, and biomechanics that prevent injury.

The main risk factors for musculoskeletal injury can be categorized under one of the following four broad headings: force, posture, repetition and duration of task. In the office or call centre environment these risk factors could be interpreted as;

  • force – is an exertion performed to overcome the weight, resistance, or inertia of the body or a work object (i.e. forceful hand movements while keying or mousing),
  • posture – awkward postures deviate from neutral or comfortable positions. (i.e. twisted neck, raised shoulder, extended wrist, etc..),
  • repetition – refers to tasks or series of motions that are performed over and again by the same muscle groups with little variation (i.e. continuous mousing or keying)
  • duration – the time which something continues (i.e. sustained neck extension to view monitor or abducted shoulder while mousing)

check back again for more on this continuing series regarding your ‘sitting in Winnipeg’…

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Concourse Physio in the Winnipeg Exchange District

Concourse Physio in the Winnipeg Exchange District

Since 1993, physiotherapy services upon immediate access, downtown convenience and with direct billing if possible…enjoy the Winnipeg Fringe Festival!