Muscle and tendon pain can be a real drag, and often injections are recommended or considered after failed conservative treatment. Especially by that bloke in the office!
But does it work, and are they damaging?
There are lots of injection options for tendinopathy; corticosteroid, platelet-rich plasma, hyaluronic acid, prolotherapy, tenocyte implantation, stem cell… the list goes on.
There are promising studies with each of these, and there is no ‘one size fits all’ answer.
Currently, corticosteroids remain the most common ‘safe bet’ for pain relief and return to rehab. But they are short term strategies, with less effective long term results.
Although widely regarded as safe, animal trials of corticosteroids have showed that they can weaken tendons, however it is not conclusive in humans.
Platelet rich plasma (PRP), injects a concentrated mix of the bodies own cells to promote healing, and is gaining momentum. However the evidence is not yet certain as there are a wide variety of techniques and the procedure appears not to be completely perfected.
All other injections are considered more experimental when compared to corticosteroids and PRP.
So in conclusion, tell your office buddy that there is no clear winner! Having said that, expertly administered injections carry relatively few risks and do often help tendon rehabilitation. Therefore it is worth considering, especially when there is little response to therapy on its own.
Alex Horne Chiropractic… more than just a little prick.
Sources available on request
Many back pain sufferers know that catching 40 winks can be tough for your back.
“But why can rest make me sore?”
Between your vertebrae, there are discs made up of fluid and strong fibres helping to distribute pressures on the spine, for example during sitting, bending or running.
During sleep, the load on our spine is relieved, giving our discs a window in which to heal and hydrate. In the morning a typical spine is 1-2cm longer* (this can be up to 5cm in space!*) as hydration causes them to expand.
These lofty heights are lovely, however more fluid in the disc creates a pressure increase. Bending in the morning produces approximately four times more strain than during the day**, putting you at a greater risk of injury.
Discs have a poor blood supply, so rely upon rehydration and protein replenishment to stay healthy. Of all cartilage in the body, they wear down the fastest*, so ignore them at your peril!
We are largely immobile when asleep, so the facet joints, which are designed to move, can also feel stiff on waking. (Problems aren’t usually caused, but accentuated by sleep).
“So what do I do?”
Mornings are quite a delicate time. Your discs need to depressurise without being subjected to heavy strain or big stretches, but, at the same time, your facet joints like to be stretched out.
The best advice is to slowly expose your back to you body’s weight before subjecting yourself to any stressors. Continue reading Make a stand in the morning!