tailieunhanh - Applications in Musculoskeletal Disorders - part 6

Nguyên nhân của khuỷu tay quần vợt vẫn còn chưa rõ ràng (Chard và 1989 Hazleman, Pienimäki et al. 1998). Trong khi hầu hết các tác giả thuộc tính đau ở epicondyle bên căng thẳng quá chèn của m. duỗi carpi radialis brevis và địa phương tendinosis | 6 Extracorporeal Shock Wave Application in the Treatment of Chronic Tennis Elbow Introduction The causes of tennis elbow remain unclear Chard and Hazleman 1989 Pienimaki et al. 1998 . While most authors attribute pain at the lateral epicondyle to overstrain of the insertion of the m. extensor carpi radialis brevis and consequent local angiofibroblastic tendinosis Finestone and Helfenstein 1994 Foley 1993 Kraushaar and Nirschl 1999 Roe-tert et al. 1995 there are reports suggesting a reflex chain between intervertebral joint dysfunction and peripherally localized soft-tissue pain syndromes Sutter 1995 Waldis 1989 Wanivenhaus 1986 Wyke 1979 . Wright et al. 1994 write that neuronal changes within the spinal cord might be more important than peripheral nociceptor sensitization in the development of chronic musculoskeletal disorders such as tennis elbow. This is in accordance with reports of an association between lateral epicondylitis and a dysfunction in the cervical spine and at the cervicothoracic junction in more than 80 of patients Ehmer 1998 . Cyriax 1982 however argues that at the age of 40-60 years it is hightly probably that any patient suffering from chronic lateral epicondylitis would have radiographical evidence of cervical spondylosis as well. He denies that pain in the elbow provoked by wrist movements could have the neck as its origin. Labelle et al. 1992 conclude that conservative procedures in tennis elbow lacked any scientific basis. Boyer and Hastings 1999 also find no conclusive studies on operative and nonoperative treatment concepts. New treatment methods have since been undergoing trials. The finding that physical stimuli are capable of activating endogenous nociceptive control systems has led to the use of shock waves in the treatment of persistent tennis elbow Rompe et al. 1996a . Extracorporeal shock wave therapy ESWT was said to fulfill major properties of hyperstimulation analgesia but the exact mechanism of pain reduction produced by ESWT is