Search

Anterior chest wall pain resulting from an athletic injury has a broad differential diagnosis including muscular strain, partial or complete pectoralis tear, avulsion of the pectoralis tendon, rotator cuff injury and referred pain. Rupture of the pectoralis major muscle is rare, except among bodybuilders, in whom this lesion has been well described. As a result of injury to the pectoralis muscles, the medial and lateral pectoral nerves may be injured as well, causing atrophy, asymmetry and weakness. We present a case of chronic pectoral pain in a twenty-five year-old male four years following his initial injury secondary to a 370 pound bench-press. Both MRI and electrodiagnostic testing were used in order to diagnose medial pectoral nerve injury. The patient was conservatively managed, with a favorable outcome. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this retrospective, pilot study was to assess changes in dizziness, pain and function in subjects undergoing an outpatient rehabilitation program focusing on cervical pain. Methods: Fifteen subjects with chronic cervical myofascial pain and concurrent dizziness of suspected cervical origin completed a retrospective questionnaire. Improvement in pain, dizziness and function were recorded on a visual analog scale (VAS) in response to a non-standardized rehabilitation program involving modalities, stretching, strengthening, trigger point injections and aerobic conditioning. Results: Subjects reported an average VAS improvement in dizziness of 59% (- 29), pain 69% (- 21%) and function 71% (- 19). Seven subjects experienced reproduction of their dizziness and pain during trigger point injections. Overall, twenty seven percent reported no further episodes of dizziness. All subjects experienced a decrease in the frequency of episodes of dizziness. There was a correlation between dizziness and pain (r=0.58), dizziness and function (r=0.60), and pain and function (r=0.74). Conclusion: Subjects with dizziness and cervical myofascial pain of suspected cervical origin may experience symptomatic and functional improvement through a rehabilitative program addressing their cervical pain. Future prospective, randomized controlled studies are needed to address which intervention is the most effective. [ABSTRACT FROM AUTHOR]

Background: Shoulder pain from rotator cuff pathology and glenohumeral osteoarthritis is a common entity encountered in musculoskeletal practices. Orthobiologic agents are being increasingly used as a treatment option and understanding their safety and efficacy is necessary., Objective: To systematically evaluate the available evidence for orthobiologic use in rotator cuff and glenohumeral pathology., Methods: A systematic review was undertaken following PRISMA guidelines. Randomized clinical trials (RCTs) and prospective cohort studies evaluating non-operative treatment with prolotherapy, platelet-rich plasma (PRP), or medicinal signaling cells (MSCs) for rotator cuff pathology and glenohumeral osteoarthritis were included. Bias risk assessments used were the Cochrane tool and Newcastle-Ottawa score., Results: The search yielded 852 potential articles, of which 20 met the inclusion criteria with a breakdown of 5 prolotherapy, 13 PRP, and 2 MSC. Sixteen studies were RCTs and 4 were cohort studies. Six studies were deemed "low risk of bias or good quality". Efficacy results were mixed, and no serious adverse events were reported from orthobiologic treatment., Conclusions: Orthobiologics offer a relatively safe management option with inconclusive evidence for or against its use for rotator cuff pathology. No studies on glenohumeral osteoarthritis met the inclusion criteria. Adoption of standardized preparation reporting and consistent use of functional outcome measures is imperative for future studies to consider.