Local closure is also called “local seal”. It is a method of injecting hormones and other drugs into the local soft tissues, tendons, tendon sheaths, and nerves of the lesion. For local sterile inflammation will play a rapid anti-inflammatory, pain-relieving effect.
There are many clinical misconceptions.
Misconception one.
Can only cope with a moment, not a complete cure Patients think that playing closed needle can only temporary pain relief point of view, in fact, like tennis elbow and some other chronic pain, by closed treatment is completely curable. The problem is that some patients in a shot after feeling relief from the symptoms will no longer cure until the next attack to play again. In this way, the disease is often prolonged due to the lack of treatment. In cases where the disease recurs after treatment, the injury is caused by the fact that they have not rested well, or that they have repeatedly stimulated the original lesion many times due to the work they are engaged in.
Misconception two.
Playing closed is with hormones will produce dependence The main component of the closed needle is hormone, many patients worry about playing after the hormone dependence. Dependence mainly refers to the use of hormone therapy for certain diseases, although the symptoms are completely controlled or partially relieved, but suddenly stop using hormones or quickly reduce the dose, the condition immediately relapsed or worsened. This situation only exists in the case of long-term, high-dose, repeated use of hormone therapy. In contrast, closed therapy is generally only 1-3 times in a row for a course of treatment, and each time will be 7-10 days apart, and the injection dose is very small, so there is no possibility of hormone dependence.
Misconception three.
Sequestration therapy has great side effects Many patients worry that the hormone drugs they choose will cause side effects to the human body, such as osteoporosis, femoral head necrosis, increased blood sugar, endocrine disorders and so on. This view is biased. Again, these symptoms are often only likely to occur with prolonged and repeated use of hormones. However, closed therapy uses a small amount of medication and a small number of doses, and generally does not have any effect on the human body.
Misconception four.
Consider that closed treatment is particularly effective and overly trusting. Many patients come to the clinic and let the doctor to play closed, think closed works, in fact, the first thing to know what disease they are in the end, suitable for closed treatment. Because the closure is also a treatment method, not everyone effective, if the chronic disease after several closed treatment, can not be alleviated, you need to cooperate with acupuncture, physical therapy, massage, traction, radio frequency, ion introduction and other comprehensive treatment.
Misconception five.
That playing closed will be very painful, the symptoms will worsen. After the closure treatment, the local pain response in 2-4 hours to reach a peak, and then gradually reduce the pain disappears after two or three days, which is related to local drug stimulation, local pressure increase, this situation is a normal response, no special treatment, if the pain is intense, you can take oral analgesic drugs as appropriate.
Local closure mechanism (more academic).
1.Block the nerve (class c fiber) transmission pathway of nociception
2.Block the vicious circle of nociception
3.Improve local blood circulation
4.Acting on sympathetic nerves and blocking their excitation
5.Glucocorticoid: inhibit the inflammatory response, i.e. anti-inflammatory and pain relief, swelling and softening of scar tissue.
Which problems can be locally closed?
Tenosynovitis; peripheral nerve entrapment disease; shoulder joint pain; muscle starting and stopping points and ligament strain (aseptic inflammation); low back pain; bursitis; degenerative osteoarthritis; rheumatoid arthritis, etc.
When can not do closed treatment?
1.Patients refuse to accept the closure or have concerns about the closure abnormality
2.Puncture site or nearby skin has local infection
3.Suspected local pain may be related to local infection
4.X-rays at or near the painful site suggest pathological changes in bone or soft tissue
5.There is a chronic systemic infection under treatment, such as tuberculosis
6.Patients with abnormal coagulation function
7.History of gastrointestinal bleeding
8.Severe hypertension or diabetes mellitus
9.Patients cannot use hormones or are allergic to hormones or anesthetics.