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LO Sken 4 Blok 11
LO Sken 4 Blok 11
LO Sken 4 Blok 11
Myofascial Release:
Many modalities can be used to treat physically active individuals, and all treatment
plans for myofascial pain should include active therapeutic exercise. None of these
interventions, however, directly address the problem of fascial restrictions and gamma
gain.
Myofascial release techniques, more specifically indirect myofascial release
techniques, place muscle and fascia in positions that remove stress from the tissues.
The application of light, sustained pressure up to the fascial resistance barrier allows
the tissue to relax. The shortened position decreases noxious stimulus from the tissue,
which in turn diminishes activity in gamma motor nerves. Direct techniques attempt
to stretch bound fascia, by applying load through a restrictive barrier. This will
decrease the afferent input from the tissue. Both types of techniques can be used to
treat myofascial pain pattern, however, the primary focus of the indirect technique is
to address gamma gain, by decreasing efferent stimulus.
http://stoneathleticmedicine.com/2013/12/gamma-gain-myofascial-pain-syndrome-andtreatment-using-myofascial-release-and-strain-counterstrain/
2. Why the doctor suggest to take the x-ray and special examination?
Your health care provider usually begins with a thorough physical examination and
medical history, including a review of symptoms. The provider will likely perform a
detailed exam of the affected muscles, including strength and range of motion testing.
He or she will rub the suspected trigger points to see if the muscles respond, or twitch,
and cause pain in a predictable pattern or specific region.
Sometimes blood tests will be performed to look for medical causes of muscle pain,
such as vitamin D deficiency or hypothyroidism.
The type of pain that you may have with myofascial pain syndrome can be similar to the
symptoms of several types of disorders. Accurately determining the correct source of your
pain is critical to successful treatment diagnostic procedures include:
Testing may include x-rays, MRI and/or CT scans, and electro-diagnosis (EMG)
An electromyogram (EMG) is a test that is used to record the electrical activity of
muscles. When muscles are active, they produce an electrical current. This current is
usually proportional to the level of the muscle activity. An EMG is also referred to as
a myogram.
Antidepressants:
o Tricyclic antidepressants, e.g. starting with a low or moderate bedtime dose
for 2-4 weeks; if helpful, continue for 2-4 months and then taper down to a
low maintenance dose.
o An alternative is a newer antidepressant such as a selective norepinephrine
reuptake inhibitor, e.g. duloxetine.
o Selective serotonin reuptake inhibitor (SSRI) antidepressants have been used,
but some (fluoxetine and paroxetine) may increase bruxism and are not
recommended.
One small case study suggested that tiagabine may be helpful for bruxism.13
also used to visualize the inside of the joint during certain surgical procedures involving the
articular disc or the articular surfaces, similar to laparoscopy.[10] Examples include release of
adhesions (e.g., by blunt dissection or with a laser) or release of the disc. [11] Biopsies or disc
reduction can also be carried out during arthroscopy.[9] It is carried out under general
anesthetic.[12]
Arthroscopy is the endoscopic examination of the joint space. It is used for both diagnosis
and treatment. Adhesions and loose bodies are the most common indications and findings for
arthroscopic treatment of the temporomandibular joint. Advancements in techniques have
allowed arthroscopy to be employed in several internal derangement procedures, including
some disc procedures.
Arthrographyjaw movements videotaped with x-rays taken after dye is injected into the
joint (gerakan rahang direkam dengan x-ray diambil setelah bahan pewarna disuntikkan ke
dalam sendi)
Arthrographythe X-ray examination of a joint after injection of a contrast medium into
the joint space
Arthrogram examinations are usually performed with a local anesthetic. The injection is
made under careful aseptic conditions, usually in a combination fluoroscopic-radiographic
examining room that has been carefully prepared in advance. The sterile items required,
particularly the length and gauge of the needles, vary according to the part being examined.
The sterile tray and the nonsterile items should be set up on a conveniently placed instrument
cart or a small two-shelf table.
After aspirating any effusion, the radiologist injects the contrast agent or agents and
manipulates the joint to ensure proper distribution of the contrast material. The examination
is usually performed by fluoroscopy and spot images. Conventional radiographs may be
obtained when special images, such as an axial projection of the shoulder or an
intercondyloid fossa position of the knee, are desired.