Shoulder Pain – NSAID Injections or Corticosteroid Injections?
A new study carried out by US researchers has found that NSAID injections are better than corticosteroid injections for relieving shoulder pain. A single injection of the nonsteroidal anti-inflammatory drug (NSAID) ketorolac demonstrated superior pain-relieving qualities compared to corticosteroid injections when treating patients with shoulder impingement syndrome. The study was a double-blind, randomized research project and the paper was recently presented to attendees of the American Orthopaedic Society for Sports Medicine (AOSSM) 2011 Annual Meeting.
Shoulder pain can be caused by a number of conditions, some acute, some chronic, and is often accompanied by neck pain and upper back pain, particularly in conditions such as spinal stenosis, degenerative disc disease and pinched nerves, or even brachial plexus injury. This study looked specifically at subacromial impingement syndrome however, a condition involving trapped tendons when the arm is elevated or the shoulder rotated internally, and which possibly leads to rotator cuff tear if unaddressed. Further problems may also develop, such as impingement of the infraspinatus tendon and biceps tendonitis.
Subacromial impingement syndrome can also be caused by arthritis, with osteophyte growth implicated in some cases. Removal of the osteophytes may be necessary to address the problem, where it is mechanical rather than simply inflammatory in nature. The condition is, however, normally treated with corticosteroid injections and possible physical therapy. Unfortunately, such injections come with a risk of tendon rupture, adverse changes in articular cartilage, and the atrophy of subcutaneous tissue (thinning of the tissue under the skin). During the study, forty-eight patients with isolated external shoulder impingement syndrome were assigned to a group receiving either 6cc of 1% lidocaine with epinephrine and 40mg triamcinolone (the corticosteroid group), or a group receiving the same dose of lidocaine (without the epinephrine) and 60mg ketorolac (the NSAID group). Both groups improved after four weeks in terms of pain and mobility but the NSAID group had a mean improvement of 7.15 compared with 2.13 on the University of California– Los Angeles Shoulder Assessment Score.
NSAID Shots for Shoulder Pain – Risks and Benefits
In addition, the group receiving NSAID shots for shoulder pain had an increase in strength on forward flexion, whereas the steroid group showed a marginal decrease in strength. Patients in the NSAID group were also more satisfied with their treatment than those receiving steroid shots. The researchers observed that, whilst both groups had initial improvements, only the NSAID group showed significant effects over a longer period of time. Using NSAID injections is preferable to using corticosteroid injections as they do not have the same side-effects of tissue loss, and cartilage damage and may be given more frequently, whereas corticosteroid shots are limited in terms of frequency. There are some potential disadvantages to NSAID shots for shoulder pain however, including complications in patients with kidney dysfunction, and possible bleeding. Taking oral NSAIDs alongside NSAID injections is also advised against, and those with gastric ulcers are not candidates for this treatment as it may exacerbate their condition.
The effect of the NSAID shots at relieving shoulder pain is thought due to the anti-inflammatory action they provide and ketorolac injections have been popular in sports medicine for many years for their ability to reduce pain. Although the study is unlikely to result in a switch from corticosteroid treatment for shoulder pain, or indeed neck pain, it does offer an alternative, particularly in cases where the steroid injections have failed to provide shoulder pain relief.
References
American Orthopaedic Society for Sports Medicine (AOSSM) 2011 Annual Meeting: Abstract 34. Presented July 10, 2011.
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Casibom, rakiplerini geride bırakarak uzun soluklu bahis platformların önüne geçmeyi başarıyor. Bu pazarda köklü olmak önemlidir olsa da, oyuncularla iletişimde bulunmak ve onlara erişmek da aynı derecede değerli. Bu noktada, Casibom’un her saat servis veren canlı olarak destek ekibi ile rahatlıkla iletişime geçilebilir olması büyük bir fayda getiriyor.
Süratle genişleyen oyuncuların kitlesi ile dikkat çekici olan Casibom’un arkasındaki başarı faktörleri arasında, sadece ve yalnızca bahis ve canlı casino oyunları ile sınırlı olmayan kapsamlı bir hizmet yelpazesi bulunuyor. Spor bahislerinde sunduğu geniş seçenekler ve yüksek oranlar, oyuncuları çekmeyi başarıyor.
Ayrıca, hem sporcular bahisleri hem de kumarhane oyunlar oyuncularına yönlendirilen sunulan yüksek yüzdeli avantajlı bonuslar da dikkat çekiyor. Bu nedenle, Casibom kısa sürede piyasada iyi bir reklam başarısı elde ediyor ve büyük bir oyuncuların kitlesi kazanıyor.
Casibom’un kar getiren promosyonları ve popülerliği ile birlikte, web sitesine üyelik ne şekilde sağlanır sorusuna da değinmek elzemdir. Casibom’a hareketli cihazlarınızdan, bilgisayarlarınızdan veya tabletlerinizden web tarayıcı üzerinden rahatça ulaşılabilir. Ayrıca, web sitesinin mobil cihazlarla uyumlu olması da önemli bir fayda getiriyor, çünkü şimdi neredeyse herkesin bir akıllı telefonu var ve bu telefonlar üzerinden hızlıca ulaşım sağlanabiliyor.
Mobil tabletlerinizle bile yolda canlı iddialar alabilir ve yarışmaları canlı olarak izleyebilirsiniz. Ayrıca, Casibom’un mobil cihazlarla uyumlu olması, ülkemizde casino ve kumarhane gibi yerlerin kanuni olarak kapatılmasıyla birlikte bu tür platformlara erişimin önemli bir yolunu oluşturuyor.
Casibom’un güvenilir bir bahis web sitesi olması da önemli bir avantaj sağlıyor. Belgeli bir platform olan Casibom, kesintisiz bir şekilde eğlence ve kazanç sağlama imkanı sağlar.
Casibom’a kullanıcı olmak da oldukça rahatlatıcıdır. Herhangi bir belge gereksinimi olmadan ve bedel ödemeden web sitesine rahatça abone olabilirsiniz. Ayrıca, site üzerinde para yatırma ve çekme işlemleri için de birçok farklı yöntem vardır ve herhangi bir kesim ücreti isteseniz de alınmaz.
Ancak, Casibom’un güncel giriş adresini takip etmek de gereklidir. Çünkü gerçek zamanlı iddia ve oyun siteleri popüler olduğu için hileli siteler ve dolandırıcılar da görünmektedir. Bu nedenle, Casibom’un sosyal medya hesaplarını ve güncel giriş adresini düzenli aralıklarla kontrol etmek gereklidir.
Sonuç olarak, Casibom hem güvenilir hem de kazanç sağlayan bir bahis platformu olarak ilgi çekici. Yüksek bonusları, geniş oyun alternatifleri ve kullanıcı dostu mobil uygulaması ile Casibom, kumarhane sevenler için ideal bir platform getiriyor.
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로드스탁과의 레버리지 방식의 스탁: 투자법의 신규 분야
로드스탁에서 제공하는 레버리지 스탁은 주식 투자의 한 방식으로, 상당한 이익율을 목표로 하는 투자자들에게 매혹적인 옵션입니다. 레버리지를 사용하는 이 방법은 투자자들이 자신의 자본을 넘어서는 자금을 투자할 수 있도록 함으로써, 증권 장에서 더욱 큰 영향력을 가질 수 있는 기회를 줍니다.
레버리지 스탁의 기본 원칙
레버리지 스탁은 기본적으로 투자금을 차입하여 투자하는 방법입니다. 예를 들어, 100만 원의 자금으로 1,000만 원 상당의 증권을 취득할 수 있는데, 이는 투자자가 기본 자본보다 훨씬 훨씬 더 많은 증권을 사들여, 증권 가격이 올라갈 경우 관련된 더욱 큰 이익을 획득할 수 있게 해줍니다. 그렇지만, 증권 가격이 떨어질 경우에는 그 피해 또한 커질 수 있으므로, 레버리지 사용을 사용할 때는 신중해야 합니다.
투자 전략과 레버리지 사용
레버리지는 특히 성장 가능성이 높은 사업체에 투입할 때 효과적입니다. 이러한 기업에 큰 비율을 통해 투자하면, 잘 될 경우 큰 수익을 획득할 수 있지만, 반대 경우의 경우 많은 리스크도 감수하게 됩니다. 따라서, 투자하는 사람은 자신의 위험성 관리 능력을 가진 상장 분석을 통해, 어떤 사업체에 얼마만큼의 자금을 적용할지 결정하게 됩니다 합니다.
레버리지의 이점과 위험 요소
레버리지 스탁은 큰 수익을 약속하지만, 그만큼 상당한 위험성 수반합니다. 주식 거래의 변화는 추정이 힘들기 때문에, 레버리지 사용을 사용할 때는 늘 장터 경향을 세심하게 주시하고, 손해를 최소화할 수 있는 방법을 구성해야 합니다.
결론: 신중한 결정이 필요
로드스탁에서 제공된 레버리지 방식의 스탁은 강력한 투자 수단이며, 적당히 이용하면 많은 수익을 제공할 수 있습니다. 하지만 상당한 위험성도 신경 써야 하며, 투자 결정은 필요한 사실과 신중한 고려 후에 이루어져야 합니다. 투자자 자신의 재정 상황, 리스크 감수 능력, 그리고 시장의 상황을 반영한 안정된 투자 방법이 중요합니다.
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