Rheumatology Book

Intra-Articular Disorders

Myofascial Pain

http://www.fpnotebook.com/

Spray and StretchAka: Stretch and Spray, Fluori-Methane, Vapocoolant Spray

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  1. Indications
    1. Myofascial Pain Syndrome
  2. Mechanism
    1. Anesthetic spray distracts patient
    2. Clinician passively stretches Trigger Point muscle
  3. Equipment: Vapocoolant Spray
    1. Fluori-Methane Spray (by Gebauer Co. in Cleveland)
    2. Contents of Vapocoolant Spray
      1. Dichlorodifluoromethane 15%
      2. Trichloromonofluoromethane 85%
    3. Spray kept at 10 to 12 degrees celsius
  4. Technique
    1. Patient positioned comfortably
    2. Fluori-Methane sprayed over involved muscle
      1. Direct spray at 30 to 60 degree angle
        1. Sweep spray parallel to muscle fibers
        2. Sweep spray toward Trigger Point
      2. Spray 2-3 times, each covering 10 cm/sec
    3. Muscle involving Trigger Point is stretched
    4. After Stretch and Spray
      1. Apply moist heat to involved muscle for 10-20 min
      2. Full active range of motion of involved muscle
    5. Repeat up to daily for 1-2 weeks
    6. Suspend treatments for 2-3 days if soreness develops
  5. Precautions
    1. Hyperirritable Trigger Points may be exacerbated
    2. Fluori-Methane is potential biohazard for ozone loss
      1. Safer alternative than ethyl chloride (explosive)
  6. References
    1. Sola in Roberts (1998) Procedures, Saunders, p. 890-901
    2. Alvarez (2002) Am Fam Physician 65(4):653
    3. Fomby (1997) Phys Sportsmed 25(2):67

Physiatric stretching of fascia (C0203921)

ConceptsTherapeutic or Preventive Procedure (T061)
EnglishPhysiatric stretching of fascia
Spanishestiramiento fisiatrico de una fascia
Parent ConceptsPhysiatric manipulation (C0203915), Therapeutic stretching (C0582956), Procedure on fascia (C1292934)
SourcesSCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


REFRIGERANT, TOPICAL (VAPOCOOLANT) (C0493876)

ConceptsMedical Device (T074)
SourcesSPN
Derived from the NIH UMLS (Unified Medical Language System)


dichlorodifluoromethane / trichlorofluoromethane Topical Spray [fluori-methane] (C1235922)

ConceptsClinical Drug (T200)
SourcesRXNORM
Derived from the NIH UMLS (Unified Medical Language System)



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