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Current concepts in the role of steroids in the treatment of sprains and strains.

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How to Treat a Sprained Ankle and Get Rid of Pain 













































   

 

Prednisone for ankle sprains. Foot or Ankle Steroid Injections



  Pain and tenderness over the sprained ligament Swelling Bruising ecchymosis Joint pain and stiffness Difficulty walking or placing the foot on the ground Gross instability or joint dislocation in a severe sprain. Acute injuries and chronic musculoskeletal conditions requiring their usage under almost all circumstances should preclude the athlete from returning to his or her sport until the medical condition has evolved to the point where these medications are no longer necessary. Aside from the specific side effect involving blood coagulation, other common side effects include gastrointestinal upset, gastrointestinal bleeding, fluid retention, and for those patients on high dose long term usage, the risk of liver or kidney damage. These can help take the edge off of the more severe pain. As an orthopedic surgeon interested in sports medicine I treat athletes who were initially prescribed medications by their primary care physicians, emergency room personnel, or have self-medicated with over-the-counter OTC medications or those found left over in their medicine cabinets. ❿  


Prednisone for ankle sprains.Ankle Sprains



  Corticosteroids are a class of steroid compounds comprising of phalangeal injuries, retrocalcaneal bursitis, ankle sprains. With the development of nonsteroidal anti-inflammatory drugs, the use of corticosteroids in the treatment of sprains and strains has greatly diminished. Early treatment of ankle sprains is important to reduce the incidence of chronic pain, stiffness, and swelling and to prevent chronic ankle instability and re-.     ❾-50%}

 

Prednisone for ankle sprains.How to Heal a Sprained Ankle and Get Rid of Pain



    A steroid injection typically takes just a few minutes. As an orthopedic surgeon interested in sports medicine I treat athletes who were initially prescribed medications by their primary care physicians, emergency room personnel, or have self-medicated with over-the-counter OTC medications or those found left over in their medicine cabinets. Recently there has been concern raised over the growing incidence of infections caused by an antibiotic resistant strain of the very common bacteria, Staphylococcus aureus. Rest The rest component means staying off your sprained ankle for as long as possible. When used in the proper setting, oral anti-inflammatory medications can be of great benefit in the treatment of specific sports related injuries and other conditions affecting the musculoskeletal system.

These complications have primarily been seen in older patients with a history of pre-existing cardiac disease, taking higher doses over longer periods of time. They may still be a beneficial in patients who are at high risk for gastrointestinal complications. Of note is that the Cox-2 inhibitors do not share the increased bleeding risk associated with the earlier generations of NSAIDs. Their use may therefore be of benefit in the treatment of certain athletic injuries where additional bleeding would be detrimental.

This, however, must be an informed decision made between patient and physician. Antibiotics: Antibiotics may be required in the treatment of sports-sustained lacerations and abrasions which become secondarily infected.

Recently there has been concern raised over the growing incidence of infections caused by an antibiotic resistant strain of the very common bacteria, Staphylococcus aureus. Infections caused by this bacteria apparently can develop without an obvious open skin wound.

It can appear rather innocuous in the first several days following its presentation but can quickly develop into a more significant infection which can be limb and even life-threatening. While often seen in athletes participating in close contact sports such as football and wrestling, it has been reported in almost every sport and its incidence seems to be growing at an alarming rate.

Any athlete who exhibits such a condition should seek immediate medical attention. When antibiotics have been prescribed they should be continued for the full treatment course. If an infection does not seem to be responding or certainly worsening while under treatment, this should be reported to the treating physician.

Miscellaneous OTC Medications: These include the highly publicized glucosamine and chondroitin sulfate, MSM, a large variety of herbal based medications, as well as nutritional and. Athletes should be aware that these are poorly monitored and controlled substances. It is important to remember that their efficacy, content, and purity are not monitored by the FDA.

Their value in the treatment of acute and chronic sports injuries is usually anecdotal and rarely supported by investigational or clinical studies. Conclusion: In summary, medications can be an important part of treatment programs designed for the management of both acute and chronic sports injuries and musculoskeletal conditions. Their use and value must, however, be considered on a case by case basis. Potential side effects must be recognized and understood.

Analgesics are valuable in the management and control of pain associated with injury. They should not, however, be used to allow an athlete to return to sports participation prematurely. This is especially true when narcotic analgesics are required. The use of narcotic analgesics should also be avoided in acute head trauma under most circumstances, especially in the critical first 24 to 48 hours. Non-steroidal anti-inflammatory medications are of considerable usefulness, particularly in the treatment of those conditions associated with inflammation or chronic in nature.

They are probably over-prescribed, however, in the acute injury setting. Because of their potential for increased bleeding, they should be used with caution in injuries where significant bleeding may occur. Athletes and parent care providers for younger sports participants need to be aware that even OTC medications have potential side effects that can be detrimental and even dangerous when used in an improper fashion.

Aside from the minor bumps and bruises that most athletes sustain during their playing careers, the utilization of medications in the treatment of athletic injuries should be discussed with physicians familiar and comfortable with their management.

Ibuprofen is marketed under its generic name, as well as, various brand names including Advil and Motrin. Depending on the area of your foot or ankle receiving the injection, you'll either sit or lie down.

The doctor puts numbing medicine on the injection site or blends it in with the steroid injection. You may feel a bit of pinching and a burning sensation that quickly goes away. The injected area may stay sore for a few days. You'll need to rest the injected area for a day or two. A steroid injection may help if there's a lot of tenderness, swelling, popping or cracking sounds in your ankle.

Once you have a steroid injection, you'll feel pain relief within hours or a couple of days. The timing depends on the type of medication you receive. Even with the risks, a steroid injection can be very effective in easing your foot and ankle pain. Foot or Ankle Steroid Injections. This stands for rest, ice, compression and elevation. Together, these work well for healing a less complicated sprain.

The rest component means staying off your sprained ankle for as long as possible. If your ankle is particularly badly sprained, a doctor may give you crutches to help you get around. Limit walking and household activities and chores as much as possible. Ice works to help reduce the swelling in the area.

You should wrap the ice inside of a cloth or pillowcase to avoid direct contact with the skin. Place it on the sprained ankle for 20 minutes at a time. Repeat several times a day. Compression means to compress your ankle.

This works by wrapping a bandage or other stability device around your ankle.

There are a few things you can do at home to help your ankle heal before or after you see a doctor. Following these rules will help get you back on your feet pun intended in no time. Doctors have developed a very simple acronym for healing soft tissue injuries: R. This stands for rest, ice, compression and elevation. Together, these work well for healing a less complicated sprain. The rest component means staying off your sprained ankle for as long as possible. If your ankle is particularly badly sprained, a doctor may give you crutches to help you get around.

Limit walking and household activities and chores as much as possible. Ice works to help reduce the swelling in the area. You should wrap the ice inside of a cloth or pillowcase to avoid direct contact with the skin. Place it on the sprained ankle for 20 minutes at a time. Repeat several times a day. Compression means to compress your ankle. This works by wrapping a bandage or other stability device around your ankle. This will help limit motion as well as bring down the swelling.

Elevating your sprained ankle above your heart is an important way to keep the swelling down. When sitting around the home or when you go to sleep, ensure your ankle is above your waist. Use pillows or other devices to keep it propped up comfortable. You may purchase these at your local pharmacy over the counter in the form of pills like Advil, Ibuprofen or Tylenol. They can help reduce the swelling of your ankle.

Your doctor may prescribe stronger drugs in the same family to help keep your pain down. These may have a slightly larger dosage than the pills you would purchase over the counter. These can help take the edge off of the more severe pain. This will not occur, however, unless your sprained ankle involves something more serious, like a ligament tear.

This may mean wearing a boot you can take off to shower and sleep, or a cast that you wear all of the time. These methods can help heal more intense sprains. Most components of how to treat a sprained ankle can be accomplished without seeing a doctor.

However, in more severe cases, you should see a doctor to eliminate ligament or tendon tears or a fracture. If your sprained ankle is severely swollen, does not get better in a few days or is so incredibly painful you cannot do daily activities, a visit to the doctor is in order. For more information on when to visit an urgent care center, visit our site.

How to Treat a Sprained Ankle: R. Rest The rest component means staying off your sprained ankle for as long as possible.

Ice Ice works to help reduce the swelling in the area. Compression Compression means to compress your ankle. Elevation Elevating your sprained ankle above your heart is an important way to keep the swelling down.

Early treatment of ankle sprains is important to reduce the incidence of chronic pain, stiffness, and swelling and to prevent chronic ankle instability and re-. They include the commonly prescribed oral form, prednisone, and the various preparations that are the main ingredient of “cortisone shots”. Sprained ankle 6 mo. ago. never seemed to heal. podiatrist tried prednisone but it didn't help. what next? allergic to all otc anti-inflammatories. A steroid injection contains medicine made from a group of drugs called corticosteroids. A steroid injection — or cortisone shot — reduces swelling, stiffness. Short answer: Zero mg. In 21 years in orthopaedics, I've never prescribed oral prednisolone (a steroid drug) for any kind of sprain, ankle or otherwise. Side effects of narcotics include GI upset, nausea, and altered consciousness. Elevating your sprained ankle above your heart is an important way to keep the swelling down. Depending on the area of your foot or ankle receiving the injection, you'll either sit or lie down. As will be discussed in more detail below, acetaminophen has no effect on blood clotting. Miscellaneous OTC Medications: These include the highly publicized glucosamine and chondroitin sulfate, MSM, a large variety of herbal based medications, as well as nutritional and. The doctor puts numbing medicine on the injection site or blends it in with the steroid injection.

As a sideline observer, I have frequently witnessed coaches, first aid providers, and anxious parents reaching into their training bags and purses, and medicating the acutely injured athlete. As an orthopedic surgeon interested in sports medicine I treat athletes who were initially prescribed medications by their primary care physicians, emergency room personnel, or have self-medicated with over-the-counter OTC medications or those found left over in their medicine cabinets.

It is important to understand the role of medication in the treatment of sports related injuries, particularly in regards to their efficacy, and most importantly, their potential side effects. The purpose of this article is to review the classes of medications commonly used in this environment and to provide guidelines for their rational usage.

While other classes of medication may be mentioned, this discussion will be focused on the most commonly used classes of drugs, pain relievers analgesics and anti-inflammatory medications. Analgesics: Analgesics are used specifically for their pain relieving property.

Two sub-categories exist, narcotic and non-narcotic preparations. Narcotics exist in both injectable and oral forms. Injectables include Morphine, Demerol, and Dilaudid. These are almost exclusively used in emergency rooms and hospitals for the treatment of moderate to severe pain associated with acute musculoskeletal injuries or following surgical treatment.

The oral forms commonly prescribed are Tylenol with codeine, Vicodin, Norco, and Lortab. Each is combined with acetaminophen to enhance its pain relieving properties. They should likewise be reserved for the treatment of moderate to severe pain. Side effects of narcotics include GI upset, nausea, and altered consciousness. They also have the capacity for recreational drug abuse and physical addiction. Acute injuries and chronic musculoskeletal conditions requiring their usage under almost all circumstances should preclude the athlete from returning to his or her sport until the medical condition has evolved to the point where these medications are no longer necessary.

One particular injury requiring special consideration is the treatment of head trauma. Because of narcotics effect on the central nervous system, including sedation and potential mental status changes, they may interfere with the need for monitoring an injured player who has sustained this type of injury, including even minor concussions.

This is particularly important in the first 24 to 48 hours following injury. The most common non-narcotic analgesic is acetaminophen.

This is marketed under its generic name, as well as the popular Tylenol brand. It has long been recognized as safe and effective in the treatment of mild to moderate pain. It is usually well-tolerated and has minimal side effects or interactions with other medications. It can be safely used to supplement the pain relieving properties of nonsteroidal anti-inflammatories.

Available in a liquid form, it may be useful in youth athletes who have difficulty swallowing tablets or pills. It does, however, have the potential for causing liver damage when used in dosages which exceed the maximum recommended daily dosage. In an adult, the maximum dosage should not exceed 4, mg 4 grams in a 24 period.

As noted above, acetaminophen is frequently combined with oral narcotics. Therefore, the patient needs to be careful that this be figured into their maximum daily dosage. As will be discussed in more detail below, acetaminophen has no effect on blood clotting. Whether or not an injured athlete using acetaminophen should continue to compete ultimately depends on the specific condition requiring its use. Anti-inflammatory Medications: The other class of drugs commonly used in the treatment of athletes are the anti-inflammatory medications.

Anti-inflammatory steroids, however, should not be confused with the anabolic steroids recently publicized as being abused by athletes.

Anti-inflammatory steroids are available only through prescription. Neither form has much value in the treatment of acute athletic injuries with the possible exception of severe head or spinal trauma.

They may be utilized in such conditions as exercise-induced asthma, or allergic reactions to environmental substances or insect bites. All initially came to market as prescription medication.

As they lose patent protection, many are sold over-the-counter OTC. The only difference between those prescribed and those sold OTC is that of dosage. Ibuprofen is marketed under its generic name, as well as, various brand names.

Naproxen sodium is the main ingredient of Aleve and Naprosyn. Additionally, they are commonly included in OTC cold and allergy preparations. These medications have two properties which make them useful in the treatment of sports injuries. Much like acetaminophen, they provide a direct analgesic effect. As their name implies, they are also useful in reducing inflammation most commonly associated with non-traumatic or more chronic musculoskeletal conditions.

Their frequent use, therefore, in the treatment of acute athletic injuries is worth some additional attention. While soft tissue swelling is often times associated with chronic inflammatory conditions, the swelling associated with acute injuries will probably be little affected by anti-inflammatory medication. This side effect has been publicized as being useful in the prevention of heart attacks in adult patients.

This is particularly the case in those injuries such as fractures, significant muscle tears, contusions often acquired in contact sports, and even the more severe ligament sprains about the knee and ankle.

In fractures and deep contusions, bleeding may cause potentially limb- threatening complications because of the build up of excessive pressure within the tissues involved. In contusions, most notably those sustained by soccer players to the lower leg, excess bleeding may result in the formation of hematomas, localized areas of blood accumulation which the body may have difficulty resorbing, ultimately requiring surgical drainage. Their use following head injury is also potentially dangerous in causing additional cerebral bleeding.

It is important to remember that the anticoagulation effects of anti-inflammatory medications will persist for a period of seven to ten days following discontinuation of their use. If an athlete has been taking these medications, it is possible sustaining an acute injury during that time frame might lead to undesirable increased bleeding and bruising. When used in the proper setting, oral anti-inflammatory medications can be of great benefit in the treatment of specific sports related injuries and other conditions affecting the musculoskeletal system.

Aside from the specific side effect involving blood coagulation, other common side effects include. Patients using these medications chronically need to be monitored. Remember that these side effects are present in both over-the-counter and prescribed forms.

Recently the lay press has highlighted the potential complications of increased risk of heart attack and stroke in patients being prescribed the newer generation of anti-inflammatory medications referred to as Cox-2 inhibitors.

These include the highly marketed Celebrex, Vioxx, and Bextra brands. These complications have primarily been seen in older patients with a history of pre-existing cardiac disease, taking higher doses over longer periods of time. They may still be a beneficial in patients who are at high risk for gastrointestinal complications. Of note is that the Cox-2 inhibitors do not share the increased bleeding risk associated with the earlier generations of NSAIDs.

Their use may therefore be of benefit in the treatment of certain athletic injuries where additional bleeding would be detrimental. This, however, must be an informed decision made between patient and physician. Antibiotics: Antibiotics may be required in the treatment of sports-sustained lacerations and abrasions which become secondarily infected.

Recently there has been concern raised over the growing incidence of infections caused by an antibiotic resistant strain of the very common bacteria, Staphylococcus aureus. Infections caused by this bacteria apparently can develop without an obvious open skin wound. It can appear rather innocuous in the first several days following its presentation but can quickly develop into a more significant infection which can be limb and even life-threatening.

While often seen in athletes participating in close contact sports such as football and wrestling, it has been reported in almost every sport and its incidence seems to be growing at an alarming rate. Any athlete who exhibits such a condition should seek immediate medical attention. When antibiotics have been prescribed they should be continued for the full treatment course.

If an infection does not seem to be responding or certainly worsening while under treatment, this should be reported to the treating physician. Miscellaneous OTC Medications: These include the highly publicized glucosamine and chondroitin sulfate, MSM, a large variety of herbal based medications, as well as nutritional and.

Athletes should be aware that these are poorly monitored and controlled substances. It is important to remember that their efficacy, content, and purity are not monitored by the FDA. Their value in the treatment of acute and chronic sports injuries is usually anecdotal and rarely supported by investigational or clinical studies.

Conclusion: In summary, medications can be an important part of treatment programs designed for the management of both acute and chronic sports injuries and musculoskeletal conditions. Their use and value must, however, be considered on a case by case basis. Potential side effects must be recognized and understood. Analgesics are valuable in the management and control of pain associated with injury.

They should not, however, be used to allow an athlete to return to sports participation prematurely. This is especially true when narcotic analgesics are required. The use of narcotic analgesics should also be avoided in acute head trauma under most circumstances, especially in the critical first 24 to 48 hours. Non-steroidal anti-inflammatory medications are of considerable usefulness, particularly in the treatment of those conditions associated with inflammation or chronic in nature.

They are probably over-prescribed, however, in the acute injury setting. Because of their potential for increased bleeding, they should be used with caution in injuries where significant bleeding may occur. Athletes and parent care providers for younger sports participants need to be aware that even OTC medications have potential side effects that can be detrimental and even dangerous when used in an improper fashion. Aside from the minor bumps and bruises that most athletes sustain during their playing careers, the utilization of medications in the treatment of athletic injuries should be discussed with physicians familiar and comfortable with their management.

Ibuprofen is marketed under its generic name, as well as, various brand names including Advil and Motrin. Aside from the specific side effect involving blood coagulation, other common side effects include gastrointestinal upset, gastrointestinal bleeding, fluid retention, and for those patients on high dose long term usage, the risk of liver or kidney damage.

Miscellaneous OTC Medications: These include the highly publicized glucosamine and chondroitin sulfate, MSM, a large variety of herbal based medications, as well as nutritional and mineral supplements.



Using benzaclin and tretinoin.Can you mix tretinoin and benzoyl peroxide?

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