[Assessment of the functional origin of shoulder pain in chronic polyarthritis by diagnostic local anesthesia of inflamed distal joints. A pilot study].
We examined 40 patients with rheumatoid arthritis suffering from painful shoulder. While the shoulder itself was not treated, Mepivacain was injected into an arthritic joint of wrist or elbow. In 36 out of 40 patients we achieved full or partial improvement of pain and movement of the shoulder. We conclude that pain in the shoulder of these patients was caused by a regulatory mechanism, triggered by nociceptors in an arthritic distal joint in order to protect this damaged structure. The therapeutic consequence implies treatment of the distal joint rather than treatment of the painful shoulder itself.
I. Medizinische Klinik des BRK Rheuma-Zentrums Bad Abbach.
K
K
Hiemeyer
R
R
Joist
H
H
Menninger
D000368:Aged; D000772:Anesthesia, Local; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000503:physiopathology*; D004551:Elbow Joint / Q000294:innervation; D005260:Female; D006801:Humans; D008297:Male; D008619:Mepivacaine; D008875:Middle Aged; D009434:Neural Pathways / Q000503:physiopathology; D009619:Nociceptors / Q000503:physiopathology; D010147:Pain Measurement / Q000379:methods*; D012785:Shoulder Joint / Q000294:innervation*; D014955:Wrist Joint / Q000294:innervation
D008619:Mepivacaine
Nachweis der funktionellen Genese von Schulterschmerzen bei chronischer Polyarthritis durch diagnostische Lokalanästhesie entzündeter distaler Gelenke. Eine Pilotstudie.