📣新冠疫苗注射後- 骨骼肌肉疼痛的問題
(幫大家整理一下國際期刊和美國疾管局的一些注射後指引)
這個月開始有更多的民眾,陸續施打新冠疫苗,常見的副作用如疲倦、發燒、畏寒,還有我們科會常碰到的全身肌肉痠痛和注射部位的肌肉痛。
疫苗注射後,肌肉的痠痛可以分為兩個部分來看:
📌疫苗誘發的免疫反應: 產生的注射部位肌肉痛,和全身肌肉痠痛,這些肌肉痠痛的問題大概1-2天就會改善很多。
📌疫苗注射技術相關: 疫苗是肩膀肌肉注射,正確應該注射到肩膀三角肌,若是注射的技術不好,注射到肩關節腔或是肩旋轉肌,就會造成”疫苗注射技術相關的肩膀傷SIRVA”(shoulder injury related to vaccine administration)。研究顯示肩滑囊炎(bursitis) 沾粘性肩周炎(adhesive capsulitis),如果再打完疫苗2-3天,肩膀持續肌肉痛,伴隨肩膀無力及關節角度受限,那就有可能是這個注射技術原因。
👨⚕️門診來看,以莫德納疫苗所產生的肌肉痛和關節痛會比施打AZ疫苗的比例高,跟疫苗研究數據差不多,尤其是原本就有骨關節舊疾(脊椎疼痛、膝關節炎等等)的病人,打完疫苗後舊傷處疼痛愈加明顯。
👉會建議大家,若注射後肌肉疼痛,48小時內可以先居家休息,若不舒服,可以先服用acetaminophen和ibuprofen這些居家藥物藥房都可以買。
👉若超過一星期,肌肉關節持續疼痛,伴隨肌肉無力關節角度受限,會建議民眾可以到復健科就診查明原因,確定是不是疫苗注射技術的問題(SIRVA)?還是疫苗誘發的免疫反應造成的肌肉關節疼痛?抑或是原本的骨關節的舊疾復發?
👨⚕️復健科醫師會藉由臨床理學檢查,確定疫苗注射完骨關節疼痛的原因,藉由以下的方法幫助民眾改善:
1.肌肉伸展及關節運動
2.物理治療儀器
3.口服消炎止痛藥物
4.超音波導引注射消炎藥
🙏現在開始有更多的民眾接受疫苗注射,也會碰到肌肉關節注射的後遺症,大
家也不須恐慌,把握以上的原則,相信可以安全的度過疫苗注射的不適期。
更多資料 https://crclinic072.com/column/columnist/content/42
參考資料:
1. Bancsi A, Houle SKD, Grindrod KA. Shoulder injury related to
vaccine administration and other injection site events. Can
Fam Physician. 2019;65(1):40-2.
2. Batra S, Page B. Shoulder injury related to vaccine administration:
case series of an emerging occupational health concern. Workplace
Health Saf. 2021;69(2):68–72.
3. Subacromial-subdeltoid bursitis following COVID-19
vaccination: a case of shoulder injury related
to vaccine administration (SIRVA)
TC Rodrigues, PF Hidalgo, AY Skaf, A Serfaty - Skeletal Radiology,
2021
4. 美國CDC網站
同時也有2部Youtube影片,追蹤數超過15萬的網紅pennyccw,也在其Youtube影片中提到,Allen Iverson's knee is doing just fine. Iverson, playing despite left knee bursitis, had 37 points and eight assists, leading the Philadelphia 76ers...
bursitis 在 J帥 Just Tri Facebook 的最讚貼文
【阿娟:放入傷兵名單】
要挑戰2020東京奧運馬拉松資格的Gwen Jorgensen,恐怕機會更渺茫了....
在她的影片中,說明了動了一種解決『Haglund’s Deformity』的手術
我在Physiopedia查了一下這病
Haglund’s deformity is a symptomatic osseous prominence of the posterolateral corner of the calcaneus resulting in posterior heel pain and swelling around the insertion of the Achilles tendon. It is associated with retrocalcaneal bursitis. Cavo varus deformities exacerbate this problem.
Hugland's Deformity are most common in the female population between the ages of 15 and 35, especially in woman who regularly wear heels. It is also common in runners.
中文參考資料部份:
這是由於阿基里斯腱重覆拉扯,造成跟骨逐漸被往上拉起,輕微的會變形凸起,嚴重的會剝離,在跟骨形成一個缺角,容易以為是骨折,但是卻看不到游離的骨片。
美國另一位知名跑者 Galen Rupp在去年底也中過一樣的病症,動了一樣的手術,所以看來仍是過度使用造成的,不過Galen Rupp預計在今年10月芝加哥馬復出,這樣也休了一年時間。
雖然不曉得美國怎麼選出奧運選手,但阿娟養傷預計3-4個月,不知道趕不趕得上出賽,總之,祝福她早日康復了!
https://youtu.be/ua1tXsHsqEk
bursitis 在 蔡 偉傑 JOE Facebook 的最佳解答
肩膀痛不一定是五十肩?!
也不一定是肩夾擠症候群?!
肩胛骨活動不良,造成旋轉肌發炎、壓迫等。功能性診斷在相關檢查⋯
1.肩關節滑囊炎(Subdeltoid bursitis)
2.旋轉肌鈣化(Supraspinatus[後簡稱 SS] calcification)
3.旋轉肌撕裂傷(Partial thickness tear of SS tendon)
4.旋轉肌全層撕裂(Full tickness tear of SS tendon)
5.旋轉肌全層斷裂(SS tendon tear)
6.二頭肌腱炎(Biceps tenosynovitis)
7.肩關節沾黏(Frozen shoulder)
意思就是說:只要你有長期駝背、圓肩、不伸展、脖子過度前傾⋯都有可能造成你的旋轉肌很弱。
當然,我只是說外增的肌肉、肌腱、韌帶。
多運動沒事
有病要看好
找醫生檢查
從問題解決
慢慢的復健
復健當運動
bursitis 在 pennyccw Youtube 的最佳解答
Allen Iverson's knee is doing just fine.
Iverson, playing despite left knee bursitis, had 37 points and
eight assists, leading the Philadelphia 76ers to a 91-74 victory
over the Detroit Pistons on Tuesday night.
"It's not getting any better, but it's not getting any worse,"
Iverson said. "I'm feeling the same. It keeps getting bigger. They
talked about draining it today, but I didn't let it happen."
Kenny Thomas added 16 points and 15 rebounds for Philadelphia,
which snapped a two-game losing skid and moved within two games of
Atlantic Division-leading New Jersey, the No. 1 seed in the Eastern
Conference.
Clifford Robinson had 16 points and Richard Hamilton added 14
for Detroit, which lost its fourth straight game.
The Central Division-leading Pistons entered the night 1½ games
ahead of Indiana. They trail the Nets by one game.
"They did a great job penetrating the defense," Robinson said.
"We couldn't keep Iverson in front of us and that hurt."
Philadelphia broke open a one-point game with a 9-0 run in the
second quarter. Iverson had two driving layups during the spurt and
capped it with a crisp bounce pass to Aaron McKie for an easy layup
that gave the Sixers a 41-31 lead.
A 3-pointer by Eric Snow right before the buzzer made it 54-43
at halftime, and the Sixers led by double digits the entire second
half.
"We got a chance to get home-court advantage. This was a big
step," Sixers coach Larry Brown said.
It was the Detroit's first game without All-Star forward Ben
Wallace, who sprained his left medial collateral ligament on
Sunday.
The Sixers again were without Keith Van Horn, who sat out his
second straight with a strained left foot.
"We just weren't able to keep them out of the paint," Pistons
coach Rick Carlisle said. "I'd like to say it was because Ben
wasn't in there, but we can't use that as an excuse. If you give up
52 points in the paint, you're not going to win. It's as simple as
that."
Iverson, who hasn't missed a game this season, was a game-time
decision. He said after Sunday's loss to Sacramento that he might
have to sit out down the stretch. However, Iverson was still on the
court with the Sixers leading by 20 and less than five minutes
left.
"I was just playing basketball," Iverson said. "I had the
same energy. It didn't feel any different. I was just able to make
things happen."
Iverson was 13-for-23 from the field and 11-for-13 from the foul
line. He shot just six free throws combined in his last two games
because his injury didn't allow him to drive to the basket much and
draw fouls.
The Sixers put the game away with an 8-0 run early in the
fourth. Iverson started it with a driving layup and 16-footer.
Derrick Coleman hit a 14-footer and Thomas nailed another jumper to
make it 83-60.
bursitis 在 pennyccw Youtube 的最讚貼文
With Keith Van Horn sidelined and Allen Iverson playing poorly, the Houston Rockets took advantage against the Philadelphia 76ers.
Yao Ming had 20 points and 13 rebounds as the Rockets defeated
Philadelphia 88-79 Friday night.
Iverson, playing with left knee bursitis, missed 19 of his 23 shots, including his final 16, and finished with just eight points -- all in the first quarter. He wasn't fouled and missed his only free throw.
The Sixers lost Van Horn to a foot injury in the second quarter.
An MRI revealed a strained plantar fascia and bone bruise. Van Horn
will be day-to-day.
"When you play so many games, you are going to have one of
these nights,'' Iverson said. "I struggled mentally and
physically. I just couldn't get on track. I just want to forget
this one.''
Iverson, who had his knee drained before the game, isn't sure if he'll play against Sacramento on Sunday.
"There's no way I can play like this,'' Iverson said. "I'm going to have to sit out. My wife didn't think I should play tonight, but I was stubborn. It didn't bother me before the game, but it got worse as the game went on.''
James Posey added 19 points and 12 rebounds as the Rockets moved
within one game of Phoenix for the final playoff spot in the
Western Conference.
"We're going to have to play like this every night,'' Posey
said. "We're still in the thick of things.''
Kenny Thomas had 17 points and 10 rebounds and Eric Snow added
17 points for the Sixers, who had their three-game winning streak
snapped and dropped to 20-6 since the All-Star break. The Sixers
are 1½ games behind first-place New Jersey in the Atlantic Division.
Houston, which trailed by 11 at halftime, scored the first 10
points of the fourth quarter, taking a 73-64 lead. Cuttino Mobley
began the run with a turnaround jumper and ended it with another
turnaround shot.
After the Sixers got within 73-68, the Rockets put it away with
a 12-4 run. Posey's third 3-pointer made it 82-72, and a 3-pointer
by Mobley gave Houston its biggest lead, 85-72, with 3:30 left.
"The significance of this game isn't just moving up in the standings,'' Yao said through his interpreter. "It was big for our spirits.''
Iverson, having perhaps his best all-around season, had averaged
30.8 points and 9.4 assists in his previous five games. But the
three-time NBA scoring champion couldn't find his shooting touch
all night. He had six assists.
"If AI is going to miss 16 straight, we're in trouble,'' Sixers coach Larry Brown said. "We didn't have anybody who could make a shot.''
A 16-4 run in the third quarter gave the Rockets a 60-58 lead.
The Rockets made six straight free throws before Steve Francis hit
a 17-foot jumper to tie it at 58. Francis then made another
17-footer to put Houston ahead by two.
The Sixers took a 40-29 lead following a 14-4 run midway through
the second quarter. Aaron McKie and Derrick Coleman hit consecutive
3-pointers during the spurt and Coleman closed it with a 20-foot
jumper.
bursitis 在 Bursitis, Causes, Signs and Symptoms, Diagnosis ... - YouTube 的推薦與評價
Bursitis is the inflammation of one or more bursae (small sacs) of synovial fluid in the body. They are lined with a synovial membrane that ... ... <看更多>