Malone Stryhn (perchmole55)

Chronic conditions such as the sequalae of an untreated rupture or Achilles tendinopathy can be debilitating but often respond well to non-operative management. Achilles tendon injuries can be divided into acute ruptures and chronic overuse injuries. Both can be debilitating, with significant morbidity for patients; fortunately, both types of injuries respond well to non-operative interventions, with only a small proportion requiring surgery. Management of acute Achilles tendon rupture has evolved, with increasing evidence that non-operative management is appropriate providing patients participate in a functional rehabilitation protocol. Chronic conditions such as the sequalae of an untreated rupture or Achilles tendinopathy can be debilitating but often respond well to non-operative management. The carpometacarpal joint of the thumb is one of the joints most commonly affected by arthritis. The dominant hand is involved in 60-65% of cases, with a higher prevalence among women. The condition results in significant disability of the hand, which affects activities of daily living. Management is dependent on both the clinical stage of the disease and patient expectations and demands. The aim of this article is to review the current non-operative and operative modalities in managing pain symptoms, and explore evidence for the use of these modalities. Basal thumb arthritis is a very common condition encountered by the general practitioner. Treatment must focus on functional expectations and demands of the patient, and individualised treatment plans need to be tailored to the patient. Hand therapy in addition to patient education and use of an orthosis has been shown to be very effective in management of the early stages of basal thumb arthritis. With more advanced disease, surgical modalities provide better symptomatic control. Basal thumb arthritis is a very common condition encountered by the general practitioner. Treatment must focus on functional expectations and demands of the patient, and individualised treatment plans need to be tailored to the patient. Hand therapy in addition to patient education and use of an orthosis has been shown to be very effective in management of the early stages of basal thumb arthritis. With more advanced disease, surgical modalities provide better symptomatic control. Low back pain (LBP) is a common presentation in general practice. Clinical workup must exclude sinister underlying diseases. Treatment of central LBP is difficult given the numerous treatment options available. The aim of this article is to help clinicians assess patients with LBP and formulate evidence-based treatment decisions. Patient presentations can be stratified according to the presence of red flags andpain type (ie non-spinal, radicular, non‑organic and central). The vast majority ofpatients with acute central back pain experience improvement of their symptoms. Treatment options includeeducation, lifestyle modification, heat, massage, graduated return to early activity, nonsteroidal anti-inflammatory medications and muscle relaxants when appropriate. Chronic LBP treatment can also include paracetamol and physiotherapy. Second-line treatment caninclude psychological therapy, multidisciplinary rehabilitation, targeted injections and antidepressants. Tapentadol is a safe and effective medication frequire controlled analgesia. Surgical treatment has narrow indications in central non-radicular back pain and is considered as a last-line treatment in selected patients. Lateral epicondylitis, more commonly referred to as 'tennis elbow', is a common condition seen in general practice. Iteffects approximately 4-7 per 1000 individuals. Despite this, the aetiology and pathophysiology remain poorly understood. Often presenting as lateral elbow pain, the differential diagnosis includes entrapment syndromes, cervical radiculopathy, osseous pathology and inflamma