Rheumatology Book

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Spray and Stretch

Aka: Spray and Stretch, Stretch and Spray, Fluori-Methane, Vapocoolant Spray
  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):653-60 [PubMed]
    3. Fomby (1997) Phys Sportsmed 25(2):67-75 [PubMed]

Physiatric stretching of fascia (C0203921)

Concepts Therapeutic or Preventive Procedure (T061)
SnomedCT 57443006
English Physiatric stretching of fascia, Physiatric stretching of fascia (regime/therapy), Physiatric stretching of fascia (procedure)
Spanish estiramiento fisiátrico de una fascia (procedimiento), estiramiento fisiátrico de una fascia (régimen/tratamiento), estiramiento fisiátrico de una fascia
Sources
Derived from the NIH UMLS (Unified Medical Language System)


REFRIGERANT, TOPICAL (VAPOCOOLANT) (C0493876)

Concepts Medical Device (T074)
English REFRIGERANT, TOPICAL (VAPOCOOLANT)
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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

Concepts Clinical Drug (T200)
English dichlorodifluoromethane / trichlorofluoromethane Topical Spray [fluori-methane]
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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