Yumuşak Doku Yaralanmalarına Yaklaşım ve Tedavide Oral Nonsteroid Antiinflamatuvar İlaçların Yeri

ÖzÜst ve alt ekstremite yumuşak doku yaralanmaları toplumda sık rastlanan rahatsızlıklardır. Yumuşak dokulara mekanik yüklenme bu dokuların gerilebilme, karşı koyabilme güçlerinin üzerindeyse doku hasarı gelişir. Sportif aktiviteler sırasında, büyük fiziksel zorlanmalarda veya uzun süre tekrarlayan fiziksel travmalar olduğunda ligaman, tendon, tendon kılıfı, bursa, sinir ve kaslarda yaralanma olur. Lokal doku hasarı ardındangelişen inflamasyon şişlik ve ağrıya neden olur; mobilite kısıtlanır, fonksiyonlar etkilenir. Akut yumuşak doku yaralanmasının erken dönem tedavisinin amacı ağrı ve infla-masyonun kontroludur. RICE (Rest-istirahat, Ice-buz, Compression-kompresyon, Elevation-elevasyon) protokolu ilk tedavinin temel prensibidir; ancak progressif mekanikyükler yaralanmış dokuların fonksiyonel iyileşmesini sağladığından, fonksiyonel tedavi yaklaşımı RICE protokolundan daha etkindir. Yumuşak doku yaralanmalarında antiinflammatuvar ve analjezik etkileri nedeniyle nonsteroid antiinflammatuvar ilaçlar yaygın olarak reçetelenir, ancak yan etki profilleri yüksektir. Fiziksel ajanlar da ağrı kont-rolu sağlayabilir, egzersiz ve rehabilitasyon uygulamaları yumuşak doku yaralanmalı hastalarda fonksiyonel kazançların sağlanması için kullanılmalıdır.

Anahtar Kelimeler:

yumuşak doku yaralanma-ları, nonsteroid antiinflamatuvar ilaçlar

To Soft Tissue Injuries Approach and Place of Oral Nonsteroid Antiinflammatory Drugs in Treatment

AbstractSoft tissue injuries of the upper or lower extremities are common in general population. When mechanical load on soft tissues exceeds their tensil strenght, tissue injuryoccur. Sport activities, high physical strain, or prolonged repetetive physical factors cause ligament, tendon, tendon sheat, bursae, nerve and muscle injuries. Local tissue injuryand inflammation causes swelling and pain; limits mobility and functions. The objective of the initial treatment of the acut soft tissue injury is the control of the inflammation and pain. Rest, ice, compression, and elevation (RICE) protocol is the basic principle of the initial treatment but functional treatment approach is more effective than theRICE protocol because progressive mechanical loads cause the functional healing of theinjured tissues.Nonsteroidal anti-inflammatory drugs are commonly prescribed for soft tissue injuries because of their anti-inflammatory and analgesic effects, but they have high adver-se effect profile. Physical agents can control the pain; exercise and rehabilitation protocols should be used for the functional gains for the patients with soft tissue injury.

Keywords:

soft tissue injury, nonste-roidal antiinflammatorydrugs,

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