Soft Tissue Rheumatism

Definition

Includes: Tennis/Golfers Elbow
Fibromyalgia
Plantar Fasciitis
Services- Rheumatology

When to refer

1. Unsure of diagnosis.
2. Failure of first line management.
3. Symptoms unrelieved by a local injection of hydrocortisone acetate and lignocaine.
   

Rheumatology Referral

Investigations

• FBC
• ESR
  

First Line Management

1. Rest area from resisted activity for 2 weeks.
2. Physiotherpy.
3. Local injection of hydrocortisone acetate and lignocaine (do not inject lignocaine into carpal tunnel).
4. For epicondylitis, consider, in association with injection, an epicondylar clasp (available from Appliances, Bullen's at APH or any good chemist).
5. For generalised fibromyalgia consider low dose amytriptiline 5-30 mg daily.

Document Information
Expiry Date: 11/04/04
Author: Dr Tom Kennedy
Organisation: Arrowe Park Hospital