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Cortico Steroids

Corticosteroids are commonly used in the practice of pain management for their anti-inflammatory properties. These agents, produced by the adrenal cortex, are widely used in epidural, joint, peripheral nerve and various types of soft tissue injections.

About Corticosteroids

Corticosteroids can be classified as anti-inflammatory (glucocorticoids), androgenic/estrogenic and salt-retaining (mineralocorticoids). Despite these individual classifications, most corticosteroids have some overlapping properties with predictable adverse reactions. This article will review the mechanism of action of corticosteroids, basic properties of individual drugs, adverse reactions and applications in pain management.

The use of corticosteroids is widespread among pain management clinicians. One should be familiar with their mechanism of action, basic drug properties, adverse reactions and use with injections. The indications for corticosteroid use are extensive, but often met with controversy and misunderstanding. Clinicians should educate their patients and peers on the judicious and proper use of corticosteroids.

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Frequently Asked Questions

What is sclerotherapy?

Sclerotherapy or injection of varicose veins is a procedure designed to improve the appearance of your varicose veins. The veins are injected with a solution called a sclerosant which damages the internal lining of the vein and causes blood clotting within the vein.

In time, your own body will then destroy the vein and it will disappear. The solution normally used for this procedure is called sodium tetradecyl sulphate (STD) and is available in different concentrations depending on the size of the vein being treated.

What is foam sclerotherapy?

Normally STD is injected as a solution directly into the vein to be treated. Foam sclerotherapy involves making small volumes of the solution into foam by rapid mixing and agitation with a small volume of air. This can then be used to treat some of the larger underlying abnormal veins which would not normally be treated with conventional sclerotherapy.

This is performed under ultrasound control. The foam solution causes intense spasm of the vein and a greater volume can be injected without using too much of the STD solution.

Is foam better than conventional sclerotherapy?

The initial results with foam sclerotherapy are very promising and this method of treatment offers a possible alternative to surgery. However, it should be emphasized that this is a new treatment and at present, the long term results are not yet known and it’s not possible to say how this treatment compares in terms of results with conventional surgery or sclerotherapy.

What happens after treatment?

You should keep the compression pads, bandage, and stocking on continuously for 5 days. After this, you may remove the pads and bandage and then replace the stocking which should be worn for a further 7 days. During this 7 day period, you may remove the stocking to shower and you may remove it at night if you wish. If you find the stocking comfortable and wish to wear it for longer, this may be helpful. Please bring your stocking back with you to your next visit as it may be possible to reuse it if you have further injections.

You should do plenty of walking and may generally do most normal activities without any problem. If in doubt ask your doctor.

You can be active as usual after the treatment and do not need to avoid anything in particular. However, you should not drive on the day the procedure is performed, just in case you experience any visual disturbances

Will I need further treatment?

It is unlikely that all your varicose veins will improve after one set of injections and you may need several treatments. You will be seen again in a few weeks’ time and further injections can be performed at that stage. Some of the untreated veins may have shrunk at that stage.

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Address 1:
Ground Floor, 7-1-220/46,
Sravya D Estates, Balkampet,
Hyderabad, Telangana 500016

Address 2:
Karuna Scan Center and
Nursing Home, Tanuku,
West Godavari Dist, AP – 534211.

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