Infiltrationsbehandlung bei akuten Muskelverletzungen: Sinn oder Unsinn?

Objective: Muscular problems in leisure and elite sports represent the most common causes for training and competition breaks. There is currently no general consensus concerning the treatment of muscle injuries and no scientific evidence for the efficacy of various treatment options. Methods: The focus of the present paper is injection treatment of muscle lesions. A literature review and our own experiences are presented. Results: Early recognition of the injury pattern and magnitude is the key to successful treatment. The diagnosis is based on the anamnesis and clinical examination, which can be complemented by imaging results. Multiple treatment options are available: manipulation of sacroiliac joint and rehabilitation programmes, NSAIDs (meclofenamate and diclofenac) and intramuscular injections. The use of muscle infiltrations is an established procedure in sports medicine. Most often local anesthetics, corticosteroids, Actovegin/Traumeel and PRP (platelet rich plasma) are used. However, there are currently only few publications; in particular, studies with larger numbers of cases and randomized studies are needed. Discussion: This systematic review highlights a lack of good quality studies on the treatment of acute muscle lesions. Common methodological limitations are the small number of participants, lack of an appropriate control group, lack of randomisation and lack of blinding of patients, therapists and assessors. An improved scientific database is urgently needed before a generalized recommendation can be given.