blog - Orthopedic & Sports Medicine

Emergency Orthopedic First Aid: How to Handle Traumatic Situations

in General Orthopedics, Nutrition & General Health, Prevention

Article featured on Orthopedic Associates

Accidents happen, and sometimes they can lead to orthopedic injuries like fractures, dislocations, or sprains. Knowing what to do in these emergency situations can make a big difference in someone’s recovery.

In this article, we will guide you through the basics of first aid fortraumatic orthopedic situations, so you can be prepared to provide essential care until professional help arrives.

Understanding Trauma

Trauma refers to physical or psychological damage or injury caused by an external force or event.

In the context of orthopedic situations, trauma typically refers to the physical harm and injury sustained to the bones, joints, muscles, or surrounding tissues due to accidents or falls.

This type of trauma involves injury or damage to the body’s structures, such as fractures, dislocations, sprains, and strains. Physical trauma can result from incidents like falls, sports injuries, or car accidents.

1. Assess the Situation

The first step in any emergency is to assess the situation. Ensure the safety of both the injured person and yourself. Before approaching the injured person, make sure the area is free from any hazards like:

Traffic
Sharp objects
Slippery surfaces

2. Call 911

In severe orthopedic injuries, such as a bone protruding through the skin, severe deformities, or if the person cannot move or feel a limb, call 911 immediately. Professional medical help is important in these cases.

3. Stay Calm and Reassure the Injured Person

Being calm can help ease the anxiety of the injured person. Keep reassuring them that help is on the way, and that they are in good hands.

4. Immobilize the Injury

If you suspect a fracture or dislocation, it is essential to immobilize the injured area to prevent further damage. To stabilize the injured limb, you can use materials like:

Splints
Rolled-up newspapers
Clothing

Be gentle and try not to move the injured area unnecessarily.

5. Control Swelling

To reduce swelling, apply a cold pack or bag of ice wrapped in a cloth to the injured area for 15-20 minutes at a time. Ensure there is a barrier between the cold source and the skin to prevent frostbite.

6. Elevate the Injured Area

Elevating the injured limb slightly can also help reduce swelling. Keep it elevated at a level above the heart if possible.

7. Pain Management

Over-the-counter pain relievers can help manage pain. Follow the dosing instructions and consult a healthcare professional if you have any concerns.

However, do not give pain medication without knowing the allergies of the injured individual.

8. Do Not Attempt to “Pop” Joints Back

In cases of dislocations, never try to pop the joint back into place on your own. Leave this to medical professionals who have the necessary training and equipment.

9. Observe for Complications

Keep an eye out for signs of complications, such as loss of circulation, numbness, tingling, or changes in skin color. If any of these occur, loosen the splint or immobilization device slightly to relieve pressure and maintain circulation.

10. Stay with the Injured Person

Until professional help arrives, stay with the injured person and provide reassurance. If the situation worsens or changes, be ready to update the 911 operator with any new information.

The Importance of Timely First Aid

In orthopedic trauma situations, acting quickly with first aid is vital for several reasons:

Immediate Pain Relief: Orthopedic injuries can be extremely painful. Timely first aid measures, such as immobilization and pain management, can provide instant relief to the injured person.
Preventing Further Damage: Rapidly stabilizing the injured area reduces the risk of additional harm or complications, ensuring the injury does not worsen.
Speedier Recovery: Prompt care after an injury sets the stage for a faster and smoother recovery, minimizing the risk of long-term issues.
Ensuring Safety: Orthopedic injuries can leave individuals vulnerable to further harm, making quick first aid essential to their safety.
Preserving Circulation and Nerve Function: Quick action helps maintain proper blood flow and reduces the risk of nerve damage.
Professional Assessment: Seeking medical attention promptly ensures a precise diagnosis and appropriate treatment, including surgery if necessary.

Timely first aid in orthopedic trauma situations is critical. It eases pain, prevents worsening of the injury, and supports a faster recovery, all while ensuring the injured person’s overall well-being.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

8 Tips for Stronger Bones

in Bone Health

Article featured on Time

Orthopedic doctors have a bone to pick with all the people who forget they’re carrying a very important skeleton around every day. We might not be able to see our ribs or tailbone or humerus, but it’s still important to make bone health a priority—because it’s tied to every other aspect of well-being.

“Your bone health and joint health is really tied to your overall wellness and health,” says Dr. David Shau, an orthopedic surgeon and assistant professor at the Burnett School of Medicine at Texas Christian University. Consider, for example, that about 54 million Americans have osteoporosis, low bone mass, or both, and 2 million osteoporotic fractures occur annually. That number will exceed 3 million per year by 2040, researchers predict. “When that happens, you have a period of time where you have to heal and recover,” Shau says. “You can’t be active with your family. You can’t travel. You can’t exercise, so your cardiovascular health goes down, and you start seeing metabolic issues and other health issues.” It’s a potentially devastating chain of events, he says, that can spell trouble far into the future.

It’s never too early to start thinking about preserving your bones. Your bone density is highest when you’re in your mid-20s, Shau says, after which it typically starts to decline. That can lead to osteopenia, or decreasing bone density that isn’t yet low enough to be considered full-blown osteoporosis but is still associated with an increased risk of fractures. Once someone develops osteoporosis, they’re prone to experiencing fractures from even minor incidents—but since it’s a silent disease, many people don’t realize they have it until their bones start breaking.

With that in mind, we asked four orthopedic doctors what we can all do every day to protect and preserve our bone health.

1. Keep moving

People tend to think of bones as a static part of the body—but they’re actually dynamic, with old bone constantly breaking down and being absorbed into the bloodstream, and new bone forming. That process, called remodeling, is affected by lots of factors, including mechanical stress from weight-bearing exercise. For example: walking, climbing the stairs, playing sports like pickleball, doing push-ups, and jumping rope. “You’ll increase your bone density in the areas where the bone is seeing force,” says Dr. Jack Steele, an orthopedic surgeon at the University of Maryland St. Joseph Medical Center. “In areas where you’re not putting stress on the bone, your body will start to resorb that bone, and you’ll lose bone density—and that can lead to osteopenia or osteoporosis.” While these conditions aren’t reversible, they are treatable with a range of medications, and progression can be slowed, minimizing damage.

Patients often ask Steele how much they need to exercise; some like walking for 30 minutes a day, while others squeeze in two hours of tennis on the weekend. Either approach works. The most important thing, he tells them, is to be consistent and move around as regularly as possible, rather than allowing days to pass by without any activity.

2. If you’re in menopause, prioritize strength-training

A growing body of research suggests that menopause takes a toll on bone health. It can lead to a decline in bone density—increasing the risk of osteoporosis—as well as muscle loss from decreasing estrogen. One way to counteract that damage: lift weights. “It’s very important for women to add strength training into their routine, because there’s so much muscle and bone loss as you get into those perimenopausal and menopausal years,” says Dr. Pamela Mehta, an orthopedic surgeon and founder of Resilience Orthopedics in San Jose, Calif. If you’re new to weight lifting, consider doing some squats while holding free weights, or experiment with beginner-friendly moves like bicep curls and chest presses.

3. Focus on two essential nutrients

Lots of minerals and nutrients play a role in strengthening bones—but two deserve special attention. Calcium, which you can only get from food or supplements, is particularly important; if you don’t get enough, your body will start to pull it from your bones, making them weaker. Vitamin D, meanwhile, helps the body absorb calcium and plays a key role in preventing osteoporosis. “You really need to have a good quantity of both,” Shau says. Depending on age, most adults need 1,000 to 1,200 mg of calcium per day, and 15 to 20 mcg of vitamin D.

To boost your calcium intake, focus on dairy products like milk, cheese, and yogurt; almonds; dark leafy greens like kale; and soy products including tofu, he advises. Foods high in vitamin D, meanwhile, include egg yolks, tuna, sardines, salmon, and cheese.

4. Try to get sunlight every day

Basking in the sun is a great move for bone health. “When sunlight hits your skin, your body produces vitamin D,” Steele says. “You can get some vitamin D through your diet, but you get the majority through sunlight.” Of course, the sun can lead to plenty of negative effects, as well, so it’s important to proceed carefully: Aim to go outside when the UV Index is under 8, ideally in the early morning or evening hours, and always wear sunscreen. “It doesn’t need to be hours and hours,” he adds. “Even 30 minutes walking outside and being in the sun will produce vitamin D.” Plus, a sunny walk doubles as weight-bearing exercise—a win-win for your bones.

5. Consider calcium and vitamin D supplements

If you’re not getting enough calcium or vitamin D, you might benefit from supplements. How do you know if that’s you? Try keeping a food diary, suggests Dr. Christine Jablonski, who leads the bone health and osteoporosis program at Orlando Health. “You can look over it and see, on a typical day, what am I doing?” she says. If you’re getting at least 1,000 mg of calcium, you’re in good shape. If you’re consistently falling short, you can either make some dietary tweaks or talk to your doctor about starting a supplement.

Vitamin D is a little trickier to track, Jablonski acknowledges, especially since much of it comes from sun exposure. “A lot of people are deficient without knowing it,” she says. If you already have osteoporosis, your doctor should be doing regular blood draws to monitor your levels. If you haven’t been tested lately, bring it up at your next check-in with your primary care physician, especially if you’ve noticed symptoms of a possible deficiency, like bone pain, fatigue, or mood changes.

6. Double-check your medications

Certain medications are associated with poor bone health. For example: proton pump inhibitors (which are used to treat heartburn), selective serotonin receptor inhibitors, anticonvulsants that control seizures, glucocorticoids (steroid hormones), and the blood thinner heparin. “If you need them, you need them,” Jablonski says. But it’s possible you could talk to your doctor about switching to a different medication, or only staying on for a short time. “Always ask questions and do your own research with reliable sources,” she advises.

7. Go easy on the alcohol and caffeine—and quit smoking

Your caffeine or cocktail habit could be detrimental to your bone health. “Those things basically limit the ability of the body to heal,” Steele says. “The bone is always breaking down, and you’re always building new bone and then breaking it down.” Consuming too much alcohol or caffeine could disrupt that process, he adds, and cause you to lose bone mass over time.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

A Guide to Managing Arthritis Pain Throughout the Body

in Arthritis, General Orthopedics

Article featured on YaleMedicine

Anyone who struggles to button a shirt or get up from a chair because of arthritis knows how painful and limiting the condition can be. Symptoms worsen with age, but if you’re young and think you are still years away from experiencing them, you may be surprised to learn that although the onset of arthritis is typically after age 40, even people in their 20s can develop it.

There are more than 100 different types of arthritis, a general term for conditions that affect the joints, tissues around the joints, and other connective tissues. About 25% of adults in the U.S. have some form of arthritis.

The most common type, by far, is osteoarthritis (OA), a degenerative disease resulting from a breakdown of the cartilage that eases friction between the joints. Inflammatory joint diseases, like rheumatoid arthritis (RA) or psoriatic arthritis, are autoimmune conditions in which the body’s immune system attacks the joints, causing redness, stiffness, painful swelling, and deformity; they commonly begin in middle age. Yet another type is post-traumatic arthritis, which can occur years after an injury—even if the injury itself was successfully treated.

Whatever type of arthritis you may have, the one thing you should not do is ignore it.

“People with symptoms of arthritis should get evaluated early to find out if they have it and, if so, how far it has progressed, so they can make a plan for the future,” says David Gibson, MD, a Yale Medicine orthopaedic surgeon. “There are many medical and surgical treatments available that can ease pain and help with mobility.”

Depending on their type of arthritis, people may see a rheumatologist or an orthopaedic surgeon—or both—for care. “Rheumatologists have made advances in treating RA with disease-modifying, anti-rheumatic drugs that suppress inflammation, and with biologics that target specific molecules involved in the development of RA,” says Insoo Kang, MD, a rheumatologist who treats various forms of arthritis. “We treat RA with medications, but if your joints need to be surgically treated, we’ll refer you to our colleagues in orthopaedics.”

We spoke to Yale Medicine orthopaedists and rheumatologists about how to treat arthritis in four of the most common areas where it develops.

Hip arthritis

How it happens: The hip is a ball-and-socket joint that is padded and protected by smooth cartilage during movement. When that cartilage breaks down due to overuse, aging, stress on the body from obesity, and/or any number of other factors, bone rubs against bone, causing pain and other symptoms. It’s a common area for OA to develop. And, while RA usually starts in the smaller joints, it can show up in the hip as well.

“The hip really drives the boat,” says Dr. Gibson, who specializes in both hip and knee disorders. “If the hip isn’t working, the feet and ankles are under stress, and it becomes harder to move your knee. A person may notice a ’locking’ noise with movement, decreased range of motion, a limp, and/or pain in the groin that can move down the leg and up into the back. You might eventually start to walk with an altered gait.”

Self-care: Start an exercise program (or change the one you have to avoid high-impact sports, such as running or tennis), maintain a healthy diet, and lose weight, if needed.

Dr. Gibson suggests trying “a gentle cyclic loading program,” like walking or low-impact aerobics. These types of activities have been shown to be protective of joints. Talk to your doctor about taking an over-the-counter pain reliever, such as a non-steroidal anti-inflammatory drug (NSAID), but remember that these are intended for short-term use.

How a specialist can help: Consult a professional when your hip arthritis limits daily function or regular activities.

A specialist will start with noninvasive treatments, including physical therapy and oral medications. If these simple treatments don’t work, more invasive treatments, like corticosteroid hip injections, can minimize symptoms and preserve function. One caveat is that injections are “a double-edged sword” in that they relieve inflammation and provide acute pain relief, but they can be toxic to the areas where they are administered. So, you don’t want to do too many—maybe two or three at most in a given year.

If you’re considering surgery: Hip replacement is considered one of the most successful operations in orthopaedics. It’s minimally invasive and can be done as an outpatient surgery in many cases. It’s really a dramatic, transformative operation—someone who was sedentary can get to a place where they can do pretty much everything again.

Replacement hips use implants—made of a combination of metal, plastic, and ceramic—that last decades. One operation, called the direct anterior approach, avoids cutting through muscle to replace a hip, and surgeons say that leads to easier rehabilitation.

Whatever approach a patient chooses, the key is to find a surgeon who has done a high volume of that particular operation and is comfortable performing it, Dr. Gibson adds.

Hand and base-of-the-thumb arthritis

How it happens: The small joints of the hands are a place where both OA and RA can develop. One difference with RA is that it typically develops on both sides of the body, whereas OA is less symmetrical. OA often starts in the most distal, or faraway, joint on an index finger. But it hurts more at the base of the thumb, where it is incredibly common, especially in women, since they have looser joints, which is necessary for giving birth. It also can be accelerated by very heavy manual labor—so it affects a high number of people who do work with their hands that requires a heavy grip, as in construction and woodworking.

Self-care: Moving and exercising the affected joints can help, but the key is to avoid putting too much stress on the area. Find ways to adapt, such as buying clothes that don’t have buttons, snaps, or zippers. Talk to your doctor about taking NSAIDs for pain.

How a specialist can help: They can prescribe a brace (there are rigid ones for sleep and softer daytime ones that don’t restrict mobility).

While it is very adaptable, the hand is prone to stiffness, adding that it can do more harm than good to wear a splint for too long.

If you’re considering surgery: “There are three approaches,” says Dr. Luo. “The first, done only at the base of the thumb, is called resection arthroplasty, and it removes the joint completely. While it’s highly successful, a full recovery takes up to two years.” The second replaces the small joints in the fingers and may need to be redone in 8 to 11 years. The third, also in the fingers, is called joint fusion—while the joint will never move again, the fusion provides stability that relieves pain, he adds.

Knee arthritis

How it happens: The knee is the largest and strongest joint in the body. It includes three important bones that are covered with cartilage, which protects the knee as you bend or straighten it, and the meniscus—two pieces of cartilage that cushion the thigh and shin bones.

It’s a common area for OA to develop, and RA can sometimes show up in the knee as well. Sports injuries, motor vehicle accidents, or falls—even after they are treated with surgery—can also damage both cartilage and bone. These injuries can change the way a person moves their knee, which can lead to post-traumatic arthritis.

Self-care: Lose weight, if needed; switch from high-impact activities, like running, to low-impact ones, like walking or swimming; avoid movements, like lunges and squats, that could make the condition worse. Apply ice or heat for pain, and talk to a doctor about taking NSAIDs.

How a specialist can help: They can recommend specific exercises and/or physical therapy, and provide assistive devices like canes. They also prescribe oral and topical medications, as well as injections, starting with cortisone shots. “A second line of treatment is the injection of hyaluronic acid, a substance that occurs naturally in the joint and can add some temporary lubrication and cushioning in patients who have little or no swelling,” Dr. Gibson says.

If you’re considering surgery: There are a variety of knee surgeries, including synovectomy, which replaces a joint lining damaged by RA, and cartilage grafting, which uses healthy tissue from another part of the knee to replace damaged cartilage. If a knee replacement is called for, it may be performed as a same-day surgery using materials (that are longer lasting than have been used in the past) for implants.

“We’ve become better with anesthesia and with pain control afterwards,” says Dr. Gibson. Anesthesiologists use nerve blocks, a type of pain relief that leaves people more comfortable in the day or two after surgery and can minimize or eliminate the need for opioid medicines.

Surgeons want patients to start moving soon after knee surgery to prevent scar tissue from developing. “You have to really get that motion early,” says Dr. Gibson.

Foot and ankle arthritis

How it happens: The foot hitting any surface (whether you are walking or running) puts a high degree of contact stress on arthritic joints—every step hurts. The pain can be quite excruciating if a joint is damaged. Range of motion becomes limited, and bone spurs can develop. Pain is common in the big toe, on the top of the foot, and in the ankle.

Self-care: Keep your weight under control, as being overweight or having obesity puts stress on the foot and ankle. Modify your activity if overuse seems to be exacerbating the pain, and try ice packs. Ankle-strengthening exercises (using a resistance band) and Achilles-stretching exercises can also help reduce pain. Talk to your doctor about using NSAIDs.

How a specialist can help: We always have to think of evenly distributing mechanical load. He compares the foot and ankle to a tripod and says it must be well-balanced to be optimized for even the most basic functions, like taking a step. Some people with foot arthritis will compensate to avoid feeling pain and that can throw off the balance, he adds. Supportive shoes, an ankle brace, and orthotics may help.

If you’re considering surgery: Surgeons who have special training can address problems with biomechanics by surgically realigning the foot, ankle, and lower leg to “off-load” the area that is damaged by arthritis, Dr. Oh says. “I can remove bone spurs and clean up the joint using a minimally invasive technique or realign the ankle in a way that evenly redistributes the load, so that the stress to the impacted area is lessened.”

Replacing or fusing arthritic joints may also be recommended. There are innovative joint replacement options for such surgical treatments as toe implants and total ankle replacements for people whose joints are severely damaged or who have no cartilage left.

That’s important for young patients because while the materials used in replacements in the feet and toes are always improving, they have a limited lifespan.

Therefore, optimizing the balance of the foot and ankle is crucial for extending the longevity of those implants, he explains.

Should you get help for arthritis?

Whatever type of arthritis a person has, a key factor in determining when to treat it—and when to perform surgery—is how they tolerate pain, says Dr. Luo. There are people with mild arthritis who seek care early to avoid prolonged pain, while others don’t remark on their pain, even after an X-ray shows extensive damage, he explains. “Some have a lot of arthritis and never need treatment, while others have a lower level of arthritis and need surgery. Everyone is different,” he says.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

How to Stay Healthy When Exercising

in Health & Wellness

Article featured on Thrive Global

Getting the proper amount of sleep each day is a vitally crucial factor in staying healthy. The more rest combined with exercise and a healthy diet will impact how you perform in the workforce. Exercising regularly decreases work stress, staying pain-free and getting the proper amount of sleep is the recipe for a balanced and successful lifestyle.

WHO, WHY AND HOW INJURIES OCCUR

Those who are vulnerable to upset that balance, are health-conscious active people who exercise and train regularly. There are many types of exercisers, weekend warriors, gym rats who work out for hours at the gym, competitive runners who train for 10 k’s or marathons while others play pickleball, tennis, golf, softball or walk counting their steps each day. Patients will tell me that once they hit a certain level of activity if not in shape their body fatigues and they are more prone to injuries, it is the too much, too soon, too quickly syndrome we are all vulnerable too. Regardless of what form of exercise you choose, your feet play a significant role, they are the engines that keep your body moving. So, when your feet hurt, you hurt all over, the engine shuts down, your energy changes and your normal sleep patterns are disrupted.

Injuries occur from soft tissues inability to stabilize unstable bone segments. Repetitive Stress of a specific exercise movement can cause muscle imbalances and muscle fatigue. The main contributing factors as to why injuries occur when exercising are as follows. Poor technique of your exercise routine and abnormal foot biomechanics in your lower extremity creates unhealthy habits that can lead to repetitive overuse injuries. Repetitive overuse syndrome is the result of gradual microtrauma due to an increase of stress on a particular body part such as your legs or feet. Structural limitations in our bodies can limit our ability to perform at a high or any level for prolonged periods of time and the body breaks down. These two factors can trigger problems leading to plantar fasciitis, muscle/tendon strains, shin splints, ankle and knee Joint pain and ligament sprains. Finally, the shoes you wear during exercise and the types of surfaces that you participate on are also major factors causing injuries. Something as simple as wearing the wrong type of footwear for a sport or the wrong size can be a major factor in answering the mystery of why” I got hurt.” Court shoes are for racket and paddle sports whereas running shoes are for runners and walkers but should not be worn while playing tennis, pickleball or other court sports. Wearing a shoe that is too narrow and tight in the toe box area can trigger painful ingrown toenail problems that can impact how you walk and sleep. Hard unyielding playing surfaces such as concrete can fatigue your muscles faster and wear you down. If you are a runner, grass, dirt, or all-weather surfaces are better shock-absorbing ones giving your feet and lower legs a softer landing by reducing the impact load and stress on your body.

There are two types of injuries that active exercisers can experience. Acute which is pain with sudden onset, your “OMG, OUCH” moment. The injured area becomes inflamed quickly and often micro edema/swelling is present. Aggressive treatment will minimize your downtime. I usually recommend using ice packs or ice in a zip lock bag for 15 minutes on and 15 minutes off the first few hours, over the counter topical remedies in gel or cream form that have a homeopathic remedy called arnica in it which is a natural anti-inflammatory, rest, compression and sometimes elevation. These types of injuries may require additional treatment by a medical professional if you do not see a positive change in the first 24-36 hours. Obviously, if the injured area usually resolves quickly and normal healing occurs your back exercising quickly. However, “Never wish and hope an injury will get better on its own after a day or two” if you are still experiencing constant pain. Soft tissue injuries that are not treated immediately can become chronic over time which can last for days, weeks or months.

Most injuries that exercisers experience in their lower extremity are soft tissue in nature, usually affecting the legs and feet. The common ones are plantar fasciitis and shin splints.

The treatment falls into two categories traditional and alternative. Traditional treatments would consist of cortisone injections, physical therapy, oral non-steroidal anti- inflammatory medications known as NSAID’S, custom made orthotics or over the counter arch supports and a last resort surgery. Alternative therapy options include homeopathy injections with arnica as the main anti-inflammatory which comes in oral and topical forms, stem cell therapy, prolo – therapy (proliferation therapy), acupuncture or electrical current therapy using a variety of electrical frequencies (i.e., Interferential) to increase blood flow and reduce swelling.

The reason that acute injuries become chronic is because of denial and lack of urgency to take the time to seek medical treatment. The most common excuse is “I thought it would get better on its own” or “it only hurt a little bit and I can push through it”.” As we all know, “when your feet hurt everything hurts” which can disrupt normal sleep causing focus and alertness problems in the workplace.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

What is Texting Thumbs?

in Finger Injuries, Hand Injuries

Article featured on Burlington County Orthopedic Specialists

You may have scanned the title of this article and thought to yourself: “Texting thumbs? Is that really a medical condition?” Well, in a manner of speaking – yes, yes it is. The proliferation of smartphones, tablets, laptops and handheld gaming systems in today’s high-tech world has brought with it an unfortunate consequence – a new host of repetitive strain injuries (also known as RSIs) that stem from our increased use of these devices.

What’s a repetitive strain injury?

In a nutshell, an RSI takes root when a part of either the musculoskeletal or the nervous system is strained or damaged due to a repetitive task that causes a person to sustain an awkward or forceful position or exertion. A sudden, sharp pain, unusual fatigue, or tingling and numbness in the afflicted area are among the symptoms of an RSI.

All Thumbs

Opposable thumbs are a much-lauded feature of our primate species, and for good reason; tech use aside, they sure do come in handy (pun intended) for all sorts of tasks and inventions that have advanced the human race. But we ask a lot of our thumbs these days – too much, some might argue. They hit our space bars, compose our on-the-go emails, and help the Super Mario Brothers save Princess Peach on family game night. And for the text-messagers and gamers among us, especially, our thumbs don’t get much of a break. The RSI associated with overuse of our thumbs has had different names over the years, says Dr. Bowers. “In the late ‘80s, we called it ‘Nintendo thumb.’ In the ‘90s, it became ‘Blackberry thumb.’” No matter what you call it, the swelling, pain, and tenderness are the same, and it can put you at greater risk for more serious issues. These include carpal tunnel syndrome or even stenosing tenosynovitis, also called ‘trigger thumb,’ in which the thumb locks into a bent position and needs to be manually straightened. “The more severe cases can require injections, or even surgery,” warns Dr. Bowers. Her advice? “If you can, back off from the offending activity. You might, for example, pick up the phone instead of sending 30 texts to have the same conversation.” For those for whom texting or mobile email is required for work: “Try recruiting other fingers, and take frequent breaks. Massage the affected area, and take an over-the-counter oral non-steroidal anti-inflammatory for pain as needed.”

For the Laptop Lovers

When the laptop computer was first introduced to the market, it was not meant to replace its stationary desktop counterpart. In fact, it wasn’t able to – technologically speaking, buying a laptop years ago meant settling for slower processing speed and less memory. These days, however, many laptops are just as powerful as their bigger, bulkier siblings. Translation: more and more people are using laptops as their primary, or even sole, computer. Convenient, yes, but bad news for our bodies.

The built-in track pad found on most laptops concentrates a lot of activity into a cramped space, and one that forces awkward hand movement. The keyboard and screen being so close together makes for uncomfortable typing, and, in most cases, the need to bend at the neck to properly view the display. Because laptops are so portable, users are often away from their desk and computing at long stretches with far-from-ideal body posture.

“If possible,” says Dr. Bowers, “use a desktop computer as your primary work machine.” The United States Department of Labor’s Occupational Safety & Health Administration has a whole section of their website dedicated to setting up a safe and ergonomic desktop workstation.

And when you must use a laptop? “Use a peripheral mouse and keyboard whenever possible,” says Dr. Bowers. Several companies now are even making a new kind of mouse that is basically a high-tech glove – your hand becomes the mouse. “Some of those options may be expensive, but they’re worth at least checking out.”

Sit up Straight!

Your mother was right – good posture not only improves your appearance, but it’s just plain good for your body. Today’s final culprit of tech-induced tribulation is the sinister slouch. To illustrate, here’s a quick quiz: How have you been sitting as you’ve read this article? a) My head is held high b) My computer screen is directly in front of me, at eye level c) My shoulders are back and my spine is straight d) Both of my feet are flat on the floor e) All of the above f) None of the above If you answered e), congratulations! You can be an example for the rest of us, who largely tend to fall into the f) group. The unfortunate news for the rest of us: Sustained slouching can lead to all sorts of aches and pains – even, in some cases, serious injury. “You can develop headaches, neck pain, back pain, bursitis, nerve impingement, issues with the trapezius (shoulder) muscles, the rotator cuff,” says Dr. Bowers. The list goes on and on. “But these problems are all avoidable. Good lower back support, straight posture of the upper back, and frequent breaks (she recommends a 10-minute break for every hour spent sitting in front of the computer) are all going to help prevent problems down the road.”

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Golfers and Baseball Elbow: What is it?

in Golf Elbow, Joint Replacement, Sports Medicine, Sports Related Injuries

Article featured on UW Medicine

What is medial epicondylitis?

Medial epicondylitis is also known as golfer elbow, baseball elbow, suitcase elbow, or forehand tennis elbow. It causes pain from the elbow to the wrist on the inside (medial side) of the elbow. The pain is caused by damage to the tendons that bend the wrist toward the palm. A tendon is a tough cord of tissue that connects muscles to bones.

What causes medial epicondylitis?

Medial epicondylitis is caused when too much force is used to bend the wrist toward the palm. This can happen when swinging a golf club or pitching a baseball. Other possible causes of the condition include:

Serving with great force in tennis or using a spin serve
Weak shoulder and wrist muscles
Using a tennis racket that is too tightly strung or too short
Throwing a javelin
Carrying a heavy suitcase
Chopping wood with an ax
Using a chain saw
Frequent use of other hand tools on a continuous basis

What are the symptoms of medial epicondylitis?

The most common symptom of medial epicondylitis is pain along the palm side of the forearm, from the elbow to the wrist, on the same side as the little finger. The pain can be felt when bending the wrist toward the palm against resistance or when squeezing a rubber ball.

The symptoms of medial epicondylitis may look like other health problems or conditions. Always see your healthcare provider for a diagnosis.

How is medial epicondylitis diagnosed?

The diagnosis of medial epicondylitis often can be made based on a physical exam. Your healthcare provider may rest your arm on a table, palm side up, and ask you to raise your hand by bending your wrist against resistance. If you have the condition, pain often is felt in the inner aspect of the elbow.

How is medial epicondylitis treated?

Treatment for medial epicondylitis includes stopping the activity that produces the symptoms. It is important to stop doing the movement that caused the condition in the first place. Treatment may include:

Ice packs to reduce inflammation
Activity modification
Strengthening exercises
Anti-inflammatory medicine
Bracing
Physical therapy
Surgery (rare)

What can I do to prevent medial epicondylitis?

Being aware of your daily movements can help prevent this condition. Some suggestions include:

Using correct form when doing repetitive activities, such as work or sports movements
Keeping shoulders, forearms, and wrist muscles strong
Gently stretching forearm muscles before and after repetitive tasks
Using correct body mechanics when lifting or moving objects

Key points about medial epicondylitis

Medial epicondylitis causes pain from the elbow to the wrist on the inside (medial side) of the elbow.
It’s more common in people who play golf or pitch baseball.
Treatment includes stopping the activity that caused the pain.
Using the correct form when doing repetitive activities can help prevent the condition.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

Know the reason for your visit and what you want to happen.
Before your visit, write down questions you want answered.
Bring someone with you to help you ask questions and remember what your provider tells you.
At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new directions your provider gives you.
Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
Ask if your condition can be treated in other ways.
Know why a test or procedure is recommended and what the results could mean.
Know what to expect if you do not take the medicine or have the test or procedure.
If you have a follow-up appointment, write down the date, time, and purpose for that visit.
Know how you can contact your healthcare provider if you have questions.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

What is Bursitis?

in Bursitis, Joint Pain

Article featured on John Hopkins Medicine

What is bursitis?

Bursitis is inflammation of a bursa. A bursa is a closed, fluid-filled sac that works as a cushion and gliding surface to reduce friction between tissues of the body. The major bursae (this is the plural of bursa) are located next to the tendons near the large joints, such as in the shoulders, elbows, hips, and knees.

Bursitis is usually a temporary condition. It may limit motion, but generally does not cause deformity.

Bursitis can happen in any bursa in the body, but there are some common types of bursitis, including:

Retromalleolar tendon bursitis. This type of bursitis is also called Albert disease. It’s caused by things like injury, disease, or shoes with rigid back support. These put extra strain on the lower part of the Achilles tendon. This attaches the calf muscle to the back of the heel. This can lead to inflammation of the bursa located where the tendon attaches to the heel.
Posterior Achilles tendon bursitis. This type of bursitis, also called Haglund deformity, is in the bursa located between the skin of the heel and the Achilles tendon. This attaches the calf muscles to the heel. It is aggravated by a type of walking that presses the soft heel tissue into the hard back support of a shoe.
Hip bursitis. Also called trochanteric bursitis, hip bursitis is often the result of injury, overuse, spinal abnormalities, arthritis, or surgery. This type of bursitis is more common in women and middle-aged and older people.
Elbow bursitis. Elbow bursitis is caused by the inflammation of the bursa located between the skin and bones of the elbow (the olecranon bursa). Elbow bursitis can be caused by injury or constant pressure on the elbow (for example, when leaning on a hard surface).
Knee bursitis. Bursitis in the knee is also called goosefoot bursitis or Pes Anserine bursitis. The Pes Anserine bursa is located between the shin bone and the three tendons of the hamstring muscles, on the inside of the knee. This type of bursitis may be caused by lack of stretching before exercise, tight hamstring muscles, being overweight, arthritis, or out-turning of the knee or lower leg.
Kneecap bursitis. Also called prepatellar bursitis, this type of bursitis is common in people who are on their knees a lot, such as carpet layers and plumbers.

What causes bursitis?

The most common causes of bursitis are injury or overuse. Infection may also cause it.

Bursitis is also associated with other problems. These include arthritis, gout, tendonitis, diabetes, and thyroid disease.

What are the symptoms of bursitis?

The following are the most common symptoms of bursitis. However, each person may experience symptoms differently.

Pain
Localized tenderness
Limited motion
Swelling and redness if the inflamed bursa is close to the surface of the skin

Chronic bursitis may involve repeated attacks of pain, swelling, and tenderness. These may lead to the deterioration of muscles and a limited range of motion in the affected joint.

The symptoms of bursitis may resemble other medical conditions or problems. Always see a healthcare provider for a diagnosis.

How is bursitis diagnosed?

In addition to a complete medical history and physical exam, diagnostic tests for bursitis may include:

X-ray. A diagnostic test that uses invisible electromagnetic energy beams to make pictures of internal tissues, bones, and organs on film.
Magnetic resonance imaging (MRI). An imaging test that uses a combination of large magnets, radiofrequencies, and a computer to make detailed pictures of organs and structures within the body.
Ultrasound. An imaging test that uses high-frequency sound waves to look at the internal organs and tissues.
Aspiration. A procedure that involves using a thin needle to remove fluid from the swollen bursa to check for infection or gout as causes of bursitis.
Blood tests. Lab tests may be done to confirm or rule out other conditions.

How is bursitis treated?

The treatment of any bursitis depends on whether or not it involves infection.

Aseptic bursitis. This inflammation results from local soft-tissue trauma or strain injury. The bursa is not infected. Treatment may include:
R.I.C.E. This stands for rest, ice, compression, and elevation
Anti-inflammatory and pain medicines, such as ibuprofen or aspirin
Injection of a steroid into the affected area to help decrease pain and swelling
Splints or braces to limit movement of the affected joint
Septic bursitis. The bursa becomes infected with bacteria. This causes pain and swelling. Treatment may include:
Antibiotics
Repeated aspiration of the infected fluid (a needle is used to take out the fluid)
Surgical drainage and removal of the infected bursa. This is called a bursectomy.

What can I do to prevent bursitis?

Try the following measures to prevent bursitis:

Warm up before exercising or before sports or other repetitive movements.
Start new exercises or sports slowly. Gradually increase the demands you put on your body.
Take breaks often when doing repetitive tasks.
Cushion “at risk” joints by using elbow or knee pads.
Stop activities that cause pain.
Practice good posture. Position your body properly when doing daily activities.

When should I call my healthcare provider?

Call your healthcare provider if you have any of the following:

Pain or trouble moving affects your regular daily activities
Pain doesn’t get better or gets worse with treatment
A bulge or lump develops at the affected joint
Redness or swelling develops at the affected joint
You have fever, chills, or night sweats

Key points about bursitis

Bursitis is inflammation of a bursa, a closed, fluid-filled sac that works as a cushion and gliding surface to reduce friction between tissues of the body.
The most common causes of bursitis are injury or overuse, but it can also be caused by infection.
Pain, swelling, and tenderness near a joint are the most common signs of bursitis.
Bursitis can be treated with rest and medicines to help with the inflammation. Antibiotics are used if infection is found. If needed, surgery can be done to remove the bursa.
You can help prevent bursitis by doing things like warming up before exercise or sports, increasing activity slowly, padding joints, taking rest breaks often, and stopping activities that cause pain.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

How Long Does it Take to Recover from Orthopedic Surgery?

in General Orthopedics, Surgery Recovery

Article featured on Orthopedic Associates

Preparing for orthopedic surgery can make a person nervous and hopeful at the same time. You are optimistic about the potential results and improvements that can come from surgical interventions. At the same time, there are often questions about the recovery process.

If you have an injury or chronic health issues affecting your function and movement, orthopedic surgery might be the key to restoring your health. Rest assured, knowing that the surgeon will plan the ideal treatment to address your unique needs, as well as recommendations to speed up your healing time and optimize overall results during recovery.

In addition to the surgical treatment, it’s just as important to ensure that you are diligent about implementing rehabilitation and care to support your healing. It takes time and effort to recover after surgery, but it will be worth the inconvenience because of the long-term results you can achieve.

How Long Does It Take to Recover from Orthopedic Surgery?

Remember that it is going to take time to recover from orthopedic surgery. Many patients are anxious to return to normal lifestyles as quickly as possible. But it’s critical that you follow the doctor’s recommendations to ensure proper healing.

Depending on the type of surgery you need, it can take anywhere from a few weeks to a few months to recover from orthopedic surgery.

The initial days and weeks after surgery often require immobilization and limited activities. But as your body heals, you can return to normal activities once again. Always follow the doctor’s recommendations because certain things might slow your progress if you aren’t careful about this healing time.

Initially, you will likely be dealing with pain, swelling, and inflammation. As these post-operative symptoms start to subside, your recovery treatment can change to include treatments that help you move again and restore normal function.

What Is Involved in Post-Surgery Recovery?

Each patient receives unique recommendations for their recovery plan, depending on the type of surgery and personalized concerns. Common recommendations during rehabilitation include services from medical experts and at-home methods to support the healing process.

Physical therapy
Occupational therapy
Ice and heat therapy
Stretching and strength training
Electrical stimulation
Pain management medications
Other medications to reduce inflammation and lower the risk of infection
Time off work and daily activities
Wound care

The more diligent you are in following the surgeon’s recommendations, the faster you can return to normal activities in the coming weeks and months. It’s critical that you respect this recovery period to allow your body time to heal. Returning to certain activities too soon could potentially harm your progress because of the damage or stress that occurs to the surgical site.

Recommendations for Post-Surgery Rehabilitation

Always plan time for recovery after orthopedic surgery. Your doctor will recommend how many days, weeks, or months you will need during this recovery time.

While there are unique recommendations depending on the type of surgery you need, general suggestions apply to all types of surgery.

Have Patience During Your Recovery

Even though you are anxious to return to your normal activities as quickly as possible, it’s essential that you are patient with yourself during this recovery time. Be kind to yourself and remember that time is one of the most important factors in supporting your healing.

Recovery won’t happen overnight. Healing takes time, and you need to respect your body and allow the natural healing processes to take place. A positive attitude about this process will help you maintain consistency in implementing the recommended practices during your recovery.

Talk to the surgeon before the treatment to understand realistic expectations for your recovery period. This conversation will help you know what to expect so you can maintain the right mindset, including realistic expectations for the recovery timeframe and specific treatments to assist with this healing period.

There’s no question that surgery is a major, life-changing procedure. Not only will this treatment affect your life, but it also has an impact on the lives of your family and friends. Loved ones can step in to assist during this treatment time.

Additionally, your recovery ensures that you can return to your family and career responsibilities after the surgery. Our team at Orthopedic Associates prioritizes your overall health, helping you return to an optimal way of living as quickly as possible.

Long-Term Perspective for Optimal Recovery

Not only are we helping you with a fast and effective recovery, but we also want to be sure that you achieve the best possible results in the future.

The small recovery steps you take right now can impact the long-term results you can achieve in the future.

If immobilization is recommended after surgery, avoiding activities that could overwork this part of the body is essential. For example, if you have knee surgery and the doctor recommends no weight on that leg for the first few weeks, then be diligent about using crutches. Wait to walk on the leg until you have consulted with the surgeon, and they have determined that sufficient healing has occurred.

What to Expect After Different Types of Orthopedic Surgeries

Post-recovery recommendations will vary depending on the type of surgery and the area of the body that is treated. Small surgeries might only require a few days of downtime. But major treatments will need several weeks or months to ensure proper healing.

Knee Surgery: Often, knee surgery is required after a sports accident or to fix wear-and-tear in the joint. If you have a partial or complete tear in the knee ligaments, you will likely need 6 – 8 months for recovery.
Bone Fractures: Depending on the severity of the break, you will likely need six to eight weeks for upper limb recovery or as long as 12 weeks for lower limb recovery.
Spinal Surgery: The most common type of spinal surgery is to address nerve pain or alignment of the spinal column. Often, months of recovery are required, especially for more invasive types of spinal surgery. For example, you might need 12 – 18 weeks for your recovery time, depending on the complexity of the surgery.

Each situation is unique, and your doctor can offer recommendations to support your healing period. The best thing you can do is follow these suggestions to ensure your injured area recovers as quickly and effectively as possible.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Microdiscectomy: A Modern Fix for Disc Herniation

in Back Pain, Herniated Disk

Article featured on HSS

Microdiscectomy is a minimally invasive surgical procedure designed to relieve the pain and discomfort caused by a herniated disc pressing on spinal nerves. Common symptoms like sciatica, muscle weakness, and nerve pain can often improve dramatically after this surgery, which uses small incisions and advanced techniques to minimize tissue disruption. Typically recommended after non-surgical treatments like physical therapy and medication fail to provide relief, microdiscectomy offers a high success rate and shorter recovery time for eligible patients. Understanding the procedure and recovery process can help patients make informed decisions about their spine health.

Microdiscectomy is a type of minimally invasive discectomy commonly used to treat a herniated disc. When a herniated disc compresses a spinal nerve, symptoms can include pain (which may extend down one or both arms and legs, as is the case in sciatica), muscle weakness and difficulty with repetitive motions.

What is microdiscectomy?

Microdiscectomy is a surgical procedure for the relief of pain and other symptoms that occur when a herniated disc in the spine presses on an adjacent nerve root. During the operation, the surgeon frees the nerve by removing small fragments of disc, bone and ligament.

Microdiscectomy is sometimes described as a minimally invasive spine surgery, because it requires only a small incision and the use of a microscope or surgical glasses, called loupes, to magnify the site where the injury has occurred. The surgeon also uses smaller tools and instruments to work in the restricted space of the spine. Microdiscectomy is a type of spinal decompression surgery, and the term microdecompression – which describes the surgical removal of any bone or ligament that is compressing a nerve – may also be used to describe the procedure. However, the term “microdiscectomy” is more specific to the removal of the fragment of herniated disc tissue that is causing the patient’s symptoms.

Because most patients will recover from a herniated disc without surgery, microdiscectomy is recommended only after conservative treatment, including physical therapy, cortisone shots, and other medication have been tried for a period of at least 6 to 12 weeks, without bringing relief. In some cases, motor weakness may be a reason to have this surgery sooner. Patients with cauda equina syndrome require immediate surgical intervention. This is a condition in which pressure on the nerves in the lower portion of the spine affects bladder and bowel function, but it affects less than 1% of people.

How does a surgeon perform a microdiscectomy?

Microdiscectomy surgery may be approached using one of three minimally invasive techniques to gain access to the herniated disc and nerve: a midline, tubular or endoscopic microdiscectomy.

Historically, a traditional discectomy required a large incision and involved removal of the entire disc. Today, with the availability of advanced techniques and equipment, almost all spine surgeons perform microdiscectomies. The procedure usually results in rapid, and sometimes immediate, pain relief.

Microdiscectomy techniques

A midline microdiscectomy, in which the surgeon makes a one to two-inch vertical incision in the back, lifts the surrounding muscles off the vertebrae, and uses instruments to hold apart the layers of tissue during the procedure.
A tubular microdiscectomy, in which the surgeon inserts a series of small tubes or dilators through a small incision to create a corridor through the muscle in which to operate, thereby causing less disruption to this tissue.
Endoscopic microdiscectomy (sometimes also known as microendoscopic discectomy), in which an even smaller incision is made and the surgeon employs a miniaturized camera and instruments; this approach also involves less disruption to surrounding tissues.

What are the benefits of a microdiscectomy?

Regardless of which particular microdiscectomy technique selected, the surgical goal is the same: to remove the disc fragment and any bone or ligament that may be compressing the nerve root. To do so, the surgeon creates a small window in the vertebra (a procedure also called a laminotomy) and pulls away the ligamentum flavum, the underlying tissue, to reveal the dura (the covering of the spine) and the nerve root. The herniated part of the disc is then removed to complete the nerve decompression.

Imaging techniques, including X-rays, are used before, and sometimes during, the surgery to ensure localization of the correct operative site.

While herniated discs may occur in almost any level of the spine, lumbar microdiscectomy – surgery in the lower portion of the back – is the most common site for this procedure.

How long does a microdiscectomy take?

On average, microdiscectomy surgery takes between 30 to 60 minutes to complete. However, because patients are given general anesthesia and must spend time afterward in the recovery room for a period of monitoring, the total time usually extends to about two hours.

In almost all cases, people undergoing microdiscectomy may return home the same day. Upon discharge from the hospital, patients are typically given a small amount of pain medication – including acetaminophen or small dose of opioid medication – and a muscle relaxant with instructions regarding postsurgical care and how to taper these medications appropriately. Special emphasis is given to symptoms that signal the need for immediate medical attention, including muscle weakness, change in bladder or bowel function, and extreme and unexpected back or leg pain.

What complications can occur with microdiscectomy?

During surgery, multiple safety measures are followed to control bleeding, prevent infection and avoid injury to any surrounding tissues. Rarely, a tear in the dura (the tissue surrounding the spinal nerves) may occur. The surgeon repairs this with a suture or a patch made of collagen.

What is the expected microdiscectomy recovery time?

Following a two-week period of rest to allow the soft tissues to heal, many patients feel well enough to return to work. However, microdiscectomy recovery typically requires a six-week period of modified activity and includes a course of physical therapy starting at week two or three.

Physical therapists focus on helping patients strengthen core muscles and loosen stiff joints, as well as creating a home exercise program to help protect the spine. All patients are cautioned to ease back into their previous routines gradually, especially those whose work requires physical labor. Because sitting in a chair and leaning forward places pressure on the spine, people with more sedentary jobs also need to be attentive to their posture and take a short walk or do some gentle exercise every hour or so.

Patients who plan to resume driving after surgery must wait until they are pain-free, finished with any medication that causes drowsiness, and able to both shift their foot between pedals and turn in their seats easily and without pain. To test individual comfort, a practice drive in a parking lot or other safe space, in the company of another driver is recommended before returning to regular roadways.

Is a microdiscectomy painful?

Following surgery, most patients do well with a small amount of non-opioid pain medication and a drug that relaxes the muscles. While there is some discomfort associated with the surgical incision, many patients experience rapid relief of the pain caused by the herniated disc.

In patients who have experienced nerve compression and associated symptoms over an extended period, pain relief may take longer. When leg pain has been the primary symptom, the pain typically retreats up the leg over time. In addition, patients may experience muscle cramping or mild numbness or tingling after surgery which typically resolves with time.

Who is eligible for microdiscectomy?

Most patients with herniated discs that do not respond to a trial of medication and physical therapy over time, are eligible for a microdiscectomy. While the condition is usually seen in individuals aged 30 to 50, it does occur outside this age range.

Herniated discs are rare in children and young adults, who are more frequently able to recover without surgical intervention. Microdiscectomy may be appropriate for adults in their 80s or 90s, though they should be cautioned that there is an increased chance of medical or surgical complications in this population.

How successful is microdiscectomy?

Overall, microdiscectomy success rates are excellent, with many patients expressing a high degree of satisfaction with the outcome. Careful presurgical screening and evaluation, as well as patient commitment to maintaining good spine health following microdiscectomy, contribute to the success of the surgery.

It should be noted that some people with herniated discs are also found to have other issues in the spine that are causing nerve-related pain and disability. In such cases, additional procedures such as a laminectomy – removal of the lamina (bony roof over the spinal canal) in one or more vertebrae, may be required if it is felt that these issues are contributing to their disability.

Can microdiscectomy be used on a disc that herniates a second time?

In cases of disc reherniation, microdiscectomy can be performed for a second time on the same disc, often with good results. However, if herniation occurs in the same disc a third time, a different type of treatment will be recommended.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

What is Cubital Tunnel Syndrome?

in Elbow Injuries, Health & Wellness, Wrist

Article featured on UW Medicine

Cubital tunnel syndrome occurs when the ulnar nerve, which runs through the inside of the elbow, becomes irritated or compressed. This condition causes pain, numbness, and tingling, often in the hand, ring finger, and little finger, and may worsen when the elbow is bent or during certain activities. Repetitive movements, leaning on the elbow, or previous injuries are common culprits, but in some cases, the cause is unknown. Treatment options range from rest and elbow protection to physical therapy and, in severe cases, surgery. Understanding cubital tunnel syndrome is key to relieving symptoms and preventing complications.

What is cubital tunnel syndrome?

Cubital tunnel syndrome happens when the ulnar nerve, which passes through the cubital tunnel (a tunnel of muscle, ligament, and bone) on the inside of the elbow, becomes inflamed, swollen, and irritated.

Cubital tunnel syndrome causes pain that feels a lot like the pain you feel when you hit the “funny bone” in your elbow. The “funny bone” in the elbow is actually the ulnar nerve, a nerve that crosses the elbow. The ulnar nerve starts in the side of your neck and ends in your fingers.

What causes cubital tunnel syndrome?

Cubital tunnel syndrome may happen when a person bends the elbows often (when pulling, reaching, or lifting), leans on their elbow a lot, or has an injury to the area.

Arthritis, bone spurs, and previous fractures or dislocations of the elbow can also cause cubital tunnel syndrome.

In many cases, the cause is not known.

What are the symptoms of cubital tunnel syndrome?

The following are the most common symptoms of cubital tunnel syndrome:

Numbness and tingling in the hand or ring and little finger, especially when the elbow is bent
Numbness and tingling at night
Hand pain
Weak grip and clumsiness due to muscle weakness in the affected arm and hand
Aching pain on the inside of the elbow

The symptoms of cubital tunnel syndrome may seem like other health conditions or problems, including golfer’s elbow (medial epicondylitis). Always see a healthcare provider for a diagnosis.

How is cubital tunnel syndrome diagnosed?

In addition to a complete medical history and physical exam, diagnostic tests for cubital tunnel syndrome may include:

Nerve conduction test. This test measures how fast signals travel down a nerve to find a compression or constriction of the nerve.
Electromyogram. This test checks nerve and muscle function and may be used to test the forearm muscles controlled by the ulnar nerve. If the muscles don’t work the way they should, it may be a sign that there is a problem with the ulnar nerve.
X-ray. This is done to look at the bones of the elbow and see if you have arthritis or bone spurs in your elbow.

How is cubital tunnel syndrome treated?

The most effective treatment for cubital tunnel syndrome is stopping the activity that is causing the problem. Treatment may include:

Resting and stopping any activity that aggravates the condition, such as bending the elbow
A splint or foam elbow brace worn at night (to limit movement and reduce irritation)
Using an elbow pad (to protect against chronic irritation from hard surfaces)
Anti-inflammatory medicines (such as ibuprofen or naproxen)
Nerve gliding exercises

If these treatments don’t work, the healthcare provider may talk to you about surgery.

What can I do to prevent cubital tunnel syndrome?

To prevent cubital tunnel syndrome:

Keep your arms flexible and strong.
Don’t rest on your elbows, especially on a hard surface.
Warm up before exercising or using your arms for sports or other repetitive movements.

When should I call my healthcare provider?

Call your healthcare provider if you have:

Pain or trouble moving that affects your regular daily activities
Pain doesn’t get better or gets worse with treatment
Numbness, tingling, or weakness in the arm or hand

Key points about cubital tunnel syndrome

Cubital tunnel syndrome is a problem with the ulnar nerve, which passes through the inside of the elbow. It causes pain that feels a lot like the pain you feel when you hit the “funny bone” in your elbow.
Cubital tunnel syndrome may happen when a person frequently bends the elbows, leans on their elbow a lot, or has an injury to the area. Arthritis, bone spurs, and previous fractures or dislocations of the elbow can also cause it. In many cases, the cause is not known.
The most common symptoms of cubital tunnel syndrome are numbness, tingling, and pain in the hand or ring and little finger, especially when the elbow is bent.
Cubital tunnel syndrome can be treated with rest and medicines to help with pain and inflammation. Exercises may help, too. In some cases, surgery may be done.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

Know the reason for your visit and what you want to happen.
Before your visit, write down questions you want answered.
Bring someone with you to help you ask questions and remember what your provider tells you.
At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.
Ask if your condition can be treated in other ways.
Know why a test or procedure is recommended and what the results could mean.
Know what to expect if you do not take the medicine or have the test or procedure.
If you have a follow-up appointment, write down the date, time, and purpose for that visit.
Know how you can contact your healthcare provider if you have questions, especially after office hours or on weekends and holidays.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

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