blog - Orthopedic & Sports Medicine

Lumbar Spine Surgery

December 14, 2019/in Back Pain, Disk Injuries, Spinal Surgery /by orthosportsmed

Article Featured on Spine Health

Lumbar surgery refers to any type of surgery in the lumbar spine, or lower back, between one or more of the L1-S1 levels. There are two general types of lumbar spine surgery that comprise the most common surgical procedures for the lower back:

Lumbar Decompression

The goal of a decompression surgery is usually to relieve pain caused by nerve root pinching. There are two common causes of lumbar nerve root pressure: from a lumbar herniated disc or lumbar spinal stenosis.

This type of pain is usually referred to as a radiculopathy, or sciatica.

A decompression surgery involves removing a small portion of the bone over the nerve root and/or disc material from under the nerve root to relieve pinching of the nerve and provide more room for the nerve to heal. The most common types of decompression surgery are microdiscectomy and laminectomy.

There are also a few alternatives available to the above two standard procedures, such as an X-STOP which is a possible option instead of a laminectomy for lumbar spinal stenosis.

Lumbar Fusion

The goal of a lumbar fusion is to stop the pain at a painful motion segment in the lower back. Most commonly, this type of surgery is performed for pain and disability caused by lumbar degenerative disc disease or a spondylolisthesis.

A spinal fusion surgery involves using a bone graft to stop the motion at a painful vertebral segment, which in turn should decrease pain generated from the joint. Spine surgery instrumentation (medical devices), bone graft procedures, and a bone stimulator are sometimes used along with spinal fusion.

There are also many surgical approaches to performing spinal fusion, such as ALIF, PLIF, XLIF, TLIF, posterolateral gutter fusion, anterior/posterior fusion, and certain minimally invasive approaches.

In addition to the above conditions, decompression and/or spinal fusion may be performed to address other types of lumbar spine pathologies, such as infection or tumors.

Lumbar Spine Surgery Alternatives

In addition to the traditional one-level fusion or decompression surgery that is done for lumbar degenerative disc disease or spinal stenosis, respectively, there are a number of surgical alternatives available. Several of the most common ones include:

Artificial Disc Replacement

Artificial disc technology can be used in specific cases of lumbar degenerative disc disease.

Motion Preservation Technologies

It should be known that while spinal fusion has been a classical treatment for ongoing pain and disability from the lumbar spine, alternatives to fusion do exist for posterior conditions (problems in the back of the lumbar spine) such as spinal stenosis. Inserting an interspinous process spacer, such as the X-STOP device, can actually preserve motion as opposed to stopping it via fusion.

Vertebral Augmentation

A surgery called vertebral augmentation may be done to treat pathological fractures from tumors or osteoporosis.

Multilevel Lumbar Fusion

Lumbar spine fusion surgery for symptomatic degenerative disc disease is typically done on one level of the spine (most commonly toward the bottom of the spine, at L5-S1 or L4-L5). In certain cases it may be done on two levels, and only very rarely would it be considered on 3 or more levels. Multilevel spine fusion may be indicated in cases of scoliosis.

There are only two things that surgery can do. Surgery can decompress a nerve root or it can stabilize a painful motion segment. So we have to identify a nerve root that’s pinched or we have to identify a painful motion segment. And if we can do that, that would make you a candidate for surgery. Just having pain and having failed conservative treatment is not an indication for surgery if there is no pathological cause of the pain – it doesn’t mean there’s not pain, but we have to identify the cause of pain in order to be able to correct it. The only thing surgery can do is actually correct an anatomical defect, so we have to be able to identify it.

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, 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 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 Degenerative Disc Disease?

December 11, 2019/in Back Pain, Disk Injuries, Spinal Surgery /by orthosportsmed

By Brian McHugh, MD | Featured on Spine Health

Degenerative disc disease is one of the most common causes of low back and neck pain, and also one of the most misunderstood.

Tips for Exercising When You Have Osteoarthritis

December 7, 2019/in Osteoarthritis, Osteoporosis /by orthosportsmed

By K. Aleisha Fetters | Featured on US News

IF YOU HAVE osteoarthritis, your relationship with exercise is bound to be a tricky one. After all, increasing physical activity is one of the fundamental must-dos for managing the degenerative wear-and-tear joint disease and slowing its progression. But if you have osteoarthritis, certain exercises can be incredibly painful and contribute to further joint damage.

That’s why it’s critical to take a smart, measured approach to exercise if you’re one of the more than 30 million Americans that has osteoarthritis, according to the Centers for Disease Control and Prevention.

Here are seven pro pointers for reaping all of the joint-protecting benefits of exercising with osteoporosis and reducing the risk of exercise aches and pains:

Consult with a specialist.
Warm up.
Focus on low-impact workouts.
Use your full range of motion, as long as it’s pain-free.
Learn isometric exercises.
Keep things short and frequent.
Tune into your body and adjust as necessary.

Consult With a Specialist

Discussing your individual joint health, symptoms and exercise history with an expert is the perfect starting point when increasing physical activity with osteoarthritis, says Katrina Pilkington, a Nevada-based National Academy of Sports Medicine certified personal trainer and corrective exercise specialist. She recommends reaching out to your rheumatologist and getting set up with a personal trainer or physical therapist.

Working with a trainer or physical therapist is especially important if you have never worked with one in the past. Both can teach you the fundamentals of exercise form to ensure you perform all activity in the safest, healthiest manner for you.

Warm Up

When you’re short on time, it can be tempting to dive straight into your workout, but don’t give in. It’s critical to take a few minutes at the beginning of any exercise routine to increase blood flow to the muscles and joints you’re about to work, according to the Arthritis Foundation. Some gentle warmup drills include arm circles, side-to-side marches, partial bodyweight squats and light cardio, such as walking and cycling.

Focus on Low-Impact Workouts

High-impact exercises involving running and jumping can help strengthen your bones, joints and their supporting musculature, but this isn’t the best starting place for anyone with joint disease. “I would recommend starting with lower-impact exercises and gradually progress based on how you feel,” says physical therapist William Behrns, a board-certified Orthopedic Clinical Specialist at the Hospital for Special Surgery in New York City.

Great low- and no-impact forms of exercise include cycling, swimming and strength training, in which both feet stay planted on the floor at all times. For example, instead of stepping back and forth during lunges, performing them with a stationary split stance eliminates any potential jolting of your ankles, knees and hips. Similarly, swap out jump squats for goblet squats (where you hold a single weight in front of your chest) to work your muscles just as hard while reducing potentially irksome stress to your joints.

Use Your Full Range of Motion as Long as It’s Pain-Free

Your joints’ ability to freely move is contingent on regular movement, Pilkington says. It’s a use-it-or-lose-it scenario. However, it’s important that you don’t force your body into painful positions.

For example, maybe you can get into a very low squat, but it hurts your knees and/or hips. Stick to a shorter range of motion, bending at the hips and knees only as far as you can do so without pain, Behrns says.

Learn Isometric Exercises

In some joints, just about any motion can be painful – and that’s where isometric exercises come in handy. In them, rather than moving up and down or side to side, you hold a position.

With isometric exercises, it’s important to remember that you’ll only challenge and strengthen your muscles in the positions that you’re holding. So, if possible, hold each exercise in multiple positions. For instance, if you’re performing isometric lunges, try holding the exercise for 30 seconds near the bottom of your available range of motion and again for 30 seconds near the top.

Other isometric exercises to try include squats, glute bridges and shoulder raises. These are particularly helpful since osteoarthritis most commonly affects the knees, hips and shoulders.

Keep Things Short and Frequent

Sprinkling short activity sessions throughout the day is a great way for anyone to fit exercise into their daily routine and break up time spent sitting. But for anyone with osteoarthritis, short activity sessions can also be useful in ensuring that, when you do exercise, you don’t overstress your joints, Pilkington says.

Any movement, no matter how brief, counts toward your daily activity goals. Behrns recommends getting 150 cumulative minutes of moderate-intensity or 75 minutes of vigorous-intensity exercise per week. A combination of the two also works.

Tune Into Your Body and Adjust as Necessary

Exercising with osteoarthritis can be frustrating, especially if exercise mistakes contributed to your condition or you’re a longtime exerciser who’s suddenly limited in what your body can and can’t do.

However, if you move forward based on how your body feels – rather than what you’re used to or what you expect your body to do now – you’ll be far better off, Behrns says. He recommends listening to your symptoms and if you experience any pain, to immediately think through what aggravated your body and do something about it. That could mean switching up exercise variations, scheduling more recovery work into your routine or adjusting the time during the day that you work out.

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, 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 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

6 Exercises for Osteoarthritis

December 5, 2019/in Osteoarthritis /by orthosportsmed

Article Featured on US News

OSTEOARTHRITIS IS THE most common type of arthritis, affecting 31 million people in the U.S., says Marcy O’Koon, senior director, consumer health, Arthritis Foundation.

Staying Active and in Shape During the Holidays

November 28, 2019/in Health & Wellness, Holiday Tips /by orthosportsmed

By Paige Waehner | Article Featured on Verywellfit

It’s hard enough to exercise the rest of the year, but add holidays to the mix and many of us find exercise becomes less of a priority as to-do lists grow longer and longer.

6 Low Back Pain Symptoms, Locations, Causes & Treatments

November 27, 2019/in Back Pain /by orthosportsmed

Article Featured on eMedicineHealth

What Should I Know About Low Back Pain?

What Is the medical definition of low back pain?

Pain in the lower back or low back pain is a common concern, affecting up to 80% of Americans at some point in their lifetime. Many will have more than one episode. Low back pain is not a specific disease, rather it is a symptom that may occur from a variety of different processes. In up to 85% of people with low back pain, despite a thorough medical examination, no specific cause of the pain can be identified.

A Patient’s Guide to Rheumatoid Arthritis

November 23, 2019/in Arthritis /by orthosportsmed

Article Featured on US News

The human body is an incredibly complex machine. Most of the time, all the parts work correctly, with various gears and components clicking in harmony. But occasionally, something gets out of whack. When this happens, the guardian of the machine – the immune system – can get turned around and begin attacking the body it usually protects. This is what happens in an autoimmune disease like rheumatoid arthritis, an inflammatory disease that affects the joints.

A Surgeon’s Guide to Recovering From Hand Surgery

November 19, 2019/in Hand Fractures, Hand Injuries, Surgery Recovery /by orthosportsmed

Article Featured on Ark Surgery Hospital

Hand surgery recovery is a delicate and often frustrating process. Be sure to follow all of your surgeon’s instruction to ensure you regain your full range of motion.

Whatever the reason for your hand surgery, you can prepare yourself by planning a hand surgery recovery timeline with the help of your orthopedic surgeon and following these helpful guidelines:

Tips for Hand Surgery Recovery

All hand surgery recovery periods last at least several weeks— and sometimes months—before you can return to your everyday activities. You can make several minor lifestyle modifications to help keep you comfortable while you are recovering.

Achilles Tendinitis

November 16, 2019/in Ankle Injuries, Feet /by orthosportsmed

Article Featured on AAOS

Achilles tendinitis is a common condition that occurs when the large tendon that runs down the back of your lower leg becomes irritated and inflamed.

Easing the Pain of Osteoarthritis of the Knee

November 13, 2019/in Knee Pain, Massage Therapy, Osteoarthritis, Recovery /by orthosportsmed

Article Featured on AMTA

There’s been more than one study suggesting massage therapy helps relieve the pain associated with osteoarthritis of the knee. More recently, the results have again been affirmed by research supported by the National Center for Complementary and Alternative Medicine.