What Different Types of Knee Pain Mean

Article featured on Healthgrades

If you’ve ever experienced pain in one or both of your knees, you’re not alone. About one-third of all Americans have felt pain in this major joint at some point in their lives. Women are slightly more likely than men to be affected by it (about 20% of women versus 15 to 20% of men).

Yet the millions of people with this pain don’t all feel the same thing. Knee pain can be sharp or dull, burning or excruciating, accompanied by strange noises or silent. What does your knee pain tell you about what’s wrong?

1. Knee pain with a ‘crunch’

Sometimes knees creak, crack or crunch when you bend them. These sounds—called ‘crepitus’—may be alarming, but don’t necessarily signify a problem, unless your knee hurts at the same time.

If that happens, you could have an injury, such as a torn meniscus (a type of cartilage in your knee) or a dislocated kneecap. The sounds together with pain also could indicate osteoarthritis. Your doctor should check for the source of both your painful sensations and strange sounds.

2. Knee pain when running

If you have a dull pain in and around your kneecap when you run or are doing other activities, you may have ‘runner’s knee,’ also called patellofemoral pain syndrome. Other symptoms include kneecap tenderness, pain when you sit for a long time with your knees bent, and rubbing, grinding or clicking sounds when you bend or straighten your knee.

This syndrome can be caused by running and overuse, as well as structural defects in the knee, shoes that aren’t supportive enough, walking or running with your feet positioned improperly (such as turning in), and injury.

3. Knee pain in the morning

If you wake up with a painful and stiff knee, but find that the aching eases over the course of the day, you may have rheumatoid arthritis. This is an inflammatory disorder in which the body’s immune system attacks joints, such as the knee. Other autoimmune disorders, such as lupus, also can cause similar symptoms.

If you have rheumatoid arthritis symptoms, contact your doctor, especially if you are experiencing pain and stiffness in other joints. Left untreated, rheumatoid arthritis can lead to joint disfigurement.

4. Knee pain when climbing stairs

One of the first signs of osteoarthritis is pain in the knee when going up or down stairs. This pain tends to get worse throughout the day. While osteoarthritis knee pain is usually achy, it can also sometimes be sharp or burning. Other symptoms include swelling, stiffness and feeling like your knee is grinding or may give way.

Osteoarthritis is a degenerative condition in which protective cartilage at the end of your leg bones wears down. This can ultimately result in bones rubbing against each other, causing pain, swelling, and loss of motion.

5. Knee pain with a pop

One common type of knee injury is a tear to the anterior cruciate ligament, or ACL, which connects your thigh bone to your shin and helps keep your knee stable. When the injury happens, you’ll likely hear a loud pop or else feel a popping inside, along with severe pain.

A damaged ACL is likely to leave you with rapid, significant swelling; difficulty fully straightening your leg or bending your knee; and pain when you try to put weight on it. You may feel like the knee is going to give way. In some cases, surgery to repair the ligament may be necessary.

6. Knee pain that’s sudden and severe

If you experience a sudden onset of severe knee pain along with redness, warmth and swelling, especially in the early morning, you might have gout, an arthritic condition that is most commonly seen in the big toe. However, gout also can strike other joints, especially in the leg. Gout can recur and should be treated to help prevent permanent joint damage.

Another reason for sudden severe pain and swelling in a knee is Lyme disease. Children are especially likely to have this symptom of Lyme disease, an infection caused by bacteria from an infected tick. If you suspect Lyme disease, promptly seek care to reduce the risk for complications associated with the disease.

7. Knee pain with bending and kneeling

People in professions that require repetitive kneeling, such as roofers, floor installers, plumbers, coal miners, gardeners and maids, are most at risk for bursitis of the knee. Bursitis refers to inflammation of the bursal sacs of fluid that are around joints.

Repeated bending and kneeling, especially on hard surfaces, can irritate the bursa in the knees, causing gradually worsening symptoms. These symptoms include pain, redness, warmth, swelling, joint stiffness, and sometimes fever, which is a sign of infection. Notify your doctor for a full evaluation and to rule out infection. Bursitis also can be caused by an injury, but this is less common.


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

Causes of Sciatica

Article featured on News-Medical

Sciatica is caused by pressure on the sciatic nerve or its roots. Any condition which causes compression of the spinal cord, or the nerve roots emerging from the spinal foramina, causes sensory and motor symptoms in the area supplied by the sciatic nerve in a dermatomal distribution. The most common cause of sciatica is disc herniation in the lumbar region.

The causes of sciatica include:

  • Lumbar disc prolapse, or herniation of the cartilaginous intervertebral discs, which then put pressure upon one or more nerve roots in the lumbar region, causing the symptoms of sciatica.
  • Lumbar spinal stenosis, or narrowing of the bony canal surrounding the spinal cord, which puts pressure on the lumbar cord and its nerve roots, producing the classic symptoms of compression of the sciatic nerve. Occurring mostly in older people, it is characterized by more or less constant back pain, with leg pain or numbness soon after the patient starts walking.
  • Spondylolisthesis, where one disc slips forward over the one beneath, leading to narrowing of the available spinal canal space at that point. This can compress the spinal cord and nerve roots, and in the lumbar region, it causes sciatica. The fourth and fifth lumbar vertebrae are most commonly affected in lumbar spondylolisthesis, which is usually a sequel of spinal arthritis.
  • Spinal infection leading to abscess formation in the paraspinal region, causing pressure on the nerve roots or the spinal cord, depending on the location.
  • Spinal trauma or injury, leading to deformity which puts pressure on the spinal nerve roots.
  • Tumors growing within the spine, which compress the nerve roots.
  • Bone spurs or osteophytes, which are outgrowths of bone that form on stressed or degenerating bone, especially following cartilage loss. These can narrow the spinal space, or the space between adjacent vertebra where the nerve roots emerge.
  • Piriformis syndrome: the piriformis muscle is a thick small muscle located deep to the large buttock muscles or glutei, and it passes over the sciatic nerve. Spasm, swelling or tightening of this muscle leads to the piriformis syndrome by compressing the nerve. In addition, the nerve passes through the muscle rather than below it in about 14% of people, which may carry a higher risk of sciatic nerve compression.
  • Space-occupying lesions in the lumbar region, such as abscesses, clots, tumors, put pressure on lumbar nerve roots or the sciatic nerve itself.
  • Poor sitting posture can lead to paraspinal muscle spasm, ligamentary laxity or spinal deformity, putting pressure on the lumbar spine and pinching the nerve roots.

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

Know the Warning Signs of Knee Osteoarthritis

Article featured on MedicalNewsToday

Osteoarthritis of the knee happens when the cartilage that cushions the bones in the knee starts to erode. The bones begin to rub against each other, resulting in damage, swelling, and pain.

Cartilage is a smooth but tough tissue that stops the bones from rubbing together and prevents damage. It allows the bones to move pass smoothly over each other. As people get older, the weight they carry can cause the cartilage to wear away.

As the cartilage breaks down and the bones rub together, osteoarthritis (OA) can result.

OA is the most common type of arthritis. The symptoms include swelling, pain, and stiffness. When it affects the knee, it can be difficult for a person to exercise, to climb stairs, or even to walk.

Early signs and symptoms

OA usually affects people who are over 50 years of age, but it can happen earlier, too.

Symptoms that can appear at the early stages of knee OA are:

  • pain, especially on bending and straightening the knee and with weight bearing
  • swelling, caused by a buildup of fluid in the joint, or by bony growths called osteophytes that form as the cartilage breaks down
  • warmth in the skin over the knee, especially at the end of the day
  • tenderness when pressing down on the knee
  • stiffness when moving the joint, especially first thing in the morning or after a period of inactivity or walking
  • creaking or cracking on bending, known as crepitus

Activity can make symptoms worse, leading to pain at the end of the day, especially after a long time of standing or walking.

If the knee is red, the person has a fever, or both symptoms occur, the problem is probably not OA.

Treatment

Treatment of OA depends on how severe the symptoms are.

Home treatment

Some remedies and over-the-counter treatments for OA of the knee can be used at home and are readily available from the pharmacy.

These include:

  • Applying heat or cold: Heat relieves stiffness, and cold can ease pain and swelling. The heating pad or ice pack should be covered with a towel so as not to burn the skin.
  • Using an assistive device: A cane or walker can help take some of the weight off of the knees. Holding the cane in the opposite hand to the painful knee is most effective.
  • Pain relief medications: These are available over the counter, but people should use them with caution as they can cause side effects.

Medical treatment

If home or over-the-counter remedies do not help, the person should see a doctor.

They may prescribe one of the following:

  • steroid injections in the knee joint to reduce inflammation
  • physical therapy, with exercises to improve flexibility and range of motion in the joint

If these solutions do not work and damage is severe, the physician may recommend surgery to replace the joint.

When to see a doctor

For some people, pain and other symptoms are severe enough to interfere with daily life, and over-the-counter medications do not help.

The next step is to consult a general physician, who may refer the person to a rheumatologist or orthopedic surgeon.

To find out whether a patient has OA, the doctor may ask:

  • When and how did the pain start?
  • Where does it hurt?
  • Is there any stiffness, creaking, warmth, or swelling?
  • What makes it better? What makes it worse?
  • How have you treated it? Did home treatments work?
  • How have the symptoms affected daily activities?

The doctor will examine the knees, moving them forward and back to note the range of motion and to find out which movements cause pain.

They will look for areas of tenderness, check the warmth and see if any swelling is present. The physician will also check the ligaments for stability.

Diagnosis

A number of tests can help to diagnose OA:

  • Joint aspiration: The doctor uses a needle to draw a sample of fluid from the joint. They send the fluid to a laboratory for tests to check for signs of other joint problems, such as gout or infection.
  • Magnetic resonance imaging (MRI): This can provide detailed images of the knees, which may show fluid buildup in the thigh or knee bones.
  • X-rays: These can reveal damage to the knee joints in the later stages but may not detect changes in the early stages.

Lifestyle changes

Some lifestyle changes can relieve the pain and stiffness that occurs with knee arthritis:

Losing weight can relieve pain and prevent further joint damage.

For people with OA of the knee and either overweight or obesity, current guidelinesTrusted Source strongly recommend weight loss. A doctor can advise on how much weight to lose.

Exercise, and especially low-impact activities such as walking, riding a recumbent bicycle, or swimming, can relieve arthritis pain.

Swimming is ideal because the buoyancy of the water takes pressure off the joints, while the warmth soothes them.

Exercise increases motion and flexibility and strengthens the muscles that support the joints. It also helps people to maintain a healthy weight.

Takeaway

OA is a common but painful condition that affects many people as they age. Pain, stiffness, swelling, warmth, or cracking in the joints may be early signs that it is time to seek medical help.


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 Mallet Toe or Hammer Toe?

Article featured on Mercy Health

What is hammer toe or mallet toe?

Hammer toe is a foot abnormality that occurs because of imbalanced muscles, tendons, or ligaments around the toe. It typically impacts the second, third, or fourth toes. The toe appears like a hammer because it is bent in the middle joint of the toe.

Hammer toe can be healed with relatively simple treatments, but if left untreated may require surgery. Many people with hammer toe develop corns or calluses on the top of the middle joint of the toe or on the tip of the toe.

mallet toe is like hammer toe but impacts the joint closest to the tip of the toe.

Causes of hammer toe or mallet toe

There are many causes of hammer or mallet toe including:

  • Shoes that do not fit properly such as high-heeled shoes that do not have a proper toe box.
  • An impact such as jamming and breaking the toe can cause hammer toe or mallet toe.
  • Imbalanced toe muscles can cause toes to contract.

Risk factors for hammer toe or mallet toe

  • Age — hammer toe or mallet toe affect older people more than younger people but all ages can develop the conditions.
  • Gender — women are more likely to develop hammer or mallet toe.
  • Heredity — hammer toe or mallet toe can be passed down from parents.
  • Second toe length — a person who has a long second toe (longer than the big toe) is more likely to develop hammer or mallet toe.

Symptoms of hammer toe or mallet toe

Symptoms of hammer toe or mallet toe include:

  • Bend in the joint of the toe that is not typical
  • Pain when bending the toe
  • Corns or calluses that form from rubbing in shoes
  • Pain in the ball of the foot under the bent toe
  • Swelling and redness in the toe joint

Diagnosis of hammer toe or mallet toe

A primary care physician or an orthopedic specialist will diagnose hammer toe or mallet toe in a physical exam.

In order to get a better view of what is happening in the bones, joints, and muscles the physician may also order an x-ray.

Treatments for hammer toe or mallet toe

Treatments for hammer toe or mallet toe can be as simple as changing your shoes to surgery for the most severe cases. More advanced treatment options include:

  • Orthotics
  • Splint or brace
  • Rehabilitation or physical therapy

Recovery from hammer toe or mallet toe

Recovery after surgery to correct hammer toe can take as few as 2 weeks to as many as 3 months depending on the severity of the injury.

It is important to follow your physician’s instructions on resting your foot and choice of footwear during the healing process.

Patients who have surgery on the right foot will need to avoid driving for a few weeks to allow the injured toe to heal.


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 Manage & Prevent Arthritis in the Hands

Article featured on MedicalNewsToday

There is no known cure for arthritis, which commonly affects the hands. However, a person can take steps to lower the risk of arthritis developing or worsening and to reduce and manage pain. These steps include practicing specific exercises and making dietary changes and adjustments to daily habits.

Arthritis is a general term that describes several conditions that affect a person’s joints. There are more than 100 different types of arthritis. Arthritis is generally not preventable, but a person may be able to reduce their risk by changing the risk factors that they can control.

According to the Centers for Disease Control and Prevention (CDC)Trusted Source, the most common type of arthritis in the United States is osteoarthritis. Osteoarthritis can affect nearly any joint in the body, but it most commonly affects the joints in the knees, hips, and hands.

This article discusses how to reduce the risk of developing arthritis in the hands or prevent it from worsening. It also explains how to reduce and manage the pain of arthritis.

Osteoarthritis vs. rheumatoid arthritis

Osteoarthritis occurs over time as a person’s cartilage erodes, whether from general wear and tear or due to underlying inflammation. Once the cartilage has worn away enough, a person can experience pain and stiffness in their joints.

A person can take steps to help reduce the risk of osteoarthritis.

Rheumatoid arthritis is an autoimmune condition in which the body’s immune system attacks the joints.

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a combination of genetic and environmental factors triggers the development of rheumatoid arthritis.

These factors can activate the immune system years before symptoms appear.

Both osteoarthritis and rheumatoid arthritis often affect the hands and fingers, and they can both cause joint stiffness or difficulty moving the joint.

However, there are some differences between the two conditions.

Osteoarthritis often affects the last joint on the finger, which is the one closest to the tip. Rheumatoid arthritis typically does not affect this joint.

In addition, the NIAMS note that osteoarthritis stiffness usually goes away within 30 minutes of waking up or resting, whereas the pain and stiffness associated with rheumatoid arthritis tend to last longer than 30 minutes.

General arthritis prevention

Not all forms of arthritis are preventable. However, a person can take some steps to reduce their risk of developing osteoarthritis in their joints.

According to the CDC, these steps include:

  • stopping smoking, if a smoker, or avoiding secondhand smoke
  • achieving or maintaining a moderate weight, as this helps protect the joints throughout the body
  • seeking treatment for any signs of infection, which can damage the joints
  • protecting against injury by performing exercises and stretches or avoiding activities that carry the risk of injury
  • using tools that do not place undue stress on the joints
  • avoiding repetitive motion when possible

Preventing arthritis in the hands

A person can try several techniques to help prevent arthritis in the hands from becoming debilitating.

Hand exercises

Several exercises may help with preventing or alleviating arthritis pain in the hand and fingers.

A person should talk to a doctor or occupational therapist about the best routine or exercises to help prevent disease progression or worsening pain or stiffness.

One simple exercise that many people should be able to do is making a fist.

To do this, a person starts with their fingers and thumb straight out. Then, they curl their fingers slowly into their palm and close their thumb around the outside of their fingers.

The person should not squeeze the hand too tight during this exercise, but they should hold the fist position for 2–3 seconds before releasing it. They can then repeat the action 10 times.

Another exercise that a person can try to prevent or alleviate arthritis symptoms is squeezing a stress ball or a tennis ball. Similar to making a fist, the motion should be slow and deliberate.

Learn more about hand exercises for arthritis here.

Daily habit adjustments

People who have not developed arthritis can take steps to help prevent joint damage in their hands. Some tips for preventing joint damage include:

  • using an ergonomic keyboard and mouse when working at the computer
  • avoiding lifting heavy items that can put strain on the fingers and hand
  • using splints or braces to reduce the risk of injury when using the hands for repetitive activities, such as sewing or chopping food

Methods to reduce hand pain

If a person is living with pain in their hands from arthritis, they may wish to try:

  • practicing gentle motion hand exercises that promote movement and help reduce stiffness
  • seeking physical therapy and occupational therapy from certified professionals
  • talking to a doctor about medications and topical pain relievers to help with the pain

The Arthritis Foundation add that a person can also:

  • use hot or cold therapy
  • modify their daily routine to avoid putting stress on the hands and fingers
  • talk to a doctor about steroid injections

Some additional steps that a person can take to help prevent arthritis pain in the hands include:

  • using kinetic tape as a preventive measure
  • using dictation software instead of typing
  • avoiding placing excess strain on the fingers by using large joints, such as the elbows or shoulders, to carry the weight of shopping bags
  • using other body parts besides the hands to close a door
  • using the palm of the hand to hold a phone or tablet to avoid placing strain on the fingers
  • changing daily habits, such as stirring food using a shoulder motion
  • using utensils with large, easy-to-grip handles

A person should talk to a doctor if at-home methods or treatments are ineffective in managing their arthritis symptoms. It is possible that a doctor will recommend surgery as a treatment option.

Outlook

It is not possible to prevent arthritis, but a person may be able to manage the pain that it causes and slow its progression.

At-home techniques and modifications to everyday routines may help prevent pain and minimize the loss of joint function.

Summary

Arthritis is a common condition, and there are numerous different types.

Although arthritis is not usually preventable, a person can take some steps to help protect their joints and potentially reduce their risk of the disorder.

A person can also take several steps to manage the pain and discomfort of arthritis at home.

If at-home treatments do not work, a person can work with a doctor to identify therapies and treatments that may help.


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

6 Signs of Spinal Stenosis

Article feature on Spine-Health

Does your back, arm, or leg pain seem to come and go, depending on what you’re doing at the moment? This sign may indicate spinal stenosis.

Spinal stenosis happens when the bony openings for your spinal nerves (foramen) and/or the spinal cord (central canal) become narrow. This narrowing may compress your spinal cord and/or spinal nerves and can develop at various points along your spine. Spinal stenosis is a condition that’s more likely to occur in people over 60 years of age and tends to worsen as the years add up.

Here are 6 typical signs and symptoms to watch out for if you suspect your pain is from spinal stenosis. Depending on the type and location of the stenosis, one or more symptoms may be experienced:

1. Neurogenic claudication

When the nerves in your lower back get compressed, you may experience neurogenic claudication in your legs. Neurogenic claudication usually has the following characteristics:

  • Constant pain and/or numbness in your legs while standing
  • Increased pain and/or numbness in your legs while walking variable distances and/or while bending the spine backward
  • Difficulty in performing upright exercises or activities
  • Improvement or resolution of pain and/or numbness with rest

Neurogenic claudication pain is typically relieved when you bend your spine forward (such as while leaning on a shopping cart/walker, squatting, or sitting and leaning forward).

Your doctor will likely need to differentiate this pain from vascular claudication, which can mimic neurogenic claudication.

2. Sciatica

Compression of the nerve roots in your lower back may lead to lumbar radiculopathy or sciatica (depending on the nerve roots affected). Sciatica is experienced as nerve pain and weakness typically felt in one leg at a time.

Depending on the nerve root(s) affected, pain may occur in your lower back, buttock, thigh, calf, leg, and/or foot. A pins-and-needles sensation, tingling, weakness, and/or numbness may also occur in the areas affected by pain.

3. Foot drop

Compression of the L4 and L5 nerve roots in the lower spine may cause motor weakness in your foot, resulting in foot drop. This condition typically causes a feeling of weakness while attempting to lift the foot and/or toes upward. As a result, the individual may involuntarily drag their foot or tend to trip while attempting to walk.

The compression of the S1 nerve root may cause weakness while walking on tip-toes.

4. Gait problems

Spinal stenosis can affect walking in different ways depending on its location within the spine, for example:

  • Lumbar spinal stenosis (in the lower back) may cause gait problems due to foot drop. The condition may also cause weakness in thigh and leg muscles, such as the quadriceps and the calves.
  • Cervical spinal stenosis (in the neck) with spinal cord compression may cause difficulty in maintaining balance while walking, especially in the dark. However, cervical spine stenosis with a pinched nerve does not cause gait imbalance.

Changes in gait may be too subtle to notice at first. Over time, the condition may present with progressively increasing falls.

5. Radiating arm pain

Cervical spinal stenosis may cause mild to moderate burning or shock-like pain in the neck, shoulder, and/or arms. Abnormal sensations, such as tingling, crawling, and/or numbness may be felt in both hands. The arms and hands may feel weak.

6. Loss of fine motor skills

Spinal stenosis in the cervical spine may cause difficulty in doing tasks that involve fine motor skills of the hand, such as buttoning a shirt. In the advanced stages, there may be difficulty with writing, eventually making holding a pen impossible.

If these symptoms sound familiar, check with your doctor, since spinal stenosis may get worse without treatment.

Red-flag signs and symptoms of spinal stenosis

Rarely, severe spinal stenosis may cause red-flag symptoms, such as bowel and/or bladder incontinence, numbness in the inner thighs and genital area, and/or severe weakness in both legs.

These symptoms indicate a serious medical condition, such as cauda equina syndrome, which must be treated urgently to prevent permanent loss of function in the legs.

An accurate diagnosis by a medical professional is necessary to determine the underlying cause of spinal stenosis. Depending on the cause and severity, your doctor may suggest nonsurgical treatments, such as physical therapy, pain-relieving medications, and/or activity modification. Sometimes, minimally invasive procedures, such as epidural steroid injections may be advised. Surgery is rarely advocated as the first-line treatment unless there are severe symptoms or neurologic deficits.


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

Manage Rheumatoid Arthritis Pain With 7 Essential Everyday Exercises

Article featured on Healthline

If you have rheumatoid arthritis (RA), you may know that exercise is good for you. But finding the time, energy, and motivation to actually get moving may be difficult. This can be especially true when you’re dealing with painful, stiff joints.

Exercise can help people living with RA:

  • reduce pain
  • improve joint function
  • strengthen muscles around the affected joints
  • boost energy
  • enhance mood
  • improve day-to-day functioning

Here are seven types of exercise that can be especially beneficial for people living with RA.

Water exercise

The Centers for Disease Control and Prevention report that people living with RA show greater improvements in health after participating in hydrotherapy, or exercising in warm water, compared with other types of activities.

Results from a large research review found that people living with RA who participated in hydrotherapy experienced less pain and joint tenderness compared with those who didn’t try this activity. The research also suggested that hydrotherapy may also help boost mood and overall well-being.

Water-based exercises, like swimming and water aerobics, may also help improve the use of affected joints and decrease pain.

Tai chi

Tai chi, which is sometimes called “moving meditation,” is a traditional Chinese martial art that combines slow and gentle movements with mental focus. This exercise improves muscle function and stiffness and reduces pain and stress levels in people living with RA.

Results from one study of people living with RA found that practicing tai chi can help reduce anxiety and depression and improve self-esteem, self-efficacy, and motivation.

To get started, you can purchase DVDs, follow an online program, or sign up for a class in your area.

Biking

If you have RA, getting your heart pumping is essential. This is because those living with RA are at a higher risk for cardiovascular diseases and complications. Biking is one type of exercise that offers heart-healthy benefits. It’s an excellent, low impact exercise that’s easier on the joints than other aerobic exercises.

Biking can help maintain cardiovascular health, increase leg strength, and reduce morning stiffness. You can bike outside, join a cycling group, or use a stationary bike at the gym or in your home.

Walking

A walk in the park may sound too simple, but it’s one of the easiest and most convenient forms of exercise.

In addition to getting your heart rate up, walking can help loosen your joints and reduce pain. Research published in 2015 suggests that just 30 minutes of walking a day can boost your mood, too.

If you’re having trouble with balance, try using walking poles to help stabilize yourself. If the weather has you stuck inside, consider heading to an indoor track or hopping on a treadmill instead.

Yoga

Yoga, which combines postures with breathing and relaxation, can also help improve RA symptoms. A 2013 study looked at the quality-of-life impact Iyengar yoga had on a small group of young women living with RA. The research showed that practicing yoga improved their pain and mood.

In research published in 2015, scientists from Johns Hopkins University found similar results: People living with RA experienced fewer tender and swollen joints after practicing yoga than they did beforehand. The research involved a small group of adults ages 18 years and older living sedentary lifestyles.

“Yoga or yoga stretching can help patients improve flexibility and range of motion,” says Dr. Mario Siervo, a primary care physician in Florida.

Other types of stretching

Healthcare professionals often recommend stretching for people living with RA.

“Stretching should include the muscles of your arms, your back, your hips, the front and back of your thighs, and calves,” says Dr. Philip Conwisar, an orthopedic surgeon in California. “Do some stretches first thing in the morning, take a stretch break instead of a coffee break, or stretch in the office for a few minutes.”

Dr. Naheed Ali, author of “Arthritis and You,” also recommends finger curling, mild wrist bending, and thumb stretching.

Strength training

RA often leads to weakened muscles, which can worsen joint pain. Strength training helps increase muscle strength. Stronger muscles better support your joints, which can decrease pain and make daily activities easier.

Try lifting weights at home two to three times a week. You can also use resistance bands as long as it does not increase the risk of causing RA complications or worsen current RA impact in your fingers and wrists.

Talk with your doctor and consider working with a personal trainer if you’re not sure about lifting weights or using resistance bands on your own.

Adjust to your condition

Whichever exercise you choose, the important thing is to keep at it.

Some days you’re likely to feel more pain than others. When that happens, aim to exercise with less intensity, try a new low impact exercise, or take the day off.

If you do not have enough hand strength to grip a weight, you might want to consider using a resistance band around your forearm instead.

If you’re having a day where walking seems like the best option, consider going for a stroll outside or walking inside. Even if you need to walk at a slower pace, you can still benefit from the exercise because it has the potential to help you feel much better afterward.


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 Treat & Identify Calf Pain

Article featured on Cleveland Clinic

What is calf muscle pain?

Calf muscle pain can be a dull ache or a sharp pain in the back of your leg, behind your shinbone. It can feel a little different for everyone. If you get pain when you’ve been doing something physical like walking or running, the cause is generally muscular. But if the pain comes on suddenly without a clear cause, it could be a problem with your blood vessels.

Who gets calf muscle pain?

Anyone can get calf muscle pain. It’s more common in athletes and people who exercise and put excess stress on their calf muscles. People over age 65 are also at a higher risk of lower leg pain due to muscle weakness, certain health conditions or if they’ve been inactive.

Other factors that can make calf muscle pain more likely include:

  • Certain medications, including cholesterol-lowering drugs.
  • Diseases such as hypothyroidism (underactive thyroid gland), liver disease, kidney disease, diabetes or peripheral artery disease (PAD).
  • Edema (swelling due to fluid build-up) in your lower leg.
  • Heat exhaustion.
  • Low electrolytes due to dehydration or dialysis (a procedure to clean your blood).
  • Pregnancy.
  • Short or tight calf muscles.
  • Smoking or using tobacco products.

Possible Causes

What causes calf muscle pain?

Calf muscle pain can have a variety of causes, including:

  • Claudication: Narrowed arteries can prevent your calf muscles from receiving enough blood, which deprives them of oxygen. Intermittent claudication can cause muscle pain when you exercise or walk. It’s especially common in people who smoke or who have diabetes or PAD.
  • Contusions: A direct blow to a muscle, such as a kick in the calf, can damage your muscle tissue without breaking your skin. Calf contusions usually cause bruising and soreness. Severe contusions can lead to compartment syndrome, a dangerous condition that prevents blood from getting to your leg muscles.
  • Cramps: Leg cramps occur when the muscles suddenly contract (shorten), causing a painful muscle spasm. A calf cramp is often called a “charley horse.” Cramps can be the result of dehydration or overexertion. A cramp might last for just a few seconds, but your muscle can feel sore for hours afterward. Leg cramps and calf muscle pain at night are very common.
  • Deep vein thrombosis (DVT): In rare cases, what seems like calf muscle pain can actually be DVT. This is a serious condition that causes a blood clot to form in your lower leg. It can lead to a pulmonary embolism, which is life-threatening.
  • Strains: A pulled calf muscle, or a calf muscle strain, occurs when you overstretch your calf muscles. Severe overstretching can cause a torn calf muscle.
  • Tendonitis: Tendons attach your calf muscles to bones in your leg. Tendonitis (tendon inflammation) can put pressure on your calf muscle or make it painful for the muscle to work.

Care & Treatment

How is calf muscle pain treated?

You can usually treat mild calf muscle pain at home using the RICE method:

  • Rest: Avoid walking or running with calf muscle pain. Don’t push through pain, which can make the problem worse.
  • Ice: Put an ice pack or cold compress on your calf muscles for 20 minutes every two hours. Don’t apply ice directly to your skin.
  • Compression: Apply a compression bandage or wrap to your calf. Compression helps reduce blood flow to the painful area and minimize swelling.
  • Elevation: Lift your leg into an elevated position, preferably above the level of your heart. Support the entire length of your leg with pillows, blankets or cushions.

If you have sore calves from a muscle cramp or feel a painful knot in your calf muscle, it may help to gently stretch your calf.

Your healthcare provider may recommend additional treatments depending on the cause of your calf pain, including:

  • Pain relievers.
  • Physical therapy.
  • Soft cast or boot to immobilize your lower leg in the case of a strain or tear.

How is vascular calf muscle pain treated?

If your healthcare provider determines your calf muscle pain is the result of claudication, treatments may include:

  • Diet modification to reduce your intake of sodium (salt), cholesterol, saturated fat and sugar.
  • Exercise.
  • Medications to manage high blood pressure, cholesterol and diabetes.
  • Medication to prevent or treat blood clots.
  • Medications to improve blood flow in the legs.
  • Quitting smoking and using tobacco products.

Will I need surgery for calf muscle pain?

Most people don’t need surgery for calf muscle pain. In rare cases, people need surgery for torn calf muscles, blood clots or blocked arteries in the calf.

When to Call a Doctor

When should I contact my doctor about calf muscle pain?

Contact your doctor if you have:

  • Discoloration, such as very pale or bluish skin, in your leg, feet or toes.
  • Problems moving or walking.
  • Severe or sudden calf pain.
  • Swelling in your calf or anywhere in your lower leg.

Calf muscle pain is a common complaint and isn’t usually cause for alarm. But sometimes pain in your calf is a sign of a more serious condition, such as problems with the blood vessels in your leg. Seek help if the pain developed without activity or persists even with rest. This could be a sign of a more severe condition that needs to be evaluated.


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

3 Common Causes of Heel Pain & How it is Treated

Article featured on NY Orthopedics

Heel pain is one of the most common complaints of patients with foot and ankle disorders — but what causes heel pain, exactly? The pain often occurs at the back surface of the heel and can limit any standing, walking, or running activities. Explore our guide to the common causes of heel pain to learn how a foot and ankle specialist can get you back on your feet in no time.

Why Does My Heel Hurt?

Heel pain is not typically caused by a single injury, like a twist or fall, but from repetitive stress and pounding of the heel. Common heel pain causes include:

  • Plantar fasciitis. Too much running or jumping can inflame the fascia (tissue band) that connects the heel bone to the base of the toes. The pain, centered under your heel, may be mild at first but flares up when you take your first steps in the morning. Muscle cramps in the calf may also occur if the Achilles tendon tightens as well. If plantar fasciitis is left untreated, it may lead to heel spurs.
  • Stress fracture. This is often linked to repetitive stress to the bone over a short period of time, especially in young athletes who alter their training regimen suddenly. This may include more sprints, increased mileage while running, or increased training intensity. Stress fractures can also be caused by osteoporosis.
  • Achilles tendonitis. Achilles tendonitis occurs when the tendon that attaches to the calf muscles to the heel becomes inflamed or painful due to overuse. Any activity that requires pushing off — like basketball or running — can result in tendonitis.

How Can Heel Pain Be Treated?

Treatment for heel pain varies depending on the severity of the injury and your health goals. Your foot and ankle specialist may first suggest some home remedies — like rest, applying ice to the heel, and over-the-counter pain medications — to ease your symptoms. If your heel pain doesn’t get better within a few weeks, you should make an appointment with your doctor so that they can provide you with the appropriate treatment.

Your doctor may prescribe physical therapy in most cases. This can help strengthen the tendons and muscles in your foot, helping to prevent further injury. If your pain is severe, your foot and ankle specialist may provide you with anti-inflammatory medications that can be injected into the foot or taken orally. They may also recommend that you support your foot as much as possible — either by using orthotics or taping the foot.

In very rare cases, your foot and ankle specialist may recommend surgery to correct the problem.


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

Painful Knee Caps: What Causes Them?

Article featured on The Noyes Knee Institute

Pain in the knee caps (patella) is caused by several factors, ranging from old age and overuse to injury and infection. A strenuous activity during the day can cause mild discomfort around the knee, which heals with rest and sleep. Knee cap pain can also be persistent and chronic, calling for the services of an experienced orthopedic knee surgeon. Here’s an overview of the five leading causes of knee cap pain:

1. Knee Overuse

The patella is a knee joint bone structure that suffers wear and tear. Your knee supports walking, jogging, running, jumping, kneeling, and squatting. Straining the knee joint through overuse can result in pain and discomfort around the patella. Knee cap pain resulting from overuse may stop if the strenuous activity is ceased or moderated. Other cases trigger a degenerative process with intermittent and worsening pain.

2. Knee Injury

The knee cap protects the rest of the knee joint structures, including ligaments, cartilages, and muscles. A traumatic blow to the front of the knee area is likely to hurt the patella first, resulting in severe pain. A knee injury can result from falling, participation in sports, a car crash, or other situation strenuous situations. Pain from injury may go away with functional medicine and physical therapy, but occasionally requires knee surgery to repair the damage.

3. Chondromalacia Patellae

Knee cap pain can stem from Chondromalacia, a condition in which the cartilage found behind the patella softens. Normal cartilage is tough and flexible to protect the ends of the joint bones from rubbing on each other. When the cartilage becomes soft, the shinbone and thighbone can move too close to each other or even touch. Chondromalacia weakens cushioning and shock absorption capabilities, resulting in pain around the knee joint, including the patella. With rest and treatment, this condition can heal.

4. Patellofemoral Pain Syndrome (PFS)

PFS or runner’s knee is a widespread condition highlighted by pain behind the knee cap area. It develops when the knee joint moves abruptly. PFS also results from knee overuse through running, cycling, climbing, and other strenuous activities. Pain levels vary from mild to severe and are felt around the front of the knee (patella). Runner’s knee is common among athletes and starts as dull recurring pain. This condition is reversible.

5. Muscle Imbalances & Tendonitis

The knee joint relies on the thigh, hip, and knee muscles, which work in tandem to ensure proper movement and support. Injury or imbalance can result in the wrong movements and reflexes, causing pain and inflammation. Conditions like tendonitis inflame the patellar tendons and quadriceps tendons, causing stiffness, tenderness, swelling, and knee pain. Injury, disease, or infection on one of the connected muscles and tendons can cause pain.

Working With a Trusted Orthopedic Knee Surgeon

Knee cap pain can be reversed with rest and sleep, but some conditions are severe and require proper medical attention. Others will need a corrective operation from a licensed orthopedic knee surgeon.


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