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Causes & Treatments for Fibromyalgia

Article featured on Brigham’s and Women’s Hospital

Fibromyalgia is a chronic condition characterized by widespread pain in muscles and soft tissues throughout the body. It often brings fatigue, sleep disturbances, and cognitive challenges known as “fibro fog.” Although the exact cause remains unclear, researchers link it to stress, sleep issues, and possible biochemical or immune factors. While there’s no cure, a combination of medical treatments, exercise, and lifestyle changes can help manage symptoms and improve quality of life. Understanding fibromyalgia is the first step toward taking control of the condition.

What is fibromyalgia?

Fibromyalgia is a condition that causes pain in muscles and soft tissues all over the body. It is an ongoing (chronic) condition. It can affect your neck, shoulders, back, chest, hips, buttocks, arms, and legs. The pain may be worse in the morning and evening. Sometimes, the pain may last all day long. The pain may get worse with activity, cold or damp weather, anxiety, and stress. This condition is more often diagnosed in people between the ages of 20 and 50. It is most common in middle-aged women.

What causes fibromyalgia?

The cause is unknown. Researchers think there may be a link with sleep problems and stress. It may also be linked to immune, endocrine, or biochemical problems.

What are the symptoms of fibromyalgia?

Each person’s symptoms may vary. But chronic pain is the most common symptom. The pain most often affects the muscles and the points where muscles attach to bones. These are the ligaments and tendons.

Pain may start in 1 part of your body, such as your neck and shoulders. But any part of the body may be affected. The pain ranges from mild to severe, with “flare ups” and times of improvement. The discomfort from fibromyalgia may feel like burning, soreness, stiffness, aching, or gnawing pain, often times with sore spots in certain parts of your muscles. The pain may feel like arthritis. But it doesn’t damage muscles or bones.

Other common symptoms of fibromyalgia include:

Medium to severe tiredness (fatigue)
Less exercise endurance
Sleep problems at night
Depressed mood
Anxiety
Headaches
Irritable bowel symptoms, such as belly (abdominal) pain and bloating, diarrhea, and constipation
Restless legs
Painful menstrual periods
Trouble thinking clearly (called “fibro fog”)

These symptoms can seem like other health conditions. Make sure to see your healthcare provider for a diagnosis.

How is fibromyalgia diagnosed?

There are no tests that can confirm a diagnosis of fibromyalgia. Instead, diagnosis is based on your symptoms, a physical exam, and possibly ruling out other conditions.

How is fibromyalgia treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

There is no known cure for fibromyalgia, but symptoms can be managed. Mild cases may get better with stress reduction or lifestyle changes. More severe cases may need to be treated with a healthcare team approach. This may include your primary healthcare provider, a specialist called a rheumatologist, a physical therapist, and a pain management clinic. Treatment may include:

Anti-inflammatory medicines to ease pain and help you sleep
Other pain medicines
Medicines approved for treating fibromyalgia (duloxetine, pregabalin, and milnacipran)
Medicines to ease depression (antidepressants)
Exercise (low impact) and physical therapy to stretch muscles and improve cardiovascular fitness
Relaxation methods or cognitive behavioral therapy
Heat or cold treatments
Alternative treatments, such as acupuncture and chiropractic or massage therapy

Talk with your healthcare providers about the risks, benefits, and possible side effects of all medicines.

Living with fibromyalgia

Fibromyalgia is a chronic condition, but it may be managed by working with your healthcare providers. In addition to medicines, lifestyle changes can help symptoms. These include getting enough sleep and exercise.

When should I call my healthcare provider?

If your symptoms get worse or you have new symptoms, tell your healthcare provider.

Key points about fibromyalgia

Fibromyalgia is a chronic condition that causes pain in muscles and soft tissues all over the body.
Researchers think it may be linked to sleep problems, stress, or immune, endocrine, or biochemical problems.
Symptoms may also include lack of energy (fatigue), sleep problems, depression, headaches, and other problems.
There is no known cure, but symptoms can be managed.
Treatments may include medicine, exercise, relaxation, heat or cold, and massage.

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 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 Trigger Finger?

in Hand Injuries

Article featured on MedicineNet

A trigger finger is a condition that can turn simple hand movements into a frustrating experience, often causing pain and discomfort. From gardening to repetitive motions, certain activities can put your fingers at risk. Learn about the causes, symptoms, treatments, and prevention tips to keep your hands healthy and functional.

A trigger finger is a “snapping” or “locking” condition of any of the digits of the hand when opening or closing. Stenosing tenosynovitis is the medical term for the trigger finger.

What causes trigger finger?

Local swelling from inflammation or scarring of the tendon sheath (tenosynovium) around the flexor tendons causes trigger fingers. These tendons normally pull the affected digit inward toward the palm (flexion). When they are inflamed, they tend to catch where they normally slide through the tendon sheath.

Usually, the trigger finger occurs as an isolated condition because of repetitive trauma. Activities such as gardening, pruning, and clipping are risk factors for trigger fingers. Sometimes, the trigger finger is an associated condition resulting from an underlying illness or medical condition that causes inflammation of tissues of the hand, such as rheumatoid arthritis.

Data presented at the 2005 American College of Rheumatology national meeting suggested that a majority of patients with rheumatoid arthritis have inflammation around the tendons of the palm that could develop into trigger fingers. The trigger finger most often affects the right or left index finger, the digits likely to pull the trigger on a gun.

What are the symptoms of trigger finger?

Symptoms and signs of trigger finger may occur when any of the four fingers of the hand attempts to flex closed while gripping. Instead of a smooth, continual closure, the digit hesitates, then snaps closed (causing a “trigger” effect), and is associated with a stiffness sensation of the digit. Symptoms and signs may occur in more than one digit.

When attempting to extend the digit, a similar hesitation may occur before it “snaps” into full extension. In severe cases, people must manually bring the digits into full extension or flexion because of the stiffness. The closure is frequently associated with pain at the base of the finger on the palm. Sometimes it’s possible to feel a tender nodule in the area of the inflamed tendon. There may be mild swelling in the affected area of the palm.

Triggering can also affect the thumb (trigger thumb, De Quervain syndrome), so many clinicians include the thumb in the diagnosis of the trigger finger.

Diagnosis of trigger finger

Primary care doctors, including general practitioners, family medicine physicians, and internists, commonly diagnose the trigger finger. Specialists who treat trigger fingers include orthopedic surgeons, sports-medicine doctors, plastic surgeons, hand surgeons, and rheumatologists. Occupational therapists and physical therapists can be involved in the care of patients with trigger fingers.

Health care professionals diagnose trigger fingers based on the history of “snapping” sensation that the patient experiences, as well as noting in the physical examination that there is tenderness and nodular irregularity of the involved flexor tendon in the palm. Typically, the nodule is not visible but can be felt in the palm. There can be contracture of the affected digit into a bent position.

What are the treatments for trigger finger?

Stretching, ice, and anti-inflammation treatments can be helpful. Oral anti-inflammatory medications may be helpful.

The quickest and most effective treatment is a local cortisone injection into the tendon sheath around the affected tendon. Most patients will respond well to the steroid injection . A trigger finger can recur after a period of normal function.

When a trigger finger persists after two steroid injections and is not responsive to the above nonsurgical treatments, consider surgical procedures to release the tendon sheath and/or remove the inflamed or scarred tissue. Trigger finger surgery is usually a permanent cure for this condition.

Initially, people can treat trigger fingers at home with remedies including cold packs, resting, and over-the-counter medications, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen. Massaging the involved area of the palm gently followed by a cold pack application can be helpful. Take care to avoid reinjuring the strained tendon in the palm.

What is the prognosis of trigger finger?

The prognosis of the trigger finger is excellent. Nearly all patients recover completely after medical professionals administer cortisone injections and the tendon again glides freely through the tendon sheath. Sometimes it may be necessary to get repeat injections. Surgical treatments may be necessary for rare instances.

Is it possible to prevent trigger finger?

People can prevent trigger fingers by avoiding activities that strain the finger flexor tendons in the palms of the hands.

Understanding Hip Osteoarthritis: Causes and Symptoms

in Hip Conditions, Osteoarthritis

Article featured on Orthopaedic Associates

Hip osteoarthritis is a condition that many people have heard of but often do not fully understand. It is a problem that affects the joints in your hips, causing pain and stiffness. While it is commonly seen in older adults, it can actually affect people of all ages.

Let’s explore what hip osteoarthritis is, why it happens, and what symptoms to look out for.

Causes of Hip Osteoarthritis

Hip osteoarthritis develops when the hip cartilage tissues wear down over time. Several factors can contribute to the development of hip osteoarthritis, and understanding these causes is essential for effective prevention and management.

Let us explore the primary causes in more detail:

Age-Related Wear and Tear

One of the most common causes of hip osteoarthritis is the natural aging process. As we age, the cartilage cushions the hip joint may gradually wear down. This age-related wear and tear can lead to the development of osteoarthritis.

It is important to note that while aging is a significant risk factor, hip osteoarthritis can occur at any age.

Genetic Factors

Genetics can play a role in the development of hip osteoarthritis. If you have a family history of osteoarthritis, you may be genetically predisposed to the condition.

Certain genetic traits can affect the structure and stability of your joints, increasing the likelihood of osteoarthritis development.

Obesity and Lifestyle Factors

Carrying excess weight places additional stress on the hip joints. The more weight the hips have to support, the greater the risk of developing osteoarthritis.

Additionally, a sedentary lifestyle with limited physical activity can contribute to muscle weakness and joint stiffness, further increasing the risk.

Injuries and Joint Damage

Past injuries or trauma to the hip joint can increase the risk of hip osteoarthritis, even if the injury occurred years ago.

Fractures, dislocations, or other joint injuries may:

Lead to long-term damage and joint instability
Contribute to the development of osteoarthritis

Overuse and Repetitive Motion

Engaging in activities or occupations that involve repetitive hip movements can lead to overuse and strain on the joint.

Athletes or individuals with physically demanding jobs may be at a higher risk of hip osteoarthritis due to the constant stress placed on the hip joint.

Congenital Abnormalities

In some cases, congenital abnormalities or structural issues present from birth can predispose individuals to hip osteoarthritis.

These abnormalities can affect the alignment and stability of the hip joint, leading to increased wear and tear over time.

Understanding these causes allows individuals to take proactive steps, such as:

Maintaining a healthy weight
Staying physically active
Seeking medical attention for injuries

Early intervention and lifestyle adjustments can make a significant difference in managing this condition effectively.

Symptoms of Hip Osteoarthritis

Hip osteoarthritis typically begins with subtle warning signs that may be easy to dismiss. Early symptoms often include:

Stiffness: You may notice stiffness in your hip joint, especially in the morning or after prolonged periods of inactivity.
Discomfort: A mild, nagging discomfort in the hip region is common. It might feel like a dull ache.
Reduced Range of Motion: You may find it slightly harder to move your hip as freely as before, particularly when trying to rotate or flex.

Progression of Symptoms

As hip osteoarthritis progresses, these initial warning signs can intensify. You may experience:

Pain: The discomfort can evolve into more pronounced pain. This pain might interfere with your daily activities and sleep.
Limping: To alleviate pain, you might start to favor one leg over the other, resulting in a noticeable limp.
Crepitus: You could hear or feel a grinding or popping sensation in the hip joint when moving.
Loss of Flexibility: The range of motion in your hip may become significantly restricted, making simple tasks challenging.

Impact on Daily Life

The impact of hip osteoarthritis on daily life can be substantial. Chronic pain and reduced mobility can affect your ability to perform everyday activities, such as:

Walking: You may find it painful to take even short walks.
Climbing Stairs: Going up and down stairs can become a challenging task.
Sitting and Standing: Transitions between sitting and standing can be uncomfortable.

It is important to recognize these symptoms early on and seek medical attention to prevent the condition from worsening.

Understanding these signs can help individuals take proactive steps toward managing hip osteoarthritis effectively.

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

Does a Herniated Disc Need Surgery to Heal?

in Back Pain, Herniated Disk

Article featured on NY Orthopedics

Back pain is one of the most common types of pain you are likely to encounter, whether that’s due to pushing yourself too hard on the field or just a result of aging. A herniated disc is one common cause of back pain that can bring people a bit of anxiety when diagnosed. The most common question people have is whether they will need surgery to relieve their pain.

To answer these questions, let’s go over what a herniated disc is and what causes it. We’ll also look at some common ways doctors treat a herniated disc and when surgery is the right decision.

What is a Herniated Disc?

Your spinal column is made up of multiple vertebrae stacked upon one another. Between each vertebra is a thin disc composed of a soft nucleus surrounded by a thick layer of tissue called the annulus. These discs act as a shock absorber that provides support to the spine every time you move.

A herniated disc occurs when the disc’s nucleus starts protruding outside the annulus and into the spinal canal. As time goes on, the disc starts putting more pressure on spinal nerves within your spinal column, causing a range of symptoms that include:

Numbness and tingling in other body parts
Weakness in the legs or hands that make daily activities a chore
Pain you may feel in the lower back and other parts, like arms, legs, feet, and buttocks.

What Causes a Herniated Disc?

While injuries or sprains can certainly cause a herniated disc, it’s more commonly the cause of natural wear and tear as we age. As we get older, the annulus becomes more prone to tears, increasing the chances that a disc might slip during activity. There are also a few risk factors that can increase your chances of getting a herniated disc:

Weight. The more weight placed on the vertebrae, the greater the chance a disc might slip.
Sedentary lifestyles. Staying active and increasing physical strength helps to support the back and put less stress on the spinal column.
Rigorous jobs. If your occupation requires a lot of heavy lifting, it may increase your chances of a herniated disc.

Smoking. Studies show that tobacco can decrease oxygen to the spinal column, increasing the chances that disc tissue will break down.
Genetics. People with family histories of herniated discs are more at risk.

What Are Some Common Herniated Disc Treatments

If you’re diagnosed with a herniated disc, that does not mean you require surgery. Depending on the severity of your herniated disc, you may only require conservative, non-surgical treatments to eliminate any pain you may feel. Some common, non-surgical treatments include:

Light activity to reduce inflammation
NSAIDs to help relieve mild pain. In some cases, a doctor may opt for a spinal injection to better target the area of the herniated disc.
Routine physical therapy to strengthen the muscles and put less stress on the discs.

In more severe cases, surgery may be required to correct a herniated disc if more conservative treatments are ineffective. The most common surgical procedure is a discectomy, where a doctor will remove the damaged portion of a disc. This type of surgery is performed more often with herniated discs that cause arm and leg pain. If possible, a surgeon will opt for a microdiscectomy which is less invasive than traditional discectomies, where a large incision is made to remove the entire affected disc.

What Should I Expect During a Herniated Disc Surgery?

During a microdiscectomy, a surgeon will place you under general anesthesia. From there, a surgeon may choose one of several approaches to reach the affected disc:

Midline Microdiscectomy. Here the surgeon will make a small incision in the back and lift the nearby muscles away from the vertebrae. They will then hold the layers of muscle back as they remove portions of the damaged disc.
Tubular Microdiscectomy. During this procedure, a surgeon will make a tiny incision and insert small tubes through the muscle to give them access to the damaged disc.
Endoscopic Microdiscectomy. A surgeon makes a microincision in the back and inserts a small camera and instruments to remove the damaged tissue. This helps provide the least amount of trauma to the surrounding muscles and tissue.

What Does Recovery Look Like for a Herniated Disc?

Recovery times from a discectomy can vary depending on the type of procedure performed. However, a doctor will generally suggest around two to three weeks of rest to allow the tissue to heal. Typically, it will take around six weeks before most patients will be cleared to return to work.

A doctor will likely suggest routine physical therapy around three weeks in to help strengthen the muscles and speed recovery. People who work in sedentary jobs that require a lot of sitting should be conscious of their posture and try not to place any additional stress on their back as it heals.

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

Chronic vs. Acute Rotator Cuffs

in Shoulder Injuries

Article featured on Modern Orthopaedics of New Jersey

Shoulder pain can be a common day-to-day occurrence. We’ve all experienced it at some point. However, if that pain lingers for a long time and affects your life on a day-to-day basis, it may be a sign there’s a bigger problem.

A rotator cuff tear is the most common reason for excessive and excruciating shoulder pain. The best way to determine if your shoulder pain is due to a rotator cuff tear is to see an orthopedic surgeon who specializes in treating the shoulder and who can evaluate and diagnose the underlying cause of your shoulder pain. This is done by taking a detailed history, performing a physical exam, and ordering shoulder X-Rays and, if necessary, a shoulder MRI.

However, not all rotator cuff injuries are the same. In fact, there are two different types of rotator cuff tears: Acute rotator cuff tears and chronic rotator cuff tears.

We’ll explain everything you need to know about rotator cuff tears and how acute and chronic tears differ.

The Rotator Cuff

The shoulder is essentially a ball-and-socket joint, but the socket is very shallow. The best way to think of this joint is a golf ball on a tee, but tipped 90 degrees to the side! The ball is the head of the humerus (the upper arm bone) and it fits into the socket of the shoulder blade called the glenoid. The humeral head (“the golf ball”) is stabilized against the glenoid (“the tee”) by the rotator cuff tendons, which tension the humeral head onto the glenoid and prevent it from sliding off. The rotator cuff tendons are part of a 4-muscle complex that both stabilizes the shoulder joint and generates movement of the arm for elevation, internal rotation, and external rotation. Without the rotator cuff, the humeral head will start to slide off the glenoid and bump into the surrounding structures, often causing pain and difficulty moving the arm into elevation or rotation.

The rotator cuff consists of four muscles that each have an essential role to play:

Supraspinatus: This muscle holds your humerus in place and helps your arm maintain its stability. It also assists with elevation of your arm. The supraspinatus tendon is the most commonly torn tendon.
Infraspinatus: The main muscle of the four that facilitates shoulder external rotation.
Teres Minor: This muscle is the smallest, but it also helps your shoulder with external rotation (rotation of your arm away from your body).
Subscapularis: This muscle holds your upper arm to your shoulder blade and is the only cuff muscle that is responsible for internal rotation of your shoulder.

All four muscles begin at the shoulder blade and cross the shoulder joint as they combine into a “cuff” of tendons that attach onto the humeral head. Because these muscles all must work in unison, one or more torn muscles can cause extreme discomfort and dysfunction.

What’s a Rotator Cuff Tear?

The rotator cuff tendons of the shoulder are very susceptible to gradual “atraumatic” tears over time from repetitive use, and acute “traumatic” tears that can occur from a sudden violent force imparted onto the shoulder like from a fall or while playing sports. When the rotator cuff is torn, it is often painful, particularly if the tear is traumatic. Rotator cuff tears can also cause biomechanical dysfunction, leading to an inability to elevate the shoulder.

Chronic Rotator Cuff Tears

Chronic tears are often due to degeneration of the rotator cuff tendon tissue over time. Over the years our muscles and tendons can degenerate. People over 40 years old are at higher risk of developing a rotator cuff tear. A chronic, “atraumatic” type of tear is typically the result of wear and tear over time from overuse in an aging rotator cuff. These rotator cuff tears often begin as partial tears, meaning the tendons aren’t completely torn. A partial rotator cuff tear can progress to a full-thickness, or complete tear over time, disconnecting one or more of the affected muscles from its connection to the humeral head. Some of the most common causes of chronic rotator cuff tears occur in folks who have manual labor jobs in which they perform repetitive overhead activities with heavy loads.

Some risk factors for chronic rotator cuff tears include the following:

Repetitive Motion: Sports like baseball, tennis, rowing, or jobs that require repetitive motion can cause overuse in the shoulder joint and cause a degenerative cuff tear.
Decreased Blood Supply: As we age, the blood supply within the rotator cuff tendon decreases, making it harder for the body to heal a tear.
Bone Spurs: Bone overgrowth and spurs on the acromion bone can develop due to age. The spurs can sometimes impinge or rub against the rotator cuff tendons, creating a tear.

Acute Rotator Cuff Tears

Most acute rotator cuff tears happen during a fall or from lifting a heavy object. Many people sustain this type of injury from overstretching their arm or lifting something heavy with a quick-jerk motion. An acute tear can also occur in conjunction with other injuries, such as a broken collarbone or a dislocated or separated shoulder. Acute partial rotator cuff tears have a higher potential to heal than a chronic “atraumatic” partial rotator cuff tears. An acute partial tendon tear can take roughly six to eight weeks to heal if the tear is minor.

Rotator Cuff Tear Symptoms

Some more common symptoms of a rotator cuff tear include:

Pain in the shoulder while at rest
Pain that awakens you from sleep
Pain from lying on the affected shoulder
Shoulder weakness when lifting or rotating your arm
A crackling sensation when moving your shoulder

Sudden tears can cause intense pain almost immediately, especially from falling. You may even feel a snap or weakness in your upper arm.

Tears that develop slowly over time can also cause pain and weakness in your arm/shoulder. You may first notice pain when you lift your arm overhead. The longer you live with a slowly developing tear, the more discomfort you’ll feel, specifically while at rest. You’ll notice everyday tasks like combing your hair, brushing your teeth, or reaching for something off a shelf becomes much more difficult.

Your doctor can confirm the diagnosis of a rotator cuff tear by ordering an X-ray and an MRI (magnetic resonance imaging) or an ultrasound.

Treatment

While many rotator cuff treatment options are available, your doctor will determine the best course of action based on your:

Age
Activity level
General health
Type/degree of tear

Nonsurgical

Nonsurgical treatment can relieve pain and improve shoulder function.

Some nonsurgical options include:

Rest: Rest and limiting activities will allow your muscles and tendons to recuperate.
Physical Therapy: Specific exercises can be prescribed by a physical therapist to strengthen your shoulder and restore movement. The exercises will mainly consist of stretches that improve shoulder flexibility and range of motion, and resistant band exercises that strengthen the rotator cuff muscles and the scapular stabilizing muscles.
Steroid Injections: Steroid (cortisone) injections can be temporarily effective at treating persistently inflamed bursitis and/or pain related to a rotator cuff tear, but in the long term, cortisone can have a detrimental effect on the rotator cuff tendon strength and its ability to heal itself or resist further tearing. Caution should be used when considering a cortisone injection.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Anti-inflammatory drugs, such as aspirin, ibuprofen, and naproxen can help reduce painful symptoms and swelling.

Surgical

A rotator cuff repair surgery through a scope may be necessary if nonsurgical treatment doesn’t help with the pain. Your doctor may consider surgery for your injury if:

Symptoms have lasted 6 to 12 months or more and have not responded to a course of physical therapy
The tear is full thickness and retracted
You’re experiencing significant weakness and loss of function

During rotator cuff surgery, your doctor will reattach the tendon to the bone at the head of your humerus. Physical therapy and other forms of treatment are recommended after surgery to ensure you regain your shoulder motion and strength.

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

10 Common Back Pain Myths

in Back Pain

Article featured on Summit Orthopedics

When it comes to avoiding, or treating, back pain, there is a lot of unreliable information out there. Knowing the difference between back pain myths and back pain facts is key to keeping your back healthy and pain-free.

Myth: Back pain is always dangerous

Truth: There are very few instances where back pain is life threatening or immediate medical intervention is required. Most injuries (strains, pulls, etc.) can be managed on your own. Chronic back pain is similar. In most cases, surgery is not required, although it may take more time to heal than a more acute injury.

Myth: Persistent or chronic back pain means something is seriously damaged

Truth: In reality, most injuries physically heal within three months. If pain persists for longer, there are likely other factors contributing to the pain. Stress, poor sleep, a sedentary lifestyle, and doing too much too soon all play a role in making your back and surrounding tissues more sensitive to movement and exercise.

Myth: Scans/imaging always show the cause of back pain

Truth: If everyone got a scan of their back, chances are something would be found (disc bulge, arthritis, disc degeneration). Imaging can be useful for some people, but scans don’t always predict how much pain you will be in or how disabled you are.

Myth: Back pain is caused by poor posture

Truth: There is no one “perfect” posture that is better than another. Your body does not like being in one position for a long time, which is why it may feel as though a “slouched” posture is causing your pain. Your body likes to move, and being in various postures is healthy for the back. You should sit or stand in a posture that’s comfortable for you and change it every 30 to 60 minutes.

Myth: Back pain is caused by a weak core

Truth: A weak core does not lead to back pain. Back pain can cause the core muscles to tense up in order to protect the back, so learning to relax your core can be helpful with managing your pain. You will need a strong core in certain cases, such as lifting heavy things, so strengthening your core is not a bad idea.

Myth: Back pain is caused by “wear and tear”

Truth: Similar to muscles, using the back will make it stronger. The back is meant to bend, extend, and twist, so lifting, pushing, and pulling will make it healthier and more resilient.

Myth: Flare-ups mean you are making the damage worse

Truth: Even though flare-ups are no fun, it’s unlikely you are making things worse. Common reasons for flare-ups are poor sleep, increased stress, inactivity, a depressed mood, or doing something your body was not used to nor ready to do. Addressing these issues can help with preventing flare-ups, and keeping calm when one does happen will help as well.

Myth: Injections, drugs, and/or surgery are the solution to back pain

Truth: Having an injection or using strong painkillers is like putting on a bandage — it might take the pain away temporarily, but it does not address the root cause of the problem. Surgery may be beneficial for some, but in most cases, it will not fix the problem, especially in those with persistent back pain.

Myth: You should only rest when you have back pain

Truth: It may be helpful to rest for the first few days after an injury, but after that, it’s time to get moving. Your joints and muscles will get sensitive and stiff if you rest for too long, so start gently and move through a range that you can tolerate. It’s okay if there is some pain with exercise and movement (it is usually a reflection of how sensitive things are, not how damaged things are), and it usually will calm down as you move more.

Myth: You should never let your low back bend when lifting

Truth: Your back is meant to bend. If you always lift with a “straight” spine, it won’t be ready for the instance where you do have to let it bend. Your joints, discs, and muscles adapt to the forces that are and aren’t placed on it. If you never expose your back to lifting in these bent positions, it won’t be able to handle it when you do.

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 & Treatments for Arch Pain

in Feet, Foot Pain

Article featured on Sydney Heel Pain

Arch pain can be the result of one or a combination of conditions that develop in the sole of the foot. Patients will often describe a tightness, pulling, strain, burning or ripping sensation through the mid arch of the foot, in front of the heel but behind the ball of the foot.

The pain in the arch can come on suddenly as in a one off day of increased walking or a sporting event, or progressively over a period of time as in walking in inappropriate shoes. Arch pain can be present every day and can be consistently present, in that it interferes with day to day activity. It will often feel worse in bare feet or thongs or flat and flimsy shoes such as ballet flats.

In extreme cases the pain can be excruciating and can cause burning and throbbing in bed at night. The soft tissue in the arch can be torn and this can be detected via ultra sound or MRI.

Conditions Causing Arch Pain

Plantar Fasciitis
Peroneal Tendonitis
Tibialis Posterior Tendonitis

Do You Have Burning Arch Pain in Your Foot?

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ARCH PAIN TREATMENT

It is important to assess and diagnose which part of the foot is affected and causing the pain. Physical examination is usually sufficient but in complex cases the patient can be referred for ultra sound imaging. An MRI is not usually necessary.

It is also important to determine whether or not the ligament, fascia or tendon has been torn as this will determine which treatment path to take. If the tissue is not torn, then it is important to determine what has caused the condition so that these contributing factors can be resolved. Factors such as footwear, exercise or even stretching techniques are common contributing factors.

If there are bio mechanical issues affecting the patients foot then these need to be addressed also. Orthotics can be arranged and shoes can be changed. Strapping can be applied to the foot and in extreme cases an immobilisation boot can be used.

Shock wave therapy can applied to the foot which can stimulate blood flow and accelerate healing in addition to relieving pain. Correct stretching techniques must be instructed and followed.

TREATMENT OPTIONS

Strapping
Orthotics where necessary
Footwear changes
Shock wave therapy
Stretching
Immobilisation boot

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

Walking or Running: Which Is Better for Your Health?

in Health & Wellness, walking

Article featured on Healthline

Walking and running both provide several health benefits. The best option for you depends on your health goals, mobility, and personal preference. Read on to learn more about both options. Walking and running are both excellent forms of cardiovascular exercise. Neither is necessarily “better” than the other. The choice that’s best for you depends on your fitness and health goals.

If you’re looking to burn more calories or lose weight fast, running is a better choice. But walking can also offer numerous benefits for your health, including helping you maintain a healthy weight.

Keep reading to learn more about the benefits, risks, and the types of walking and running that fit your health goals.

Benefits of Cardio

Walking and running are both aerobic cardiovascular, or “cardio” exercise. According to researchers, some of the health benefits of cardio include:

helps you lose weight or maintain a healthy weight
boosts immune system
helps prevent or manage chronic conditions
strengthens your heart
can extend your life

Cardiovascular exercise is also good for your mental health. One study found that both running and walking can reduce anxiety and depression. It can also improve your mood and self-esteem.

Another study found that just 10 minutes of running at a moderate intensity improved the mood of the participants afterwards. So, you don’t have to run for hours on end to reap the benefits.

Is Walking Better Than Running?

Walking can provide a lot of the same benefits of running. One study found that running burns around double the number of calories as walking.

You need to burn approximately 3,500 calories to lose one pound. If your goal is to lose weight, running is a better choice than walking.

If you’re new to exercise or aren’t able to run, walking can still help you get in shape. Walking is accessible for nearly all fitness levels. It can boost your heart and give you more energy overall.

Walking Vs Running For Weight Loss

Speed and power walking vs. running

Speed walking is walking at a brisk pace, usually 3 mph or greater. Your heart rate is elevated during speed walking. You can burn more calories per minute by speed walking rather than walking at your usual pace.

Power walking is usually considered from 3 mph to 5 mph, but some power walkers reach speeds of 7 to 10 mph. Power walking burns a similar number of calories as running. For example, power walking at 4.5 mph for one hour would burn the same as jogging at 4.5 mph for one hour.

For an effective workout, try pace training. Increase your speed for two minutes at a time, then slow back down.

Speed walking doesn’t burn calories as fast as running. To burn the same amount of calories as running, you would have to speed walk for longer. But it can be an effective workout to elevate your heart rate, boost your mood, and improve your aerobic fitness level.

Walking with a weighted vest

Walking with a weighted vest may increase the number of calories you burn. To stay safe, wear a vest that’s no more than 5 to 10% of your body weight.

If you’re looking for an alternative way to lose weight or tone your muscles, try interval walking instead. Pick up the speed for a certain amount of time before slowing down. Or alternatively, try walking with light dumbbells in each hand.

Incline walking vs. running

Incline walking involves walking uphill. It can burn a similar number of calories as running. If you keep the same speed as walking on a flat surface, you burn more calories at an incline.

Look for a hilly area or walk on an incline on the treadmill. Increase the incline by 5, 10, or 15% at a time to practice incline walking. If you’re new to incline walking, you can start gradually and work up to a 15% incline.

Benefits Vs. Risks

Running is a great way to get in shape and lose weight, but it’s a high-impact exercise. High-impact workouts can be harder on your body than low-impact exercises like walking.

According to researchers, over time, running may lead to common overuse injuries such as:

stress fractures
plantar fasciitis
ITB friction syndrome

It is estimated that 50% of runners experience an injury each year that prevents them from running.

If you’re a runner, you can take steps to stay injury-free. Don’t increase your mileage too quickly and try to cross-train several times a week.

Or, try walking instead. Walking offers many of the health benefits of running without the same risks for injury.

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

Common Injuries in Youth Sports

in Sports Related Injuries

Article featured on DukeHealth

Physical activity is important for a healthy lifestyle, and organized sports can help develop life skills such as communication, teamwork, and responsibility. The downside is that injuries can and do occur. Children and teens suffer about three million injuries due to sports or recreational activities every year, according to the CDC, and one in every five pediatric visits to the ER is for a sports or recreational injury. The good news is that about half of them are preventable.

Strategies for Preventing Injuries

No matter which sport your child plays, they can guard against injury by following these recommendations.

Avoid sport specialization at a young age. This can lead to overuse injuries.
Take time off between seasons and take rest days during the week.
Engage in proper warm-ups and cool-downs.
Eat a healthy, well-balanced diet.
Wear appropriate protective equipment.
Always be honest about injuries and allow for a full recovery before returning to your sport.

Sports-Specific Injuries

Baseball and Softball

Growth plate irritation and tendinitis

Follow pitch count rules.
Take days off during the week.
Learn proper throwing technique.

Basketball

Ankle sprains: Wear appropriate, well-fitting shoes.

Football

Concussions

Learn and follow proper tackling techniques.
Follow the rules of the game.

Lacrosse

Head and face injuries: Wear proper protective equipment including a helmet, mouth guard, and goggles.

Soccer

ACL tears: Consider an ACL prevention program to correct muscle imbalances and improve jumping and cutting skills.

Track and Field

Shin splints and stress fractures

Engage in a proper warm-up and cool-down.
Get conditioned before the first practice to avoid going from 0 to 100.
Eat a healthy, well-balanced diet to account for calories burned.

Volleyball

Shoulder injuries

Engage in a proper warm-up.
Strengthen your rotator cuff.

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

Common Neck Injuries

in Neck Injuries, Neck Pain

Article featured on TriHealth

We usually don’t give much thought to our neck until it becomes tight, sore or difficult to turn. When this happens, we realize all the muscles, tendons and bones in the neck (cervical spine) allow us to move freely.

Common Neck Injuries

When your neck is sore – whether it’s from a poor night’s sleep or sudden injury – it can make simple tasks a challenge. Turning your head when driving, lifting objects or just playing a favorite sport can become painful and uncomfortable. Discover the most common neck injuries and how you can find relief.

Types and Causes of Common Neck Injuries

The most common neck injuries include:

Neck sprain or strain – A sprain can happen when ligaments in the neck are torn. A strain refers to a torn muscle or tendon. This can occur as a result of a sudden injury during physical activity or even a minor car accident.
Stiff muscles and tendons – Often called a crick in the neck, stiffness can be caused moving awkwardly or keeping the neck in the same position for a long period of time (like sleeping overnight).
Herniated disc – A herniated disc occurs when a spinal disc becomes torn and the soft jellylike interior leaks or bulges out of the disc. Most commonly a result of wear and tear, herniated discs can also be caused by a sudden injury, including a fall.
Pinched nerve – Bone, tissue or tendons can push against surrounding nerves, which causes pain. This can happen as a result of a muscle sprain or strain.
Fractured cervical spine – Though rare, a fractured cervical spine (or broken neck) is a serious condition that requires immediate medical attention.

Common neck injury symptoms

Your symptoms will depend on the type and severity of your injury, but most common symptoms include:

Difficulty turning the neck
Headaches
Muscle spasms in neck and shoulders
Neck pain
Stiffness in the neck
Weakness in the legs, arms, hands or fingers

Common neck injury treatment

Your treatment will depend on the cause of your neck injury. Treatment may include:

Physical therapy – A certified physical therapist will teach you exercises to reduce pain, improve flexibility and strengthen muscles in the neck.
Medicine – Over-the-counter and prescription medicine can help relieve pain, reduce inflammation and help you find comfort.
Injections – Corticosteroid injections, medial branch blocks and other injections can help reduce inflammation and help relieve pain caused by several different injuries to the neck.
Acupuncture – Thin needles are inserted into specific spots along the spine to trigger the release of certain chemicals into the body, helping reduce pain. Acupuncture, used with traditional treatment, like pain management or physical therapy can help.
Massage – Medical massage therapy can help reduce inflammation, ease pain and provide relief from certain back conditions. Your doctor may recommend massage therapy along with other treatments.
Anti-inflammatory Diet – A diet that helps boost your body’s natural ability to fight inflammation may help reduce symptoms when combined with other treatment plans.

Our team will work closely with you to manage your pain before recommending surgery. If you continue to experience pain and loss of motion, cervical spine surgery may be recommended. These include:

Mazor X – A robotic-guided spine surgery, Mazor X uses 3D imaging to allow your surgeon to customize the surgery to your specific anatomy and needs. This leads to better outcomes and faster recovery.
Cervical discectomy and fusion – A damaged cervical disc can be removed and replaced with an artificial disc. You may also need a fusion surgery, which helps fuse two or more discs with hardware to stabilize and support the cervical spine (neck).
Laminectomy – A laminectomy removes part or all of the back of vertebrae and thickened tissue around the vertebrae to allow more room for the spinal cord. This helps relieve pressure on the affected nerve.

Common neck injury risk factors

Several common risk factors contribute to a neck injury. These include:

Genetics – A family history of neck pain or neck arthritis
Tobacco use – If you are a smoker
Repetitive neck movement – If you have a job that requires repetitive neck movement or overhead work
Trauma or injury to the neck – Either through an accident, sports or even sleeping wrong

Common neck injury prevention

It may be impossible to completely prevent an injury to the neck, but you can take steps to reduce your risk and protect your spine health:

Maintain a healthy weight
Exercise regularly
Strengthen back and core muscles
Eat healthy
Look for ergonomic pillows, chairs and other materials to help properly position your spine
Use good posture when standing and sitting
Use caution when lifting, twisting and turning

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