Article featured on Penn Medicine
The pain may come on suddenly, as a sharp stitch on the left side of your back. Or it may throb to life on your right side, growing slowly worse each day. No matter its exact location, though, one thing is sure: Back pain isn’t fun—but it’s a familiar foe.
Some 80% of the population in the U.S. will have a back problem in their lifetime, and Americans spend upwards of $50 billion a year treating it, according to the American Chiropractic Association.
That pain can radiate from the bones, joints, ligaments, muscles, or a combination of sources. Lifestyle plays its part in back pain, too. Everything from sports injuries and poor posture to obesity and psychological stress can contribute to back pain.
When the pain is isolated to one side, though, you may wonder what exactly is going on. The pain could represent something minor from which your body will heal itself, or it could indicate a more serious condition.
One-sided back pain is a fairly common issue,” says Bradley Tucker, MD, a Penn Medicine Physician and Assistant Professor of Clinical Physical Medicine and Rehabilitation.
Read on to learn symptoms to watch for and what back pain on one side may mean. Penn Medicine offers an online assessment test to help you learn when it is time to see a doctor for your back and neck pain.
Tissue Injuries
Injuries to the spinal structures can happen in the muscles, discs, or joints, and make up the most common cause of back pain on just one side. They often occur after minor injuries or from an impact in sports or a car accident.
Tissue injuries typically cause pain central to the spine, but they can lead to pain entirely on either the right side or the left side of the back. And of tissue injuries overall, muscle strains are the most common cause of lower back pain on one side.
Poor posture is another possible culprit for this type of one-sided back pain, according to Dr. Tucker. “Typically when you sit, everything should be at a 90 degree angle: knees, ankles, hips, and elbows,” he explains.
Muscle Strain Symptoms Include:
- Limited range in motion
- Tenderness or swelling
- Muscle spasms
- Pain the improves with rest, ice or NSAIDs
- Pain that worsens after sitting or getting out of bed
Bone Issues
Arthritis, bone spurs, or spinal stenosis (a narrowing of the spinal column) also all may cause pain on one side of the back. The pain may radiate down the leg or cause weakness. For instance, Dr. Tucker says, “If someone has right hip pain from arthritis, they may walk in a way meant to prevent falling and minimize hip irritation. But then they might have left-side back pain as a result.
He adds that this compensation might not be something your body does consciously. “It’s just the body protecting itself from worsening pain, which causes muscles and other joints to be overused or over-fatigued,” he says.
Your treatment options depend on how badly the issue interrupts your daily life: walking, sitting, and other activities you enjoy. Your physician will discuss your optimal treatment options based on the severity of your symptoms.
Treatments may include pain medication and hot/cold packs. They may also range from physical therapy to surgery. Keep in mind that while frustrating, finding the right treatment that works for your specific back pain will likely take time, trial, and error.
Internal Organ Problems
Though you may not think of them at first, pain on the right side or left side of your back may actually come from the organs in your mid-back, abdominal, or pelvic area. That pain may signify infection, inflammation, or irritation, and the potential affected organs include:
- Kidneys
- Pancreas
- Colon
- Uterus
There are a lot of one-sided issues you could have from pelvic or abdominal structures, but it’s not the typical back pain people think of,” says Dr. Tucker. “For instance, kidney stone pain tends to radiate from the flank down to the groin.
Your kidneys live toward your lower back and can cause pain if infected. However, if you’re experiencing kidney stones or a kidney infection, you’ll likely have other symptoms, too, including pain when urinating, nausea, or fever.
Chronic inflammation of the large intestine, called ulcerative colitis, can also cause back pain—along with abdominal cramping, digestive issues, weight loss, and fatigue, as well. And in women, pelvic pain from endometriosis or fibroids can radiate into the lower right back. This pain often comes with other issues, too, including abnormal menstruation, frequent urination, and pain during intercourse.
Emergency Symptoms
Nobody wants to rush to the Emergency Room over back pain, but it’s important to take right-side or left-side back pain seriously. Go to the emergency room if your back pain is severe or if you believe it could be an emergency, such as a serious health problem or injury.
You’ll also want to recognize if it’s happening in conjunction with other symptoms, such as spinal tenderness, swelling, or bowel or bladder problems.
One such issue is a serious nerve condition called cauda equina syndrome, which involves nerve compression at the end of the spinal cord. “Usually, symptoms include numbness around the groin, significant leg pain, loss of bowel/bladder control, and paralysis,” explains Dr. Tucker.
But emergency symptoms that cause back pain don’t necessarily have to do specifically with the back. An abdominal aortic aneurysm causes the abdominal aorta to balloon and, in some cases, rupture. If the aneurysm ruptures, there is often associated sudden and severe abdominal or chest pain radiating to one side of the back. It’s important to familiarize yourself with emergency symptoms and seek medical attention immediately if you suspect you may be having an issue.
In general, remember: It’s better to be overly cautious when dealing with back pain on your right or left side, especially if the pain interrupts your daily life or comes on suddenly and doesn’t go away with rest or medication.
Talk with your doctor or go to an emergency room to solve exactly what’s going on behind your back.
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, sports injuries, degenerative diseases, infections, tumors and congenital disorders.
Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.
Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.
If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.
Phone:
503-224-8399
Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209
Hours
Monday–Friday
4 Signs of Potential Nerve Damage
in NeuropathyArticle featured on the American Society for Surgery of the Hand
Nerves can be damaged in a number of ways, and it often happens with some type of injury. Did you suffer some sort of trauma like a car accident? If so, your nerve may have been crushed or torn (an avulsion). Did you suffer from a serious cut from a knife or machine? If so, the cut may have gone deep enough to damage your nerve.
These injuries are most certainly painful and may result in a variety of symptoms. Here are four signs that you’ve suffered from nerve damage:
If your nerve injury was severe enough, there’s a chance you’re suffering from these symptoms constantly. If your hand surgeon has confirmed your nerve injury, you will likely need to have the nerve repaired. Nerves are essentially the body’s telephone system. They send messages to your brain that tell the body to move, indicate when the body feels pain or too much pressure, or tell your brain when something is too hot or too cold. When the nerves are injured or cut, these messages can no longer make it to the brain, which explains why you may feel numb or unable to move the affected limb.
Treating nerve damage depends on your specific circumstances and how severe your injury was. Your hand surgeon will examine you and work with a neurologist to perform tests such as an EMG or NCS. Unfortunately, the longer you’ve suffered from the nerve damage, the harder it may be to treat.
In a nerve repair surgery, your hand surgeon may be able to stitch the nerve back together. If your injury is more severe, your surgeon may need to use a nerve graft, which is a piece of nerve that can bridge the two ends of your cut nerve to help it come back together. Even after surgery, nerves grow very slowly, only about one inch per month. If your injury was severe, it may take months for your nerve to grow back, and you may not regain all of the function you originally had.
If you think your nerve is damaged, contact your hand surgeon as soon as possible.
The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.
Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.
Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.
If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.
Phone:
503-224-8399
Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209
Hours
Monday–Friday
How Can I Improve My Balance?
in Prevention, RecoveryArticle featured on Summit Ortho written by Kyle Hall, DPT
Although it is often overlooked, balance is an important part of your overall physical fitness. Poor balance increases your chance of falls or other causes of injury and can reduce your overall mobility.
“Your body relies on three things for balance: your eyes, your inner ear, and receptors in your joints — that’s the part that can decline with age or injury,” Hall said. These joint receptors contribute to balance by sending signals back to the brain to tell you that you are falling or that there is more pressure to one side or another.
How can I improve my balance?
Yoga and Pilates are excellent for improving your steadiness, and core-strengthening exercises like planks and straight leg raises can help as well. Heel raises can increase ankle strength, which can help support you if you wobble. But if you have problems with your balance, it may be smart to add specific balance-building exercises into your daily routine three to five times a week.
A typical progression of balance exercises may include:
If you’re an athlete who wants to attain higher levels of performance, try using a minitrampoline, plyometrics, and box jumps. You can also catch a ball thrown by someone else, with planned and unplanned changes in direction.
Should I be working on balance?
There are several easy ways to test your balance:
“Standing with your feet together and your eyes closed, you should be able to stand for about 30 seconds. If not, balance is something to work on,” Hall said.
Other balance benchmarks include:
There are many good balance tests available for free online. Hall suggests the Berg Balance Test, which will tell you if you’re at high risk of falling or should use a cane or walker for safety.
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, sports injuries, degenerative diseases, infections, tumors and congenital disorders.
Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.
Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.
If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.
Phone:
503-224-8399
Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209
Hours
Monday–Friday
Torn Meniscus and What it Means
in Meniscus TearArticle featured on Mayoclinic.
Overview
A torn meniscus is one of the most common knee injuries. Any activity that causes you to forcefully twist or rotate your knee, especially when putting your full weight on it, can lead to a torn meniscus.
Each of your knees has two C-shaped pieces of cartilage that act like a cushion between your shinbone and your thighbone (menisci). A torn meniscus causes pain, swelling and stiffness. You also might feel a block to knee motion and have trouble extending your knee fully.
Conservative treatment — such as rest, ice and medication — is sometimes enough to relieve the pain of a torn meniscus and give the injury time to heal on its own. In other cases, however, a torn meniscus requires surgical repair.
Symptoms
If you’ve torn your meniscus, you might have the following signs and symptoms in your knee:
When to see a doctor
Contact your doctor if your knee is painful or swollen, or if you can’t move your knee in the usual ways.
Causes
A torn meniscus can result from any activity that causes you to forcefully twist or rotate your knee, such as aggressive pivoting or sudden stops and turns. Even kneeling, deep squatting or lifting something heavy can sometimes lead to a torn meniscus.
In older adults, degenerative changes of the knee can contribute to a torn meniscus with little or no trauma.
Risk factors
Performing activities that involve aggressive twisting and pivoting of the knee puts you at risk of a torn meniscus. The risk is particularly high for athletes — especially those who participate in contact sports, such as football, or activities that involve pivoting, such as tennis or basketball.
Wear and tear on your knees as you age increases the risk of a torn meniscus. So does obesity.
Complications
A torn meniscus can lead to a feeling of your knee giving way, inability to move your knee normally or persistent knee pain. You might be more likely to develop osteoarthritis in the injured knee.
Diagnosis
A torn meniscus often can be identified during a physical exam. Your doctor might move your knee and leg into different positions, watch you walk and ask you to squat to help pinpoint the cause of your signs and symptoms.
Imaging tests
Arthroscopy
In some cases, your doctor might use an instrument known as an arthroscope to examine the inside of your knee. The arthroscope is inserted through a tiny incision near your knee.
The device contains a light and a small camera, which transmits an enlarged image of the inside of your knee onto a monitor. If necessary, surgical instruments can be inserted through the arthroscope or through additional small incisions in your knee to trim or repair the tear.
Treatment
Initial treatment
Treatment for a torn meniscus often begins conservatively, depending on the type, size and location of your tear.
Tears associated with arthritis often improve over time with treatment of the arthritis, so surgery usually isn’t indicated. Many other tears that aren’t associated with locking or a block to knee motion will become less painful over time, so they also don’t require surgery.
Your doctor might recommend:
Therapy
Physical therapy can help you strengthen the muscles around your knee and in your legs to help stabilize and support the knee joint.
Surgery
If your knee remains painful despite rehabilitative therapy or if your knee locks, your doctor might recommend surgery. It’s sometimes possible to repair a torn meniscus, especially in children and young adults.
If the tear can’t be repaired, the meniscus might be surgically trimmed, possibly through tiny incisions using an arthroscope. After surgery, you will need to do exercises to increase and maintain knee strength and stability.
If you have advanced, degenerative arthritis, your doctor might recommend a knee replacement. For younger people who have signs and symptoms after surgery but no advanced arthritis, a meniscus transplant might be appropriate. The surgery involves transplanting a meniscus from a cadaver.
Lifestyle and home remedies
Avoid activities that aggravate your knee pain — especially sports that involve pivoting or twisting your knee — until the pain disappears. Ice and over-the-counter pain relievers can be helpful.
Preparing for your appointment
The pain and disability associated with a torn meniscus prompt many people to seek emergency care. Others make an appointment with their family doctors. Depending upon the severity of your injury, you might be referred to a doctor specializing in sports medicine or a specialist in bone and joint surgery (orthopedic surgeon).
What you can do
Before an appointment, be prepared to answer the following 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, sports injuries, degenerative diseases, infections, tumors and congenital disorders.
Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.
Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.
If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.
Phone:
503-224-8399
Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209
Hours
Monday–Friday
Potential Causes of Stiff Joints and What to do About Them
in Joint PainFeatured on MedicalNewsToday
Many people experience stiff joints as they age. Others may experience joint stiffness due to medical conditions and lifestyle choices. Sometimes, people can treat stiff joints at home.
Many people who experience joint stiffness tend to feel it after sitting for prolonged periods or after first waking up. Some people experience a mild discomfort that goes away after moving again. Others find that the stiffness lasts longer and is more uncomfortable.
In more severe situations, stiff joints may impact a person’s mobility. People may have difficulty putting weight on their joints, or they may have problems standing or walking.
What are the causes?
Most people will experience joint stiffness at some point, but the reasons for the discomfort may vary based on a variety of factors. Some causes are more severe than others.
Causes of stiff joints include:
Sleeping posture
Many times the way people sleep at night can contribute to joint stiffness.
When a person does not sleep in a way that aligns the spine and keeps their neck in a neutral position, they may wake up feeling stiff or achy.
People who sleep on their sides may want to avoid lying on a particular side if it is already feeling stiff. Using a variety of pillows around the body can help keep it in the right sleep position for a good night’s rest and less joint stiffness.
Time of day
In addition to sleeping posture, research shows that joint stiffness may be more severe in the morning when a person first wakes up due to a correlation between inflammation and a person’s circadian clock. This is more likely in cases of joint stiffness resulting from rheumatoid arthritis.
In addition, there is some evidence that poor sleep may make joint discomfort worse at night. This, in turn, contributes to poor sleep. For this reason, people who have conditions like arthritis may struggle to get enough rest at night.
Age
Older adults may have stiffer joints simply because of a lifetime of use. Over time, a person’s range of joint motion becomes more restricted. A person may also become less flexible.
The cartilage, which is the cushion that protects the connection between a person’s bones, also begins to wear down. This causes inflammation and can lead to arthritis.
Obesity
When a person is overweight, their weight is higher than what doctors consider healthy for their height. The most common way to measure this is with the Body Mass Index (BMI). The Centers for Disease Control and Prevention define BMI higher than 25 as overweight, higher than 30 as obese, and higher than 40 as severely obese.
When the body carries additional weight, this weight places extra pressure on the joints. In addition, fat cells can release proteins into the body that can cause inflammation. Both of these factors together may lead to arthritis, which can cause joint stiffness.
In addition, research shows that being overweight may cause all kinds of metabolic problems in the body, which may have a negative effect on bone health.
Diet
Eating animal and dairy products may play a role in triggering conditions that can cause joint stiffness such as gout or arthritis.
When people eat more of these foods and fewer plant-based foods, they may be more susceptible to joint stiffness.
Research shows that choosing some variation of a Mediterranean or vegan diet may help reduce stiffness. Specifically, eating more fiber, whole grains, fruits, vegetables, healthy fats, probiotics, herbs, and spices may be beneficial.
Bursitis
Bursitis develops when tiny, fluid-filled sacs in the joints called bursae become inflamed. The inflammation causes pain as well as stiffness.
Bursitis can happen in nearly any joint, but it is most common in larger joints, such as:
Bursitis usually heals by itself with rest. A person should typically reduce activities that move the joint and rest the joint for long periods.
Resting the joint allows the bursae to recover, causing the pain and stiffness to go away.
Osteoarthritis
Osteoarthritis is a degenerative type of arthritis that affects over 32.5 million people in the United States. This type of arthritis is due to wear and tear and is, therefore, more frequently seen in people over the age of 65.
Osteoarthritis often affects:
As it progresses it can cause: swelling and pain, as well as cracking noises with movement.
Treatments usually center around relieving pain and reducing swelling in the joints. People whose osteoarthritis is particularly painful and debilitating may require surgery.
Rheumatoid arthritis
Rheumatoid arthritis (RA) is another common arthritis that affects about 1.5 million people in the U.S. RA typically appears in adults between the ages of 30 and 60.
RA is an autoimmune disorder that causes the immune system to attack otherwise healthy joints. People with RA will experience pain and swelling as the body attacks the joints.
There is no cure for RA. Treatments focus on slowing the progression of the disease.
Lupus
Lupus is another autoimmune disease that causes the immune system to attack healthy tissue, such as muscles and joints. When lupus attacks the joints, symptoms include:
Lupus is often difficult to diagnose because many of the symptoms are similar to other medical conditions. There is no cure and symptoms will get worse over time. Treatment focuses on treating the symptoms. Available treatments can be effective in helping people find symptom relief.
Gout
Gout is a sudden onset arthritis that tends to affect males more often than females. Gout is a condition that develops quickly, with symptoms sometimes appearing overnight, often in the big toe.
Symptoms include:
Gout can develop in any joint. Gout will typically appear for a short period and go away. People with gout often get symptoms on and off throughout their life. Treatment focuses on reducing the severity of the symptoms and lowering levels of uric acid in the blood.
Fibromyalgia
Fibromyalgia is a chronic condition that causes a person pain throughout the body. This condition also includes joint stiffness as one of its symptoms. Because people who have lupus or rheumatoid arthritis may be more prone to this condition, these people may be at more particular risk for joint stiffness.
Bone cancer
While there are different types of bone cancer, the most common kind is osteosarcoma. While cancer doesn’t cause joint stiffness often, it may do so occasionally. When a person gets stiff joints due to bone cancer, they usually get in the arms and the legs.
Treatment
There are many over-the-counter (OTC) and home remedies to help alleviate joint stiffness, pain, and swelling. One type of OTC medication a person can take is nonsteroidal anti-inflammatory drugs (NSAIDs), which include medications like ibuprofen (Advil), as well as other pain relievers such as acetaminophen (Tylenol).
For people who experience severe joint stiffness as a result of conditions like arthritis, recent research still shows NSAIDs may be more effective than opioids like morphine.
It is essential that people speak to their doctor if the cause of the joint pain is unknown, comes on suddenly, or is accompanied by other symptoms.
What are the home remedies?
People can also choose to try home remedies to reduce joint stiffness along with any other treatments that a doctor has recommended or prescribed.
Home remedies can include:
When to see a doctor
People do not need to see their doctor if joint stiffness typically occurs first thing in the morning or after sitting for extended periods. However, they should consult a doctor if stiffness comes on suddenly or does not go away after a few days.
People should also speak to their doctor if they have:
Stiff joints can be a sign of a more significant health problem. People should speak to their doctor about their symptoms if in any doubt.
Summary
Many people will experience joint stiffness as they age. Most often this stiffness will wear off after a person gets up and moves around. Other people, however, may experience joint stiffness as a result of an underlying condition.
Anyone who has any doubt about the cause of their joint stiffness should speak to their doctor to help rule out or treat a potential underlying condition. With proper treatment and some home remedies, a person can typically relieve their stiff joints.
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, sports injuries, degenerative diseases, infections, tumors and congenital disorders.
Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.
Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.
If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.
Phone:
503-224-8399
Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209
Hours
Monday–Friday
Knee Hyperextension: What is it?
in Knee Injuries, Knee PainArticle featured on News Medical Life Sciences
Knee hyperextension is a condition caused when the knee straightens too far, beyond the normal maximum limit of 00 and often with the joint in varus malalignment. In the properly aligned knee, the load is borne on a line running down the center of the hip, knee and ankle, but in a varus deformity (bowleg form), the line is shifted outwards and back.
The most common injuries are posterolateral joint injury and avulsion of the bone attached to the anterior cruciate ligament, and they are especially common in young children due to their softer bones. Posterior cruciate ligament, however, is rare.
Causes
Knee hyperextension may occur because of:
Symptoms
The cause of hyperextension predicts the symptoms, which may be minor pain and swelling when it occurs to a trivial degree, but may consist of sharp pain, strained or torn cruciate ligaments, avulsion of bone chips accompanying such tears, and bone bruising may occur on the anterior part of the knee joint. When the injury is at the posterolateral aspect, the ACL and the PCL typically tears. The rate of strain doesn’t seem to be the major factor as anterior cruciate ligaments tears vary at all rates of strain. Genu recurvatum may present with knee pain, abnormal gait, and a lack of proprioceptive perception, which makes it difficult to tell when the terminal extension of the knee is attained.
The hyperextended knee gait is marked by various degrees of abnormality. In some, the patient can walk only with the aid of a cane or a crutch. In others with minimal weakness, the knee becomes hyperextended only when the patient walks too much or indulges in other heavy work or exercise, leading to muscle fatigue and loss of joint support. The associated ligamentary and muscle weakness and joint integrity also contribute to the final abnormality of gait, as does the presence of arthritis in the knee joint.
Another symptom is knee instability, or a feeling of giving way at the knee, in part or full, during normal activities.
Pain may be felt over the knee or to the medial side, and is caused by compression of the soft tissues by the malaligned knee, as well as on the posterolateral aspect, due to stretching of the soft tissue. In acute hyperextension injury the knee may pop and acute swelling often occurs within a few hours of the injury. The pain can become too severe for normal support of weight during walking or running.
Anatomy
The knee joint is supported on the lateral and posterior aspects by the fibular collateral ligament, and the popliteus muscle with its tendon and ligament. This complex of structures keeps the knee compartment from widening laterally, prevents dislocation of the lateral surface of the tibial component of the knee to the back, keeps the tibia from rotating, and thus prevents both knee hyperextension and genu recurvatum. The bones may show varus alignment, in some cases. A triple varus knee is caused by three factors:
In most cases both the posterolateral structures and the anterior cruciate ligament is damaged or at least weak, as following a knee injury or any other cause of muscle atrophy. Patellofemoral arthritis is another cause, but in this case the hyperextended knee gait is due to pain as well as muscle weakness.
Diagnosis
The history will offer clues to the diagnosis, such as prior knee injury. A physical examination will help confirm and grade the injury, including joint mobility, visible injury, bruising or swelling, and locking of the joint. Imaging is needed in severe injury and especially if surgery is contemplated. MRI and X-ray imaging are typically performed.
Treatment
Minor hyperextension of the knee may require only the R.I.C.E approach:
Severe cases will require physical therapy, with graded exercises of the quadriceps and other hip and knee muscles. This should be done under supervision so that further injury does not occur, and full joint mobility is attained. Surgery is required to reattach torn ligaments and will again be followed by physical therapy.
Correction of the hyperextended knee gait is crucial if the deformity is to be corrected permanently, otherwise the excessive tensile force on the ligaments inside the joint and increased muscle force could increase the load on the joint capsules, especially the medial and lateral compartments. This can be harmful to joint integrity in varus malalignment.
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, sports injuries, degenerative diseases, infections, tumors and congenital disorders.
Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.
Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.
If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.
Phone:
503-224-8399
Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209
Hours
Monday–Friday
Recovery from an Ankle Sprain
in Ankle InjuriesArticle featured on Harvard Health Publishing
All it takes is a simple misstep, and suddenly you have a sprained ankle. An ankle sprain is one of the most common musculoskeletal injuries in people of all ages, athletes and couch potatoes alike. The injury occurs when one or more of the ligaments in the ankle are stretched or torn, causing pain, swelling, and difficulty walking. Many people try to tough out ankle injuries and don’t seek medical attention. But if an ankle sprain causes more than slight pain and swelling, it’s important to see a clinician. Without proper treatment and rehabilitation, a severely injured ankle may not heal well and could lose its range of motion and stability, resulting in recurrent sprains and more downtime in the future.
Anatomy of an ankle sprain
The most common type of ankle sprain is an inversion injury, or lateral ankle sprain. The foot rolls inward, damaging the ligaments of the outer ankle — the anterior talofibular ligament, the calcaneofibular ligament, and the posterior talofibular ligament. (Ligaments are bands of fibrous tissue that connect bone to bone; see illustration.)
Ankle ligaments
Less common are sprains affecting the ligaments of the inner ankle (medial ankle sprains) and syndesmotic sprains, which injure the tibiofibular ligaments — the ligaments that join the two leg bones (the tibia and the fibula) just above the ankle. Syndesmotic sprains, which occur most often in contact sports, are especially likely to cause chronic ankle instability and subsequent sprains.
The severity of an ankle sprain depends on how much damage it does and how unstable the joint becomes as a result. The more severe the sprain, the longer the recovery (see “Grades of ankle sprain severity”).
Grades of ankle sprain severity
Immediate ankle sprain treatment
The first goal is to decrease pain and swelling and protect the ligaments from further injury. This usually means adopting the classic RICE regimen — rest, ice, compression, and elevation. If you have severe pain and swelling, rest your ankle as much as possible for the first 24–48 hours. During that time, immerse your foot and ankle in cold water, or apply an ice pack (be sure to cover the ankle with a towel to protect the skin) for 15–20 minutes three to five times a day, or until the swelling starts to subside.
To reduce swelling, compress the ankle with an elasticized wrap, such as an ACE bandage or elastic ankle sleeve. When seated, elevate your ankle as high as you comfortably can — to the height of your hip, if possible. In the first 24 hours, avoid anything that might increase swelling, such as hot showers, hot packs, or heat rubs. Nonsteroidal anti-inflammatory drugs such as ibuprofen can help reduce pain and swelling and may also speed recovery.
Ankle sprain medical evaluation
Unless your symptoms are mild or improving soon after the injury, contact your clinician. He or she may want to see you immediately if your pain and swelling are severe, or if the ankle feels numb or won’t bear weight. He or she will examine the ankle and foot and may manipulate them in various ways to determine the type of sprain and the extent of injury. This examination may be delayed for a few days until swelling and pain improve; in the meantime, continue with the RICE regimen.
X-rays aren’t routinely used to evaluate ankle injuries. Ligament problems are the source of most ankle pain, and ligaments don’t show up on regular x-rays. To screen for fracture, clinicians use a set of rules — called the Ottawa ankle rules, after the Canadian team that developed them — to identify areas of the foot where pain, tenderness, and inability to bear weight suggest a fracture. A review of studies involving more than 15,000 patients concluded that the Ottawa rules identified patients with ankle fractures more than 95% of the time.
Ankle sprain functional treatment
To recover from an ankle sprain fully, you’ll need to restore the normal range of motion to your ankle joint and strengthen its ligaments and supporting muscles. Studies have shown that people return to their normal activities sooner when their treatment emphasizes restoring ankle function — often with the aid of splints, braces, taping, or elastic bandages — rather than immobilization (such as use of a plaster cast). Called functional treatment, this strategy usually involves three phases: the RICE regimen in the first 24 hours to reduce pain, swelling, and risk of further injury; range-of-motion and strengthening exercises within 48–72 hours; and training to improve endurance and balance once recovery is well under way.
Generally, you can begin range-of-motion and stretching exercises within the first 48 hours, and should continue until you’re as free of pain as you were before your sprain. Start to exercise seated on a chair or on the floor. As your sprained ankle improves, you can progress to standing exercises. If your symptoms aren’t better in two to four weeks, you may need to see a physical therapist or other specialist.
Exercises to help restore function and prevent injury
Range-of-motion, stretching, and strengthening: First 1–2 weeks
Flexes. Rest the heel of the injured foot on the floor. Pull your toes and foot toward your body as far as possible. Release. Then point them away from the body as far as possible. Release. Repeat as often as possible in the first week.
Ankle alphabet. With the heel on the floor, write all the capital letters of the alphabet with your big toe, making the letters as large as you can.
Press down, pull back. Loop an elasticized band or tubing around the foot, holding it gently taut (A). Press your toes away and down. Hold for a few seconds. Repeat 30 times. Tie one end of the band to a table or chair leg (B). Loop the other end around your foot. Slowly pull the foot toward you. Hold for a few seconds. Repeat 30 times.
Ankle eversion. Seated on the floor, with an elasticized band or tubing tied around the injured foot and anchored around your uninjured foot, slowly turn the injured foot outward. Repeat 30 times.
Ankle inversion. Seated on the floor, cross your legs with your injured foot underneath. With an elasticized band or tubing around the injured foot and anchored around your uninjured foot, slowly turn the injured foot inward. Repeat 30 times.
Stretching and strengthening: Weeks 3–4
Standing stretch. Stand one arm’s length from the wall. Place the injured foot behind the other foot, toes facing forward. Keep your heels down and the back knee straight. Slowly bend the front knee until you feel the calf stretch in the back leg. Hold for 15–20 seconds. Repeat 3–5 times.
Seated stretch. Loop an elasticized band or tubing around the ball of the foot. Keeping the knee straight, slowly pull back on the band until you feel the upper calf stretch. Hold for 15 seconds. Repeat 15–20 times.
Rises. Stand facing a wall with your hands on the wall for balance. Rise up on your toes. Hold for 1 second, then lower yourself slowly to the starting position. Repeat 20–30 times. As you become stronger, do this exercise keeping your weight on just the injured side as you lower yourself down.
Stretches. Stand with your toes and the ball of the affected foot on a book or the edge of a stair. Your heel should be off the ground. Use a wall, chair, or rail for balance. Hold your other foot off the ground behind you, with knee slightly bent. Slowly lower the heel. Hold the position for 1 second. Return to the starting position. Repeat up to 15 times, several times a day. This exercise can place a lot of stress on the ankle, so get your clinician’s go-ahead before trying it.
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, sports injuries, degenerative diseases, infections, tumors and congenital disorders.
Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.
Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.
If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.
Phone:
503-224-8399
Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209
Hours
Monday–Friday
7 Causes of Shin Pain
in Legs & FeetArticle featured on MedicalNewsToday, medically reviewed by Angela M. Bell, MD, FACP — Written by Anna Smith on July 23, 2020
People may typically associate shin pain with shin splints. However, other issues can also cause shin pain.
Medial tibial stress syndrome, or shin splints, is the inflammation of the tendons, muscles, and bone tissue around the tibia. People describe shin splint pain as sharp, or dull and throbbing.
According to the American Academy of Orthopaedic Surgeons (AAOS), shin splints are a common cause of shin pain, there are many other causes of shin pain, such as an injury, bone bruise, or stress fracture.
This article will cover a range of reasons why a person may have shin pain, as well as symptoms, treatments, and how to prevent them.
1. Minor injury
A person who has an injury to their shinbone from a fall or blow may experience some pain or bruising.
Symptoms
Symptoms of a minor injury can include:
Treatment
Minor injuries due to a blow to the shin will generally heal quickly. A person with a minor injury to their shin can treat it in the following ways:
2. Bone bruise
A bone bruise on the shin can occur due to injury, such as a fall or playing sports.
A bone bruise occurs when a traumatic injury to a bone damages blood vessels and blood and other fluids build up in tissues. This causes discoloration to the skin around the damaged area, but the injury is typically deeper than the familiar bruises that appear on the skin. Although a person can bruise any bone, bones nearer the skin, such as the shin, are most common.
Symptoms
It is not always possible to detect whether the bruise is a superficial skin injury or on the bone. Symptoms of a bone bruise on the shin can include:
Treatment
A person can treat their bone bruise in the following ways:
For more severe bruises, a doctor may need to drain the bruise to remove excess fluid.
3. Stress fracture
Stress fractures occur when muscles become tired through overuse, and they are unable to absorb any extra stress.
When this happens, the muscle transfers the stress to the bone. This causes tiny cracks, or stress fractures, to form. According to the AFP, females, athletes, and military recruits are at higher risk of developing stress fractures.
Stress fractures can be the result of:
Females, athletes, and military recruits are all at a higher risk of developing stress fractures, according to the AFP.
Symptoms
Symptoms of a stress fracture in the shinbone include:
A stress fracture requires immediate treatment to prevent the small crack from getting bigger.
Treatment
A person who has a stress fracture can treat it in the following ways:
4. Bone fracture
The shinbone is the long bone that people fracture most often, according to the AAOS. A fracture to the shinbone can occur due to significant trauma to the leg, such as from a car accident or a bad fall.
Symptoms
Symptoms of a fractured tibia include:
If a doctor suspects a person has broken their shinbone, they will confirm it with an X-ray.
Treatment
Treatment for a fracture will depend on the type of fracture a person has. For less serious fractures, treatment involves:
If the person has an open fracture or one that does not heal with nonsurgical methods, it may require surgery.
5. Adamantinoma and osteofibrous dysplasia
According to the AAOS, adamantinoma and osteofibrous dysplasia (OFD) are rare forms of bone tumors that often begin growing in the shinbone. There are many similarities between the two tumors, and doctors think that they are related. Adamantinoma is a slow-growing, cancerous tumor that accounts for less than 1% of all bone cancers.
Adamantinoma can spread to other parts of the bone. According to the National Cancer Institute, adamantinoma typically appears in young people after their bones have stopped growing. OFD also accounts for less than 1% of all tumors in bones. It is a noncancerous tumor that does not spread and often forms during childhood.A third type of tumor called OFD-like adamantinoma contains cancerous and noncancerous cells and does not spread to other parts of the body.
Symptoms
The most common symptoms of both tumors include:
Treatment
A healthcare professional will observe and suggest X-rays for both OFD and OFD-like adamantinoma.
Adamantinomas will require surgery to remove them as they do not respond to chemotherapy or other cancer treatment.
6. Paget’s disease of the bone
Paget’s disease of the bone is a disease of the skeleton that causes newly forming bone to become abnormally shaped, weak, and brittle. Although Paget’s disease can affect any bone in the body, it mainly appears in the spine, pelvis, femur, and shinbone.
Symptoms
Up to 70%of people with Paget’s disease will have no symptoms. However, if symptoms are present, they can include:
Treatment
If a person does not experience any symptoms from Paget’s disease, a doctor may simply monitor it. Treatments for Paget’s disease can include:
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, sports injuries, degenerative diseases, infections, tumors and congenital disorders.
Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.
Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.
If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.
Phone:
503-224-8399
Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209
Hours
Monday–Friday
4 Reasons You May Have Back Pain on Only One Side
in Back PainArticle featured on Penn Medicine
The pain may come on suddenly, as a sharp stitch on the left side of your back. Or it may throb to life on your right side, growing slowly worse each day. No matter its exact location, though, one thing is sure: Back pain isn’t fun—but it’s a familiar foe.
Some 80% of the population in the U.S. will have a back problem in their lifetime, and Americans spend upwards of $50 billion a year treating it, according to the American Chiropractic Association.
That pain can radiate from the bones, joints, ligaments, muscles, or a combination of sources. Lifestyle plays its part in back pain, too. Everything from sports injuries and poor posture to obesity and psychological stress can contribute to back pain.
When the pain is isolated to one side, though, you may wonder what exactly is going on. The pain could represent something minor from which your body will heal itself, or it could indicate a more serious condition.
One-sided back pain is a fairly common issue,” says Bradley Tucker, MD, a Penn Medicine Physician and Assistant Professor of Clinical Physical Medicine and Rehabilitation.
Read on to learn symptoms to watch for and what back pain on one side may mean. Penn Medicine offers an online assessment test to help you learn when it is time to see a doctor for your back and neck pain.
Tissue Injuries
Injuries to the spinal structures can happen in the muscles, discs, or joints, and make up the most common cause of back pain on just one side. They often occur after minor injuries or from an impact in sports or a car accident.
Tissue injuries typically cause pain central to the spine, but they can lead to pain entirely on either the right side or the left side of the back. And of tissue injuries overall, muscle strains are the most common cause of lower back pain on one side.
Poor posture is another possible culprit for this type of one-sided back pain, according to Dr. Tucker. “Typically when you sit, everything should be at a 90 degree angle: knees, ankles, hips, and elbows,” he explains.
Muscle Strain Symptoms Include:
Bone Issues
Arthritis, bone spurs, or spinal stenosis (a narrowing of the spinal column) also all may cause pain on one side of the back. The pain may radiate down the leg or cause weakness. For instance, Dr. Tucker says, “If someone has right hip pain from arthritis, they may walk in a way meant to prevent falling and minimize hip irritation. But then they might have left-side back pain as a result.
He adds that this compensation might not be something your body does consciously. “It’s just the body protecting itself from worsening pain, which causes muscles and other joints to be overused or over-fatigued,” he says.
Your treatment options depend on how badly the issue interrupts your daily life: walking, sitting, and other activities you enjoy. Your physician will discuss your optimal treatment options based on the severity of your symptoms.
Treatments may include pain medication and hot/cold packs. They may also range from physical therapy to surgery. Keep in mind that while frustrating, finding the right treatment that works for your specific back pain will likely take time, trial, and error.
Internal Organ Problems
Though you may not think of them at first, pain on the right side or left side of your back may actually come from the organs in your mid-back, abdominal, or pelvic area. That pain may signify infection, inflammation, or irritation, and the potential affected organs include:
There are a lot of one-sided issues you could have from pelvic or abdominal structures, but it’s not the typical back pain people think of,” says Dr. Tucker. “For instance, kidney stone pain tends to radiate from the flank down to the groin.
Your kidneys live toward your lower back and can cause pain if infected. However, if you’re experiencing kidney stones or a kidney infection, you’ll likely have other symptoms, too, including pain when urinating, nausea, or fever.
Chronic inflammation of the large intestine, called ulcerative colitis, can also cause back pain—along with abdominal cramping, digestive issues, weight loss, and fatigue, as well. And in women, pelvic pain from endometriosis or fibroids can radiate into the lower right back. This pain often comes with other issues, too, including abnormal menstruation, frequent urination, and pain during intercourse.
Emergency Symptoms
Nobody wants to rush to the Emergency Room over back pain, but it’s important to take right-side or left-side back pain seriously. Go to the emergency room if your back pain is severe or if you believe it could be an emergency, such as a serious health problem or injury.
You’ll also want to recognize if it’s happening in conjunction with other symptoms, such as spinal tenderness, swelling, or bowel or bladder problems.
One such issue is a serious nerve condition called cauda equina syndrome, which involves nerve compression at the end of the spinal cord. “Usually, symptoms include numbness around the groin, significant leg pain, loss of bowel/bladder control, and paralysis,” explains Dr. Tucker.
But emergency symptoms that cause back pain don’t necessarily have to do specifically with the back. An abdominal aortic aneurysm causes the abdominal aorta to balloon and, in some cases, rupture. If the aneurysm ruptures, there is often associated sudden and severe abdominal or chest pain radiating to one side of the back. It’s important to familiarize yourself with emergency symptoms and seek medical attention immediately if you suspect you may be having an issue.
In general, remember: It’s better to be overly cautious when dealing with back pain on your right or left side, especially if the pain interrupts your daily life or comes on suddenly and doesn’t go away with rest or medication.
Talk with your doctor or go to an emergency room to solve exactly what’s going on behind your back.
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, sports injuries, degenerative diseases, infections, tumors and congenital disorders.
Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.
Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.
If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.
Phone:
503-224-8399
Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209
Hours
Monday–Friday
Rotator Cuff Problem: Do You Need Surgery?
in Shoulder InjuriesArticle featured on WebMD, Reviewed by Tyler Wheeler, MD on May 16, 2021
What Causes Rotator Cuff Problems
Your rotator cuff is a group of tendons and muscles in your shoulder. It helps you lift and rotate your arm. It also helps keep your shoulder joint in place. But sometimes, the rotator cuff tendons tear or get pinched by the bones around them. An injury, like falling on your arm, can cause this to happen. But wear and tear over time can take its toll on your shoulder, too. The pain can be severe.
Treatment
Home care can treat many rotator cuff problems. Your doctor will tell you to rest your shoulder joint and ice the area. Over-the-counter pain relievers can help ease your pain and swelling while your rotator cuff heals. Physical therapy will help restore your shoulder strength.
What About Surgery?
If you’re not getting any relief with these steps, surgery may be the next option for you.
You may need surgery if:
What Type of Surgery Do I Need?
Surgery can relieve your pain and restore function to your shoulder. Some are done on an outpatient basis. For others, you may need to stay in a hospital.
The most common types are:
Arthroscopic repair. After making one or two very small cuts in your skin, a surgeon will insert a tiny camera called an arthroscope and special, thin tools into your shoulder. These will let them see which parts of your rotator cuff are damaged and how best to fix them.
Open tendon repair. This surgery has been around a long time. It was the first technique used to repair the rotator cuff. If you have a tear that’s very large or complex, your surgeon may choose this method.
Recovery
Recovery from arthroscopic surgery is typically quicker than open tendon repair. Since open tendon repair is more involved, you may also have more pain right afterwards.
No matter which surgery you have, a full recovery will take time. You should expect to be in a sling for about 6 weeks. This protects your shoulder and gives your rotator cuff time to heal. Driving a car will be off limits for at least a month.
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, sports injuries, degenerative diseases, infections, tumors and congenital disorders.
Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.
Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.
If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.
Phone:
503-224-8399
Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209
Hours
Monday–Friday
What Good Posture Means and How to Improve It
in Back PainArticle featured on Harvard Health Publishing
“Stand up straight.” That’s timeless advice we’ve probably all heard at one time or another. It’s worth heeding. Good posture is important to balance: by standing up straight, you center your weight over your feet. This also helps you maintain correct form while exercising, which results in fewer injuries and greater gains. And working on balance can even strengthen your abilities in tennis, golf, running, dancing, skiing — and just about any other sport or activity.
Not an athlete? It still pays to have good balance. Just walking across the floor or down the block requires good balance. So do rising from a chair, going up and down stairs, toting packages, and even turning to look behind you.
Poor posture isn’t necessarily a bad habit, either. Physical reasons for poor posture include:
The good news: You can improve your posture with a few simple exercises. Balance-specific workouts address posture and balance problems with exercises that build strength where it counts and stretches that loosen tight muscles. Quick posture checks in the mirror before and during balance exercises can also help you get the most from your regular workout. And increasing your core strength and flexibility can help you improve your posture noticeably in just a few weeks.
Good posture means:
When sitting down, keep your chin parallel to the floor; your shoulders, hips, and knees at even heights; and your knees and feet pointing straight ahead.
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, sports injuries, degenerative diseases, infections, tumors and congenital disorders.
Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.
Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.
If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.
Phone:
503-224-8399
Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209
Hours
Monday–Friday