Article featured on Arkansas Surgical Hospital
What is Spinal Stenosis?
Spinal stenosis is a deterioration of vertebrae that causes narrowing of the openings of the spinal column. Over time, this puts pressure on the nerves inside the spinal column. In most cases, individuals develop spinal stenosis in either the neck (called cervical stenosis) or the lower back (called lumbar stenosis).
What Causes Spinal Stenosis?
The most common cause of spinal stenosis is osteoarthritis that causes bone spurs. These spurs can impinge on the spinal cord or pinch one or more nerves emanating from the spinal column. Other causes of spinal stenosis include pressure on the spinal cord or nerves from herniated discs, tumors, thickened or inflamed ligaments, or trauma that dislocates or breaks vertebrae.
Types of Spinal Stenosis & Their Symptoms
Some people develop mild cases of spinal stenosis without experiencing any symptoms. However, if the deterioration continues over time, a variety of symptoms can develop. Symptoms are most common in individuals over 60 years of age and tend to become more severe with age due to wear and tear on the spinal vertebrae. Symptoms typically vary based on the location of the stenosis in the spine.
Lumbar Spinal Stenosis
Spinal stenosis is more common in the lower back than in the neck. This type of spinal stenosis is called lumbar stenosis. The most common symptom of lumbar stenosis is neurogenic claudication, which is leg pain that comes and goes due to pinched nerves in the spinal cord. It can cause weakness or cramps in the legs that can be severe. It is more troublesome when standing or walking for long periods, and it may become less severe or go away when you sit or bend forward.
Numbness or a pins-and-needles sensation in one or both legs is another symptom. The sensation is similar to when your foot falls asleep, but is more frequent or may last longer. Weakness in the feet or legs can also indicate lumbar stenosis. Gait issues such as foot drop may arise from weakness in the calves or quadriceps. Foot drop is the inability to raise the front of the foot properly due to weakness. Instead, the foot drops forward, often dragging on the ground or causing the person to trip.
When the pain is in one leg and accompanied by weakness, it may be referred to as sciatica, depending on which nerve is compressed. Some individuals may feel pain in the buttocks and lower back as well.
Cervical Spinal Stenosis
The narrowing of the spinal column that causes pressure on the spinal cord in the neck is called cervical stenosis. People with cervical stenosis can develop problems with their gait and keeping their balance, which affects their mobility. The gait problems arise from the compression of the spinal cord rather than a pinched nerve. This condition progresses over time, with the individual falling more frequently as the compression worsens.
Pain in the shoulder, arm, or neck may also be a sign of cervical stenosis, particularly if the pain is shock-like or is accompanied by a burning sensation. Some people experience numbness or a pins-and-needles tingling sensation in one or both hands. This is sometimes accompanied by weakness and loss of fine motor skills. Over time, it becomes increasingly harder to fasten buttons, use a pen, or perform simple tasks that require small movements.
In exceedingly rare cases, individuals with severe spinal stenosis may experience incontinence, severe weakness in the legs, or loss of feeling in the genitals and inner thighs. If this happens, contact emergency medical help immediately. For most people, spinal stenosis is diagnosed and treated before it progresses to this point.
Diagnosing Spinal Stenosis
Your doctor will initially diagnose cervical or lumbar stenosis based on your symptoms, medical history, risk factors (such as age and injury), and a complete physical exam. To confirm the diagnosis, they will use imaging procedures to determine the cause of your symptoms. These may include x-rays of the spinal column, MRIs, and CT scans. These techniques can reveal bone spurs, herniated discs, tumors, and areas where there is pressure on the spinal cord or nerves.
Conservative Treatments for Spinal Stenosis
There are several treatment options for mild to moderate spinal stenosis. Your doctor can help determine the best treatment (or combination of treatments) for you based on the severity of your condition and your pain level.
Conservative treatments for mild to moderate spinal stenosis may include:
- Pain relievers such as naproxen, ibuprofen, or acetaminophen for short-term relief
- Antidepressants to minimize chronic pain and any resulting minor depression
- Prescription opioids such as hydrocodone (used sparingly for short periods of time)
- Physical therapy to improve muscle tone and strength, maintain spinal stability, and improve balance
- Steroid injections to reduce the inflammation of irritated nerves
While these methods don’t correct spinal stenosis and may not work for everyone, they are typically done to reduce swelling, pain, and other symptoms. Surgery is the last resort after other options for alleviating the symptoms of spinal stenosis have proven ineffective.
Surgical Solutions for Spinal Stenosis
When the symptoms of spinal stenosis become moderate or severe, surgery may be the only option. This is particularly important when neurological issues, pain, or mobility problems have developed. The goal of spinal stenosis surgery is to relieve pressure on the nerves or spinal cord so they can heal and return to proper functioning.
Laminectomy
The most common surgical treatment for either cervical or lumbar stenosis is a laminectomy. During this procedure, two vertebral laminae—which form the “roof” of the spinal canal—and the bony area connecting them are removed, relieving pressure on the spinal cord. Bone grafts or instrumentation are added to stabilize the site and protect the spinal cord. Depending on the severity of the stenosis, fusion of the surrounding vertebrae may be performed for added stability.
Transforaminotomy
Transforaminotomy is generally for less severe cases of lumbar stenosis. This option is not as involved as a laminectomy and is reserved for situations when the stenosis is restricted to a small area of the lumbar spine. Transforaminotomy involves the widening of the bony openings between affected vertebrae, including the removal of any bone spurs that have developed. Your surgeon may also remove damaged soft tissue or herniated discs.
Discectomy
If spinal stenosis is caused by a degenerated or herniated disc pressing on a nerve or the spinal cord, discectomy surgery may be done to remove all or part of the affected disc. Partial discectomies are typically performed for lumbar stenosis, while complete discectomies are more common for cervical stenosis. Your surgeon may fuse the surrounding vertebrae if needed.
Any of these surgical procedures may include minimally invasive options, depending on the severity of the spinal stenosis. After surgery, appropriate care must be taken to allow the area to heal. In some cases, patients will need physical therapy to ensure proper mobility following surgery.
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
8:00am – 4:30pm
What a Dislocated Elbow Means
in Elbow InjuriesArticle featured on the Cleveland Clinic.
The elbow is composed of three bones. A dislocation happens when any of these bones become separated or knocked out of place. If you think you have dislocated your elbow, you should get immediate medical help.
What is a dislocated elbow?
A dislocated elbow occurs when any of the three bones in the elbow joint become separated or knocked out of their normal positions.
Dislocation can be very painful, causing the elbow to become unstable and sometimes unable to move. Dislocation damages the ligaments of the elbow and can also damage the surrounding muscles, nerves and tendons (tissues that connect the bones at a joint).
You should seek immediate medical treatment if you think you have an elbow dislocation. Treatment reduces the risk of irreversible damage.
How common is a dislocated elbow?
The incidence of the injury has been estimated at 2.9 events per 100,000 people over the age of 16. In children, dislocations can happen when someone yanks on the child’s arm.
SYMPTOMS AND CAUSES
What causes a dislocated elbow?
There can be various causes of a dislocated elbow.
What are the signs and symptoms of a dislocated elbow?
A dislocated elbow can be partial or complete. A complete elbow dislocation involves a total separation and is called a luxation. When the elbow joint is partially dislocated, it is called a subluxation.
Doctors also classify elbow dislocations according to the extent of the damage and where it occurs. The 3 types include:
The signs and symptoms of a dislocated elbow vary depending on the severity of the injury and the bones involved. They include:
DIAGNOSIS AND TESTS
How is dislocated elbow diagnosed?
A doctor diagnoses a dislocated elbow by looking at the arm and moving the joint.
In many cases, doctors use an imaging test called an X-ray to see if the bone is injured. Occasionally, doctors use tests called MRI or CT scans to look for damage to the surrounding muscles and tendons.
MANAGEMENT AND TREATMENT
How is a dislocated elbow condition managed or treated?
Some dislocated elbows return to their usual position on their own. More severe cases need a doctor to return the bones to their proper position.
Treatment for a dislocated elbow varies according to the severity of the injury. Steps you can take to reduce pain while you wait to see a doctor include:
Treatments for an elbow dislocation include:
PREVENTION
Can dislocated elbow be prevented?
Caution can help reduce your risk of a dislocated elbow. Be careful on slippery surfaces and stairs to avoid falls. Avoid overtraining in sports to avoid overuse injuries.
What are the risk factors for dislocated elbow?
People at higher risk for a dislocated elbow include those who:
OUTLOOK/PROGNOSIS
What is the prognosis (outlook) for people with dislocated elbow?
Recovery times vary according to the severity of the elbow dislocation. Many dislocated elbows do not cause any further problems once they heal. They usually feel better as soon as a doctor puts the joint back in place.
LIVING WITH
When should I call the doctor?
Contact your doctor if you have the symptoms of a dislocated elbow. Do not try to push a dislocated elbow back into place yourself. This effort could damage the surrounding tissue and tendons and lead to complications. If you have a dislocated elbow, let your doctor know if you think you are not healing correctly or continue to have problems.
What questions should I ask my doctor?
If you have a dislocated elbow, you may want to ask your doctor:
When can I go back to my regular activities?
Healing time for a dislocated elbow varies depending on the severity of the injury. Most people with a dislocated elbow can return to their usual activities once a doctor has returned the joint to its normal position.
A sling can help protect the elbow joint so you can return to your usual activities while the joint heals. Your doctor will let you know when you can resume more physical activities such as sports or lifting heavy objects.
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
8:00am – 4:30pm
Managing Neck and Lower Back Pain
in Back Pain, Neck PainArticle featured on Cone Health
According to Dahari Brooks, MD, neck and lower back pain is often caused by muscle strain, degenerative disc disease or arthritis.
“If the pain comes on suddenly and out of the blue, you may have pulled a muscle and can begin with at home treatments,” shares Dr. Brooks.
If you suspect a pulled muscle, Dr. Brooks suggests resting for a day. You can treat pain with over-the-counter anti-inflammatory medications. In the first 24 hours or so, cold therapy can help minimize pain and swelling. Place an ice pack on the painful area for 10 minutes followed by 20-minute breaks. Later, you can consider cold and/or heat therapy for relief. Ease back into exercising with walking and stretching.
“On the other hand, if your chronic pain has worsened over time or you experience a sudden onset of arm or leg weakness, pain or numbness, it is time to make an appointment,” adds Dr. Brooks. “A comprehensive physical examination will help determine the cause of your problem.”
During office visit, you will be examined for issues such as a pinched nerve. You may need to take an x-ray to rule out structural issues. Often, physical therapy or steroid injections can offer improvement. If not, soft tissue imaging can reveal bone spurs or discs that have herniated, degenerated or broken down over time.
“If you are experiencing horrific or radiating pain, weakness or numbness in the neck or limbs or lack of balance, make an appointment to be seen right away,” concludes Dr. Brooks. “These types of symptoms can signal a more serious issue and require more immediate attention.”
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
8:00am – 4:30pm
Is It Time for a Pain Management Reboot?
in pain reliefArticle featured on WebMD
Now that we are entering a new phase in the COVID-19 pandemic where access to vaccines is high, infection rates are declining, and there is greater access to health-related services, this might be a time to reevaluate your pain management plan and consider what changes can make a positive impact.
Let’s start by taking a look at some of the ways the pandemic may have increased your pain problem:
Now that access to resources has likely improved in many of your communities, here are some thoughts to help you navigate your next steps:
Now might be the perfect time to consider what you can safely add or modify to your pain management plan. Before starting something new or restarting something that maybe you haven’t done in over a year, it is always a good idea to first talk with your doctor.
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
8:00am – 4:30pm
Cervical Disc Surgery: Disc Replacement or Fusion?
in Disk Injuries, Spinal Surgery, SpineArticle featured on WebMD, medically reviewed by Sabrina Felson, MD
The vast majority of people — more than 90% — with pain from cervical disc disease will get better on their own over time with simple, conservative treatments. Surgery, however, may help if other treatments fail or if symptoms worsen to the point that weakness in your arms and or legs develop. This is called a cervical myelopathy and surgery is recommended.
Cervical disc disease is caused by an abnormality in one or more discs — the cushions — that lie between the neck bones (vertebrae). When a disc is damaged — due to degenerative disc disease (or DDD) or an unknown cause — it can lead to neck pain from inflammation or muscle spasm. In severe cases, pain and numbness can occur in the arms from pressure on the cervical nerve roots or spinal cord.
Surgery for cervical disc disease typically involves removing the disc that is pinching the nerve or pressing on the spinal cord. This surgery is called a discectomy. Depending on where the disc is located, the surgeon can remove it through a small incision either in the front (anterior discectomy) or back (posterior discectomy) of the neck while you are under anesthesia. A similar technique, microdiscectomy, removes the disc through a smaller incision using a microscope or other magnifying device.
Often, a procedure is performed to close the space that’s left when the disc is removed and restore the spine to its original length. Patients have two options:
In 2007, the FDA approved the first artificial disc, the Prestige Cervical disc, which looks and moves much like the real thing but is made of metal. Since then, several artificial cervical discs have been developed and approved. Ongoing research has shown that the artificial disc can improve neck and arm pain as safely and effectively as cervical fusion while allowing for range of motion that is as good or better than with cervical fusion. People who get the artificial disc are often able to return to work more quickly as well. The surgery to replace the disc, however, does take longer and can lead to more blood loss than with cervical fusion. It’s also not known how the artificial discs will last over time. People who get an artificial disc can always opt for cervical fusion later. But if a patient has cervical fusion first, it’s not possible to later put an artificial disc in the same spot.
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
8:00am – 4:30pm
Why Do My Knees Pop?
in Knee Injuries, Knee PainArticle featured on Cone Health Medical Group
Have you ever bent down to pick up something and heard a loud pop or crack coming from your knees? This sound is called “crepitus,” which is defined as “joint noise.” Popping knees are not unusual. It happens when carbon dioxide builds up in the joint’s synovial fluid and is released as a gas bubble that bursts when the joint adjusts rapidly. It is the same process that causes knuckles to crack.
Most of the time, this noise should cause no concern. There has been a rumor circulating for years that popping joints are a sign of impending arthritis, but there has been no research that supports this.
Some folks may hear a grinding noise in the knee when they squat. This is another form of crepitus and is typically nothing to be concerned about. The sound is caused by the cartilage rubbing on the joint surface and other soft tissue when the knee moves.
Most people experience crepitus their entire lives with no problems.
What if it hurts when my joints pop or grind?
You should be concerned if you have joint noise that is accompanied by pain, discomfort or swelling. This could be a sign that medical attention is required. Two of the most common cause for knee pain are:
What are the treatment options for knee injuries?
To help protect the knees, try exercises that develop the quadriceps, which are the muscles in the front of the thigh. Exercises that benefit this muscle group are walking, cycling and swimming. Other effective ways of protecting the knees are wearing supportive shoes, warming up before and stretching after exercise, and maintaining a healthy body weight.
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
8:00am – 4:30pm
Back Strains and Sprains
in Back PainArticle featured on Cleveland Clinic
A back strain is an injury to either a muscle or tendon, while a back sprain is the stretching or tearing of a ligament. The symptoms, causes and treatment of back strains and sprains are discussed.
Overview
The back is a complex structure of bone and muscle, supported by cartilage, tendons and ligaments, and fed by a network of blood vessels and nerves. The back—especially the lumbar, or lower back—bears much of the body’s weight during walking, running, lifting and other activities. It makes sense, then, that injuries to the lower back—such as strains and sprains—are common.
What is a strain?
A strain is an injury to either a muscle or tendon. Tendons are the tough, fibrous bands of tissue that connect muscle to bone. With a back strain, the muscles and tendons that support the spine are twisted, pulled or torn.
What is a sprain?
A sprain is the stretching or tearing of a ligament. Ligaments are the fibrous bands of tissue that connect two or more bones at a joint and prevent excessive movement of the joint.
How common are back strains and sprains?
Strains and sprains are very common injuries. Next to headaches, back problems are the most common complaint to healthcare professionals.
Symptoms and Causes
What causes a back strain or sprain?
Twisting or pulling a muscle or tendon can result in a strain. It can also be caused by a single instance of improper lifting or by overstressing the back muscles. A chronic (long-term) strain usually results from overuse after prolonged, repetitive movement of the muscles and tendons.
A sprain often occurs after a fall or sudden twist, or a blow to the body that forces a joint out of its normal position. All of these conditions stretch one or more ligaments beyond their normal range of movement, causing injury.
In addition, several factors can put a person at greater risk for a back strain or sprain, including:
Playing sports that involve pushing and pulling—such as weightlifting and football—also increases the risk of a low back injury.
What are the symptoms of a back strain or sprain?
Symptoms of a strain or sprain include:
In some cases, the person may feel a pop or tear at the time of the injury.
Diagnosis and Tests
How are back sprains and strains diagnosed?
Mild strains and sprains can usually be diagnosed based on a medical history—including a review of the symptoms and how the injury occurred—and a physical examination by a healthcare provider. In cases of more severe strains and sprains, especially when there is weakness or loss of function, an X-ray may be taken to rule out a fractured (broken) or herniated (bulging) disc as the cause of the back pain.
Management and Treatment
How are back strains and sprains treated?
The treatment for strains and sprains is similar, and often takes place in two phases.
The goal of the first phase is to reduce the pain and spasm. This may involve rest, and the use of ice packs and compression (pressure), especially for the first 24 to 48 hours after the injury. An over-the-counter nonsteroidal anti-inflammatory drug, may be recommended to help reduce pain and swelling.
After the first 24 to 48 hours, returning to normal activities, as tolerated, is advisable. Extended bed rest or immobility (nonmovement) simply prolongs symptoms and delays recovery.
Most people with lumbar strain/sprain symptoms improve in about 2 weeks. If symptoms continue for more than 2 weeks, additional treatment may be required.
What complications are associated with back strains and sprains?
The most common complication of a back strain or sprain is a reduction in activity, which can lead to weight gain, loss of bone density, and loss of muscle strength and flexibility in other areas of the body.
Prevention
How can back sprains and strains be prevented?
It is not possible to prevent all back injuries, but you can take some steps to help lower the risk of a sprain or strain:
Outlook/Prognosis
What is the prognosis (outlook) for people with back strains and sprains?
Most people with back strains and sprains have a full recovery with treatment within 2 weeks.
Living With
When should I contact my healthcare provider about a back strain or sprain?
Call your healthcare provider if:
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
8:00am – 4:30pm
How to Prevent Shin Splints
in Sports Related InjuriesArticle featured on Humpal Physical Therapy & Sports Medicine Centers
A shin splint, which is medically referred to as tibial stress syndrome, is a painful injury to the shin that commonly affects runners, but also dancers and other athletes.
Shin pain most often occurs on the medial side of the shin (termed medial tibial stress syndrome, or MTSS) but can also occur on the lateral or anterior side of the lower leg. Shin splint pain develops due to the overexertion of pressure on muscles in the lower legs causing stress on the tissues in that region. If left untreated, shin splints can lead to lower leg compartment syndrome or even a stress fracture.
Several risk factors have been identified to increase the likelihood of developing shin splints, particularly in runners. These factors include:
Obviously some of these risk factors cannot be changed (such as your gender!) but many of these factors as well as others can be addressed by your Physical Therapist in order to lower your chances of developing shin splints.
Unfortunately there are no proven methods available to definitively prevent shin splints. There are several strategies, however, that may help in preventing shin splints. These strategies include wearing appropriate fitness shoes, warming up before engaging in recreational activities, gradually increasing activity so the body can adapt, discontinuing the activity if you start experiencing pain in the shins, keeping your body weight in check, and seeking the attention of a Physical Therapist before pain arises in order to assess your running or sport biomechanics.
For active individuals such as runners, it is important to take time to find a comfortable shoe that protects the foot and promotes normal mobility. Bulky and ‘shock-absorbing’ shoes may not be the ideal type to allow body’s natural foot and ankle placement. If you do not have any foot injuries or complications, minimalist type shoes, which replicate the movement of a bare foot are highly recommended. However, you will likely need to seek advice on transitioning from your current footwear to minimalist shoes to avoid injuries from sudden change.
Minimalist type shoes improve the strength of the feet over time by allowing the feet to bear more of the impact force that is experienced during physical activity. In addition, they promote an increased cadence (step frequency), which subsequently decreases the strain on your lower extremities. There is also reliable evidence available on prevention of shin splints by using shock-absorbing insoles within your shoes, however, more quality research is certainly required before this advice becomes universal. You can assess your running and walking pattern, as well as assess your foot and lower extremity alignment and biomechanics to help you determine the best footwear. Taking adequate time for the feet to adjust to new shoes and gradually increasing the level of physical activity, along with replacing your shoes regularly in order to maximize their function will also help to prevent injury.
Taking ample time to properly warm up before engaging in physical activity can also reduce the occurrence of injuries. A warm up that includes a short activity to get the heart rate up followed by dynamic stretching is best. Dynamic stretches are stretches that involve quick movements of the limbs and body and, for best results, should simulate the activity you are about to engage in. When athletes perform dynamic warm-ups, they typically demonstrate enhanced flexibility and improved performance. Runners, for example, may do dynamic stretching by swinging their legs back and forth to simulate running or do several jumps on the spot. These quick stretches stimulate the nervous system and increase the range of motion in the muscles and joints.
If you start experiencing pain in your shins during physical activity it is important to discontinue the activity and allow the muscles in the legs adequate time to rest and recover. Simple icing can be very effective in this early stage of pain. Continuing to exercise when pain is felt in the shins can cause overexertion, which may lead to chronic shin splints, or a compartment syndrome or stress fracture developing.
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
8:00am – 4:30pm
RA Symptoms You Shouldn’t Ignore
in Rheumatoid ArthritisArticle featured on WebMD, Medically reviewed by Brunilda Nazario, MD
Rheumatoid arthritis can have many symptoms. The most common are stiff, painful joints and fatigue.
But this disease causes inflammation in many body parts, so you may have symptoms that you don’t realize are related to RA. Some are signs of serious complications that put your organs, or even your life, at risk.
If you have any of these symptoms, don’t try to deal with them on your own. Call your doctor right away.
Broken Bones
Both RA and medications to treat it, like steroids, cause your bones to become weaker. You’re more likely to break a bone if you fall. Exercise, especially weight-bearing activity like walking, helps to keep your bones strong.
Chest Pain
RA makes you more likely to get heart disease. Over time, plaque builds up in your arteries. Doctors call this atherosclerosis. This can lead to a heart attack. Chest pain is a common symptom.
RA is a possible cause of a painful heart problem called pericarditis. That’s when thin layers of tissue around your heart get inflamed. You may feel severe chest pain that’s easy to mistake for a heart attack.
Even though your chest pain may not be a heart attack, if you have it, call 911 or go to the emergency room right away.
Dryness
RA sometimes causes dry eyes. This makes you more likely to get an eye infection.
People with RA could get another autoimmune condition called Sjögren’s syndrome. It often leads to dry mouth, nose, eyes, vagina, or skin. Your lips or tongue may dry out, crack, and get infected.
Eye Problems
It’s rare, but RA can cause inflammation in the white part of your eye, called the sclera. The symptoms are mostly redness and eye pain. You might have blurry vision. If you notice these signs, see your doctor.
Work With Your Doctor to Prevent RA Complications
With RA, it’s important to treat more than just your joints. Talk to your doctor to tailor a plan.
Fever
It can be a sign of infection. RA medications like biologics and steroids slow down your immune system. While they ease joint pain and swelling, it’s harder for you to fight off bugs like the flu. RA makes you more likely to get an infection just because the disease wears down your immune system.
Mild fever is also one sign of an RA flare. That’s when inflammation gets out of control. If it gets too high, your doctor will check for infection.
Hearing Loss
There may be a slightly higher risk of hearing loss with RA.
Tinnitus, or ringing in your ears, can be a side effect of treatments like nonsteroidal anti-inflammatory drugs (NSAIDs) and disease-modifying antirheumatic drugs (DMARDs).
Mood Changes
RA is tied to depression, anxiety, and other mood problems. That’s because the disease causes pain, fatigue, and stiffness that make it harder to do the things you enjoy. Depression and anxiety could also come from inflammation.
Some people with RA get fibromyalgia. This illness causes muscle pain and often leads to depression and anxiety. Stress makes all of your symptoms worse.
If your mood changes seem to take over your life, talk to your doctor. Depression and anxiety can become serious if you don’t treat them.
Numbness or Tingling
RA sometimes affects the small nerves in your hands or feet. They might feel numb or like you’re being stuck with pins and needles.
If these tiny blood vessels in your hands or feet shut down, your fingers or toes may feel cold or numb. They could even change color when it’s cold outside and look white, red, or blue.
Rheumatoid vasculitis, which affects blood vessels, can also cause numbness, tingling, burning, or pain in your hands or feet due to damaged nerves. If your hands or feet are so numb that they drop or go limp when you try to raise them, see your doctor right away.
Numbness and tingling are side effects of biologics, too.
Stomach Pain or Indigestion
RA and medicines used to treat it are linked to mouth and stomach ulcers, stomach bleeding, acid reflux, diarrhea, and constipation. Painful diverticulitis (inflamed pouches in your GI tract) and colitis (an inflamed colon) are also possible if you have RA.
RA drugs like NSAIDs often cause ulcers or an upset stomach.
Belly pain is sometimes a sign of a rare RA complication called rheumatoid vasculitis — when inflammation spreads to your blood vessels. Weight loss and lack of appetite are other symptoms. Vasculitis is serious, so see a doctor right away.
Trouble Breathing
If you have a hard time getting your breath and can’t figure out why, maybe RA is to blame. Some people with the disease, especially men who smoke or used to smoke, are more likely to get serious lung problems.
When RA inflammation causes scar tissue to form in your lungs, you might notice chronic cough, shortness of breath, fatigue, and weakness.
RA may inflame the tissue that lines your lungs. That can lead to shortness of breath or pain or discomfort when you breathe.
See your doctor right away if you have unusual breathing problems or a cough that won’t go away.
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
8:00am – 4:30pm
Symptoms & Solutions: Spinal Stenosis
in Spinal Stenosis, SpineArticle featured on Arkansas Surgical Hospital
What is Spinal Stenosis?
Spinal stenosis is a deterioration of vertebrae that causes narrowing of the openings of the spinal column. Over time, this puts pressure on the nerves inside the spinal column. In most cases, individuals develop spinal stenosis in either the neck (called cervical stenosis) or the lower back (called lumbar stenosis).
What Causes Spinal Stenosis?
The most common cause of spinal stenosis is osteoarthritis that causes bone spurs. These spurs can impinge on the spinal cord or pinch one or more nerves emanating from the spinal column. Other causes of spinal stenosis include pressure on the spinal cord or nerves from herniated discs, tumors, thickened or inflamed ligaments, or trauma that dislocates or breaks vertebrae.
Types of Spinal Stenosis & Their Symptoms
Some people develop mild cases of spinal stenosis without experiencing any symptoms. However, if the deterioration continues over time, a variety of symptoms can develop. Symptoms are most common in individuals over 60 years of age and tend to become more severe with age due to wear and tear on the spinal vertebrae. Symptoms typically vary based on the location of the stenosis in the spine.
Lumbar Spinal Stenosis
Spinal stenosis is more common in the lower back than in the neck. This type of spinal stenosis is called lumbar stenosis. The most common symptom of lumbar stenosis is neurogenic claudication, which is leg pain that comes and goes due to pinched nerves in the spinal cord. It can cause weakness or cramps in the legs that can be severe. It is more troublesome when standing or walking for long periods, and it may become less severe or go away when you sit or bend forward.
Numbness or a pins-and-needles sensation in one or both legs is another symptom. The sensation is similar to when your foot falls asleep, but is more frequent or may last longer. Weakness in the feet or legs can also indicate lumbar stenosis. Gait issues such as foot drop may arise from weakness in the calves or quadriceps. Foot drop is the inability to raise the front of the foot properly due to weakness. Instead, the foot drops forward, often dragging on the ground or causing the person to trip.
When the pain is in one leg and accompanied by weakness, it may be referred to as sciatica, depending on which nerve is compressed. Some individuals may feel pain in the buttocks and lower back as well.
Cervical Spinal Stenosis
The narrowing of the spinal column that causes pressure on the spinal cord in the neck is called cervical stenosis. People with cervical stenosis can develop problems with their gait and keeping their balance, which affects their mobility. The gait problems arise from the compression of the spinal cord rather than a pinched nerve. This condition progresses over time, with the individual falling more frequently as the compression worsens.
Pain in the shoulder, arm, or neck may also be a sign of cervical stenosis, particularly if the pain is shock-like or is accompanied by a burning sensation. Some people experience numbness or a pins-and-needles tingling sensation in one or both hands. This is sometimes accompanied by weakness and loss of fine motor skills. Over time, it becomes increasingly harder to fasten buttons, use a pen, or perform simple tasks that require small movements.
In exceedingly rare cases, individuals with severe spinal stenosis may experience incontinence, severe weakness in the legs, or loss of feeling in the genitals and inner thighs. If this happens, contact emergency medical help immediately. For most people, spinal stenosis is diagnosed and treated before it progresses to this point.
Diagnosing Spinal Stenosis
Your doctor will initially diagnose cervical or lumbar stenosis based on your symptoms, medical history, risk factors (such as age and injury), and a complete physical exam. To confirm the diagnosis, they will use imaging procedures to determine the cause of your symptoms. These may include x-rays of the spinal column, MRIs, and CT scans. These techniques can reveal bone spurs, herniated discs, tumors, and areas where there is pressure on the spinal cord or nerves.
Conservative Treatments for Spinal Stenosis
There are several treatment options for mild to moderate spinal stenosis. Your doctor can help determine the best treatment (or combination of treatments) for you based on the severity of your condition and your pain level.
Conservative treatments for mild to moderate spinal stenosis may include:
While these methods don’t correct spinal stenosis and may not work for everyone, they are typically done to reduce swelling, pain, and other symptoms. Surgery is the last resort after other options for alleviating the symptoms of spinal stenosis have proven ineffective.
Surgical Solutions for Spinal Stenosis
When the symptoms of spinal stenosis become moderate or severe, surgery may be the only option. This is particularly important when neurological issues, pain, or mobility problems have developed. The goal of spinal stenosis surgery is to relieve pressure on the nerves or spinal cord so they can heal and return to proper functioning.
Laminectomy
The most common surgical treatment for either cervical or lumbar stenosis is a laminectomy. During this procedure, two vertebral laminae—which form the “roof” of the spinal canal—and the bony area connecting them are removed, relieving pressure on the spinal cord. Bone grafts or instrumentation are added to stabilize the site and protect the spinal cord. Depending on the severity of the stenosis, fusion of the surrounding vertebrae may be performed for added stability.
Transforaminotomy
Transforaminotomy is generally for less severe cases of lumbar stenosis. This option is not as involved as a laminectomy and is reserved for situations when the stenosis is restricted to a small area of the lumbar spine. Transforaminotomy involves the widening of the bony openings between affected vertebrae, including the removal of any bone spurs that have developed. Your surgeon may also remove damaged soft tissue or herniated discs.
Discectomy
If spinal stenosis is caused by a degenerated or herniated disc pressing on a nerve or the spinal cord, discectomy surgery may be done to remove all or part of the affected disc. Partial discectomies are typically performed for lumbar stenosis, while complete discectomies are more common for cervical stenosis. Your surgeon may fuse the surrounding vertebrae if needed.
Any of these surgical procedures may include minimally invasive options, depending on the severity of the spinal stenosis. After surgery, appropriate care must be taken to allow the area to heal. In some cases, patients will need physical therapy to ensure proper mobility following surgery.
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
8:00am – 4:30pm
What to Do for Hand and Wrist Pain
in Hand Injuries, WristArticle featured on verywellfit, Medically reviewed by Vanessa Nzeh, MD on May 01, 2021
Office work is well known for being detrimental to people’s backs due to prolonged periods of sitting.
But, there’s another body part that excessive typing, texting, scrolling, and mouse-clicking wreak havoc on, too—the hands and wrists.
Hand and wrist pain is a notable side effect of office work that many people assume they have to live with. Thankfully, there are actually numerous ways to lessen office-work-induced hand and wrist pain, and ways to help prevent it.
Let’s look at why hand and wrist pain are so prevalent and what you can do about it.
Common Causes And Effects of Hand And Wrist Pain
There is an abundance of hand movement repetition in the tasks for office work, with the main activities performed being typing, scrolling or clicking with a mouse, and texting on a cell phone.
When we overuse our hands and wrists by typing, our bodies are put at risk of developing numerous conditions. These include:
These effects are usually not permanent, but they can be very painful. Once you have frequent hand and wrist pain from typing, other activities in your life, such as exercise or sports, or even opening doors, might also be affected.
Additionally, the prolonged inflammation in your hands and wrists can lead to arthritis in coming years.
Ways to Reduce Hand and Wrist Pain
In addition to life being better when you’re not in pain, it’s important to take steps to prevent that potential occurrence too. Luckily, there are numerous actions you can take to prevent your hand and wrist pain from worsening.
Pausing to stretch your hands and wrists can help bring back flexibility and can improve the blood flow that may be impacted by a lack of arm movement.
If you notice that stretching your hands and wrists reduces your pain, you may opt to stretch briefly every hour or two. In the same way as it’s a good idea to get up and stand every hour to break up your sitting, it’s a good idea to keep your hands and wrists flexible as you use them throughout the day.
Wrist Stretching
Stretching your wrists is an easy way to reduce the pain in them caused by typing. Some examples of wrist stretches you can try are below:
Hand and Finger Stretching
Stretching our hands and fingers isn’t something we tend to think a lot about unless we’re doing a sport that involves gripping, but it can be very helpful in reducing the pain from typing and texting all day.
Here are some ways to stretch your hands and fingers:
Strengthening Exercises
You don’t need a whole workout for your hands and wrists, but taking the time to strengthen this part of your body can have the effect of less pain due to overuse. You don’t need any gym equipment for these exercises.
Use Household Items
There are numerous household items that can be used to help strengthen your hands and wrists such as:
Exercises using those items can be done in just a few short minutes and are very simple, such as putting a rubber band around your fingers and then pushing your fingers out against it.
Unlike the small and simple moves with household items, wrist curls are a more common move for actual exercise workouts.
They can be beneficial to your hands and wrists as well as your forearms, which is the part they’re best known for strengthening.
The goal for this exercise isn’t to get sore, as it might be for some people when they use weights, but too slowly and gradually build strength so that your hands and wrists are in the best possible condition for the daily activities they perform.
Home Remedies For Pain
There are many inexpensive and easy ways to manage pain by reducing inflammation. You could take an over-the-counter pain reducer, which serves to temporarily lower inflammation, or try one of the following remedies below.
Heat and Cold
Alternating between hot and cold treatments through the use of a heating pad and an ice pack can lower inflammation while also providing temporary relief from pain. In the same way that you’d use heat and cold to relieve a sports injury, you can do the same for hand and wrist pain caused by overuse.
Turmeric
This Ayurvedic root is well proven to relieve pain and inflammation. It has been used for millennia and is an incredibly effective natural pain reliever.
With a bright golden color and a mild flavor, you can use ground turmeric in your meals, drink shots of the fresh juice, or make it into a tea.
Ginger
Also an Ayurvedic root used for many generations as a pain and inflammation reducer, ginger has been proven effective for relieving symptoms of arthritis.
Similarly to turmeric, you can use ginger as a dried spice in your cooking, make a tea from the root or powder, or drink fresh juice shots.
Reduce Systemic Inflammation With Everyday Activities
When you make efforts to reduce inflammation, it won’t only be your hands and wrists that will thank you.
Reducing systemic inflammation improves health overall and helps lower your risk for an assortment of illnesses.
There are many ways to go about reducing inflammation on a daily basis. Some you can try include yoga, eating fewer inflammatory foods, managing stress, and getting a sufficient amount of sleep.
How to Prevent Hand and Wrist Pain
Now that you know of ways to reduce the wrist and hand pain you may already have, it’s helpful to know how to keep it gone once you get rid of it.
In addition to taking steps to lower inflammation in your body, and stretching and strengthening your wrists, proper positioning when typing and the use of wrist and hand supports can lower the chances of your pain returning.
Positioning
When sitting to type, start by making sure you’re using a supportive chair that allows for good posture. Having your back straight will assist with the positioning of your arms and wrists. You’ll want to keep your hands hovered lightly over the keyboard, not resting on it, and your fingers curved over the keys.
If you aren’t able to find a comfortable position, you can try a keyboard with a different shape than the one you currently use.
Cushioning
In addition to choosing a keyboard that feels comfortable for your hands, you may find extra comfort in a mouse cushion and a keyboard cushion.
Though a mouse cushion can be used while you are actively using your mouse, a keyboard cushion should only be used when you are paused on typing. That’s because if you use it while you’re typing, you’ll be pushing your wrists up at a sharp angle.
Utilize a keyboard cushion while scrolling with your mouse, taking a brief break in typing, or reading.
Wrist Support Products
There are several types of products that provide support to your hands and wrists. In order to find one that allows you enough mobility while simultaneously providing sufficient support, you may need to try a few on.
Support options for hands and wrists include stabilizers, wraps, and braces.
Your wrists and hands may be in pain, but they don’t have to be! Try one or more of these suggestions to keep yourself pain free, no matter how much you type.
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
8:00am – 4:30pm