5 Signs You Should See a Joint Replacement Specialist

in ,

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Synovitis: Causes and Treatments of Joint Inflammation

in

Article featured on Verywellhealth

Synovitis is a condition that occurs when there is inflammation of the synovial tissue, the lining of a joint. This condition can cause joint pain and swelling. It is the hallmark of all inflammatory joint diseases.

This article will explain what synovial tissue is, the causes of synovitis, and how you can treat the condition so you can gain relief from the inflammation and pain.

What Is the Synovium?

The synovium is a thin layer of tissue that lines the joints and tendon sheaths; it is only a few cells thick. The synovium acts to control the environment within the joint and tendon sheath. It does this in two ways:

First, it acts as a membrane to determine what can pass into the joint space and what stays outside.
Second, the cells within the synovium produce substances that lubricate the joint.

Synovitis Symptoms

The signs of synovitis are similar to other joint disorders:

  • Arthralgia, aching or pain in the joint
  • A warm sensation in the area of the joint
  • Stiffness, which may be worse when you first wake up
  • Swelling; although in some cases, your joint may not swell at all.

You may feel the symptoms of synovium inflammation in different joints throughout your body, or the pain and discomfort might be restricted to one area.

Causes of Synovitis

The primary cause of inflammation of the synovium is related to an overactive immune system. In these situations, your immune system attacks your healthy synovium. This causes excessive growth of the synovium. The membrane becomes inflamed and produces additional synovial fluid.

With these conditions, the joint cartilage and bone can eventually become damaged, leading to stiffness, swelling, warmth in the joint, and significant pain.

Inflammation of the synovial tissue is often related to arthritic conditions. It’s most common in rheumatoid arthritis (RA). However, it also presents with psoriatic arthritis, lupus, and gout.

Synovitis can also be seen with trauma and infection.

Diagnosis

When diagnosing synovitis, a healthcare provider usually starts with a physical exam of the joints, checking for warmth and seeing if they are tender when touched. The thickening of the area manifests as a sponginess that can be felt.

In cases where the inflammation is related to a joint that is deeper under the skin and can’t be checked by hand or eyes, your healthcare provider may order an MRI or musculoskeletal ultrasound.

Treatment

To reduce inflammation and relieve pain, your healthcare provider will likely advise rest and nonsteroidal anti-inflammatory drugs (NSAIDs).

Disease-modifying antirheumatic drugs (DMARDs) that help manage arthritis may also relieve symptoms of synovitis. Sometimes, your healthcare provider may prescribe steroid injections to reduce swelling and discomfort.

If medication does not help ease synovitis, you may be referred to an orthopedic surgeon who can perform a synovectomy. This is a procedure in which part of the synovium is removed.

Summary

Synovitis is the medical term for inflammation of the tissue that lines your joints. This tissue can become damaged, which leads to a thickening of the membrane and excessive fluid. An underlying autoimmune disease that affects the joints, usually RA, is the most likely cause of synovitis, but other types of arthritis and wear and tear can also cause it.

Anti-inflammatory medications are the first line of treatment. However, DMARDS, steroid injections, or even surgery may be required to relieve your pain.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Arthritis Symptoms and Joint Replacement

in , ,

Article featured on Mass General Brigham

What is Arthritis?

Both osteoarthritis and rheumatoid arthritis are conditions that can affect your joints and cause joint pain, stiffness, and swelling. Over time, this can cause cartilage damage. Cartilage is a smooth tissue that protects the movement of the joint. As arthritis progresses, the cartilage continues to break down, causing more pain and reduced range of motion.

What are common arthritis symptoms?

Common symptoms of arthritis include:

  • Swelling
  • Stiffness
  • Pain
  • Limited range of movement

Managing arthritis pain

There are nonsurgical options available if you want to reduce the pain associated with arthritis. Eating healthy foods and losing weight can be a good place to start. “One pound off the body is 4 pounds off the hip and knee. I always tell patients to celebrate when they take 1 pound off, because that’s 4 pounds off of all their joints. This makes them feel better and can help them move better too,” says Dr. Chen.

Other non-surgical treatment options include:

  • Over-the-counter medications, to manage the pain
  • Joint injections like steroids or hyaluronic gel
  • Low-impact strength training to strengthen the muscles to support your joints

Arthritis and joint replacement

“If your joint pain persists after trying these options, and you can’t do your daily activities, it might be time for you to get your joint replaced,” says Dr. Chen.

The most common arthritis joint replacement procedures are:

  • Hip replacement
  • Knee replacement
  • Partial knee replacement (depending on where your arthritis is located)

Hip replacement surgery

If you have hip arthritis, the cartilage in the ball and socket joint wears away. During a hip replacement, your surgeon makes an opening from the front, the side, or the back of your hip. They remove the ball and resurface the socket. They then place a new socket, liner, ball, and stem in your hip.

Knee replacement surgery

If you have knee arthritis, the cartilage between your thigh bone, shin bone, and kneecap wears away. During a knee replacement, your surgeon makes an opening to the front of the knee. They remove the damaged cartilage, replace it with metal, and add a plastic insert in the middle of the joint that allows your knee to glide smoothly. Depending on where your arthritis is located, your surgeon also may remove the back part of your kneecap and replace it with plastic.

Joint replacement surgery recovery

Everyone’s recovery is different, but most patients can walk with an assistive walking device immediately after their surgery. These devices can include:

  • Walkers
  • Canes
  • Crutches

“The most important thing to do is to move as much as possible after surgery,” Dr. Chen says. “Walking is a great option. Not only does it make your mobility better, but it also reduces your risk of blood clots.”

Following surgery, you need to do exercises either on your own or with a physical therapist. A physical therapist can develop a routine targeted to your needs to help you recover from your 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, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

How to Find Relief from Stiff Joints

in

Article featured on Healthline

With age, stiff joints become a reality for many people. Years of use can take a toll on joints, muscles, and bones, but there are steps you can take to find relief.

Why does joint stiffness occur?

Many people experience stiff joints just after waking up. Lying down for several hours to sleep reduces fluid amounts, making moving joints more difficult first thing in the morning.

Joint stiffness may be mild and only impact your mobility for a brief period each morning or after sitting for extended periods of time. The stiffness can also be more severe and impact your mobility.

In some cases, pain and inflammation accompany joint stiffness. This may make walking, standing, or putting weight on your joints painful.

Not all stiff joints are the result of age. Many other conditions can cause stiff joints. These include arthritis, lupus, and bursitis. Lifestyle factors, including diet and weight management, can also impact joint mobility.

Keep reading to learn more about possible causes and treatments.

Possible causes

1. Rheumatoid arthritis (RA)

The most common cause of joint pain is arthritis. About 15 million people with arthritis report experiencing severe joint pain.

Rheumatoid arthritis (RA) is one of the most common forms of arthritis, affecting over 1.5 million Americans. Its symptoms typically appear between ages 30 and 60.

RA is a chronic inflammatory disorder. It’s also an autoimmune disease. This means that your immune system attacks healthy parts of your body, such as the lining of your joints. This causes inflammation, pain, and stiffness. Over time, it can also cause joint deformity and bone erosion.

Common symptoms of RA include:

  • joint pain
  • joint stiffness
  • joint swelling

RA has no cure, so its symptoms can’t be entirely eliminated. They can be managed through medication and other treatments. However, little can be done to prevent the disease once it has advanced.

2. Osteoarthritis (OA)

Another common form of arthritis is osteoarthritis (OA). OA is sometimes called degenerative arthritis. It affects nearly 32.5 million Americans. It’s most common in people over age 50.

This type of arthritis results from wear and tear on your joints. Cartilage, the thin tissue that protects the bones in your joints, wears away with use. Over time, the cartilage can no longer protect your bones.

OA can affect any joint in the body, but it most often affects the:

  • knees
  • hips
  • fingers
  • neck
  • back

As OA progresses, it can begin to cause symptoms other than stiffness. These include:

  • pain
  • swelling
  • cracking sounds when the joint is in motion

As the condition worsens, you could develop bone spurs. In the advanced stages of OA, the cartilage virtually disappears. Bones rub against other bones in your joint. This can cause extreme pain, stiffness, and disability.

Treatment for OA can help. Lifestyle treatments can be effective, such as exercise to reduce weight and pressure on joints. Additionally, medication may be administered to help relieve immense pain, such as:

  • pain relievers
  • paracetamol
  • non-steroid anti-inflammatory drugs (NSAIDs)
  • opioids

In severe cases, joint replacement surgery may be necessary.

3. Lupus

Lupus is an autoimmune disease like RA. Your body attacks itself, including your organs and tissues. Lupus that attacks your joints can cause stiffness, pain, and swelling.

Lupus is difficult to diagnose because its symptoms mimic many other conditions. A lupus diagnosis may take several months while tests rule out other conditions.

Like RA, lupus is chronic. Once you develop it, you will likely experience symptoms of the condition for the rest of your life. There isn’t a cure, but treatments effectively reduce and control symptoms. Treatments include:

  • Benlysta (belimumab): a biologic therapy taken with other medications that help prevent autoreactive B cells (an underlying cause of lupus) from remaining in the body for too long.
  • Saphnelo (anifrolumab): a prescription medication that blocks type 1 interferon activity, which plays a central role in how lupus affects the human body.
  • Lupkynis (voclosporin): another prescription medication that binds to calcineurin proteins in the body, helping reduce inflammation in the kidneys.

Other potential treatment options include hydroxychloroquine, corticosteroids, and a shift toward healthier lifestyle choices may also be prescribed to combat lupus symptoms.

4. Bursitis

Bursae are tiny fluid-filled sacs that cushion the bones, ligaments, and muscles in your joints. You develop bursitis when those sacs become inflamed. This condition can cause stiffness and pain in the affected joint.

Bursitis can affect any joint, but it is most common in large joints like the:

  • elbow
  • shoulder
  • hip

Other common sites include the following:

  • knee
  • ankle
  • big toe

Bursitis is often temporary, and treatment relies on resting the affected joint for several weeks. This may mean you need to reduce physical activity and keep the joint stationary for periods, allowing the bursae to recover and stiffness to resolve.

Your healthcare professional may ask you to perform exercises to relieve certain bursitis pain.

5. Gout

Unlike some other possible causes of joint stiffness, gout comes on suddenly. It may appear while you’re asleep, making the joints especially painful when you wake up.

Severe, sudden episodes of pain and tenderness in joints characterize gout. Gout can impact any joint. The big toe is frequently the first joint to experience symptoms.

Gout is a type of arthritis. It affects men more often than women, but a woman’s risk for developing gout increases after menopause. Most people will deal with periods of gout symptoms for the rest of their life, but symptoms are treatable.

6. Bone cancer

This is rarely a cause of joint pain and stiffness, but it is possible. People with bone cancer may experience joint pain or bone pain. You may also experience swelling or sensitivity near a bone.

Not everyone will have pain, which is why bone cancer may advance and begin causing other symptoms before it’s discovered.

Cancer is treatable, but the outcome depends on several factors. These factors include the size, location, and type of tumor.

Treatment options for bone cancer include radiation, chemotherapy, and surgery. Additionally, immunotherapy (immuno-oncology), a newer treatment option, uses checkpoint inhibitors such as Keytruda (pembrolizumab) to boost the immune response against cancer cells.

How to find relief

The best way to ease joint stiffness depends on what’s causing it in the first place. If stiffness lasts longer than 30 minutes after you wake up or if symptoms worsen, it’s important you seek medical attention.

Diagnosing the underlying problem will help you and your doctor determine the best way to ease stiffness and stop other associated symptoms.

Hot or cold compress

Both temperature extremes may be beneficial for stiff joints.

Apply a cold compress or bag of ice to your stiff joint for 15 to 20 minutes several times a day. This can help reduce inflammation or swelling and ease the joint into movement. It can also dull pain receptors, so you experience less pain.

Heat is also therapeutic to joints and muscles. Use a heating pad, hot water bottle, or warm water from a shower or bath to relax muscles and increase circulation.

Over-the-counter (OTC) medication

Many mild symptoms of joint pain can be relieved by OTC medicines. NSAIDs are the most commonly used medication for arthritis. Generic names for NSAIDs include aspirin, ibuprofen, and naproxen.

Steroids

If inflammation and swelling in the joint cause joint stiffness, steroids may be a treatment option. Swelling and inflammation are common with arthritis.

Corticosteroids reduce inflammation. When inflammation decreases, joint pain and stiffness decrease too.

Steroids may not be beneficial for people with advanced arthritis. In some cases, relief may be short-lived, and future steroid injections may not be as effective.

Exercise

Exercise and physical therapy may help increase joint mobility, reducing stiffness.

It’s also a great way to lose or maintain a healthy weight. Carrying around excess pounds can increase your risk for conditions that cause joint pain and stiffness.

If you’re unsure how to begin exercising or have difficulty with movement, talk with your doctor or a trained physical therapist. Exercise is an easy way to relieve pain and stiffness, but you can aggravate certain conditions if you don’t take precautions before beginning an exercise plan. Causes, Relief Tips, When…

When to see your doctor

If joint stiffness and pain come on suddenly, talk with your doctor. Likewise, if the stiffness and pain don’t resolve after five to seven days, you should seek medical attention.

You should also seek attention from your doctor if you experience any of these symptoms:

  • severe pain
  • rapid swelling
  • joint deformity
  • inability to move the joint
  • intense redness and hot to the touch

Though joint stiffness isn’t uncommon, especially as you age, it can be the first sign of another condition. A physical exam is an easy way to determine what might be causing the issue.

If a physical exam isn’t conclusive, your doctor may suggest some treatments to help ease the stiffness while you wait to see if it disappears. If it doesn’t disappear, you may need tests to get a diagnosis.

Once your doctor determines the cause, they can help determine the best treatment plan for you. This may help ease your symptoms and reduce the risk of recurrence.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Common Dance Injuries and Prevention Tips

in , , , ,

Article featured on Johns Hopkins Medicine

Dance may look effortless, but it requires a lot of strength, flexibility and stamina. It also comes with a high risk of injuries. Whether you are a dancer, the parent of a dancer or a dance teacher, you should be aware of the most common dance injuries and learn how to avoid them.

Johns Hopkins performing arts physical therapists Andrea Lasner and Amanda Greene share valuable information about dance injury treatments and prevention tips. Lasner and Greene, both dancers, have turned their love for the art into a means of helping injured dancers.

What are some common dance injuries?

A few studies that looked into dance injuries found that injuries from using your joints and muscles too much (overuse injuries) are the most common in dancers. The majority of these overuse injuries involve an ankle, leg, foot or lower back. Some common dance injuries are:

  • Hip injuries: snapping hip syndrome, hip impingement, labral tears, hip flexor tendonitis, hip bursitis and sacroiliac joint dysfunction
  • Foot and ankle injuries: Achilles tendonitis, trigger toe and ankle impingement
  • Knee injuries: patellofemoral pain syndrome
  • Stress fractures: metatarsals, tibia, sesamoids and lumbar spine
  • Dancers are also likely to develop arthritis in the knee, hip, ankle and foot

Generally, dancers have a much lower rate of anterior cruciate ligament (ACL) injuries than other athletes. One explanation could be that dance training involves much more intense jumping from an earlier age than other sports, which helps improve muscle control.

How do I know if the pain is from an injury?

In most cases, the pain you experience after dancing is muscle soreness that usually subsides within 24 to 48 hours. Sometimes, it takes a few days for muscles to get sore, which is also normal. However, if you experience the following types of pain, you may have suffered an injury:

  • Pain that wakes you up at night
  • Pain that is present at the start of an activity
  • Pain that increases with an activity
  • Pain that makes you shift your weight or otherwise compensate your movements

If you experience such pain, consult with a medical specialist — preferably a physical therapist or physician with experience in treating dancers. They will be able to determine whether additional testing is needed and will formulate an appropriate treatment plan.

Why do dance injuries happen?

Dance is a physically demanding activity. Dancers perform repetitive movements for several hours a day. Studies have shown that dancing five hours a day or longer leads to an increased risk of stress fractures and other injuries.

On top of the intensive training, many dancers get little time to recover between the sessions and have no “offseason.” Restrictive diets and unhealthy body weights may also contribute to dance injuries. Proper nutrition is important for dancers of all ages.

How do dancers get ankle sprains?

Ankle sprains are the number one traumatic injury in dancers. Traumatic injuries are different from overuse injuries as they happen unexpectedly. When an ankle is sprained, ligaments on the inside or outside of your foot get twisted or overstretched and may experience tears. Ankle sprains often happen due to improper landing from a jump, misaligned ankles (when they roll in or out) or poorly fitted shoes. Torn ligaments never heal to their preinjury condition. Once you’ve sprained your ankle, you are at risk of doing it again. It’s important to build muscle strength to prevent further injuries.

Dance Injury Prevention

How can dance injuries be prevented?

The majority of overuse injuries and even some traumatic dance injuries can be prevented. Follow these guidelines to reduce your risk of injury:

  • Eat well and stay hydrated before, during and after class.
  • Get enough rest and avoid overtraining.
  • Do cross-training exercises to build strength and endurance in all parts of your body.
  • Always wear proper shoes and attire.
  • Always warm-up before training or performances.
  • Lead a healthy lifestyle and get to know your body.

When injuries happen, address them immediately and get advice from a doctor or physical therapist.

What are good cross-training exercises for dancers?

Core and hip strengthening exercises like Pilates and stability-based yoga are great for dancers. And so are aerobic and cardiovascular activities, such as running, swimming or biking. They get your heart rate up and help build stamina for long performances.

Many dancers don’t do enough cardio during their regular training. Just 30 minutes three to four times a week is usually enough to improve your endurance. As always, do this in moderation and in short intervals to avoid stressing your joints. Being screened by a physical therapist with experience treating dancers will help you identify individual areas of weakness to address with specific exercises.

How much rest should a dancer get?

While many experts stress the importance of proper rest, there are no specific guidelines on the frequency and amount of rest. However, we know that dancing five hours a day or longer is linked to an increased risk of injury. It is also known that intense activity leads to microdamage, which peaks in recovery 12 to 14 hours after a workout. So it would make sense to take the next day off after a high-intensity activity. Dancers should work at their highest intensity a couple of times per week and then take at least two days off, preferably in a row. Also, a three- to four-week period of rest after the season is ideal for recovery.

Dance Injury Treatment

Should I ice or heat after a dance injury?

If it’s a sudden injury, it’s best to apply ice first to reduce swelling and inflammation. RICE treatment is a common approach that involves rest, ice, compression and elevation. After a few days, you can switch to heat to increase blood flow to the area and promote healing. However, every person is different. If you feel that ice helps you better than heat, then there is nothing wrong with continuing to ice. But be careful not to ice before dancing or stretching, because you want those muscles to be warmed up to prevent re-injury.

What are my treatment options for a dance injury?

It depends on the type of injury, your level as a dancer and many other factors. For example, for traumatic injuries like ankle sprains, your doctor may recommend RICE, joint protection and physical therapy. For stress fractures you may need to limit weight on your foot by using crutches, wearing a leg brace or walking boots. Surgery is typically used as the last resort. It is best to discuss your treatment options with a doctor who specializes in dance injuries. And if you are working with a physical therapist, make sure he or she is experienced in treating dancers. A big part of physical therapy is correcting the training technique that led to the injury. Otherwise, you risk hurting yourself again by making the same mistake.

What should be in the first aid kit for dance injuries?

Your regular first aid kit might already have many of the essentials for handling a medical emergency. However, when it comes to common dance injuries, you may want to include a few additional items, such as:

  • Instant cold pack
  • Pre-wrap and athletic tape (if qualified providers are available to apply)
  • Elastic bandages (to be used only for compression, not support while dancing)
  • Crutches
  • Topical pain reliever

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Joints Most Commonly Affected by Arthritis

in ,

Article featured on Healthgrades

Arthritis is a long-term (chronic) condition that causes joint inflammation. When you’re living with arthritis, a simple task, such as tying your shoe or buttoning your shirt can become a challenging one. Not only does the swelling and aching interfere with work and daily living activities, it can also be painful and sometimes debilitating.

There are more than 100 different types of arthritis, but the most common include rheumatoid arthritis (an autoimmune disease) and osteoarthritis (a “wear-and-tear” condition related to aging, injury or obesity). Both cause joint stiffness, pain and decreased range of motion, and can affect many different joints throughout the body.

1. Knee

The knee is one of the most common joints affected by osteoarthritis. This happens when there’s a breakdown of cartilage, which cushions the ends of the bones where they meet the joints. Symptoms of knee arthritis include stiffness, swelling, and pain, which can make it hard to walk and get in and out of chairs and bed. In severe cases, osteoarthritis in the knees can lead to disability.

2. Hand

When you have arthritis in your hands, it usually includes aching, stiffness or numbness in the fingers or at the base of the thumb joint, making it difficult to pinch or grip items. Small, bony knobs may appear on the middle or end joints (those closest to the fingernails) of the fingers, which can become enlarged and gnarled. This type of arthritis in the hands seems to run in families.

3. Hip

The hip is also a common arthritis site. You may have pain and stiffness in your hip joint, but some people also notice pain in the groin, buttocks, lower back, or front or inner thigh. Or they may have pain in only one of these areas. This type of hip arthritis can affect your ability to move or bend, and make daily activities a challenge.

4. Spine, Neck and Back

Arthritis in the spine usually results in stiffness and pain in the neck or lower back, but in some cases, it may not lead to any pain at all. Arthritis changes can also cause pressure on the nerves where they exit the spinal column, leading to weakness, tingling or numbness of the arms and legs. Since these symptoms can often seem like other health conditions, always check with your doctor for a diagnosis.

5. Foot and Ankle

Arthritis can also cause swelling and pain in the foot and ankle. It most often affects the joint at the base of the big toe, which can make walking difficult. The swelling can also lead to bunions on the toes, which can sometimes make the pain and deformity of the foot worse. With rheumatoid arthritis, the same joints on both sides of the body (such as both feet or both ankles) are usually affected.

6. Elbow

Joint inflammation can also be to blame for elbow pain or loss of function. Rheumatoid arthritis is the most common type of arthritis in the elbow, and if one elbow is affected, the other likely will be, too. While elbow osteoarthritis is more common in weight-bearing joints, such as the knee and hip, it can also occur in the elbow, and is often the result of overuse or an injury, such as in the case of a tennis or baseball player.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Why You Shouldn’t Ignore Joint Pain

in

Article featured on

If you have sudden or ongoing pain in your knee, hip or shoulder, you may wonder when it’s time to seek medical care for your joint problem. You may be able to manage pain on your own for a while, but how do you know if joint pain is a sign of a serious problem that needs care?

When should you seek care for joint pain?

If you have joint pain or mobility issues, it’s important to contact an orthopedic expert who specializes in treating conditions that affect the muscles, bones, joints and connective tissues.

Joint symptoms can be addressed through a range of treatment options and making an appointment with an orthopedic surgeon is often the first step in finding relief. Some of the reasons to see an orthopedic surgeon include:

  • New joint pain that isn’t getting better on its own
  • Chronic joint pain that has lasted for months or years
  • Limited mobility, such as difficulty walking, climbing stairs or reaching above your head
  • Difficulty changing position, such as moving from a sitting position to a standing position
  • New use of a cane, walker or wheelchair due to your joint pain or mobility issues
  • Severe pain that may wake you at night
  • Regular use of over-the-counter medications to manage your joint pain
  • Changes to a joint’s appearance, like a straight leg that has begun to bow

“You shouldn’t have to live with joint pain,” says Jeffrey Lange, MD, a hip and knee surgeon at the Center for Joint Health and Mobility at Brigham and Women’s Hospital. “If something is wrong, call us to be evaluated. Every evaluation is different, because every patient is unique.”

Delaying joint care can lead to injury and other problems

For patients who have joint pain or mobility issues, it’s important to stay current with your joint health. In some cases, ignoring joint pain for too long may increase pain or mobility problems, or even result in a fall or injury.

“The more proactive you are in preserving your joints, the longer we anticipate they will last,” says Dr. Lange. “Taking care of your joint pain early could delay or prevent the need for surgery. If you do need surgery, having surgery earlier can lead to better outcomes in many cases. The details differ for every person, which is why we always suggest having an evaluation with a clinician to better understand your own unique situation.”

A check-in with your orthopedic specialist can help you understand all the available options for your unique situation. Together, you and your orthopedic specialist can:

  • Address your joint symptoms and concerns
  • Review or order imaging, such as an X-ray or an MRI
  • Discuss exercises or other lifestyle changes that can reduce pain and improve mobility
  • Discuss the role of pain medicine
  • Schedule a cortisone injection to help relieve pain and inflammation in a joint
  • Pursue a referral to physical therapy
  • Discuss joint replacement surgery or another procedure
  • Discuss the risks and benefits of continuing care versus waiting for a period of time

Benefits of virtual care for joint problems

A consultation with an orthopedic specialist can be done in-person or virtually. A virtual visit allows you to accomplish many of the same things you would review during an in-person visit. Many patients are realizing the benefits of virtual care for joint problems, including:

  • Convenience: Patients don’t have to drive to the clinic or hospital. This is particularly helpful for orthopedic patients who may be in pain or who have limited mobility.
  • Saving time: The average virtual visit lasts about 20-30 minutes and doesn’t involve the time needed to do things like travel to an appointment and find your doctor’s office.
  • Connection: Many patients have been able to maintain strong emotional connections with their providers during virtual visits.

“Going to the doctor’s office used to be a half- or even full-day affair for some patients,” says Dr. Lange. “With a virtual visit, patients can meet with me for a short period of time from the comfort of their homes. They feel like they are still connected with their provider without having to put themselves at risk by leaving their home during this difficult time.”

Safe care for joint pain during COVID-19

While many knee, hip and shoulder problems can be addressed remotely, your orthopedic specialist may want to see you in person for a follow-up evaluation. If you need to visit the clinic, your provider can give you an overview of what to expect during your in-person meeting.

Guided by our Safe Care Commitment, the Center for Joint Health and Mobility has put many safety measures in place to provide the safest possible environment for patients during COVID-19. If you need to visit the clinic for an in-person visit, you will encounter the following safety protocols designed to protect patients and staff:

  • A universal masking policy that requires all patients and staff to wear a face mask
  • Screening of all patients and staff to confirm they don’t have symptoms of COVID-19
  • Spacing of furniture in waiting rooms and other common spaces to maximize physical distancing
  • Signage that directs foot traffic and optimizes the flow of staff and patients
  • Fewer patients in waiting rooms and fewer providers in clinical spaces at any one time
  • Regular deep cleaning of clinical spaces, waiting rooms and frequently-touched surfaces
  • Cleaning and disinfecting of exam rooms after each visit

Patients who are admitted to the hospital for an orthopedic surgery are required to get a COVID-19 test prior to their scheduled procedure. Patients who test positive for the coronavirus must reschedule their operation.

“Many patients who have joint replacement surgery during the pandemic choose to go home on the same day of their procedure,” says Dr. Lange. “Patients can stay in the hospital after their procedure if they choose, but patients who qualify for a same-day surgery have the option to go home faster if they want.”

Patient-centered approach to caring for your joints

The Center for Joint Health and Mobility at the Brigham is home to expert orthopedic specialists who combine advanced treatments with a modern and personalized approach to manage your joint health.

“We’re not just a joint replacement center, we’re a joint health center,” says Dr. Lange. “We provide a single center where patients can get all of their joint health needs in one place, from rehabilitation specialists to joint replacement surgeons. We take a holistic approach to keeping your joints healthy and in optimal condition for as long 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
8:00am – 4:30pm

Brief Overview of Osteoarthritis of the Hip

in , ,

Article featured on UCSF Health

Osteoarthritis of the hip causes the hip joint to get stiff and inflamed and can progress until resting no longer relieves your pain. Bone spurs might build up at the edges of the joint. When the cartilage wears away completely, bones rub directly against each other, making it very painful to move. You may lose the ability to rotate, flex or extend your hip. If you become less active to avoid the pain, the muscles controlling your joint get weak and you may start to limp.

Osteoarthritis, resulting from the wear and tear of your body as you age, affects more than 20 million people in the United States. The pressure of gravity on your joints and surrounding tissues causes physical damage, leading to pain, tenderness, swelling and decreased function. The smooth and glistening covering on the ends of your bones, called articular cartilage, which help your joints glide, may wear thin. Initially, osteoarthritis is not painful and its onset is subtle and gradual, usually involving one or only a few joints. The joints most often affected are the knee, hip and hand. In some instances, joint replacement (arthroplasty) of the hip or knee may be recommended to treat osteoarthritis.

Our Approach to Osteoarthritis of the Hip

When treating hip osteoarthritis, our goals are to relieve pain and restore normal movement. Treating the condition early, with nonsurgical options such as medication and physical therapy, can slow cartilage degeneration, minimize pain and preserve function. If the arthritis is already severe, joint replacement surgery can help, eliminating pain and improving the ability to walk.

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

Chronic Inflammation and Your Joints

in ,

Article featured on Harvard Health Publishing

Why the immune system is sometimes the culprit in joint pain.

When you suffer a joint injury — maybe a banged-up knee or a twisted ankle — a little inflammation is part of the healing process. Puffy, red, tender joints may indicate that your immune system is working to remove damage and promote the growth of new tissue, a healthy kind of inflammation. But sometimes the immune system launches unhealthy, chronic inflammation in the joints, for no apparent reason. This leads to pain, stiffness, and joint damage known as inflammatory arthritis.

The attack on joints

It’s often unknown what triggers the immune system to unleash an assault on the joints, but we do know what the cells are up to once they’re in action.

“In a common type of inflammatory arthritis like rheumatoid arthritis, a variety of immune cells can be found in the lining and fluid of the joint. These cells attract other immune cells and together lead to thickening of the joint lining, new blood vessel formation, and — ultimately — joint damage,” says rheumatologist Dr. Robert Shmerling, medical editor of the Harvard Special Health Report Fighting Inflammation (/ui).

Chronic inflammation in the joints can damage cartilage, bones, tendons (which attach muscle to bones), or ligaments (which hold joints together); irritate nerves; and produce a long list of symptoms, including pain, swelling, and stiffness. The joint damage may be progressive and irreversible.

Types

There are many types of inflammatory arthritis. Common ones include these:

  • Rheumatoid arthritis (RA): RA occurs when the immune system attacks the lining of the joints, especially in the hands, wrists, and feet. RA may also affect the heart, lungs, and eyes.
  • Gout: Gout is characterized by a buildup of uric acid, which can form crystals in the joints — especially in the big toe, and sometimes in the hands, wrists, or knees. The crystals activate a temporary inflammatory response that can become chronic.
  • Calcium pyrophosphate deposition disease (CPPD, or pseudogout): In CPPD, calcium crystals settle in the joints, especially the knee, wrist, shoulder, ankle, or elbow. Like the uric acid crystals in gout, the calcium crystals in CPPD prompt the body to respond with inflammation; over time, this may become chronic.
  • Psoriatic arthritis: About 30% of people with psoriasis (an autoimmune condition that causes raised patches of scaly skin) develop psoriatic arthritis, which can affect the knees, ankles, wrists, or fingers.

What about osteoarthritis?

Osteoarthritis, a wearing away of the smooth cartilage lining joints, has long been considered a noninflammatory form of arthritis. “But we now recognize that some inflammatory cells are present in osteoarthritis, although the inflammation is usually much less dramatic than in rheumatoid arthritis or other types of inflammatory arthritis,” Dr. Shmerling says.

The finding of mild chronic inflammation in osteoarthritis has been significant enough for researchers to begin investigating whether the condition can be treated with some of the same types of medications used to treat inflammatory arthritis.

Treatment

Many types of drugs are used to treat inflammatory arthritis. They include:

  • nonsteroidal anti-inflammatory drugs (NSAIDs), which reduce levels of prostaglandins — chemicals that promote inflammation
  • oral or injected steroids, which reduce inflammation and suppress the immune system
  • injections or intravenous infusions of nonbiologic disease-modifying antirheumatic drugs (DMARDs), which suppress the immune system
  • injections or infusions of biologic DMARDs, that suppress the immune system in a more targeted way than nonbiologic DMARDs
  • Janus kinase inhibitors, which interrupt inflammatory signals
  • drugs that lower uric acid levels (for gout).

Results with drug treatment are often good. “Medications to lower uric acid can essentially eliminate gout. And the development of newer drugs for rheumatoid arthritis, including biologics and Janus kinase inhibitors, makes it possible for far more people than in the past to experience remission and protection from ongoing joint damage,” Dr. Shmerling says.

Other ways to live with arthritis

Other ways to help reduce pain and inflammation include exercising, avoiding processed foods (which promote inflammation), reducing stress, not smoking, and getting enough sleep. Wearing a splint or brace on affected joints and seeking physical therapy may also ease your pain and keep you mobile and active.

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

Tips for Describing Your Joint Pain to Your Orthopedic Surgeon

in

Article featured on Arkansas Surgical Hospital

Joint pain can be debilitating, limiting daily activities and draining you both physically and emotionally.  In many instances, joint discomfort is the result of some type of arthritis.  There are various treatment options, including medications, physical therapy, injections, alternative therapies, and surgical solutions, depending on the severity of your joint pain and the damage to the joints.

Is It Joint Pain or Bone Pain?

Accurately describing your joint pain to your orthopedic surgeon can help them determine what treatment is best for you.  Joint pain is different from bone pain and can vary in sensation and severity.  Clearly explaining the feeling is crucial to appropriate diagnosis and treatment.  Bone pain is typically sharp and localized to a specific area, while joint pain tends to be more of an ache and occurs only in the affect joints, not all along a bone.  However, if the joint damage is severe, it may feel quite intense due to missing or damaged cartilage leading to bones grinding against each other.  Joint pain often increases with overactivity or too much weight on the joint.

Be Accurate When Describing Joint Pain

Saying that your joints are stiff isn’t helpful to your doctor or surgeon because it is too vague.  Pinpointing how much pain you’re in, what kind of pain you’re feeling, and how it impacts your ability to use the joints are all part of describing pain accurately.  Osteoarthritis pain tends to feel different from rheumatoid arthritis and other sources of joint pain, so be precise and thorough.  The more detailed your description is, the easier it is for your surgeon to determine the root of the problem.

Where is the Pain Located?

If you have joint pain in your knees, explain whether you feel it in the kneecap area, the back of the joint, or on the sides.  The knee’s complex ligaments and bone structure mean there is more than one kind of knee joint pain.  If you have joint pain in the hands, tell your doctor which joints are affected.  For instance, osteoarthritis is more common in the joints at the end of the fingers, while rheumatoid arthritis isn’t as likely in these joints.  Narrow down the area as much as possible.

What Kind of Pain Is It?

There are many kinds of pain, and the form it takes is critical when diagnosing and treating joint issues.  Descriptive words are helpful, as are comparisons such as, “It feels like something is caught in the joint.”  Here are some excellent descriptions you can use:

  • Crunching or Grinding.  When bones are rubbing against each other, you may feel like the joint is grinding rather than moving smoothly.  It may feel like gravel in the joint.
  • Snapping, Crackling, or Popping.  This is the sensation of something releasing or popping out of place and is often accompanied by a popping sound.  Osteoarthritis often leads to snapping or crackling in the joints.
  • Throbbing.  If the joint pain feels like it pulses, make sure your surgeon knows.
  • Dull or Achy.  Your pain can be dull (rather like a bruise) but still be severe.  Dull pain or aching can be an underlying, constant pain with periodic flares of other kinds of pain such as stabbing or burning sensations.
  • Stabbing.  Does it feel like somebody stuck a knife in your joint?  Your surgeon needs to know if the stabbing pain is consistent, periodic, or linked to any activities or other circumstances such as standing for long periods.
  • Burning.  Some patients describe burning pain as the joint burning from the inside or a hot sensation in the joints.
  • Radiating.  If you have pain that starts in one area then travels toward another, it is described as radiating pain.  Some people experience hip pain that radiates down the leg when they try to put weight on it.  This may indicate nerve involvement in addition to problems with the joint itself.

The When and Why of Joint Pain

Joint pain isn’t always constant.  It can come and go depending on what you’re doing and the time of day.  Make sure your surgeon knows if your pain seems to flare when you participate in in certain activities or gets worse during specific times.  If your pain is more significant when you wake up in the morning or is aggravated after activities, tell your doctor.  Some forms of arthritis may cause greater pain after you’ve been moving around a lot, while others may be worse after you’ve been inactive for too long.  If your joints lock up, give way, or feel weak or unstable, your doctor needs to know this, particularly if increased pain results.

The duration of your pain is another element of the “when” of joint pain.  While your knees or hips may hurt a lot when you first wake up in the morning, how long it lasts can indicate whether you have osteoarthritis or rheumatoid arthritis.  It can also help define the severity of the problem.  Does the discomfort after exercising last 30 minutes or several hours?  Is the pain worse when walking up a hill or a flight of stairs?  Details like this can aid your surgeon in a correct arthritis diagnosis.

Finally, be sure to inform your doctor of any other elements that affect your joint pain.  Pain that flares during certain types of weather, when you’re under stress, or when you are tired may help pinpoint an arthritis diagnosis or indicate other underlying issues.

The Severity of Joint Pain

Many physicians use a pain scale of 1 to 10, with 1 meaning little to no pain and 10 meaning unbearable pain.  No one experiences pain the same way others do, but the pain scale helps doctors get an idea of how severe your discomfort is and how much it impacts your life.

  • 0 = No pain
  • 1 = Occasional, minimal pain
  • 2 = Mildly annoying, not constant
  • 3 = Painful enough to distract you if not busy
  • 4 = Maybe distracting even when occupied
  • 5 = Can’t be ignored for long stretches, but you can still do things (although uncomfortably)
  • 6 = Can’t ignore your pain
  • 7 = Difficulty sleeping, concentrating, and socializing
  • 8 = Physical limitations and difficulty with normal functioning, nausea, and dizziness
  • 9 = Crying, inability to speak, possibly passing out from the pain
  • 10 = Unconsciousness

Successfully Treating Arthritis Pain

The two most common forms of arthritis, osteoarthritis and rheumatoid arthritis, generally require different approaches, making the proper diagnosis critical when you’re suffering from joint pain.  Arthritis surgery is one of many options available to minimize discomfort and increase range of motion.  Still, your surgeon will usually recommend it only after you’ve tried other treatments such as medications and physical therapy.

Arthritis pain may be the result of a variety of triggers, including:

  • Cracks or chips in the affected bones
  • Inflammation of the tendons and muscles around arthritic joints
  • Bone spurs
  • Muscle spasms caused by irritation from damaged bone
  • Decreased blood flow in arthritic joints
  • Loss of synovium between the bones

With so many potential causes of joint pain and a wide range of treatment options, accurately describing your pain to your surgeon is the first step in finding the best treatment for you and getting you back to doing the activities you enjoy.

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