4 Signs You May Have Nociplastic 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

Understanding 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

Tips for Mastering Acute 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

When to Use Ice Versus Heat for Pain

Article featured on Practical Pain Management

Depending on the type of pain you have, one may be better than the other.

Every pain is different. Each type can be a symptom of an underlying issue, an unpleasant sidekick to a condition, or an overall nuisance on everyday life. Treating pain can vary as well. While going straight to the doctor or trying an over-the-counter medication are options, another can be applying hot or cold compresses to the area where the pain is happening.

Hot vs Cold for Pain: What’s the Difference?
While both temperatures can soothe pain, they do so in different ways. Heat increases blood flow, nutrients, and oxygen to the affected area and, therefore, works to relax tight muscles. Cold lessens pain by reducing inflammation, muscle spasms, and circulation. While reducing circulation sounds bad, it’s actually a good thing because less circulation means your blood vessels shrink, which then lessens swelling and bleeding.

Let’s explore the different kinds of pain and how each responds when heat or cold is introduced:

Joint Pain/Inflammatory Pain

Typically caused by conditions such as arthritis and some autoimmune diseases like rheumatoid arthritis, joint pain/inflammatory pain can feel like stiffness in the joints or an “on fire” feeling throughout the body or similar to how you feel when you have the flu (fatigue, exhaustion, chills, etc.). Triggers for this type of pain can include intense physical activity, stress, and even weather. When to use heat or cold to treat joint pain depends on the cause of the pain and what works best for you. For example, gout responds well to heat because it eases stiffness and relaxes the muscles in the surrounding area. Osteoarthritis, on the other hand, does well with cold because it numbs pain. Once you know the underlying cause of your joint pain, such as an arthritis condition, you can talk to your doctor about adding heat or ice to your treatment plan and/or to manage flare-ups.

Muscle Pain

Muscle pain can affect one or more sections of the body at a time and can be caused by injury or overuse. For instance, with back pain, you could be hurting because you overworked your back muscles at the gym or because you strained (or “pulled”) a muscle by tearing the fibers of skeletal muscle. For the most part, if muscle pain is temporary (or acute) it can be treated with cold compresses for no more than 15 minutes a few times a day and rest to allow tissues to heal. At the same time, if the pain is chronic (lasts longer than 6 months) heat is the best bet; it can even be alternated with cold if desired.

Nerve Pain

Nerve pain can be caused by many different types of conditions and varies in how it feels. For example, a patient with sciatica (a condition where pain is caused by spinal nerve compression in the lower back) can be described as a “radiating” pain; other times, nerve pain can feel like numbness or tingling. Pain caused by conditions such as sciatica respond well to ice or cold treatments because that temperature tends to calm inflammation and numb any soreness in the tissue. It’s best to use cold when the pain is still sharp and move on to heat once that sharpness has subsided. The heat will increase blood flow and help tissues heal faster.

Home remedies like heating pads, microwavable gel packs, a ziplock filled with ice, or a store-bought freezer pack and other compresses can be helpful in alleviating frequent chronic pain. Apply for no more than 15 minutes at a time, two to four times a day. At the same time, it’s important to know your body’s limits. Regardless of the type of pain you are experiencing, if you get to a point where the pain is intolerable or if it turns into numbness or weakness, see your doctor right 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

7 Tips for Chronic Pain Management

Article featured on CORA Physical Therapy

Chronic pain leads many people to avoid physical activity. Pain medication is often relied on or prescribed to help manage pain. This can lead to other significant problems such as dependence. An alternative and effective pain management strategy is regular exercise. Starting an exercise program, however, can be a whole other kind of pain.

If you believe the long-term health impact of exercise is the best option for you, here are tips for becoming more active.

Tips for becoming more active

Engaging in regular activity—especially when supervised by a physical therapist—can help you overcome the daily experience of pain and discomfort.

An exercise routine and staying motivated can help you feel better. Movement, in any manner, is a type of exercise. Being mindful of the muscle groups you use during daily activities can help you understand areas of your body that can benefit from improvements. For example, climbing stairs is akin to an aerobic exercise that requires lower body strength. Lifting a laundry detergent bottle is akin to a strengthening exercise that requires upper body strength. Awareness of pain levels, and other things like shortness of breath or the inability to perform an activity can give focus to your program design.

The key is to find ways to integrate activity into your life in a way that is natural. Strength training, increasing flexibility, and improving aerobic fitness are all great goals. Physical Therapy and personal training can help you achieve your health and fitness goals effectively and efficiently. Below are tips for getting active, today.

Get active with these 7 tips

1.Try the stairs.

The elevator is convenient, but stairs are a great form of exercise.

Pro tip: Use the railing to help with balance and while you develop the strength needed to perform this one your own. Push through your heel and try to activate your butt muscles.

2. Walk as much as you can.

Whether around your house or around the store, test your capacity and add on incrementally.

Pro tip: Get the right footwear at your local specialty running shop. Keep a journal and monitor improvement. Avoid going further than 50% of weekly volume in a single walk. (I.e., total weekly walking distance is 3 miles, a single walk should not be longer than 1.5 miles OR if total weekly walking minutes is 1 hour, a single walk should not be longer than 30 minutes)

3. Exercise in front of the TV.

When engaging in any sedentary activity like watching TV, try to get more active. Try working out while watching your favorite show. No equipment required.

Pro tip: Any movement is better than no movement. Explore the directions your arms and legs can go in. One day you can do circles with your arms while the next day your reach up and down. Visit each joint and test its potential (within a pain-free pattern).

4. Walk while on the phone.

Get up and pace back and forth to get steps in as you get the job done. Location doesn’t  matter. Whether at work, home, or on vacation, walking and talking is easy fitness.

Pro tip: Talking on the phone can distract from your awareness of the area around you. Knowing where you are and where you are going can help reduce your risk of falls or getting lost if you do become distracted.

5. Schedule in time for short workouts.

Research has shown that you can get exercise benefits from multiple, shorter sessions in a day vs 1 long session. Try 10 minutes of stretching in the morning followed by a few cardio moves. Repeat that process again on your lunch break. Before bed relax with light stretching. By the end of the day, you would have fit in 30 minutes of dedicated exercise time.

Pro tip: Develop daily routines. Loosen stiff muscles in the morning through movement patterns and stretches you are familiar with. Combat your chronic back pain with core and hip strengthening. Improve your posture with repetitions of pulling your shoulder blades together. The best part? No equipment needed!

5. Exercise with your family!

Trade in an evening together on the couch for a walk, bike ride, or throwing the ball around. This is a fantastic way to increase activity while encouraging healthier habits across your household. Taking a short walk after a meal is also linked to improved digestion and reduced instances of reflux.

Pro tip: Friendly competition may help motivate the youngsters. Rewards can incentivize participation. Pick days of the week that works for everyone and make a pact to be active together.

6. Get those chores done.

Walking the dog, cleaning the house, and mowing the lawn are all physical activities. Prep for your activities with a warmup. Treat them like sport, they are challenging.

Pro tip: Be aware of your posture, alignment of joints, breathing, and balance. Also, take note of sore muscles in the day after. This will help you to be conscious of the muscles you use during these activities, and prepare to use them next time.

Don’t let pain stop you from being active

When pain hits, we may feel the desire to rest more and move less. However, in the case of chronic pain, bed rest or prolonged rest, is not the best way to approach a flare up.

Chronic pain will not go away with a bit of rest. Rather than spending more time off your feet, getting a bit more active could be what you need to help finally experience relief from your discomfort.

Of course, this does not mean that you should disregard the pain and start pushing through it on your own with intense activity.

Working with a physical therapist can help you to reduce the experience of pain and discomfort by educating you on activities that are safe, so it will not leave you feeling worse after you are done.

In fact, as stated by Physiopedia, “The nature of a physiotherapist’s (PT’s) work makes us particularly well placed to initiate a discussion about the level of Physical Activity (PA) with each of our patients.”

When pain hits, we may feel the desire to rest more and move less. However, in the case of chronic pain, bed rest or prolonged rest, is not the best way to approach a flare up.

Chronic pain will not go away with a bit of rest. Rather than spending more time off your feet, getting a bit more active could be what you need to help finally experience relief from your discomfort.

Of course, this does not mean that you should disregard the pain and start pushing through it on your own with intense activity.

Working with a physical therapist can help you to reduce the experience of pain and discomfort by educating you on activities that are safe, so it will not leave you feeling worse after you are done.

In fact, as stated by Physiopedia, “The nature of a physiotherapist’s (PT’s) work makes us particularly well placed to initiate a discussion about the level of Physical Activity (PA) with each of our patients.”

Exercise can help with chronic pain by:

  • Supporting healthy muscle development
  • Increasing range of motion
  • Supporting weight loss
  • Improving heart health

Ready to get moving?

If you have not been physically active in a while, starting small is the best place to start. Even 5 minutes can be a great starting point.

If you still are not sure where to start or if you have a nagging pain that is stopping you from starting, you can reach out to to speak with a clinician.


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

Can Electricity Relieve Your Pain?

Article featured on WebMD

Like many of my own patients, you may be interested in doing more to treat pain than just relying on medications, but you aren’t sure where to start. One simple and accessible treatment to consider is something known as TENS, or transcutaneous electrical nerve stimulation. TENS is a handheld device that sends electrical impulses through small electrodes by adhesive pads attached to your skin. The pads are usually placed right on the part of your body that hurts. When the device is turned on, the electrical impulses flow into the skin and have the potential of decreasing different types of pain.A TENS unit has controls that allow you to adjust the electrical flow to get the best results. You can change the intensity and the frequency of the electrical impulses. The intensity represents the strength of the electrical impulses you’ll feel. The frequency refers to the number of electrical impulses that get delivered through the pads each second.

Research seems to show that TENS units can relieve pain in several ways. One is at the surface, where the electrodes contact the skin. On the surface and just below it, electrical impulses balance out the nerve activity that transmit pain signals. Those pain signals travel to the spinal cord to a key spot called the dorsal horn. Using a TENS unit has been shown to alleviate the pain at that spot. Certain parts of the brain involved with processing pain also seem to respond to a TENS unit. One area in the brain is called the periaqueductal gray, where pain signals get turned down.

What types of pain can a TENS unit help treat? More acute pain, such as after surgery or a recent injury where there is active inflammation, has been shown to respond favorably to electrical stimulation. For example, a TENS unit can help reduce the pain from a swollen knee that has been newly injured. But electrical stimulation can also help treat chronic pain problems, like sore necks from too much computer use and joint problems like aching knees. Even problems like menstrual cramps, endometriosis, and diabetic neuropathy can be helped.

If you are interested in trying out a TENS unit, go to a physical therapist to see how it works. Physical therapists often have them at their clinics and are experienced at finding the best intensities and frequencies for different problems. To use one at home, check to see if your insurance will cover it with a prescription from your doctor. If you decide to buy one directly, they can be ordered online starting around 30 dollars.Before trying a TENS unit on your own, make sure to discuss it with your doctor first. While they are considered extremely safe to use, there are situations where they should probably be avoided. Those include: if you are pregnant, have certain skin sensitivities, a history of seizures or heart conditions, or have a pacemaker.


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

Is It Time for a Pain Management Reboot?

Article 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:

  • Emotionally drained. Certainly life during COVID-19 has been a source of intense stress. Whether you’ve had COVID-19 or not, the pandemic has played a role in increasing mental health problems like anxiety and depression. For some, it has intensified already stressful home environments, while for others it has meant being apart from loved ones, creating emotional distress. A drop in income and the challenges of kids doing virtual schooling at home have become common sources of added stress in many households. But both depression and anxiety can impact how much we hurt and make it harder to manage our pain.
  • Weight gain. Studies show that the average person gained around 2 pounds per month during the height of the pandemic, which means that most of us are carrying around at least a few extra pounds or more. While this added weight gain can impact underlying health problems like diabetes and hypertension, it can also potentially increase pain, too. Even small bumps in body weight can significantly increase mechanical forces on parts of the body like our knees, hips, and spines.
  • Self-medicating. According to the CDC in June 2020, 13% of Americans reported starting or increasing substance use as a way of coping during the COVID-19 pandemic, and there was an 18% increase in overdoses during the early parts of the outbreak. The combination of all the added stress along with greater difficulty accessing medical and behavioral health help may have contributed to an increase in harmful activities like misusing prescription painkillers, increased alcohol use, or using illicit substances in the hopes of finding relief.
  • Less active. In many areas, access to places like swimming pools, health clubs, gyms, and indoor exercise classes were very limited for a number of months. So if you relied on those types of places for exercise, you may have had to make do without them. Out of caution, many of my patients preferred to avoid leaving their homes as much as possible, which also cut back on their level of activity. But many patients with pain problems like back pain and arthritis rely on programs like water aerobics and yoga classes or working out in a gym, and not having access to exercise venues that they depended on made managing their pain more challenging.
  • More isolated. Most of my patients experienced a dramatic decrease in social interactions over the last year, leaving some feeling lonely and isolated. Loneliness is now considered a significant health problem and is associated with a greater risk for heart disease, strokes, depression, anxiety, suicide, and premature death.

Now that access to resources has likely improved in many of your communities, here are some thoughts to help you navigate your next steps:

  • Ease into it. If you haven’t gone for a swim or worked out in your local gym for a year, start slowly as your time away has likely left you deconditioned and with some muscle atrophy. Pare back your exercise program or activity regimen to give yourself time to build back up your strength and endurance, while minimizing pain flare-ups that can slow down your progress. Now is a good time to be patient with your body.
  • Ask for help. Making changes can be difficult, but there are people who can help. If you would like a little guidance on how to recharge and get more active, talk to your doctor for recommendations or a referral to a physical therapist. If you have developed an addiction problem during the pandemic or relapsed into an old one, please ask for help and look for resources. And if the pandemic has left you feeling more down or dampened your relationship with your significant other, look for a counselor that can help you and your family get back on track.
  • Baby steps. There may be a lot of pent-up anxiety about doing things again, like leaving the house more, mingling with others, or going to that water aerobics class. This is to be expected.  Start small and build your confidence gradually, and don’t forget to breathe!

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

12 Tips for Walking When You Have Sensitive Knees

From VeryWellFit

Sensitive knees can be a challenge for walking, but it is a recommended way to maintain your function and reduce your symptoms. If you have knee pain due to osteoarthritis or other causes, you don’t have to let that keep you from starting a walking program.

A regular program of walking can reduce stiffness and inflammation and it won’t make most chronic knee conditions worse. Walking is the preferred exercise by people with arthritis, and can help you improve your arthritis symptoms, walking speed, and quality of life, according to the CDC.

Walking is part of a healthy lifestyle to keep your heart and bones strong and your joints functioning. Here are tips for walking when you have sensitive knees.

Read more