Joints That Are Most Commonly Affected by Arthritis

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

What SI Joint Pain is and How to Treat It


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, 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 Prevent Lower Back Pain During Pregnancy

Article featured on Atlanta Spine Institute

How to Prevent Lower Back Pain During Pregnancy

Pregnancy is an exciting time. However, it also comes with a great deal of uncomfortable physical changes including lower back pain. Believe it or not, approximately 80% of women experience back pain at some point during their pregnancies. Weight gain paired with changes in hormones and posture can all lead to lower back pain.

Lower back pain can take a serious toll on a woman’s day-to-day life and cause challenges during delivery. If you’re pregnant or plan to be in the near future, here are some tips to help prevent lower back pain during pregnancy.

Engage in Light Exercises

While you should avoid high-intensity workouts, it’s a good idea to participate in light exercise routines such as yoga, pilates, swimming, and stationary biking. Not only can they strengthen your back, they can also improve your flexibility. The stronger and more flexible you are, the more likely you are to maintain good posture and prevent lower back pain.

Be Careful While Lifting

Ideally, you’d never have to lift anything throughout your entire pregnancy. Since this may not be possible, practice caution any time you lift. Rather than bending forward from your waist, move as close as you can to the object and bend your knees. This way you can keep your back straight and avoid strain.

Take Control of Your Stress

Pregnancy can be stressful, especially if you’re juggling work, childcare, and other responsibilities. Stress can raise muscle tension in the back and lead to back pain so it’s important to keep it to a minimum. If you’re feeling stressed, go for a walk with a friend, meditate, or soak in a lukewarm bath.

Wear Proper Footwear

High heels during pregnancy can exacerbate lower back pain. So swap stilettos for comfortable shoes with good arch support. You may even want to wear compression stockings to keep blood from accumulating in your legs.

Sleep on Your Side

Sleeping on your stomach and pregnancy don’t mesh well. To keep your back pain in check, sleep on your side instead of your back. If you’re unable to get comfortable, try a body pillow to support your growing tummy.

Try Hot and Cold Therapy

Take an ice pack or hot towel and place it on your back to find relief from pain. If you do so, keep the heat or ice away from the abdomen.

If your back pain becomes unmanageable during any part of your pregnancy, visit a doctor as soon as possible.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, 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

Could Your Foot Pain Be Caused by a Problem in Your Spine?

Article featured on Spine-Health

This blog provides a list of common causes of foot pain and helpful pointers to help you understand the origin of your foot pain.

Foot pain caused by a spinal problem

Nerve root irritation or compression in the lumbar or sacral spine (lower back) may cause sciatica pain to radiate down your leg and into the foot. Specifically, compression of the S1 nerve root, also called classic sciatica, can cause pain along the outer side of your foot.

Nerve roots may be compressed or irritated due to a number of causes. Common examples include:

  • Lumbar herniated disc: Leaking of the inner contents of an intervertebral disc
  • Lumbar degenerative disc disease: Age-related changes causing narrowing and shrinkage of the disc
  • Spondylolisthesis: Slipping of a vertebra over the one below it
  • Lumbar spinal stenosis: Narrowing of the bony openings for spinal nerves and/or the spinal cord

The inability to lift the front part of your foot or frequent tripping while walking may be due to a condition called foot drop. This condition is typically caused due to compression of the L5 nerve root. Rarely, compression of the L4 and/or S1 nerve roots may also cause foot drop.

Foot pain caused by compression of nerves in the hip, knee, or leg

Foot pain can also occur when nerves are compressed or damaged along their path in the hip, knee, or leg. For example:

  • Peroneal neuropathy, a condition where the peroneal nerve is compressed or injured near the knee may cause foot pain and foot drop when you try to move your foot.
  • Sciatic neuropathy or damage to the sciatic nerve in the pelvic region (hip) may cause foot pain along the top of your foot with some degree of weakness.
  • Tarsal tunnel syndrome or dysfunction of the tibial nerve within the tarsal tunnel of the inner ankle may cause a sharp, shooting pain in your ankle area and along the sole of your foot.
  • Sural nerve entrapment can occur in the leg or near the ankle and typically causes shooting pain along the outer side of your ankle and/or foot.

Additionally, a corn may develop on the skin around your toes. Corns grow over time as a result of excessive friction, and they can compress nearby nerves, causing pain and other symptoms. Another possible cause of nerve pain in your foot is Morton’s neuroma, which is a thickening of the tissue around a nerve in the foot.

How to identify the source of your foot pain

With all the possible causes of nerve pain in the foot, it may be difficult to pinpoint the exact underlying cause. Here are a few useful signs to help you identify the source of your foot pain:

  • Foot pain that follows recent trauma to the lower back, hip, knee, or ankle may help indicate the site of nerve damage
  • Foot pain due to nerve root compression or sciatica may also be associated with other symptoms, such as pain, numbness, and/or weakness in the buttock, thigh, and leg; and typically affects one leg at a time
  • Foot pain that develops after wearing tight boots or shoes may indicate peroneal or sural nerve compression near the knee or ankle
  • Foot pain that develops after a hip injection or hip surgery may indicate sciatic neuropathy.

Nerve pain in the foot may also occur due to nerve damage from systemic conditions, such as diabetes or multiple sclerosis.

Twisting, bending, or a direct hit on your ankle and/or foot may injure the foot bones, ankle joint, blood vessels, muscles, and/or tendons, causing foot pain.

Schedule a visit with your doctor

It is important to schedule an appointment with your doctor to accurately diagnose the cause of your foot pain. Treatments for foot pain can differ widely and must be directed at resolving the underlying cause; not just masking the symptoms. For example, a lumbar herniated disc may require heat therapy and exercise, while a corn on your toe can often be treated with special shoes and warm water.


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

Hip-Spine Syndrome: It’s Complicated (and Often Overlooked)

Article featured on Brigham Health Hub

A patient with hip arthritis may experience hip or groin pain as well as trouble walking, while a patient with lumbar spinal stenosis may have pain down their leg, or neurologic symptoms such as numbness, tingling, or weakness.

“Hip-spine syndrome is a distinct syndrome where both hip and spinal problems are occurring together,” says James D. Kang, MD, Chairman of the Department of Orthopaedic Surgery at Brigham and Women’s Hospital.

And yet, because hip and spine disorders have overlapping presentations and symptoms, it can often be challenging for physicians to determine if a patient’s symptoms originate from the hip, spine, or both. This can delay diagnosis and treatment, and many patients with hip-spine syndrome have seen several physicians and therapists or may have undergone various procedures that did not relieve their pain.

Hip-spine syndrome is a condition where both hip and spine problems are occurring in tandem.

“The first order of business is to make sure that the treating physician considers hip-spine syndrome in their evaluation. The problem is that many centers are so sub-specialized that hip surgeons only see hip problems, and spine surgeons only see spine problems,” says Dr. Kang.

“Our department is at the forefront of public awareness and academic awareness of this complicated syndrome. We are spearheading several efforts in orthopaedic research, including clinical investigations and patient outcome studies, trying to determine the optimal treatment plans for patients with hip-spine syndrome,” says Dr. Kang.

For patients with minor hip or back pain, Dr. Kang typically prescribes rehabilitation and physical therapy. Only patients with more advanced hip-spine syndrome who do not respond to physical therapy require invasive treatments, such as an injection therapy, or surgery.

Dr. Kang also recommends lifestyle changes to those with hip and spinal disorders, including weight reduction through diet and exercise. Since many patients with hip-spine syndrome have trouble walking or running, he recommends less active forms of aerobic conditioning, such as swimming and stationary biking.

For those with low back problems quitting smoking is also important, as prolonged exposure to cigarettes has been shown to impair oxygen delivery to tissues, and may cause damage to vascular structures of the discs and joints. Using anti-inflammatory medications can also help modulate symptoms.


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 Protect Your Spine as You Age

Article featured on Brigham Health Hub

The human spine consists of discs and joints that, like a hinge on a door, can wear out with time. While you may hear worrying terms such as “degeneration” or “arthritis” to describe these changes, it’s a natural part of the aging process.

This wear and tear don’t necessarily produce symptoms. It’s only when changes cause structures in the neck or back to press on spinal nerves that a patient may experience pain with movement, tingling, numbness, weakness, or shooting pain into a hand.

At this point, a patient may visit their primary care doctor, and leave with a prescription for an anti-inflammatory and/or a referral to physical therapy. If symptoms persist they might visit a spine surgeon.

Matching symptoms with findings from imaging

Jay Zampini, MD is a spine surgeon in the Department of Orthopaedic Surgery at Brigham and Women’s Hospital. He sees hundreds of patients a year suffering from a broad range of spinal conditions, from whiplash to a disc herniation.

“In my initial evaluation with a patient,” says Dr. Zampini, “I perform a physical exam and review X-rays or MRIs. I try to match symptoms with abnormalities on imaging.”

For example, if a patient has sensory problems or pain that radiates into the first two fingers in their hands, Dr. Zampini will discern that there’s likely damage to the cervical (neck) vertebra, probably C6.

He balances such findings with the understanding that imaging can present abnormalities that aren’t always responsible for symptoms.

Treatment starts with non-surgical options

Dr. Zampini was trained by Michael W. Groff, MD, a neurosurgeon and the Director of Spinal Neurosurgery at the Brigham. The two now work side-by-side to evaluate, diagnose and treat patients with conditions that affect the neck and back.

While Dr. Groff and Dr. Zampini are both spine surgeons, they don’t operate until a patient has exhausted all non-surgical options. In fact, 90 percent of patients experiencing back and neck pain won’t need spine surgery.

“We treat problems with the spine very conservatively. We start with anti-inflammatory medications and physical therapy, then pain management, if necessary. I might also encourage patients to continue care with a physiatrist,” says Dr. Groff.

The vast majority of patients recover after physical therapy. If a patient returns to their surgeon with persistent symptoms, the next step can be taken.

When spine surgery is needed

“If we exhaust all non-surgical options and the patient still experiences symptoms, such as pain with weakness, gait problems, or difficulty with bowel or bladder function, then we start to consider surgery,” says Dr. Groff.

Surgery is recommended if a patient has been suffering with symptoms for6 weeks or more. Likewise, severe cases of disc herniation that may risk paralysis, and serious conditions, are corrected surgically.

“If you do require surgery, the Brigham has an integrated approach to spine care and all the clinical resources of a world-class academic medical center,” says Dr. Groff.

At Brigham Health, a multidisciplinary team of surgeons, physiatrists, physical therapists and pain specialists collaborate to get patients back to their lives as quickly as possible.

Spine care is part of the Brigham’s larger ecosystem, so patients with co-morbidities, such as hypertension or diabetes, have access to resources that can address any complications that may crop up as their spinal condition is being treated.

Keep your spine healthy by knowing your limits

In most conversations with patients, Dr. Zampini usually illustrates how our spines change throughout our lives by telling a personal story about a devastating injury he suffered that changed how he now thinks about his body.

Dr. Zampini was 38-years-old when he ran a half-marathon in less than 90 minutes. It was blistering pace, a personal best, but the strenuous effort fractured his pelvis. “I was completely overdoing it, running as if I was still 25-years-old,” he says.

It was a wake-up call, and he changed his mindset during the eight months of recovery. He began listening to his body more.

“Some of my patients can relate to my story, because they’re trying to do things their bodies just can’t handle for their age,” says Dr. Zampini.

He advises his patients to understand and respect their limits. What kinds of activities and levels of intensity can you realistically handle given your age and level of conditioning?

To avoid injuries, Dr. Zampini advises patients to strengthen their core muscles, which include the lower back, hips and abdomen. These muscles work together to keep your body balanced. He also advises people to use proper technique when performing high-intensity movements and to modify movements or use lighter weights to lower intensity.

For those who work in an office, it’s also important to customize your work space to avoid muscle imbalances and repetitive injuries.

Exploring the best way forward with a spine expert

After Dr. Zampini recovered from his pelvic injury, he switched from running to lower-impact activities, including the elliptical and stationary bike. He also stretches and does yoga exercises every morning before he sees patients in his clinic.

“I still jog occasionally, but I don’t race anymore. I’ve accepted what I can and can’t do, and I’m happy about that,” says Dr. Zampini.

Both Dr. Zampini and Dr. Groff encourage anyone who has had to give up an important activity to seek consultation from a spine expert to explore the best way forward.

“In many cases, certain activities can be reclaimed in a responsible way,” says Dr. Groff. “It’s gratifying to see patients get back to the activities they love.”


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

5 Benefits Of Aquatic Therapy For Spine Pain

Article featured on Spine Health

The pool is a great place to take your workouts or physical therapy exercises. Here’s a look at five reasons why your back benefits from aquatic therapy.

Benefits of Water Therapy For Your Back

Your back can benefit from a water therapy session, but it’s important to note that aqua therapy may not be right for everyone. If you are dealing with a fever, infection, or an open wound (including a surgical incision that has yet to fully recover), water and the chemicals in the pool can make the problem much worse. If you have any of these conditions, speak with your doctor before moving forward with water-based therapy.

Here’s a look at why your back can benefit from water therapy:

  1. Decreased load bearing. Aqua therapy can decrease the stress placed on your spine because of the buoyancy provided by the water. If you are dealing with a disc issue that makes movement painful or if you are trying to re-strengthen your spine weeks after a surgery, aqua therapy can take some of gravity’s stress off your spine, which allows you to focus on your therapy exercises.
  2. Increased mobility. Along a similar vein, because of the buoyancy of water, we are often able to twist and turn more freely in water, which allows us to do range-of-motion exercises that would not be possible on land. Increased mobility is a benefit of water-based therapy.
  3. Natural resistance. If you do trunk twists on land, you’re not going to encounter any resistance and thus won’t be working your spinal muscles very hard. Try doing them in water instead. Water is roughly 600 times more resistant than air, so simple land workouts will be more effective when performed in the water.
  4. Decreased pain. Many people who suffer from back pain remark that it’s less painful to do a water workout than a normal land routine. This makes sense, because the water helps to increase blood supply to sore muscles and joints. The feel of the water is also comforting, which helps take your mind off your pain.
  5. No falling. Spinal surgery or other painful spinal conditions can have a negative impact on our balance. A painful nerve sensation or a momentary loss of balance on land due to a spinal condition can send us toppling to the earth, which can lead to fractures or other injuries. However, balance isn’t an issue when you’re up to your waist in water. You eliminate your risk of falling by conducting your workout in water, and it will also help to strengthen the muscles in your feet to improve your balance when you’re on land.

If you are dealing with spine pain and you are looking for a refreshing way to complete your physical therapy exercises, talk to your doctor about developing a water-based exercise program.


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

When to Turn to Spine Surgery When Nothing Else Will Do

Article featured on Brigham Health Hub

For many years, Diane Daigneau of Woburn, MA, was able to successfully manage her back and neck pain. Through occasional chiropractic treatments and mild pain relief medications, she was able to continue to work and play.

A few years ago, however, she discovered that circumstances can change dramatically, to the point where even the best non-surgical care fails to provide adequate relief. Such was the case during the summer of 2013, when the pain radiating through Diane’s back, neck, and arms had become so debilitating and persistent that no physician was recommending anything other than cervical spine (neck) surgery.

From Manageable to Intolerable

Diane likes making things pretty. More than that, it’s her job.

She often spends several hours hovering over a single piece of furniture while meticulously applying delicate gold or silver leafing, or some other type of elegant exterior. It’s a mentally and physically demanding job, particularly for someone who has struggled with back and neck pain. But Diane’s pain was never so bad that she ever worried about not being able to do her job or any other enjoyable pursuits. That changed suddenly during a family vacation at the end of July 2013.

Diane woke up on the second morning of her vacation with a new kind of pain. “The pain was unbearable,” says Diane. “It was something like I had never experienced before. There was nothing I could do.”

Along with intense pain, she had limited range of motion in her neck and numbness throughout her neck, shoulder, arms, and chest.

She ultimately headed back home for an MRI, which revealed that two herniated (bulging) discs were crushing nerves in her cervical spine.

A Surgical Solution

Through a colleague, Diane was referred to a spine neurosurgeon for a consultation. Based on her condition, the doctor recommended a two-level anterior cervical discectomy (disc removal).

The doctor started the procedure by approaching Diane’s spine through the front of her neck instead of through her back. There are two distinct advantages to this method. The most important is a significantly reduced risk of damaging the spinal cord. The other is less cutting of muscle, which helps to reduce postoperative pain.

Once the affected area of the spine was reached, the doctor completely removed both bulging discs to take the pressure off of the nerves. Next, to maintain the integrity of the spine, he snugly inserted a graft into each area where a disc had been removed.

The carbon fiber cages used for Diane’s surgery are now the standard of care for discectomy and fusion in the doctor’s practice, and a significant advance from the combined use of grafts (natural or synthetic) and titanium plates. A multi-center study, in which the doctor participated, demonstrated that using a carbon fiber cage alone provides the same strength and functionality as provided by a graft and titanium plate. However, the comparative simplicity of the carbon fiber cage – less material, fewer parts – decreases operation time, reduces the impact on surrounding tissue, and minimizes manipulation of the esophagus.

No Surprises

Diane admits that her recovery hasn’t been easy, but neither has it been a surprise. “I knew all along, step by step, how things were going to be for me,” she explains. “It’s not fun, but at least you’re feeling confident that things are going in the right direction.”

The doctor is similarly confident about the progress of Diane’s recovery. He told Diane that the carbon cages and fused vertebrae eventually will make her neck so strong and stable, as strong as it was before, that she could participate in extreme sports within a year.

Although she finds that claim to be reassuring, Diane doesn’t plan on jumping out of any airplanes in the near future. She’s quite happy to simply be walking, jogging, working – or waking up – without the fear of back and neck 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, 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

Keeping Your Spine Healthy

Article featured on Brigham Health Hub

While the COVID-19 pandemic has changed our lives dramatically, back and neck problems are still as common as ever. In fact, some people are experiencing pain and other discomforts for the first time due to changes in their work locations and equipment as they moved from the office to home. The good news is that most spine conditions improve with time, physical exercise and getting back to your normal activities.

During the pandemic, Michael W. Groff, MD, a neurosurgeon and the director of the Neurosurgical Spine Service at Brigham and Women’s Hospital, had a virtual visit with a patient who was having neck pain along with tingling and weakness in an arm. The patient had undergone a previous surgery with Dr. Groff and feared he might need another.

While an MRI showed more wear and tear in the man’s neck, Dr. Groff reassured his patient that the condition would likely improve without surgery. The best course of action included physical therapy and performing exercises at home.

“I’m not one hundred percent certain that this patient won’t need surgery again,” says Dr. Groff. “But I reassured him that the path to recovery was to get moving and return to his normal routine. And neither of these things would further hurt his neck.”

Dr. Groff is co-chair for the editorial board of Journal of Neurosurgery: Spine. In this role, he and others have been distributing timely information about providing safe care for spine patients during the pandemic.

Keep your back and neck strong with an exercise routine

To keep your back and neck healthy, Dr. Groff urges his patients to perform any physical activity that helps maintain fitness, strengthens the core muscles and includes stretching. If you have back issues, the best way to stay healthy is to stretch often and keep your core strong.

Many people have found virtual exercise classes or routines that include Pilates, yoga or cardio workouts. To stay in shape, you can also use elastic bands, hand weights and/or perform isometric exercises, like planks or squats at home.

“It’s especially important to avoid being sedentary for long periods of time,” says Dr. Groff. “Being inactive can cause muscles that support the spine to weaken. This can sometimes lead to back or neck pain or exacerbate an existing spine condition.”

Getting regular exercise can have other benefits, too. It can give your day structure and help break up the monotony of staying at home for an extended time. Physical exercise can also help you maintain a positive outlook while navigating this challenging period.

When to seek care for back or neck problems

If you have an acute injury, like a pulled back or neck muscle, your pain will likely only last a few days. However, if your symptoms last 2 to 3 weeks and you have weakness or tingling in an arm or leg, contact your doctor.

For pain relief, Dr. Groff recommends ice for the first 48 hours and then alternating between heat and ice for several days after. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), can also help reduce pain and lower inflammation.

For flare-ups of back or neck pain, most spine care providers recommend only staying in bed for about 3 days. In the past, doctors used to recommend a few weeks of bedrest for flare-ups until a pivotal 2016 study showed that 3 days of bed rest is all patients need before they should return to normal activity.

“Staying in bed any longer than 3 days may lead to muscle weakening that can actually worsen a pain episode,” says Dr. Groff. “If you’re having pain, I usually recommend that patients rest and recover over a long weekend and then resume their normal activities.”

Back or neck pain usually doesn’t cause physical damage

If you have back or neck pain, how you interpret it can often impact how disabling it can become. Many patients ask Dr. Groff whether their pain is “all in their heads.” It is, he says, because all pain is experienced in our minds.

“If you’re in pain, most patients find it helpful to know that their pain is most likely not causing physical damage to their spines,” says Dr. Groff. “If you know you aren’t hurting yourself, you can feel better about exercising and returning to your routines.”

Dr. Groff hopes to help patients understand their pain from this new perspective. Doing so often removes the fear of physical activity, because getting back to normal life is a common pathway out of pain for many patients.

“The experience I’ve gained during the COVID-19 pandemic gives me the confidence to say that the Brigham is providing care that’s compassionate, technically excellent and safe for you and your family,” says Dr. Groff.

Dr. Groff can see patients both in person and through virtual visits, which allow him to stay in contact with patients who prefer to connect from home.

“I can still meet with patients and discuss their symptoms during virtual visits,” says Dr. Groff. “I can review imaging and develop a care plan that’s tailored to their unique circumstances. I can also follow up with patients to see how they’re progressing.”


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

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

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

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

Phone:
503-224-8399

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

Hours
Monday–Friday

How to Protect Your Spine When You Have Osteoporosis

Article featured on Spine-Health

In some cases of osteoporosis, one or more vertebral bones can become so weak that they cannot fully support their load and develop tiny cracks. This type of fracture, called a vertebral compression fracture, can be painful and sometimes leads to worsening symptoms, such as tingling, numbness, weakness, or spinal deformity (kyphosis). Fortunately, you can take steps to lower your risk for vertebral compression fractures, as well as seek treatment if one occurs.

Visit your doctor regularly

If you’re dealing with a chronic condition, such as osteoporosis, it’s especially important to have regular checkups to monitor how you’re doing and whether the treatment plan needs to be adjusted. For example, your doctor might recommend certain medications for osteoporosis, such as bisphosphonates, which may reduce the risk for a vertebral compression fracture.

Eat healthy and quit bad habits

Everyone needs to get plenty of calcium for bone health. If you have osteoporosis or low bone mass, your doctor might also recommend calcium supplements. In addition, it is important to get plenty of vitamin D, which helps the body absorb calcium into the bones.

If you smoke, try to quit. Smoking is known to weaken bones and can worsen osteoporosis.

Regularly drinking lots of soda and/or alcohol may also contribute to weaker bones. If you are in the habit of drinking soda or alcohol every day, try to quit or cut back.

Consult with your doctor to find a balanced diet that works best for you. While it’s important to get enough calcium for bone health, too much calcium can also potentially cause problems, such as kidney stones.

Stay active but use good judgment

The phrase “use it or lose it” is especially true when it comes to your bones. Weight-bearing activities help to build and maintain bone mass. On the other hand, being inactive allows the bones to thin and weaken.

In general, it is good for people to stay active and exercise regularly. If you’ve been diagnosed with osteoporosis or low bone mass, check with your doctor regarding which activities may or may not be right for you. A supervised physical therapy program that focuses on safe resistance exercises may be recommended to help build muscle strength and bone density. Research continues to show that resistance training can strengthen both muscles and bones, even in older people, which may also lower the risk for osteoporotic fractures.

Most people with osteoporosis are encouraged to do some form of weight-bearing exercise as a way to better maintain bone mass, but some activities may be discouraged. For example, your doctor might advise against heavy lifting, doing sit-ups, or bending over to touch the toes, which could put undue stress on the spine.

Don’t ignore a compression fracture

Any time you have back pain that lasts more than a week or two, it is important to see the doctor. Ignoring back pain and potential vertebral compression fractures may lead to bigger problems down the road, such as increased pain, tingling, numbness, weakness, and severe spinal deformity.

Most vertebral compression fractures are treated nonsurgically, such as with rest, pain medications, or applying ice and/or heat while the fracture eventually heals on its own. If the pain cannot be successfully managed with nonsurgical treatments, surgery may be considered. A couple of surgical options for vertebral compression fractures include:

  • Vertebroplasty. This minimally-invasive procedure involves carefully placing a needle through the back and into the compression fracture, delivering bone cement to fill the cracks and re-stabilize the vertebra.

  • Kyphoplasty. This procedure is similar to vertebroplasty, except that a small balloon is inserted and expanded into the compression fracture to help restore the collapsed vertebra closer to its original height before injecting the bone cement.

Some studies have found that both vertebroplasty and kyphoplasty have been effective at reducing pain from vertebral compression fractures, especially when done within 2 months of sustaining the fracture.

By following these tips, you’re well on your way to protecting your spine and successfully managing osteoporosis.


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