January, 2019

Below are links to articles posted in January, 2019


Severe Shoulder Pain? It Could Be Brachial Neuritis

man with sever shoulder pain from brachial neuritis

Brachial Neuritis (BN) is a neuropathic condition (otherwise known as Parsonage-Turner syndrome or neuralgic amyotrophy) that affects nerves in the chest, shoulders, arms, and hands. This condition causes pain and loss of functionality in the nerves that act as messengers between the brain/spinal cord and the rest of the body. These nerves that run along the spinal cord, neck, and shoulders are what medical experts call the brachial plexus.

BN typically leads to terrible pain in the shoulders. After this episode expires, movement limitation then follows the extreme pain. BN is a rare disorder with a very quick onset and usually is at its worst during the night time.

There are two main types of BN: idiopathic and inherited. Idiopathic means that the cause of the condition is largely unknown, while inherited BN is passed down amongst family members. The former is much more common than the latter. Usually, the condition is the result of the patient’s immune system attacking the body’s nerves. Presently, medical experts do not exactly know how the nerve damage occurs in either idiopathic or inherited BN, but great strides in research are always being made.

x-ray of shoulder with brachial neuritis

Causes of Brachial Neuritis

It is not uncommon for BN to be the result of some sort of injury or trauma. Some injuries from contact sports, such as football or hockey, cause temporary weakness in the shoulder, as well as numbness and pain. More serious injuries from major trauma, such as a car accident or a harsh fall, lead to the same symptoms although their manifestation is much more persistent.

As stated previously, BN has to main causes: the patient either inherits it or the condition is idiopathic. The former is nowhere near as common as the idiopathic manifestation of the condition. As the name suggests, with inherited BN the parents of the patient pass down the ailment to their child. Idiopathic forms of BN are instead just forms of the condition where the cause is unknown. This version of BN is much more common than the inherited form.

A lot of the patients who have a sudden onset of BN have a few things in common. For one, many of them may say that they have just gotten over some other illness, disease, or germ. Others may say that they have just recently undergone some sort of test or treatment. This includes things such as spinal taps, injections, or other tests that utilize dyes. In addition to these treatments, some patients have a sudden onset of BN after receiving radiation treatment or surgery.

Symptoms of Brachial Neuritis

The condition almost always starts off with some level of pain, ultimately leading into periods of muscle weakness and lost functionality. The severity and persistence of these symptoms will depend on which phase of the condition the patient is going through, as well as the specifics of their case. While symptoms vary from person to person, a general list is as follows:

  • Sudden onset of extreme shoulder pain (typically the right shoulder). Many patients describe this type of pain as an intense stabbing or burning.
  • Symptoms of pain exacerbate when the patient attempts to move the affected shoulder.
  • Only the most powerful painkillers have any effect on treating the pain, with it still remaining constant for long periods of time.
  • Many patients describe a loss of function or temporary paralysis in the shoulder muscles after a painful episode.
  • Loss of muscle mass in the affected shoulder (atrophy).
  • Multiple areas of numbness develop in different areas of the arm and/or shoulder.
  • Sometimes BN affects the diaphragmatic nerves, which may result in shortness of breath.

Again, these are just to name a few general symptoms of the condition. It will always depend on the severity of your case, as well as your individual chemical composition. For more information, you should always communicate thoroughly with your doctor and remember to always ask questions.

shoulder pain from brachial neuritis

How Do Doctors Diagnose Brachial Neuritis?

A fair question–after all the most common of the two types of this condition is the idiopathic form (meaning unknown cause). Of course, knowing the cause of a condition and being able to identify that a patient has BN are two totally different things.

To begin, your doctor will ask you questions regarding the nature of your condition and will perform an examination to look for areas that cause pain. If your doctor suspects BN early on, they will almost immediately test your shoulder functionality and muscle strength. In many people, it will be apparent which shoulder to examine first, as the affected shoulder often sticks out more than normally. During this time, your doctor will likely test your reflexes for anything unusual.

Once your doctor has laid down some groundwork, he or she will likely order imaging tests such as MRIs, CT scans, or X-rays. In some cases, your doctor may order electrical tests (such as electromyography or nerve conduction study) that show if individual nerves are performing as they normally should. Additionally, if your doctor suspects any other underlying medical conditions, he or she may order blood tests to check for those as well.

Brachial Neuritis Treatments

Most often, doctors treat BN with a multifaceted approach involving medication and physical therapy. That being said, there are some instances where a doctor may feel it is necessary for the patient to have surgery. These cases, however, are few and far inbetween.

Conservative Treatment

To begin, your doctor will prescribe you with some form of pain medication. Pain is the most immediate symptom, so doctors often address this first before anything else. Once the pain situation is brought down to manageable levels, your doctor will then began treatment to eliminate paralysis of the arm and regain functionality. In order for this to happen, your doctor will most likely set you up on a rehabilitative physical therapy program that may last up to eight weeks. The length of this program, as well as the nature of the exercises, will entirely depend on the needs of your case. Don’t worry too much though, as your doctor will set you up with a physical therapist to make this process very manageable.

physical therapy for brachial neuritis

Surgery

Unfortunately, sometimes conservative treatments simply are not enough to get the job done. In such instances, your doctor may put you on the path of surgery. Usually, this only happens after two years of consistent failure from more conservative methods. Of course, you may be able to truncate this time period if you opt in for surgery earlier. For this, however, you will need to have an extensive conversation with your doctor.

Surgical treatment for BN usually involves repairing nerves via grafts from normally functioning nerves elsewhere in the body. If successful, this procedure will return function to the muscles affected by BN. Of course, surgical treatments do not just begin and end with grafts. It is also possible to perform tendon transfers if your doctor deems it necessary to restore function.

Do you have extreme shoulder pain that simply doesn’t fade no matter what you try to do about it? If so, you may want to give us a call at (855)-853-6542. Our spine doctors at the Orthopedic Laser and Spine Surgery will work tirelessly to find the treatment plan that is perfect for the needs of your case. When you come to our clinics, you will meet a team of caring people dedicated to your recovery. Contact us today.


Eliminating Back & Joint Pain with Prolotherapy

performing exam for joint pain before prolotherapy

Back and joint pain can prevent you from enjoying life. In fact, just about every movement you make can become painful if you suffer from either one of these conditions. Chronic back pain affects your ability to work, participate in hobbies, and share important moments with family and friends. If you’ve tried conservative treatments without success…. Then, you’re probably desperate for the right answer. And, while surgery may be an option for you, you may also be leery of “going under the knife.”

Alternative therapies are available for those who wish to avoid surgery. Instead, prolotherapy uses the body’s natural healing response to treat a variety of painful orthopedic conditions. While prolotherapy has its roots in ancient Egyptian times, it’s modern-day origins can be traced to the early 20th century. Can this treatment help you? Use this guide to understand prolotherapy and how it can relieve your pain.

woman receiving prolotherapy injection in shoulder

What is Prolotherapy?

Prolotherapy uses injections to activate healing in the soft tissues of an affected joint. These tissues can include ligaments, muscles, tendons, or fascia. As a result, this triggers the body’s natural abilities to promote the growth of normal cells and tissues. Sometimes known as sclerotherapy or regenerative injection therapy, this treatment has shown promising results in treating back and joint pain. Studies are limited, however, and more widespread research is needed to determine overall success rates.

During prolotherapy, a trained physician or orthopedic doctor uses a series of injections over the course of 3 to 6 months. Generally, treatments take place every couple of weeks. Most injections contain a natural irritant—usually dextrose or glucose. In some cases, sodium morrhuate (a derivative of cod liver oil) may be used.

These injections activate special proteins in the body known as growth factors. Over time, these factors strengthen the affected soft tissues, helping to stabilize the joint.

What Conditions Does Prolotherapy Help?

Prolotherapy can be used to treat a variety of back and joint issues. While some evidence is anecdotal, a growing number of individuals who deal with joint pain swear by this treatment. Here are some conditions that doctors use prolotherapy to treat:

  • Degenerative Disc Disease:As we age, the discs protecting our spine tend to dry out and lose shape. This creates an instability in the spine that often leads to back pain and nerve damage.
  • Hip Arthritis or SI Joint Dysfunction: Issues with inflammation of the hip joints and improper movement of the lower spine can result in pain in the legs and lower back.
  • Spinal Arthritis: Arthritis involves the breakdown of cartilage in the joints and discs of the spine. This usually occurs in the neck or lower back.
  • Sciatica: Pain radiating from the lower back to one or both legs, caused by pressure on the sciatic nerve.
  • Ligament and Tendon Tears: Trauma, falls, and other injuries can cause pain and inflammation to the body’s connective tissues.
  • Shoulder Instability: If you‘ve suffered a shoulder dislocation because of repeated use or sudden injury, then it is more likely to pop out again without treatment.

man with shoulder instability who needs prolotherapy

Who is a Good Candidate for Prolotherapy?

While prolotherapy is helpful for some individuals, others may not benefit from this type of treatment. Talking to your doctor or spine surgeon can help you make an educated decision about pursuing prolotherapy.

Typically, those who would benefit from prolotherapy:

  • Have had back or joint pain, especially resulting from an injury to ligaments or tendons, for over six weeks.
  • Use medications for back and joint pain management.
  • Experience more joint pain during physical activities and less while resting.
  • Haven’t achieved long-term relief from physical therapy or other manual therapies.

Types of Prolotherapy

There are three types of prolotherapy in common use today. These include:

  • Growth Factor Injection Prolotherapy: Injecting a complex protein into a joint to activate the growth of certain cells. This may help to alleviate pain from arthritis and muscle sprains or strains.
  • Growth Factor Stimulation Prolotherapy: Instead of using complex proteins, this type of injection uses a non-inflammatory injection of dextrose—less than 10% of the injection solution. This encourages the body to produce growth factors on its own.
  • Inflammatory Prolotherapy: A higher concentration of dextrose (up to 25%) may be used to stimulate temporary inflammation to the affected area. This triggers a more vigorous growth response in the body.

What to Expect During a Prolotherapy Treatment

Before receiving any type of injection, your doctor will make sure your back and joint pain is properly diagnosed. This involves obtaining a full medical history, discussing the onset and severity of symptoms, and receiving a physical examination. In addition, your doctor may order X-rays and other diagnostic imaging to obtain a clearer picture of the affected area. Since prolotherapy may not benefit everyone, it is crucial to know the exact cause of your pain.

After the examination, your doctor will discuss treatment options, benefits, and side effects of prolotherapy. If it is advised, then you should stop taking any anti-inflammatory medications a couple days before the procedure. Unlike some procedures, your doctor may also ask you to eat a protein-rich meal prior to the injection.

During a prolotherapy treatment, a doctor uses local anesthesia, such as lidocaine or procaine, to numb the area. Then the doctor uses a long, thin needle to deliver the injections around the damaged area. The number of injections will depend on your specific condition.

After the injections, you may experience side effects for up to three days after the procedure. This includes stiffness, pain, and swelling. Pain medications can help during this interval. Be sure not to use aspirin or an anti-inflammatory medication. These types of drugs may make the injections less effective. In addition, icing the area and mild exercise can be beneficial to achieving relief. Physical therapy is also often required to restore function to the affected area.

x-ray of shoulder and spine

Other Therapies That May Be Helpful for Treating Pain

  • Platelet Rich Plasma Therapy (PRP): News reports of famous athletes using PRP gave this therapy national attention. Your platelets, cell fragments in the blood, contain hundreds of growth factors that help to heal injuries. By injecting a high concentration of platelets into an affected area, it stimulates the body’s natural healing process.
  • Stem Cell Therapy: Stem cells have the ability to build and rebuild every tissue in the body. Think of these as “wild card” cells. They can divide continuously to make whatever the body needs for healthy regeneration of an injured area. Implanting these cells back into the body can potentially address a variety of injuries, diseases, and disorders.

Are You Ready to Get Help with Your Back and Joint Pain?

If you tried other conservative treatments and still haven’t found success, Orthopedic & Laser Spine Surgery is ready to help you. We take the time to listen to your story, symptoms, and goals for treatment. After pinpointing the source of your pain, we discuss the most appropriate options for your condition.

At Orthopedic & Laser Spine Surgery, our back doctors use the latest technology and research to help you achieve a pain-free life. This includes alternative treatments like prolotherapy, stem cell therapy, and platelet-rich plasma therapy. In addition, we specialize in minimally invasive procedures for a variety of spine and orthopedic issues.

With access to so many treatments, you may finally be able to find the answer to a pain-free life. Don’t suffer any longer. Calling (855) 853-6542 will put you in touch with a dedicated team who is devoted to your recovery.