Below are links to articles posted in March, 2019
A pinched nerve occurs when anatomical structures in its immediate vicinity encroach upon the nerve. In other words, the nerve becomes compressed by obstructions such as bones, tendons, muscles, or cartilage. The application of too much pressure subsequently interferes with that particular nerve’s ability to function. This translates to pain, numbness, and uncomfortable symptoms for the patient.
This situation can occur in different parts of the body although it mainly affects the back or neck. And, although this condition can be remedied by proper rest including sleep hygiene and massage, sometimes, nothing short of a visit to the orthopedic surgeon will provide comfort.
Damage caused by a pinched nerve can be transient in its duration or long-lasting. And while doctors can’t fully cure this condition in some patients, the right treatment will alleviate pinched nerve pain.
Symptoms of Pinched Nerves
This condition usually comes with a number of symptoms which signal to its presence. The most common sign of its occurrence, however, is the presence of pain. Other signs and symptoms that herald the occurrence of a pinched nerve include:
- A decline in sensitivity and feeling of numbness in the area controlled by the pinched nerve
- Paresthesia (or a pins-and-needles tingling sensation) in the limbs
- Tingling in the area of the pinched nerve
- A feeling of fatigue when performing certain activities
- Radiating pain which can feel sharp, aching, or burning
- The feeling that a limb is unresponsive or has fallen asleep
Some of the symptoms listed above can worsen when you attempt to move certain parts of your body such as your head or neck. These symptoms can also intensify at night while you attempt to sleep.
Causes of Pinched Nerves
There are several orthopedic causes that can lead to a pinched nerve. For example, one of the most common precipitating factors is poor posture. The following list includes other circumstances that can lead to a pinched nerve:
- Participating in an occupation or activity that involves making repetitive motions
- Maintaining a particular position for long periods of time (e.g. sleeping with your elbows bent)
- Becoming obese or overweight
- Engaging in sporting activities
- Sustaining an injury
- Developing osteoarthritis or rheumatoid arthritis
You will often find that pinched nerves occur in parts of the body that lack soft tissues to cushion the nerves. For instance, pinched nerves often occur near foramina (narrow openings in vertebrae through which nerves radiate outward). Such an occurrence can cause pain to develop in the neck or lower back. If the pain spreads outward from the neck region and into the shoulder or arm, doctors call this condition “cervical radiculopathy.” If the pain radiates from the lower back and into the leg or foot, then doctors term this condition “lumbar radiculopathy” or sciatica.”
Likewise, a pinched nerve can develop from the occurrence of changes in spinal discs, such as a disc’s tearing. Doctors refer to this condition more commonly as a “herniated” or “ruptured” disc.
Treating Pinched Nerves at Home
There are several ways to arrest a pinched nerve situation. Some of these are simple treatments that you can attempt within the confines of your home. The particular remedy you use should depend on the area of the body where the pinched nerve occurs and the underlying cause. Likewise, the time it takes to fully eradicate symptoms will vary depending on the individual. The following are some ways that you can address pinched nerves at home:
1. Improve your posture.
One of the many causes of pinched nerves is poor posture. This means that you can often remedy a pinched nerve by simply adjusting your posture throughout the day. The use of neck rests, cushions, and pillows will assist you in achieving a neutral spine position. This ideal position decompresses spinal nerves and may even lead to a resolution of your pain.
2. Get more rest and better sleep.
Another way that you can treat pinched nerves at home is to achieve longer and more restful sleep. The body undergoes a process of cellular repair while we sleep. This, combined with resting the affected nerve from strenuous activities, will encourage healing.
3. Perform routine stretching.
Performing regular stretching activities, such as yoga exercises, can also soothe pinched nerves. You should do your best to ensure you are not overdoing it, however. If you attempt to do too much too soon, you may actually worsen your condition. If you experience discomfort while stretching, you are advised to stop and immediately consult your doctor.
4. Use medications as prescribed or needed.
Certain medications are also useful in treating pinched nerves. Medications such as ibuprofen, which is a non-steroidal anti-inflammatory drug (NSAID), can eliminate your pain and swelling. In some cases, a reduction in inflammation can also put an abrupt end to nerve compression.
5. Test out ergonomic aids.
Consider switching to ergonomic office equipment to improve your workday posture. An ergonomic mouse and keyboard will result in less pressure being exerted on the wrists. Also, adjusting the position of your computer screen to eye-level will reduce the need to incline your neck. This will reduce muscular strain on your neck and alleviate any pinching..
6. See a massage therapist.
Massaging the affected area and its surrounding structures can relax muscles and pinched nerves. As the tension releases, you may also find that your pinched nerve vanishes.
7. Lose weight.
Remember to keep your BMI within the normal range, even if this means adjusting your eating and exercising habits. Overweight individuals are more prone to a host of orthopedic issues, including pinched nerves and osteoarthritis.
8. Apply ice & heat to the affected area.
Applying ice to the affected area will help to alleviate local inflammation, whereas heat application will improve blood flow to the region. Blood carries essential components associated with healing, which can speed the recovery process from a pinched nerve.
If you do not find relief by using the methods above, then seek out the services of a board-certified orthopedic surgeon. When conservative methods fail to deliver relief, you may need surgery. The purpose of surgery for pinched nerves to ease the pressure on the nerve and as such, put an end to it. The surgery that your doctor performs, however, will depend on the nerve that is being compressed.
The mere occurrence of a pinched nerve is more or less a warning. And if it persists past a couple of days and defies all treatment, it can result in severe damages. If you observe the following symptoms, then, you should immediately see a doctor.
- Sudden paralysis or muscular weakness in your limbs
- Bladder or bowel incontinence
- Numbness in the saddle region (the rectum, inner thighs, and buttocks)
Enlisting the help of an orthopedic surgeon will allow you to determine the best course of treatment for you. For example, if your doctor diagnoses you with a herniated disc, then you may need to undergo an artificial disc replacement. This surgery involves the removal and replacement of the herniated disc with an artificial model. Other surgeries that individuals with pinched nerves undergo include laminotomies and foraminotomies. Both of these surgeries involve removing sections of bone in order to create more room for pinched nerves.
A laminectomy, for example, involves the removal of a part of the lamina, or the backside of a vertebra. A type of decompression procedure, this technique releases pressure on the spinal cord and nerve roots. Such pressure might be a consequence of an injury, herniated discs, or even tumors.
A foraminotomy is also a decompression procedure. Your surgeon will perform this particular technique to widen the foramina, permitting the nerves to pass through unfettered.
Do you have a pinched nerve that requires intervention? If so, you don’t have to suffer any longer. Let a seasoned orthopedic team with over 20 years of clinical experience handle your case. Contact our pinched nerve doctors at Orthopedic & Laser Spine Surgery and rest assured that your recovery is in good hands!
Jumper’s knee was a term first coined in 1973 as a layman’s word for insertional tendinopathy. Such an injury describes damage to an athlete’s tendon at the point where it meets the bone. Patellar tendinitis involves the point where the kneecap tendon meets the lower kneecap pole. The condition, more specifically, refers to functional stress overload as a direct result of repetitive jumping.
Jumper’s knee is a common form of tendinopathy among athletes with mature skeletons. In fact, the condition occurs in as many as 20% of all jumping athletes. Both genders are equally affected when it comes to developing jumper’s knee on both sides of the body simultaneously. Although this may be the case, one-sided jumper’s knee is twice as likely to affect males as it will females.
Causes of Jumper’s Knee
Generally speaking, repetitive stress on either the patellar or quadriceps tendon during jumping often leads to this condition. This injury specifically affects athletes, especially those who partake in sports with ample amounts of jumping (e.g. basketball, volleyball, long jumping, etc.) Occasionally, jumper’s knee may occur in soccer players, weight lifters, and cyclists (although this is more unusual).
General risk factors for developing this condition include:
- Deformities that lead to an increased angle of the knee
- An unusually low or high kneecap
- Having a difference in leg lengths
- Performing sports on hard surfaces
Factors that influence the condition also include poor flexibility in the quadriceps and hamstrings, vertical jump ability, and the techniques that the athlete uses to jump and land. All of these considerations influence tendon loading.
Naturally, the kneecap tendon has a much greater mechanical load during landing than it does while jumping. This is due to the off-center muscle contraction of the quadriceps. This unusual muscle action, which occurs naturally when we jump, may lead to mechanical overexertion and subsequent injury.
Jumper’s Knee Classification & Symptoms
Although it may somewhat depend on the nature of the case, jumper’s knee is generally categorized into 1 of 4 stages:
- Phase 1 – Pain only occurs after the athlete completes the activity, with no functional impairment during the activity.
- Phase 2 – The athlete experiences pain during and after the stressor activity. Although there is pain during the activity, the athlete should still be able to perform adequately in their sport.
- Phase 3 – Pain persists during and after athletic activity. At this point, it becomes much more difficult for the athlete to perform at a satisfactory level.
- Phase 4 – The tendon has torn and will require surgery to fix.
Jumper’s knee may manifest as either chronic or acute, meaning that the condition may have a sudden onset or it may result from repetitive motions over time. Individuals with the condition may experience one or several of the following symptoms:
- Pain: The main, most obvious symptom. An athlete may experience throbbing pain beneath the kneecap during activities that stress the knee joint. Usually, pain worsens with activity continuation and diminishes with rest. Over time, however, the pain may become constant, even during periods of no activity. Actions such as kicking, running, and bending the knee can all exacerbate the pain associated with the condition.
- Swelling: Jumper’s knee may lead to minor swelling of the knee joint, thereby reducing the athlete’s range of motion.
- Bruising: Discoloration of the knee may be observable in cases of acute jumper’s knee.
- General Discomfort: If the case is bad enough, symptoms may manifest from daily activities such as climbing stairs, bending down, or kicking.
If you suspect you have jumper’s knee, then you should consider resting. Otherwise, the condition will only become progressively worse with time.
Jumper’s Knee Diagnosis
If you suspect that you have a sustained knee injury, then you should always seek medical help. Especially if you are an athlete. For a knee injury, the diagnostic procedure often includes:
- Physical Exam: Your doctor will almost always perform some variation of a physical exam if you walk in with a knee injury. A physical exam is useful for detecting anomalies such as swelling, limited range of motion, bruising, abrasions, and more. Your symptoms will tell your doctor a lot about the nature of your case. Throughout this process, your physician will ask you a series of questions about the causes of your injury, the kind of symptoms you are experiencing, and the intensity of your pain.
- Medical History: Almost any visit to a doctor’s office will involve providing your detailed medical history. Sustained knee injuries are no different in this regard. Your medical history is important to your physician as it will be able to tell him or her whether a pre-existing medical condition has had any bearing on your case.
- Imaging Tests: Once your physician has conducted a physical examination and reviewed your medical history, he or she will then order imaging tests (such as x-rays or MRIs). Whatever avenue your doctor decides to use will help to solidify his or her final diagnosis of your condition.
Treatment for Jumper’s Knee
As with most medical conditions, treatment for jumper’s knee usually breaks down into conservative options or surgical procedures. Usually, your doctor will attempt to exhaust conservative treatments first before considering surgery. But, this obviously depends upon the nature of your case.
If you have an immediate injury that needs attention, then you should consider using NSAIDs and the R.I.C.E method (rest, ice, compression, and elevation). Both of these methods help to reduce pain and swelling around the affected area.
The list of conservative treatments for a knee injury is quite extensive. Your doctor may recommend the following methods:
- Exercise Training: Involves a series of knee-strengthening exercises to alleviate the symptoms of your condition. These techniques are often used in conjunction with bracing to support the knee during the healing process.
- Injection Therapy: Only used for more advanced cases, this involves administering a corticosteroid injection to the athlete to reduce inflammation and accelerate healing.
- Platelet-Rich Plasma Therapy: Involves injecting the patient with their own platelet-rich plasma as a means to accelerate the healing process
- Dry Needling: With this treatment, a needle without a syringe is inserted into the injured area and moved using the guidance of an arthroscopic camera. The goal of this is to break up degenerative structures at the injury site that may be contributing to the patient’s condition.
- Hypothermic Thermotherapy: This treatment uses both a heating and a cooling source to raise the temperature of damaged tissues at the injury site. During this process, the cooling source ensures that the surface level tissues remain cool.
- Extracorporeal Shockwave Treatment: This entails sending electrical impulses into muscle tissue that surrounds the knee bone to deliver force to affected tissues. The force from these waves encourages damaged tissues to heal faster.
The two most common procedures for treating severe cases of jumper’s knee include:
- Arthroscopic Resection of the Inferior Aspect of the Kneebone: Your doctor will employ this method if the inferior aspect of the patella needs to be removed or realigned. This is performed in order to remove unwanted stress on the patellar tendon.
- Arthroscopic Debridement: A small camera and several specialized surgical implements are inserted into the affected site and then used to remove damaged tissue.
Do you believe that you have a knee injury such as patellar tendinitis? If you think you do, then seek out medical consultation as soon as possible. Unfortunately, untreated injuries will only exacerbate over time, so seek help from a board-certified orthopedic specialist. Our team is composed of passionate experts who run an efficient facility with the goal of getting you back to life and enjoying the things you love. Don’t hesitate, contact us today!