Choosing Between Shoulder Resurfacing vs. Shoulder Replacement
Shoulder arthritis is a serious condition that compromises our ability to perform day-to-day activities. As you might imagine, shoulder arthritis targets the typically smooth ball-and-socket joint of the shoulder. Under normal circumstances, the surface of this joint is smooth and allows for less friction in between the moving parts of our shoulder. Arthritis changes this fact, eliminating the cartilage in the joint that allows for the free range of motion to which we are accustomed.
Generally speaking, patients with this condition have a couple of options, but this article will focus on the two main ones: shoulder replacement and shoulder resurfacing. Shoulder joint replacement is a bit more well known, and doctors originally used it to treat catastrophic shoulder injuries. Over the years, the procedure has seen a resurgence, with doctors using shoulder replacement to treat more than just that. In fact, shoulder replacement surgery now has important uses in treating other painful shoulder conditions, such as arthritis.
Shoulder resurfacing is viewed more as an alternative to shoulder replacement and doctors typically use it on patients who are younger. Instead of replacing the humerus and scapula, shoulder replacement involves switching out the affected area with a specialized metallic head. Essentially, this replaces the surface of the joint and allows for the majority of the existing bone to remain as is.
The best treatment for you will depend on the severity of your condition. For more information, be sure to communicate regularly with your medical provider.
The Anatomy of the Shoulder
Three bones compose the shoulder joint: the humerus, scapula, and collarbone. Medical experts refer to the shoulder joint as a ball-and-socket joint. The reason for this is because the ball of the humerus fits neatly into the small socket (glenoid) of the scapula.
At the surface of where the bones touch exists a covering of articular cartilage. This is a smooth material that keeps the bones safe and enables them to have a full range of motion. Additionally, there exists a fine, smooth tissue that doctors call the synovial membrane. This membrane envelopes all of the other surfaces inside the joint of the shoulder. In a normal shoulder, the synovial membrane secretes a tiny amount of fluid that helps to eliminate the friction in between the bones of the shoulder.
Lastly, but certainly not least, there are the muscles and tendons that exist around the shoulder to provide structural support. All of these parts work together to form a joint with the greatest range of motion throughout the entire body.
Diagnosis & Evaluation
Your doctor will likely send you in the direction of an orthopedic surgeon for a more in-depth medical evaluation to determine which surgery will benefit you the greatest. Usually, such an evaluation consists of the following elements:
- Medical History: Your surgeon will need information about pre-existing medical conditions as well as the specifics of your case. This includes facts about the extent of your pain and the current functionality of your shoulder.
- Physical Examination: A physical assessment will test a multitude of things. Usually, this involves examining your shoulder’s motion, strength, and stability.
- X-Ray Imaging: As with any imaging test, x-rays will show the doctor the severity of your condition. These images will reveal things such as the loss of joint space, bone deformities, bone spurs, and any other loose articles (such as cartilage or bone) that may be floating around in places they shouldn’t be.
- Other tests: Your surgeon may deem it necessary to order other tests, such as MRIs, blood tests, or bone scans. These tests will help your surgeon determine the important factors of your condition, such as the current state of your soft tissues and bones.
Is Shoulder Resurfacing Right For Me?
You can think of shoulder resurfacing as kind of a “middle ground” treatment. It is most viable for patients who need pain alleviation, but are not quite to the point where they need a total replacement. In patients where the arthritis is mild and limited to the humeral head, it may be more ideal than a total replacement. Usually, doctors use the procedure to treat conditions such as different types of arthritis, rotator cuff injuries, and avascular necrosis.
The procedure is certainly more conservative than total shoulder replacements. That being said, only a highly skilled professional will be able to determine whether or not it is a viable alternative for the patient. In the event that the doctor does see this as a viable alternative, the possible benefits are:
- Anatomical restoration
- Less invasive surgery
- Minimal scarring/less chance of surgical trauma
- Faster recovery time
- Less painful
- The procedure is still possible in lieu of bone deformity
- No risk of fracture
- It is easy to revisit the procedure if necessary
Patients who have a shoulder resurfacing procedure can usually expect to stay in the hospital for a day or two. After a day has passed, the doctor or nurse will remove the wound dressings. Next begins the first phase of recovery, which involves a series of limited exercises. Usually, the patient will have to wear a sling for up to six weeks. After the patient leaves the hospital, they should perform exercises at home for a few weeks to restore the range of motion to the joint. Generally speaking, total recovery tends to wrap up at around three months time.
Am I a Candidate for Shoulder Replacement Surgery?
First of all, there are several different types of shoulder replacement surgeries. In fact, shoulder resurfacing is actually a subtype of shoulder replacement surgery, albeit a less invasive one. So, for the sake of brevity, this article will refer to the most common form of shoulder replacement surgery: total shoulder replacement. Whereas shoulder resurfacing involves simply replacing the surface of the humeral head with a stemless prosthesis, total shoulder replacement involves a metal ball attached to a stem with a synthetic socket.
Perhaps the biggest indicator for the necessity of this procedure is pain that is not alleviated through more conservative methods or less invasive procedures. Additionally, the pain must exhibit a progressive stiffness with accompanying loss of motion range. Typically, patients report an almost grating sensation within their ball-and-socket joint that is quite uncomfortable.
Basically, doctors only consider more traditional open surgeries like these over minimally invasive procedures when there are no other viable options. Minimally invasive procedures and conservative options are always the preferred route to take. However, the nature of how they work sometimes does not allow for proper recovery. For more information, please consult your doctor to see if this procedure is right for you.
If you have shoulder pain that has not abated with more conservative treatments, please contact Orthopedic & Laser Spine Surgery at (855) 853-6542. Our team of spine doctors are leading experts in the field of minimally invasive treatment and surgical care. We will work tirelessly to ensure that you are put on a treatment plan that suits your specific needs. Don’t hesitate, contact our practice today!
Coccydynia, sometimes referred to as tailbone pain, can be an uncomfortable, even debilitating condition. Undoubtedly, severe tailbone pain can make sitting or even standing for long periods of time very difficult.
You’re probably wondering what causes this peculiar type of pain. And, more importantly, how you can treat it. Luckily, there are some easy things that you can do to relieve an inflamed coccyx. Use this guide to understand coccydynia and discover ways to conquer the pain.
Understanding the Tailbone
The tailbone, formally referred to as the coccyx, is a series of small bones connected to the sacrum through the sacrococcygeal joint. Located at the base of the lower back, the sacrum forms the back of the pelvic wall and keeps the pelvis stable. The coccyx is the triangular-shaped mass of bone that resides directly below the sacrum. It is usually only a few inches long.
A person may have three to five coccyx bones depending on their development. These bones are fused together by small joints or disc-like ligaments. This fusion allows for some movement when sitting or standing.
Likewise, the coccyx aids in support and weight distribution when a person is seated. In addition, many pelvic floor muscles are connected to the tailbone. These muscles help with leg movements such as walking and running. They also support various functions of the anus and vagina.
If the coccyx joints or bones become damaged or inflamed, it could lead to a painful condition known as coccydynia. So how could such a small bone mass cause such major pain? Let’s look at a few common causes.
Causes of Coccydynia
Coccyx pain can occur for a variety of reasons. It is usually caused by too much or too little movement in the area. These mobility issues can apply stress to the joints, leading to pain, nearby muscle tension, pelvic floor spasms, and inflammation.
In many cases, tailbone pain occurs because of trauma or injury to the area. A bad fall can result in inflammation around the coccyx, causing further discomfort. Activities that apply prolonged pressure to the tailbone can also be to blame. This includes sitting on hard surfaces for a long time or even horseback riding. Obesity also puts a person at a higher risk for developing coccydynia symptoms.
In addition, as we age, normal wear and tear on the body can cause painful inflammation in the joints. Furthermore, degenerative joint disease can occur anywhere in the body—including the coccyx. Prior injuries to the area can also hasten the disease progression.
Moreover, gender also plays a role. In fact, women are up to 5 times more likely to suffer tailbone pain. Why women? Their anatomy generally allows for less pelvic rotation which can lead to coccyx injury. Childbirth can also be to blame. As the baby moves over the tailbone during vaginal birth, the coccyx may suffer injuries.
In rare cases, cancer or an infection to the area may cause tailbone pain. Cancer usually starts at a different area of the body, such as the prostate, cervix, or ovaries. For some, it spreads to the coccyx. An infection of the coccyx could also cause unique symptoms that require a doctor’s care.
Symptoms of Coccydynia
You’re probably wondering how you can differentiate coccyx pain from other lower back conditions. It may be easier than you think. For example, tailbone pain usually persists in a specific area. It doesn’t radiate outward to other areas of the body like the legs or feet.
Symptoms of coccydynia include:
- Pain and tenderness that are confined to the tailbone area. This can be an aching throb that ranges in intensity from mild to severe.
- Tightness around the tailbone. Sometimes this sensation can be constant. Other times it comes and goes depending on your activities.
- Increased pain while seated. Putting weight on the tailbone, especially while sitting on hard surfaces, can cause even more pain.
- Difficulty changing positions. Those with coccydynia often feel pain while sitting down or getting up from a seated position.
- Pain during bowel movements or sexual intercourse. Since the coccyx is so close to the anus and genitals, these activities may cause spikes in pain.
- Swelling, redness, or drainage near your tailbone. These symptoms can indicate an infection in the area, which often requires a doctor’s care.
Pain Management and Coccydynia Treatments
Luckily, for most people, non-surgical treatments are effective at reducing tailbone pain. Here are some things you can do to help manage your coccydynia:
Making simple changes to your daily habits can make a big difference. For example, try to avoid sitting for long periods of time. If you have a desk job, get up and walk around for a few minutes every hour. In addition, adjust your posture when seated. Leaning forward while sitting can help take pressure off the coccyx. You can also buy a specially-designed coccyx cushion (found online or at many drug stores).
Since obesity may be a factor in your coccyx pain, consider taking time each day to exercise. This can help with weight loss and strengthen the muscles surrounding the coccyx area. In addition, aerobic activity helps to release the body’s natural endorphins—pain-relieving chemicals.
If you feel pain while having bowel movements, try to eat a diet rich in high fiber foods. And also, don’t forget to stay hydrated. These dietary changes can help to soften the stool so that it’s easier and less painful to have a bowel movement. If necessary, take a stool softener or laxative if you continue to have painful bowel movements.
Use Cold Packs or Heating Pads
Just like many other muscular or orthopedic injuries, heat and cold can provide relief. Using a cold pack several times a day during a painful flare-up can reduce inflammation. A heat source like a hot water bottle, warm bath, or heating pad may also provide soothing relief. Heat typically reduces muscle tension to the affected area and increases blood flow.
Experiment with hot and cold treatments to see which combinations work best for you.
If lifestyle changes and cold packs or heating pads aren’t giving you the necessary relief, then medications may be your next step. Luckily, over-the-counter NSAIDs like ibuprofen or naproxen can be very effective. These medications can reduce inflammation and ease the pain.
For more severe cases, a doctor may order prescription pain medications. These medications can be effective for some, but they also may be habit-forming or lead to adverse side effects for others. Another option is a steroidal injection. Your doctor will administer the shot, which is a combination of a numbing agent and a steroid, to decrease inflammation.
Manual Manipulation of the Coccyx Area
Chiropractic care can allow for adjustment of the sacrococcygeal joint. This can reduce the pain caused by poor joint mobility. In addition, some people find relief with massage. Specially trained massage therapists can work on tense pelvic floor muscles with deep tissue massage.
Physical Therapy may also prove beneficial. A physical therapist can suggest an exercise routine that gently stretches the ligaments in the coccyx area. In addition, a PT can suggest modifications to your daily activities which will prevent painful flare-ups.
A doctor or physical therapist may also use a Transcutaneous Electrical Nerve Stimulator (TENS) unit. This is a small device that uses electrical stimulation to disrupt tailbone pain signals from reaching the brain. It is a good option for those who would rather not use pain medications.
Most people don’t need surgery for coccydynia. There are some individuals, however, that don’t respond to conservative treatments. If you tried several of the above pain management techniques for at least two months without results, then your doctor may consider surgery.
A coccygectomy is the typical surgical option. This involves removing part or all of the coccyx. The procedure is quick and straightforward. In many cases, it is minimally invasive. This means a small incision is used to gain access to the area and remove the coccyx. Minimally invasive surgery offers several benefits, including quicker recovery times, less damage to the body, and minimal scarring.
Such procedures generally achieve good outcomes after the initial healing process. Due to the complicated nature of the surgery, the recovery period may last anywhere from three months to a year.
Ready to Get Help for Your Coccydynia?
If you tried conservative treatments and still suffer from tailbone pain, then you may need the guidance of an orthopedic doctor. These doctors specialize in pinpointing the source of pain and finding the best treatment options based on your specific needs and goals.
Orthopedic & Laser Spine Surgery uses the most advanced and minimally invasive techniques to help you manage your pain. Our doctors believe appropriate conservative treatments should be considered before exploring surgical options. If you do need surgery, then our team has the experience and technology to ensure that you are receiving quality care for your tailbone pain.
Are you ready to once again start enjoying your life without the burden of pain? A simple call to (855) 853-6542 puts you in contact with a team of dedicated professionals who are ready to help you get back to the life you want. Calling now may be the first step toward enjoying a pain-free future.
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!
Carpal tunnel syndrome (CTS), which leads to pain, numbness, and tingling in the hand and arm, is a frequent occurrence among office workers. CTS occurs when a component of wrist anatomy compresses the median nerve (a major nerve in the hand that innervates the wrist).
In the vast majority of cases, carpal tunnel syndrome symptoms only worsen with time. Therefore, it is always important to seek a diagnosis and treatment plan as soon as possible. In the early stages, symptoms may be alleviated through conservative measures such as wearing a wrist splint or avoiding certain intensive activities.
That being said, if pressure on the median nerve persists, it may lead to nerve damage—and as a result—exacerbated symptoms. To prevent permanent damage, it may be necessary for some patients to undergo surgery in order to relieve this pressure.
The Anatomy of the Wrist
The carpal tunnel is an inch wide passageway that travels through the wrist. This tunnel is formed by the meeting of small wrist bones that medical experts refer to as the carpal bones. The root of this tunnel is a strong series of connective tissues known as the transverse carpal ligament. These boundaries are very rigid, meaning that the carpal tunnel has little to no flexibility when it comes to increasing its size.
The median nerve headlines the show going on in the hand. It begins as a group of nerve roots in the neck, and these roots bunch together to form a single nerve in the arm. This nerve then travels down the arm and forearm, where it passes through the carpal tunnel located in the wrist and leading down to the hand. The median nerve provides us with feeling in our fingers, as well as control over the muscles surrounding the base of the thumb.
In addition, the nine tendons that bend the fingers and thumb also pass through the carpal tunnel. Medical experts refer to these tendons as flexor tendons.
What is Carpal Tunnel Syndrome (CTS)?
Carpal tunnel syndrome (CTS) occurs when the tunnel that contains the median nerve narrows or when the tissues surrounding the flexor tendons begin to swell. Medical experts refer to these tissues as the synovium, and they may cause pressure on the median nerve when they swell in size. Under normal circumstances, these tissues lubricate the tendons, which allows for greater flexibility in our fingers.
When the synovium swells in size and applies pressure to the median nerve, it leads to pain, tingling, numbness, and weakness in the hand. Most cases of CTS arise from a variety of different factors. Generally speaking, women and the elderly are more likely to develop the condition.
The following list includes other risk factors that may lead to CTS:
- Repetitive Use: Repetitive actions of the hand and wrist over a period of time will aggravate the tendons associated with CTS. This causes swelling, which applies pressure to the median nerve.
- Pregnancy: Changes in the body’s hormone levels during pregnancy may cause swelling that increases pressure on the median nerve.
- Heredity: Genetics may also cause the development of smaller carpal tunnels, which changes the amount of space available in the wrist for the median nerve.
- Health Conditions: Other conditions such as rheumatoid arthritis, thyroid gland imbalances, and diabetes may lead to CTS.
- Position: Hand and wrist positions also have a bearing on the development of CTS. Any activity that involves heavy flexion or extension of the hand or wrist over time will irritate the tendons in the wrist.
Carpal Tunnel Syndrome Symptoms
The following list includes common symptoms of carpal tunnel syndrome:
- Sporadic shock-like symptoms that radiate to the thumb, index, middle, and ring fingers.
- Numbness, tingling, and pain in the thumb, index, middle, and ring fingers.
- Pain may also travel up the forearm and into the shoulder
- Weakness in the hand
- Poor hand grip (You may frequently drop objects)
Most of the time, the symptoms of carpal tunnel syndrome begin slowly, and usually without an isolated injury or cause. Symptoms often come and go at first, but as CTS worsens, symptoms may arise more frequently and persist for much longer.
Symptoms at night time are also very common. Many people sleep with their wrists at an angle, and this may lead to insomnia in patients with CTS. During daytime hours, symptoms often occur while holding something for a long period of time with the wrist bent at an angle, such as while holding a coffee mug. Many patients will move or shake their hands to relieve symptoms during this time.
Do I Need Surgery for CTS?
Over time, CTS will weaken your hand and wrist muscles. If symptoms persist for a prolonged period of time, your condition will worsen and muscle damage may occur.
Your doctor may suggest surgery in the following situations:
- Conservative treatments, such as braces, corticosteroids, and physical therapy have not alleviated your symptoms.
- You find it progressively harder to grasp objects than you once did.
- Your symptoms have persisted without getting better for at least 6 months.
There are two types of procedures that doctors commonly use for carpal tunnel release surgery: open surgery and endoscopy. Either way, your doctor will cut ligaments around the carpal tunnel to release pressure from the median nerve. This, in turn, will help to relieve symptoms. After your doctor has completed the surgery, the ligament heals back together and also allows for more room surrounding the median nerve.
Open surgery involves a larger incision that may be as long as 2 inches, extending from the wrist to the palm. Endoscopic surgery works a little differently, by utilizing several smaller incisions and a tiny camera to help guide your surgeon through the procedure. This, of course, is a much easier procedure to heal from than open surgery. That being said, not all CTS cases are viable for endoscopic surgery. You will need to talk with your doctor to find out which procedure is best for your specific needs.
CTS Surgery: The Recovery Process
Some relief may occur on the same day as surgery, but the entire healing process takes a little bit longer than that. Patients should expect to experience pain and swelling immediately after their procedure. Your doctor will prescribe you medications that will alleviate any tenderness that you may experience. Soreness may last anywhere from a few weeks to a few months after your surgery.
Your wound dressing will stay on for at least 1-2 weeks, depending upon your case. During this time, your doctor will likely give you a list of appropriate exercises to perform in order to keep your fingers from becoming too stiff. That being said, you should still be careful to avoid too much strain while completing these exercises. Over time, you will be able to return to normal activities, such as driving, writing, and grabbing objects. This improvement typically becomes apparent by 6-8 weeks out, but full functionality may not return until the 10-12 week mark.
If you have any of the symptoms mentioned above, please contact us at (855) 853-6542. At Orthopedic Laser and Spine Surgery, we pride ourselves on our ability to provide the highest level of care and treatment to our patients in need. At OLSS, you can rest assured that you will be put on a treatment plan that is tailored to address your specific needs. Don’t hesitate, contact us today!