July 23, 2012
Oh! My Aching Back
Dr. Robin Tomita
Physical Medicine and Rehabilitation Specialist Dr. Robin Tomita of Tahoe Fracture and Orthopedic Medical Clinic takes some time to answer some common questions about pack pain.
What are some common causes of back pain?
Younger individuals have more trauma related lower back injuries. This can occur with sports, motor vehicle accidents, lifting and bending type injuries and falls. In contrast, older individuals can have a more slow and gradual onset of pain, and that’s usually due to underlying degeneration of lower back over several years.
Who’s at risk for developing back pain?
Unfortunately almost everyone is at risk. Approximately 80% of the population will experience an episode of significant lower back pain in their lifetime.
How can you prevent development of back pain?
Overall, it’s difficult to completely prevent the development of lower back pain. Things that can help include:
- Staying in good physical shape
- Using proper body mechanics when lifting and bending (ex. not bending to suddenly or rapidly)
- Maintaining good posture
- Avoiding prolonged sitting
- Knowing your limitations and not over doing things
What non- invasive therapies are available for treatment of back pain?
Fortunately most episodes of lower back pain (roughly 90%) will recover within 6 weeks without any specific treatment other than relative rest and activity modification. However, for lower back pain that lasts longer, consulting a spine specialist can be helpful to best evaluate and treat the problem.
Spinal injections, although they’re not truly non-invasive, can be helpful. This includes epidural steroid injections. In some cases alternative care such as chiropractic, acupuncture and massage can be of benefit. There are a variety of more controversial treatments that aren’t scientifically valid including mechanical disk lumbar disk decompression, lumbar bracing, herbal therapy and bio feedback.
Dr. Robin Tomita is board certified in Physical Medicine and Rehabilitation. He sees patients at Tahoe Fracture and Orthopedic Medical Clinic. For more information please call 775.783.6190.
June 20, 2012
Hip Pain Causes, Risks & Treatments
Dr. Jeffrey Cummings, Tahoe Fracture and Orthopedic Medical Clinic
Dr. Jeffrey Cummings with Tahoe Fracture and Orthopedic Medical Clinic specializes in arthroscopy and sports medicine. He took some time to answer questions about common causes of hip pain, diagnosis and treatment options.
What are some of the common causes of hip pain?
Some of the most common causes of hip pain that I see are bursitis, femoral acetabular impingement and arthritis.
Who is at risk of developing hip pain?
Unfortunately, we all have a risk of developing pain in our joins and this can occur without any specific injury or incident. It may present very gradually with symptoms of pain localized in the groin area, people sometime experience pain in the buttock area and occasionally pain may radiate down the thigh. Symptoms typically are made worse with prolonged walking or hiking or flexing and rotating the hip. Some may also experience a loss of range of motion or painful range of motion. If the pain is localized laterally on the hip and it is sore to press the bony prominence (the greater trochanter) it is most like bursitis. The other symptoms may be concerning for arthritis or impingement.
When is it appropriate to see a physician for hip pain?
If the hip pain has been constant and consistent it should not be ignored. The hip joint is made up of a round ball and socket. Hip impingement occurs when people lose the spherical shape of the hip and the ball becomes more egg shaped. The egg shaped bone does not move in the round socket as well and can cause damage to the cartilage of the hip and well as the labrum. Over time, if left uncorrected, it may lead to hip arthritis. Arthritis is the loss of the cartilage covering of the bones in the joint, so when the hip joint is trying to move, instead of a nice smooth surface of cartilage to glide against it becomes bone rubbing against bone. Diagnosis is made with physical exam, X-rays and MRI.
What are treatment options available for hip pain?
Usually, bursitis can be relieved with activity modification, physical therapy, stretching and occasional cortisone injections – surgery is rarely required.
Hip impingement also starts with activity modification, physical therapy and cortisone injections. If these fail and pain persists, one of the techniques available to treat hip pain is hip arthroscopy. A hip arthroscopy is an out-patient procedure where a small video camera attached to a fiber optic lens is inserted into the hip joint to allow a surgeon to see without making a large incision. While not as common as arthroscopy of the knee and shoulder, hip arthroscopy is now used to evaluate and treat orthopedic problems in the hip joint and the space outside the hip joint known as the greater trochanteric bursa. The goal of the surgery it to correct the egg shaped ball and make it round again and to remove any other bony prominences that may impinge the motion of the hip.
For advanced arthritis (bone on bone), treatment starts with activity modification, medications, cortisone injections and sometimes the use of a cane or walker. When these conservative treatments fail, and the hip has interfered with the patient lifestyle a total hip replacement maybe the best option.
If you are experiencing constant hip pain, it is best that you call your physician or schedule an appointment with Dr. Cummings.
Dr. Cummings is Board Certified with the American Academy of Orthopedic Surgeons.
June 7, 2012
Pain in the…Shoulder?
Pain in the shoulder can have several causes, can be temporary or can require further work up for diagnosis and treatment. Ignoring pain in any joint can lead to further damage. If you are experiencing pain in the shoulder it is important to contact your physician for diagnosis and treatment. Listed below are some common causes of shoulder pain.
Tendon inflammation
Bursitis: Sometimes, excessive use of the shoulder leads to inflammation and swelling of the bursa between the rotator cuff and part of the shoulder blade known as the acromion. The result is a condition known as subacromial bursitis. Bursitis often occurs in association with rotator cuff tendinitis.
Tendonitis: A tendon is a cord that connects muscle to bone. Most tendinitis is a result of a wearing down of the tendon that occurs slowly over time, much like the wearing process on the sole of a shoe that eventually splits from overuse. Tendinitis can be acute or chronic.
Tendon tears
Splitting and tearing of tendons may result from acute injury or degenerative changes in the tendons due to advancing age, long-term overuse and wear and tear, or a sudden injury. These tears may be partial or may completely split the tendon into two pieces. In most cases of complete tears, the tendon is pulled away from its attachment to the bone. Rotator cuff and biceps tendon injuries are among the most common of these injuries.
Instability
Shoulder instability occurs when the head of the upper arm bone is forced out of the shoulder socket. This can happen as a result of a sudden injury or from overuse. Shoulder dislocations can be partial, with the ball of the upper arm coming just partially out of the socket, versus a complete dislocation where the ball comes all the way out of the socket. Repeated episodes dislocations lead to an increased risk of developing arthritis in the joint.
Arthritis
The most common type of arthritis in the shoulder is Osteoarthritis. Symptoms, such as swelling, pain, and stiffness, typically begin during middle age. Osteoarthritis can be related to sports or work injuries and chronic wear and tear. It develops slowly and the pain it causes worsens over time. Other types of arthritis can be related to rotator cuff tears, infection, or an inflammation of the joint lining.
November 22, 2011
What do my Pain Symptoms Indicate?
Chronic pain affects over 34 million Americans, which takes its toll on the quality of life, productivity, and even personal income of those living in our country.
Unfortunately, pain is subjective so there is no clear way to measure it. This creates another perplexing issue for doctors. The Carson Tahoe Pain Institute, pain specialists, or pain medicine doctors are better equipped to diagnose the cause of pain and treat it through an arsenal of different procedures and methods.
To learn more about common pain symptoms and what they may mean, please read the diagram below (Click it to make it bigger).
Many times, however, back and neck pain does not go away by itself, and it’s a good idea to have a specialist examine you to determine the exact cause of your pain.
Drs. Goode and Sullivan of Carson Tahoe Pain Institute (CTPI) can help with your pain management.
Based in Northern Nevada, Dr. Sullivan and Dr. Goode are board certified anesthesiologists that specialize in pain management and have over 20 years of experience. Sara Sullivan, MPA, PA-C works alongside the physicians at CTPI and orthopedic surgeons, assisting in all areas of patient care, management and surgery.
CTPI is a valuable resource for the medical community. The doctors expect to work hand in hand with each referring physician or medical provider. CTPI offers comprehensive treatment options for patients including injection therapy, medication management, physical therapy, pain pumps and spinal cord stimulators.
For more information about Dr. Goode, Dr. Sullivan or CTPI visit carsontahoe.com/pain.
September 30, 2011
Got Belly Fat? Now What?
What used to work for us to lose weight in our 20’s doesn’t seem to work for us in our 30’s, 40’s, 50’s and beyond due to a lifetime of accumulated wear and tear. Our bodies are not able to release the stress of old injuries and infections, which can cause elevated levels of the “stress” hormone cortisol. When we have elevated levels of cortisol in our system it shuts down the function of the thyroid which controls metabolism. This explains how someone can go to the gym, day in and day out, and not lose weight.
Exercising when the body is already stressed can cause a person to plateau, or in some cases even gain weight. Lowering calories when the body is experiencing extreme stress (no sleep, too much pain, sugar or alcohol) can cause the same problem.
If you can’t lose weight and don’t understand why, you might take a look at old injuries and infections that weren’t taken care of properly. Old problems that cause pain or interfere with ordinary bodily functions can slow down the normal activity of our body. It’s like having too many applications open on the computer. Your body just won’t work as well.
How do we fix this situation?
The obvious answer is to reduce stress. If we could only remove our jobs, traffic, work, difficult situations and people, then this would be simple. Right?
So, what we can do, is heal the body through re-establishing communication within the body, reducing the levels of cortisol and most importantly, healing the adrenals. We do this through a combination of improving the person’s sleep and eliminating pain and complications from old infections, injuries and surgeries.
A combination of lifestyle changes – including nutrition and exercise to heal the metabolism and light acupressure to get to the root of the problem – have been known to heal the body and allow it to function properly with weight loss as a much desired side effect.
The thing to remember is if the body is not healthy, it will never let you lose weight. Its first priority is function, not weight loss.
The old school method was to lose weight, and then become healthy. The problem is its not sustainable long term.
The new science is to get HEALTHY first, and THEN lose WEIGHT. When your body functions are working properly, weight loss is natural and much more sustainable!
For more information or to schedule an appointment with Dr. Layne Linebaugh, D.C., please call Alpine Wellness Center at 775.657.9026.
Here's to Your Health 