Tag Archives: back pain

IS THERE SUCH A THING AS TOO MUCH GOLF?

golf-pain

Frequent rounds of golf can cause a number of painful conditions from chronic overuse of the muscles and tendons. Back pain resulting from improper form is one of the more common complaints in orthopedics. First and foremost, having a golf pro will help avoid injuries as well as improve your game. Despite how hard you try, at some point you may fall victim to a back injury just like the golf professionals. When injuries do occur there are non-surgical and minimally invasive treatments to alleviate discomfort.

Simply avoiding the exacerbating repetitive task may alleviate pain, however, giving up your golf game is not practical. NSAIDs and the RICE (rest, ice, compression, elevate) provide temporary relief but do not necessarily address the primary reason for discomfort.

The key to preventing a back injury is working with your golf pro to optimize the mechanics of your swing. Muscle stains can be caused by an over-powerful swing or an incorrect weight shift on the follow through, thus causing your lower back pain. When this happens and, if the condition is beyond the assistance of RICE and anti-inflammatories, there are non-surgical treatments we provide to get you back in the game.

Some of the many options are:

  • Radiofrequency Ablation, otherwise known as RFA, is a safe, effective means to treat pain from arthritic joints in the neck and low back. The procedure uses heat to disable only the sensory nerves that transmit pain impulses in the spine. Benefits of this therapy may last up to a year and sometimes longer.
  • Epidural injections are used to reduce inflammation and pain from nerve root compression in the neck and low back. In many cases this provides immediate relief and may provide relief lasting up to a year.
  • PRP, platelet rich plasma, is a conservative approach to natural healing. A small amount of blood is drawn from the patient’s arm and placed into a centrifuge to separate the layers of blood. The PRP layer is then injected into the localized area to be treated. The purpose is to merge this technology with the body’s natural ability to heal itself quickly.

Dr Justin Raye is a Physical Medicine and Rehabilitation physician with a specialty in Interventional Pain Medicine at Sarasota Orthopedic Associates. While his treatment focus on pain is vast, some of the more common conditions include back/neck pain, herniated discs, sciatica, spinal compression fractures, and sports injuries. Treatment therapies include image guided injections, kyphoplasty, spinal cord stimulation, radiofrequency ablation, and regenerative medicine (Platelet Rich Plasma and Stem Cell Therapy). Dr. Raye sees patients in all three SOA locations. When needed, patients are seen on a same or next day basis.  Visit our website to make an appointment or call 941-951-BONE.

Like us on Facebook here.  Follow us on Twitter here.

backpain

SURGEON ON A MISSION

At Sarasota Orthopedic Associates, we believe in supporting our community in many ways and we encourage our staff to do so as well. Our spine surgeon, Dr Andrew Moulton, goes a step further and shares his skills globally to help children in developing countries. Our local newspaper recently interviewed him to learn more about his mission as co-founder of the Butterfly Foundation.  Read about it here:

Moulton Surgical Team

Dr. Andrew Moulton is a nationally recognized expert in the diagnosis and treatment of spinal disorders and a surgeon at Sarasota Orthopedics Associates. He is also the founder of the Butterfly Foundation, a non-profit organization dedicated to improving the lives of children with complex spinal deformity in developing countries.

Since 2003, Dr. Moulton has performed dozens of living-saving surgeries, while promoting the advancement of spine deformity treatment technology by training local surgeons. We spoke to him recently about his philanthropic work. Visit www.SOA.md for more information.

What inspired you to start the Butterfly Foundation?

As an orthopedic resident, I visited Honduras on a pediatric mission in which many club foot surgeries were performed. The next trip, there were more patients than before. I looked at the demographics and realized that the procedures themselves were a drop in the bucket compared to the size of the problem, and then decided to focus on training local surgeons. “Teach a man to fish and he feeds his community for a lifetime” is our motto.

Where are some of the places the foundation serves?

We have ongoing efforts in the Dominican Republic, Malawi, Chile, Peru, Jamaica, Vietnam, China and Myanmar.

What kind of spinal injuries or illnesses have you treated?

We treat primarily pediatric deformities, including spinal injuries and severe, life-threatening cases of scoliosis.

Moulton pt    Moulton spine film

Where did the name “Butterfly Foundation” come from?

Because of society’s attitudes toward their deformity, we saw how these kids would come in, bundled up, socially withdrawn, embarrassed, even outcast. Once they have their surgeries and heal, they stand up straight, they run, and they jump and play. There’s such a profound joy to see them move so freely, without pain. Their transformation reminded us of how a butterfly is born and the name stuck.

What was your most memorable case?

The most memorable case may have been one of the first very extensive ones. After a 15-hour surgery, with my hands bleeding from blisters acquired over the week of surgeries, I sat in a corner waiting over an hour for the patient to wake up to ensure she was not paralyzed from the surgery. She woke up in great shape. I slept well that night!

What inspires you to continue doing this work?

Doing this work takes me back to the basics of being a doctor — to why I wanted to become one in the first place. These people don’t have many chances in life. For me to give a little means a lot to them. When the people thank you, they really mean it. You’re the only chance they have.

How can our readers become involved with your foundation?

People are welcome to email inquiries to info@SOA.md.

Moulton photo

SOURCE: Herald Tribune/Style Magazine/Sunday, August 6, 2017

Link to article: http://sarasotaheraldtribune.fl.app.newsmemory.com/publink.php?shareid=0b1b06237

Butterfly Foundation Facebook Page

What’s That Sound? SNAP, CRACKLE, POP

knuckle cracking

It’s a question most orthopedic surgeons get asked on a daily basis: “My joint pops…is that normal?” Like most things in life, if it’s not broke (or hurting), don’t fix it. An acute injury resulting in an audible “pop” is different from a situation such as a hip “popping” for years. Popping, cracking, or crunching of joints is quite common and often nothing to be too concerned with, especially if it is not causing discomfort or affecting one’s activities. Here are some need to know tidbits on joint popping and cracking.

What Causes This?

  • Numerous theories and causes exist including ligament stretching, tendons snapping, nerves subluxing, or bubbles forming within the joint. A recent study investigated the bubble theory using MRI videos to propose the mechanism by which “cracking” your knuckles results in a negative-pressure event which draws synovial fluid into the joint, thus leading to the subsequent pop. Why does it feel good to crack a knuckle? Thoughts are that the pressure phenomenon within/around the joints stimulates certain receptors which allows for muscles to relax. Another theory suggests natural painkillers (endorphins) are released with such activity, which may explain why it can be a difficult habit to break.
  • Other things must also be taken into account when discussing the cause of noise around a joint, such as prior injuries, surgeries, hardware/implants around the joint, and other accompanying symptoms. It is quite common for someone who injures their ACL to feel or hear a “pop” from the ligament rupturing. This must be taken in a different context from the chronic, painless popping that someone may experience around their knee cap from soft-tissue issues.
  • Lastly, arthritis can commonly be accompanied with crunching or cracking sensations and as long as it is not resulting in increasing pain or swelling, it is something that can be observed. Some older style knee/hip implants may result in noises (e.g. squeaking), and if you were experiencing this, it would likely be best to visit with your orthopedic surgeon to check the status of things and make sure the components were not wearing out in an abnormal fashion.

Should I Be Concerned?

In general, if the popping/cracking around a joint is not causing pain or swelling to occur or interfering with your function or activities, there shouldn’t be much concern. Studies have looked at whether or not cracking your knuckles would lead to arthritis, and to date, no such correlation has been shown. That said, it is generally recommended that one not perform such activities too frequently or on purpose as there have been reports of joints/knuckles becoming loose from habitual cracking. In addition, habitual knuckle crackers have been shown to develop hand swelling (not from arthritis) and decreased grip strength which can lead to decreased manual function. Nodules can also form from such activity, and this may cause cosmetic concerns for certain patients.

Common Areas to Experience It

Any joint can develop it, but perhaps the most common areas to experience it are in the hands, knees, spine, and shoulders.

  • As already mentioned, knuckle cracking is a common occurrence.
  • With regards to the knee, the anterior aspect often experiences popping/crunching from the patellofemoral joint (knee cap). This can be from mild softening of the joint, but most of the time it is from soft-tissues in the area (e.g. plica, fat pad) that simply release themselves during motion.
  • Similar to the knuckles in the hand, the facet joints and other muscles/ligaments around the spine are prone to popping.
  • The spine is a complex unit with numerous muscles, joints, discs, and ligaments contributing to its stability. Chiropractors make a living out of therapeutically popping, cracking, and aligning patients’ backs, so why would you get too concerned with your back popping if you’re not having any discomfort with it?
  • Lastly, the AC joint of the shoulder almost always develops arthritis, but rarely causes too much pain or functional limitation. Popping over this portion of the shoulder with no other symptoms is quite common. On the contrary, patients with symptomatic instability or arthritis in the shoulder joint proper will almost always have pain or issues with their function accompanying this, and would thus be treated differently to the above mentioned scenarios.

Summary

Painless popping around joints is an issue that one should hardly ever get too concerned with. If popping occurred from an acute injury or there were other symptoms being experienced in addition to it, then a visit with your orthopedic surgeon would be recommended at that point. Otherwise, keep up what you are doing and don’t let some painless noise around a joint stress you out.

Born-077_R2

Trevor Born, MD is an orthopedic surgeon with a specialty in sports medicine. At Sarasota Orthopedic Associates our commitment is to get our patients back on their feet, back to work, back in the game, and back to life. We have four convenient locations and offer same day appointments when needed. Visit our website at www.SOA.md or call us at 941-951-2663 for an appointment. Appointments may also be made via our website.

 

TEXT NECK … Is that really a “thing”?

texting adults

Indeed it is. Think about it. We spend much of our day with our heads lowered to read our smartphones. It’s not unusual to see people “text-walking” or worse, driving while texting. With all the advantages of having a world of information at our fingertips, there is also an associated health risk.

There are over 4 billion mobile devices in the world and the average American usage is 2.7 hours per day communicating on these devices. It’s no wonder we have sore necks and shoulders. In fact, it’s becoming an epidemic affecting millions and it’s growing.

Constant lowering of the neck to look downward puts the spine in an unnatural curve that can cause reduction in the cervical spine, thus creating a “pain in the neck”. Worse, that pain can radiate through the shoulders, creating tension, and even debilitating headaches. As the situation intensifies, the arms may become weak, numb, or tingle. Over time, this pattern can become lingering and as a result, a challenge to treat.

The average head weighs about 10 pounds. When tilted downward 15 degrees, the force of your head on your cervical spine increases to about 25 pounds. The more tilt, the more weight; that can be up to as much as 60 pounds of force on your neck. Prolonged tilting downward creates excessive strain causing stress injury. Over a long period of time it may even lead to spinal misalignment, early onset of arthritis, disc compression, or nerve damage.

text neck

So how do we combat this growing concern? Resistance and strengthening are keys to reinforce the neck and shoulder muscles and offset damage. Taking frequent breaks, maintaining good posture, and doing neck stretches help circumvent damage. Most important, when using a mobile device, place it at eye level to avoid tilting of the neck. Remember … Hold Your Head Up!

If you believe you have “text neck” or any form of musculoskeletal pain, Sarasota Orthopedic Associates has four convenient locations to help you alleviate your discomfort. We offer same day appointments when needed. Give us a call at 941-951-2663 (BONE) or check our website here for more information.

 

Sources:   WFLA; LA Times; Today Health & Wellness

SUMMER IS A PERFECT TIME FOR POOL THERAPY

pool therapy

One of the advantages living in Florida is our sunny weather year round so it is not unusual to have daily access to a pool, whether at a private home, community development, or a local Y. Even if you’re in a climate with cold winter temperatures, there are gyms offering year round swimming. From an orthopedic perspective, swimming is one of the most beneficial exercises you can do, and better yet, it can be so much fun that you don’t think of it as exercise.

When prescribed as Aquatic Therapy, there are many techniques and forms of bodywork. Applications include those for spine pain, musculoskeletal discomfort, post-operative rehabilitation, and disabilities or disorders. It may be most beneficial when non-weight bearing exercises are needed or when normal range of motion is limited due to pain, inflammation, or rehabilitation.

Water has properties that provide resistance which are beneficial in exercising. Because of these properties, the muscles actually work harder when submerged in water compared to doing that same exercise on dry ground. Try to imagine running through water and how much more difficult it would be and how much more time it would take to cover the same distance as running a mile on land. Submersion into the water makes it harder to move because of the buoyancy. This resistance also helps tone muscle and improve balance.

Pool exercise can also burn calories. An average 30 minute pool exercise routine can burn off approximately 300 calories. The water also helps reduce body fatigue as it supports so much of the body weight. Pool exercises, done three or four times a week, could result in weight loss and be fun in the process!

Water is also known to have an added benefit on the body and brain. There is a theory called “blue mind” that suggests being close to, in, over, or under the water makes us happier and healthier. For this reason, yoga studios and massage spas incorporate waterfalls into their décor. The gentleness of being near or in the water sends a soothing feeling of relaxation and can lower blood pressure.

PT Pool

Pool therapy has become a widely accepted form of exercise and is now offered in many gym facilities, parks, and community developments. The Arthritis Foundation has even partnered with many YMCA’s across the country in a program called PACE, or People with Arthritis Can Exercise. In fact, they have an excellent website with great tips for a water walking routine. Always check with your physician before beginning any exercise regimen. http://www.arthritis.org/living-with-arthritis/exercise/workouts/simple-routines/water-walking.php

At Sarasota Orthopedic Associates we have an on-site therapy pool at our Bahia Vista location as well as a team of expert physical therapists at our offices. To learn more about us, click here or call us at 941-951-2663 for an appointment.

 

Sources: brainline.org; SOA.md website; Wikipedia; Arthritis Foundation

Driving … A Pain In The Neck? AND IN MY BACK!

driving neck pain

We’ve heard many times about how important it is to maintain good posture at our workplace desks to protect our neck and spine, however most of us don’t give it a second thought when driving. Unlike sitting in a chair, the spine experiences variations of force when in a car. Vibrations from car movement may push on the discs, our internal “shock absorbers”, acting as cushions.

Proper driving posture and seat positioning may avoid a myriad of chronic problems. Here are some helpful tips to avoid discomfort:

Position your car seat to the proper height and distance across from the wheel so that your hands can comfortably reach the recommended “10 and 2” or “9 and 3″ location.

  • Your thighs should rest as much as possible on the seat in order to align your knees on the same level plane as your hips.
  • Elbows should be slightly bent.
  • Consider using a neck support, one similar to that used on a plane. This keeps your neck straight. Even a 20 degree downward curve in the neck will cause stress over time.
  • If you have lumbar support in your car, use it. If not, use a portable back support or a rolled up sweater to place at the small of your back.
  • A seat cushion used for extra padding will help protect your spine from a bumpy ride.
  • For long rides, take regular breaks; get out and s-t-r-e-t-c-h.
  • If you have cruise control, use it to give your back a rest. Place both feet firmly on the car floor. Bend your ankles a few times to stimulate blood flow.

seat-position

Whatever the cause of your neck or back pain, don’t delay having it checked. Chronic pain needs assessment, particularly if it’s worse at night and wakes you up from your sleep.

The physicians at Sarasota Orthopedic Associates are experts in diagnosing, evaluating, and treating neck and back pain. Call us at 941-951-2663 for an appointment at one of our four locations in Sarasota, Lakewood Ranch, Venice, or Bradenton. For more information about us, visit our Facebook page at www.facebook.com/srqsoa or our web page at www.SOA.md

Treating Arthritic Back Pain: A SOLUTION

backpain

Arthritis or Osteoarthritis that causes back pain can be a debilitating condition for the people who suffer from it, and a challenging condition for physicians to treat. Arthritis of the back affects the facet joints in the spine and although these joints can be injected, studies have shown that this may only provide temporary pain relief.  With the recent technological advances in the field of interventional pain medicine, physicians now have the ability to block the pain from these joints for a much longer period of time.

Radiofrequency ablation is an outpatient procedure in which a specialized needle is used to apply heat directly to the nerves causing pain. After the nerves are heated, they are unable to continue sending pain signals. In addition to back pain, radiofrequency ablation is often used to treat buttock pain, posterior thigh pain, neck pain, shoulder pain, and headaches. Studies have shown that radiofrequency ablation can reduce pain severity and frequency in the majority of patients with facet arthritis for up to one to two years.

Radiofrequency ablation is carried out in two steps. In the first procedure, which is diagnostic, a medication is injected into the back over the sensory nerves of the facet joints, also known as the medial branch nerves. This medication serves to temporarily block the pain signals.

If a patient gets pain relief from the diagnostic procedure, the doctor will move forward with the second step, which is the actual radiofrequency ablation.