Tag Archives: Sarasota Orthopedic

SKINNY JEANS – RIPPED FROM THE HEADLINES

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A few months ago, several news outlets reported the case of a 35 year old female whose legs became so swollen and weak making her unable to walk. Upon being taken to the emergency room, her pants had to be removed by cutting and peeling them off due to excessive tightness. Apparently she was the victim of the fashion phenomena called Skinny Jeans. The circulation in her legs and feet slowed from wearing the jeans for a long period of time. She had been helping a friend move, requiring stooping and bending, which further exacerbated her condition. The diagnosis was compartment syndrome, a serious condition resulting from increased pressure on the nerves and muscles.

In the seventies, Swedish scientists labeled it the “Swedish Tight Pants Theory” after determining low sperm count was to be blamed on men wearing trendy tight pants. The same cause of infertility in men was attributed to UTI’s in women. Skinny jeans aren’t the only fashion culprit. Control top pantyhose and tummy control undergarments can be equal offenders in cutting off circulation.

Numbness in the leg from a sensory nerve can be caused by wearing clothing too tight. Dr Nicholas Morris, a vascular surgeon at Columbia University Medical Center indicated “the condition itself is not dangerous, but repetitive episodes may cause permanent damage.”

So what is one to do when fashion and health clash? To quote Sir Francis Bacon, “knowledge is power”. Several conditions can lead to poor circulation, not just tight pants. Common causes are diabetes, obesity, and heart problems.

Know the signs of poor circulation; a few are numbness, digestive issues, cold hands and feet, appetite loss, exhaustion, and difficulty thinking clearly. It’s also good to know that there are things you can do to improve circulation. Super foods like oranges, ginger, garlic, salmon, and even dark chocolate help, as does drinking water, cutting caffeine and alcohol. Other things you can do: reduce stress levels, elevate legs, increase physical activity, and get a massage.

Most compartment syndrome conditions are caused by an injury or fracture. Bottom line, the fashionable skinny jeans are fine in moderation … just pay attention to the warning signs and your physical activity when wearing them.

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Sources:  Business Insider, 6/22/15; CNN; The Ergonomenon; Washington Post; Natural Living.

GOING BEYOND MEDICATION TO TREAT CHRONIC PAIN

The following is a repost from: St. Jude Medical PULSE Blog: Neuro Regional MD – NanostimTM Leadless Pacemaker/SCS

For many people, traditional treatments don’t address chronic pain – a condition that impacts as many as 100 million Americans. Nomen Azeem, MD, Interventional Pain Management physician at Sarasota Orthopedic Associates, provides insights on how he helps patients find relief through technological advances in spinal cord stimulation.

chronic pain

Despite the large number of people who battle chronic pain, many remain unaware of the treatment options available to patients once physical therapy, chiropractic care, over-the-counter (OTC) and prescription medications have reached their limit. This results in many patients simply suffering in silence, unsure where to turn for meaningful relief from their pain.

National Pain Awareness Month is designed to help shed light on the problem, and raise awareness of potential therapies available to patients battling chronic pain.

The numbers may surprise you, but chronic pain affects an estimated 100 million Americans, more than heart disease, cancer and diabetes combined. The condition can negatively impact personal relationships, daily routine and work productivity. Often, someone is determined to be suffering from chronic pain if their pain lasts for three to six months.

For many patients, the road to effective management of their chronic pain can be complex and can include prescription medications, over-the-counter products, lifestyle modifications and physical therapy. But when those options have been exhausted and the pain continues, many people aren’t sure where to turn.

Nomen Azeem, M.D., is a pain specialist with Sarasota Orthopedic Associates in Sarasota, FL. Every day, he treats people with chronic pain and helps them find relief based on their individual clinical needs. According to Dr. Azeem, spinal cord stimulation (SCS) and therapies such as radiofrequency ablation (RFA) can offer some patients meaningful pain relief, but some patients arrive to his clinic unaware that these options exist.

A renowned SCS expert, Dr. Azeem was the first doctor in Florida to implant the St. Jude Medical Protégé MRITM chronic pain system, and has a great deal of experience with SCS therapy and the technology behind the treatment. Dr. Azeem recently shared his insights on the use of neurostimulation to treat chronic pain.

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What is neurostimulation?

Azeem: Neurostimulation, also known as spinal cord stimulation (SCS), is an advanced therapy option used to manage intractable chronic pain in the arms, legs and trunk, and pain caused by failed back surgery.

What is a spinal cord stimulator and how does it work?

Azeem: An SCS system involves a small device (approximately the size of a silver dollar) along the spinal cord that emits low intensity electrical pulses that intercept the body’s pain signals before they reach the brain, replacing feelings of pain with a more pleasant tingling sensation.

What new technology is available for patients considering an SCS implant?

Azeem: Earlier this year, the FDA approved the St. Jude Medical Protégé MRI™ chronic pain system, which is an important advancement for physicians because it allows people with chronic pain to remain eligible for MRIs of their head and extremities if required by their physician. The technology is also upgradeable, which means that as new therapies or software upgrades are approved, patients can access those upgrades through software updates and not repeat surgical procedures.

What do you want people to know about SCS and how it can help them?

Azeem: Spinal cord stimulation is an important option for patients who have not been able to alleviate their chronic pain through traditional methods, such as back surgery or prescription medications. Studies have shown SCS can reduce pain by 50 percent or more for many patients, and patients have the option to try a temporary implant to see if they’re comfortable with the therapy.1

 Note: Patients interested in learning more about SCS therapy and the Protégé MRI chronic pain system should visit www.poweroveryourpain.com for more information or to find a chronic pain physician in their area.

 The implantation of a neurostimulation system can involve risk, such as painful stimulation, loss of pain relief and surgical risks (e.g., paralysis). Patients are encouraged to talk to a physician to determine if SCS therapy is right for them.

For an appointment with Dr Azeem at any of our three locations, (Sarasota/Lakewood Ranch/Venice) please call 941.951.2663.  We offer same day appointments when necessary. The commitment of Sarasota Orthopedic Associates is to get our patients back on their feet, back to work, back in the game, and back to life.

 

CUTTING EDGE TREATMENT FOR VERTEBRAL COMPRESSION FRACTURES

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Vertebral compression fractures affect approximately 25 percent of all postmenopausal women in the United States and are recognized as the hallmark of osteoporosis.  The prevalence of this condition steadily increases with advancing age, reaching 40 percent in women 80 years of age. Although less common in older men, compression fractures also are a major health concern in this group. Acute and chronic pain in the elderly is commonly attributed to severe pain from vertebral compression  and often leads to further disability. In addition to physical limitations, vertebral compression fractures may produce a psychosocial and emotional burden on the aging person who already faces losses of independent function. This may cause the person to worry about what the future may bring. These worries are not unfounded, because there is a substantial risk of subsequent fractures of all types and further morbidity in persons who have had a vertebral compression fracture.

About one third of vertebral fractures are actually diagnosed, because many patients and families regard back pain symptoms as “arthritis” or a normal part of aging.  Dr. Nomen Azeem, Interventional Pain/Sports Medicine Physician at Sarasota Orthopedic Associates states, “It is vital to conduct a thorough physical examination as close to the onset of pain symptoms as possible. This is combined with imaging such as X-ray and/or MRI of the spine to confirm the diagnosis.  When it comes to vertebral compression fractures, the sooner you can treat the patient, the better!”

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Conservative treatment includes analgesic, muscle relaxers, a back brace and physical therapy. Patients who do not respond to conservative treatment or who continue to have severe pain may be candidates for percutaneous kyphoplasty. Percutaneous kyphoplasty involves using a high-pressure balloon which is placed into the center of the collapsed vertebral bone to restore the shape and height meanwhile creating a cavity.  After the cavity is created, acrylic cement is injected into the collapsed vertebra to stabilize and strengthen the fracture and vertebral body.   According to Dr. Azeem, “Kyphoplasty is a great option in the appropriately selected patient. It is amazing the magnitude of pain relief that is reported by the patient immediately following the procedure.”

The physicians at Sarasota Orthopedic Associates are committed to getting our patients back on their feet, back to work, back in the game, and back to life. Same day appointments are available in our three offices located in Sarasota, Lakewood Ranch, and Venice. You may call 941-951-BONE (2663) for an appointment.

 

COMMON CONCERNS AS WE AGE

In our senior years, we hope to enjoy retirement while checking the fun items off our bucket list. Those senior years can be fulfilling however, they sometimes bring physical pain.

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Arthritis is the #1 condition experienced by seniors, affecting more than 50% of adults over 65 years of age.  It can be painful, but the good news is that it can be managed.  Most important is to keep moving, under the supervision of your physician, in order to manage the discomfort.  “Move it or lose it” is a great motto. Here’s a useful link with information from the Arthritis Foundation: http://www.arthritis.org/living-with-arthritis/tools-resources/

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Falls and Injuries contribute almost 30% of emergency room visits with over 20% of those occurring from accidental falls in the senior population.  This risk increases with age and occur largely in the home where loose rugs and slippery floors are major hazards. Fall Prevention week was in September but it’s never too late to read up on how to avoid common accidents. This link from the Mayo Clinic has practical advice on how to avoid becoming a statistic: http://www.mayoclinic.org/healthy-lifestyle/healthy-aging/in-depth/fall-prevention/art-20047358

osteoporosis

Osteoporosis affects over 52 million Americans.  This condition of low bone mass can limit mobility. October 20 is World Osteoporosis Day and the National Osteoporosis Foundation has assembled pertinent information to help understand prevention and treatment of osteoporosis. Here is their website:  http://nof.org/

At SOA we are committed to helping our patients get back on their feet, back to work, back in the game, and back to life. Call us at 941-951-2663 (BONE) for an appointment at any of our three locations in Sarasota, Lakewood Ranch, or Venice.  Be well and stay healthy!

 

 

WHY SEE AN ORTHOPEDIC FOOT & ANKLE SURGEON IF YOU DON’T WANT SURGERY?

Foot pain

Foot and ankle pain affects a large part of the population at any given time and can be quite disabling. Even if your pain doesn’t keep you from work or play, it can significantly affect your quality of life.

I frequently have patients that are surprised when I give them exercises, medications or other lifestyle modifications to help with their foot and ankle pain. They are often even more surprised when their pain gets better with simple changes! Many of the conditions that cause significant pain in the foot and ankle result from mild biomechanical imbalances and can be addressed without surgery.

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As an orthopedic foot and ankle surgeon, I consider myself an expert in treating disorders of the bones, muscles, tendons, and ligaments of the foot and ankle. Taking care of foot and ankle problems can be challenging and requires extensive knowledge of the anatomy and biomechanics of not only the foot and ankle, but the entire body. Knowing how to expertly perform the surgery is important, but perhaps more important is knowing when it is appropriate. My approach is to use surgery as a last resort when non-surgical options have been exhausted.

If you have been dealing with pain, instability or weakness in the foot and ankle, come see me, Eric R. James, MD at Sarasota Orthopedic Associates to discuss the options we have to get you back on your feet, back to work, back in the game, and back to life. We have three locations in Sarasota, Lakewood Ranch, and Venice and offer same day appointments.

dr james cropped  Eric R. James, MD / Orthopedic Foot & Ankle Surgeon

 

How much do YOU know?

SKELETON THINKING

Try our fun orthopedic quiz …

  1. What is the meaning of the word orthopedic?
  2. How many bones in the adult human body?
  3. In what part of the body are most of our bones located?
  4. What does PRP stand for, and what is it?
  5. Where is the largest bone in the human body?
  6. What is Radiofrequency Ablation?
  7. Where is the smallest bone in the human body?
  8. What is the most commonly broken bone in the adult human body?
  9. How are falls best prevented?
  10. What is the number one cited reason for seeing an orthopedic physician?

answers

How did you do?   Check your answers here:

  1. Orthopedic comes from the Latin “ortho” (meaning free from deformity) and “pais” (meaning child). Early orthopedists would brace children to grow upward, strong, and straight. At SOA we treat children as well as adults.
  2. The human skeleton at birth is composed of 270 bones. By adulthood, some of these have fused together and decrease to 206, reaching maximum density at around age 30.
  3. Hands have the most bones, 27 in each hand. Feet are a close second with 26 in each foot.
  4. PRP stands for Platelet Rich Plasma. Blood is drawn, then centrifuged to separate the blood from the platelets; it is then injected into the appropriate site. The theory is that a large quantity of platelets might contribute to healing factors.
  5. The femur, or thighbone, is the largest bone in your body.
  6. RFA is a procedure where a specialized needle uses heat at a nerve site to block pain signals to the brain.
  7. The smallest bone is found in the middle ear, called the stapes.
  8. Almost half of adult broken bones are in the arm.
  9. Exercising may reduce injuries and improve balance.
  10. Knee pain was cited as the number reason in the U.S. for visiting an orthopedic physician.

Did you learn something new about orthopedics?  Want more?  Be sure to check all our blogs for information on many of these subjects, or, goto our home page at  www.SOA.md and learn all about us. Our goal is to get our patients back on their feet, back to work, back in the game, and back to life!  Call us at 941-951-2663 (BONE)  for an appointment at one of our three locations with one of our thirteen orthopedic physicians.

ANATOMY OF A GOLF SWING

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With today’s modern golf swing, there are numerous muscle groups and joints which need to be on the same page to best provide one with an effective, powerful stroke while minimizing the risk of injury. An often neglected part of the body with regards to many players’ swings is the hip joint and its surrounding structures.

Prevention

Placing focus on properly preparing the hip joint to maintain appropriate flexibility will best ensure that it can withstand the forces seen with one’s golf swing. Basic stretching exercises for the hamstrings, hip flexors, and rotators are essential. The average PGA golfer has roughly 45° of hip internal rotation. Lacking internal rotation leads to increased extension of a golfer’s pelvis which can result in low back pain and decreased drive. In addition, recent studies have shown that golfers with strong hip musculature have lower handicaps and longer driving distances compared to those with weak hip muscles. Combined with safe core strengthening, these steps will help one produce the maximum power with their swing while reducing the risk of back and other joint injuries.

Causes

Hip pain in golfers may be the result of minor strains, soft-tissue inflammation, such as bursitis, and even arthritis. The modern golf swing, with its requirement for large amounts of body rotation, can subject one’s body and hip joint to perhaps more than it can tolerate, rendering it vulnerable to injury. Labral tears, while perhaps more common in other sports, can also be a cause of hip pain in golfers. A stabilizing and supportive structure, the labrum can be damaged when subjected to increased pressure in a hip joint which lacks the necessary flexibility to withstand the forces seen with the modern golf swing. This may result in groin pain, clicking or locking sensations, discomfort when squatting to read a putt or pick up a ball, or even restricting one’s swing.

Treatment

The first steps to take in treating hip pain associated with golf involve the usual conservative measures, including rest, ice, and over the counter pain relievers and anti-inflammatory medications. If these fail to alleviate the discomfort, formal physical therapy with an experienced provider familiar with golf related injuries can often target the specific muscle imbalances and tightness which made one prone to such an issue in the first place. Injections, such as steroid and platelet-rich plasma (PRP), can also be useful for a variety of hip related pathologies. Lastly, when non-operative treatments fail, surgery can be considered. For labral tears, recent advances in hip arthroscopy have enabled surgeons to repair this important anatomic structure through minimally invasive techniques, and best preserve the hip joint for countless rounds of future golf.

Our commitment at Sarasota Orthopedic Associates is to get our patients back on their feet, back to work, back in the game, and back to life.  Trevor Born, MD is fellowship trained in Sports Medicine at SOA and will help you get back in the game. Same day appointments are available at any our three locations by calling 941.951.2663.

SEND IN THE CLOWNS … THE 24 HOUR GIVING CHALLENGE

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A few months ago, we announced our official orthopedic partnership with the Circus Arts Conservatory (CAC). You may wonder what orthopedics has to do with a circus.

The obvious answer is the circus is comprised of athletic performers and SOA specializes in Sports Medicine, so it’s a PERFECT match.  MOST important, SOA supports the educational aspect of the CAC. When people think of the CAC, they first think of spectacular entertainment.  What many don’t realize is the phenomenal contribution the CAC makes to our community from their Education curriculum. Did you know:

  • the Circus Education program teaches in 15 area schools across Manatee and Sarasota Counties
  • 80% of ticket revenue supports community outreach
  • Sarasota is known as  the Circus Capital of the World
  • the CAC Circus Education program teaches Newton’s physics, law of Universal Gravitation, through juggling
  • the CAC donates over 5,000 tickets annually to over 50 non-profit organizations
  • they depend on 300 volunteers annually to run their programs
  • their educational program is designed to include students who would otherwise not respond to traditional instruction
  • their outreach program proves when children are actively engaged, they are able to understand
  • their Humor Therapy educational program goes far beyond entertainment, improving the quality of life for those in hospitals and ALFs…Humor Heals
  • the Humor Therapy team made 368 visits to local care facilities this year
  • physical activity in children = higher academic achievement in school … Circus Education reaches out to grades K-8

 Wow, that’s a lot … and there’s so much more as to how the Circus Arts Conservatory reaches out to folks of all socio-economic circumstances, ethnicities, gender, and ages.

So why are we telling you this?  The Circus Arts Conservatory needs our help and we need yours. Beginning September 1st and continuing for 24 hours, the CAC will participate in the 2015 Giving Challenge. Over 400 local non-profit organizations work tirelessly without sleep to garner donations for their cause as well as vie for grant money through the Community Foundation of Sarasota and the Patterson Foundation. Over the past three years, the Giving Challenge has raised over $8 million dollars for local non-profits. Special grants will be awarded for Most New Donors, Best Overall Campaign, Best Video, and Best Business Partnership … as the CAC Business Partner, SOA is encouraging all our patients, staff, family, friends, and social media followers to join the challenge.

On September 1st at noon (not before!), please go online to www.circusarts.org/givingchallenge and make a donation.  This year, new online donations between $25 and $250 will be matched, making your gift even more important.   At the online site, you will be able to follow the 2015 Giving Challenge leaderboard of all the local non-profits to see how much is being raised in real time.  For a closer look at the CAC educational program, watch this video:  https://vimeo.com/134961942   … then donate on September 1st.  Everyone one of us at SOA appreciates your participation … WE APPLAUD YOU FOR HELPING!

CONCUSSION: Causes, Symptoms, and Treatment

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What is it and what causes it? Concussion in sports involves a complex process whereby trauma induced to the body or head creates abnormalities in processing of the brain.  While most people believe that a concussion requires a direct hit to the head, many athletes can develop a concussion even from blows to the body, which involve a sudden acceleration or deceleration force.  An estimated 3.8 million concussions occur in the US during recreational and competitive play with many more going unreported.

What are the symptoms of concussion? The symptoms from a concussion are extremely variable and no one concussion is the same as another.  Many athletes will experience headache, fogginess, dizziness, sleep difficulties, irritability, and difficulty concentrating just to name a few. Unfortunately, the symptoms of dizziness and fogginess can be associated with a longer time to recover completely.

Who is at risk of a concussion? Unfortunately some athletes may be a greater risk for a experiencing a concussion.  Younger athletes, female athletes, athletes with Attention Deficit Disorder (ADD/ADHD) as well as those who have experienced a previous concussion are at greatest risk for experiencing a concussion.

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How are concussions treated? This area of sports medicine continues to evolve and clinicians are changing the way concussions are managed.  With appropriate history, physical examination, and testing, clinicians are better able to gear specific treatment strategies towards an athlete’s symptoms.  While 90% of athletes will recover from a concussion in 3-4 weeks with relative rest and modifying aggravating activities, the other 10% may need dedicated rehabilitation strategies to help them overcome symptoms.  Once an athlete is symptom free, they can begin a graded exercise program that helps return them back to the sport safely.

At SARASOTA ORTHOPEDIC ASSOCIATES we have physicians who are trained at identifying high school athletic concussions and are able to recommend appropriate treatments, which will help them get back on their feet, back to work, back in the game, and back to life.

PAUL LENTO, MD / FAAPMR (click here for more on Dr Lento) / Triple Board Certified in Physical Medicine and Sports Rehabilitation

 

CHRONIC PAIN: A new innovative, minimally invasive treatment

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Chronic pain is a largely under-treated and misunderstood disease that affects more than 1.5 billion people worldwide according to the American Academy of Pain Medicine. Sarasota Orthopedic Associates offer an alternative solution that has proven to be quite successful for many of its patients:  spinal cord stimulation (SCS) which was approved by the FDA in 1998. In a 2009 study published in the Journal of Clinical Monitoring and Computing, researchers noted that SCS is “effective in reducing intensity, duration and frequency of pain experienced by the patient.”

SCS is for those who have endured chronic pain in the neck, back, arms or legs, neuropathic pain (burning, tingling or numbing sensations), or inadequate surgeries.  Think of it as analgesia “on demand,” though the patient must go through a broad prescreen before the trial can be done.

HOW IT WORKS

The SCS system consists of a pulse generator with remote controls, implanted to stimulate electrodes and conducting wires, known as “leads”, connecting the electrodes to the generator, similar to a pacemaker. To qualify for permanent implantation, a patient must undergo a trial period of about a week. During this time, a temporary stimulator device is implanted by the physician after a local anesthetic or sedative is administered. The physician places the leads under the skin, guided by an X-Ray machine and a radiology technician. The leads are then attached to a small, hand-held generator that the patient controls. The generator sends electrical pulses to the spinal cord, thus interfering with the nerve impulses that cause the pain sensation.

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The system replaces pain with a feeling of massaging – or merely just the absence of pain. It may allow for reduced pain medication and help the patient improve mobility. Often times patients experience relief immediately, though the leads may occasionally need to be adjusted for optimum performance.

The spinal cord stimulation devices at Sarasota Orthopedic Associates are supplied by St. Jude Medical, whose motto is “Power over pain.” The company has a longstanding relationship with physicians and are able to directly answer patients’ questions or help them out with maintenance of the device. Says Dave Moss of St. Jude Medical, “We provide the stimulation device and become the first line when dealing with it. We have an excellent relationship with Sarasota Orthopedic Associates and Dr. Nomen Azeem and, we are very ingrained in the practice while working efficiently with their staff.”

“As an interventional pain physician, I witness the debilitating effects of chronic pain physically, mentally, and psycho-socially which impact individuals’ quality of life” said Dr Nomen Azeem. “All pain physicians worry of the long term systemic effects of pain medications. Fortunately, the technological advances being made in the field of neuro-modulation are astounding and have revolutionized how we think about treating neuropathic pain.” Dr. Azeem, Interventional Pain and Sports Medicine Specialist at Sarasota Orthopedic Associates, has seen a vast increase in quality of life for many of his patients, without having to resort to invasive surgery or increased medication.

Dr. Azeem is double board-certified  in Interventional Pain Management and Physical Medicine and Rehabilitation, and an expert in minimally invasive procedures for treating chronic back pain (with or without leg pain), chronic neck pain (with or without arm pain), pain that persists after back or neck surgery, peripheral neuropathy, Reflex Sympathetic Dystrophy (RSD), Occipital Neuralgia, and Post-Herpetic Neuralgia.  Click HERE to learn more about Dr Azeem or HERE to learn more about Sarasota Orthopedic Associates.