by Comp Ortho | Jun 28, 2017 | Anti-aging, pain, Spine, surgery, Wellness
People over age 65 shouldn’t avoid surgery for a herniated disc just because of their age. Seniors benefit from the procedure as much as younger patients, Norwegian research shows.
The study involved more than 5,500 people with a herniated, or “slipped” disc. The condition occurs when one of the discs that cushions bones in the spine gets damaged, causing it to push forward. The result is lower back pain that can extend to the leg and foot, and even lead to paralysis.
Exercise, heat and pain medication provide relief in some cases. But people with severe pain or disability may need surgery, according to researchers at St. Olav’s Hospital in Trondheim, Norway and the Norwegian University of Science and Technology (NTNU).
The investigators compared patient-reported outcomes after disc surgery. The study included nearly 5,200 patients under age 65, and about 380 older patients.
The researchers reported that older patients had less back pain after surgery than younger patients. But the seniors experienced more minor complications and had slightly longer hospital stays. However, the study authors said that these issues were not serious and didn’t affect the success of their treatment.
“This study shows that it is fully possible to do good surgical research on elderly patients,” study leader Mattis Madsbu said in a NTNU news release. Madsbu is a medical student at the university.
The study was published recently in JAMA Surgery.
More information
The U.S. National Library of Medicine has more about herniated discs.
SOURCE: The Norwegian University of Science and Technology, news release, May 2017
by Comp Ortho | Jun 28, 2017 | lower leg, pain, Wellness
Female runners with a low body weight are more likely to have stress fractures and take longer to recover from them, according to a new study.
Researchers from the Ohio State University Wexner Medical Center reviewed data on dozens of injuries suffered by female college runners. They found that runners with a body mass index (BMI) below 19 were more likely to suffer stress fractures than others. BMI is an estimate of body fat based on weight and height.
Women with a low body weight were also sidelined longer after an injury. Among those with the most severe stress fractures, recovery time was 13 weeks for women with a BMI of 19 or higher. That compared to more than 17 weeks for those with a BMI below 19, the study found.
“We found that over time, we were able to identify the factors that put female runners at an increased risk of developing a stress fracture,” said study co-author Dr. Timothy Miller, assistant professor of clinical orthopedic surgery and sports medicine.
“One of the most important factors we identified was low body weight, or low body mass index,” he said in a hospital news release.
Having too little lean muscle mass to dissipate the impact of repetitive pounding on hard surfaces makes the bones of runners’ legs vulnerable to injury, according to Miller.
“When body mass index is very low and muscle mass is depleted, there is nowhere for the shock of running to be absorbed other than directly into the bones. Until some muscle mass is developed and BMI is optimized, runners remain at increased risk of developing a stress fracture,” he explained.
Female athletes should maintain a BMI of 20 to 24, Miller suggested.
A woman who is 5 feet, 5 inches tall and weighs 120 pounds has a BMI of 20, according to the U.S. Centers for Disease Control and Prevention.
The BMI for an average American woman is 26, the CDC says.
To prevent injury, Miller said women should stay at a healthy BMI and include resistance training in their workout regimen to strengthen their lower legs, “even if that means adding weight from additional muscle mass.”
The study was published recently in the journal Current Orthopaedic Practice.
by Comp Ortho | Jun 28, 2017 | Anti-aging, Hand, pain, Wellness, Wrist
FRIDAY, June 23, 2017 (HealthDay News) — People who spend lots of time on their smartphones may be scrolling, tapping and swiping their way to carpal tunnel syndrome, a painful wrist and hand disorder.
A small study found a link between extended use of smartphones and other hand-held electronic devices and a greater likelihood for experiencing the telltale wrist and hand pain of the syndrome.
But the researchers did not prove that heavy smartphone use caused carpal tunnel syndrome, and one hand surgeon said very few people in the real world use their smartphones as much as the heavy users in the study did.
Study author Peter White said the findings suggest “caution may be warranted when using hand-held electronic devices, in order to minimize the chance of developing carpal tunnel syndrome.”
White is an assistant professor in the department of health technology and informatics at Hong Kong Polytechnic University.
The carpal tunnel is a narrow and hard pathway of bone and ligament found at the base of the hand, according to the U.S. National Institute of Neurological Disorders and Stroke. It contains tendons, which enable finger-bending, as well as the so-called “median nerve,” which runs from the forearm to the palm and provides feeling to some fingers.
Carpal tunnel syndrome can gradually develop following repeated pressure to the point where the median nerve passes into the hand and meets the wrist.
A common cause, said White, are work conditions that call for “repetitive, forceful or awkward hand movements, for example, when typing.” And the result is often pain (sometimes extending up the arm), numbness, finger tingling and weakened grip strength.
To explore whether smartphone use might up the carpal tunnel syndrome risk, White and his associates followed up on their prior investigation involving 500 Hong Kong University students.
Those students fell into two camps: intensive users of hand-held electronic devices (meaning five or more hours of use per day) and non-intensive users (less than five hours per day). Hand-held devices included mobile phones, tablet computers and game consoles.
More than half (54 percent) of the intensive group reported musculoskeletal pain and/or discomfort, compared with 12 percent among the less intensive group.
The new study looked at 48 students from the first study. Half were intensive users who spent (on average) more than nine hours a day using their devices. Those in the other group spent just under three hours a day on their devices.
The participants answered questionnaires on electronic device habits and any pain or discomfort in their neck, shoulder, back, elbow or wrist/hand region.
Ultrasounds and physical exams on the wrist region were also done.
Muscle pain was found to be more common among intensive users.
The researchers also found that intensive electronics users had “significantly” more discomfort, and more severe discomfort, in their wrist and hand.
The more time a person spent using a hand-held electronic device, the more intense and long-lasting their wrist and hand pain was.
To explain why, the researchers pointed to device design, which requires the repeated use of fingers to click, swipe, scroll, tap and press. The result is an enlargement and flattening of the median nerve, alongside bulging of a key ligament.
To minimize risk, White advises keeping the wrist as straight as possible when using devices.
He added, “One should try to minimize repetitive movements of one’s fingers and thumb when using hand-held electronic devices, especially for single-hand use. It is also important to take regular rest periods, so as to avoid continuous intensive use, so as to allow recovery time and to prevent prolonged stress.”
But hand surgeon Dr. Dori Cage questioned how much of a risk smartphone use really poses.
“The strong correlation of carpal tunnel syndrome with smartphone use is surprising, as I have not seen that in my practice,” said Cage, an American Academy of Orthopaedic Surgeons spokesperson.
Cage, who’s with San Diego Hand Specialists, also suggested that “it is unlikely that the general population would have [the] degree of phone use” seen among the intensive users in the study.
“This is likely an issue affecting only a small percentage of cellphone users,” she said.
The study was published June 21 in the journal Muscle and Nerve.
More information
There’s more information on carpal tunnel syndrome at U.S. National Institute of Neurological Disorders and Stroke.
