Comp Ortho, Author at Comprehensive Orthopaedics

Should I Use Ice or Heat for My Aches and Pains?

by Comp Ortho | Feb 12, 2024 | Wellness

Both hot and cold therapy can relieve pain and stiffness. But which one is right for you?

Whether it’s during an intense workout or just some yard work, there’s no doubt you’ll suffer from aches and pains at some point. It’s perfectly normal and usually nothing to worry about. To ease your discomfort and get moving again, you can try at-home remedies. Two of the most popular home-based treatments are hot and/or cold therapy. But which one is better for your pain?

Which one you choose depends on the type of injury or pain you’re experiencing. These simple guidelines should help you decide the therapy that will provide the fastest relief.

When to use cold therapy

If you’ve suffered an injury that’s accompanied by swelling, ice is your best bet. Applied within 72 hours of the injury, the cold temperature narrows the blood vessels, thus reducing the inflammation, edema, and pain. Because ice counters inflammation, it’s a good choice for inflammatory injuries such as a sprained ankle or tendonitis. Never apply cold to an open wound. It’s also not recommended if you have diabetic neuropathy or peripheral vascular disease.

If you don’t have an ice pack at hand, you can apply a bag of frozen vegetables or a towel soaked in cold water. Make sure there is a cloth between the cold compress and your skin and never leave the ice on for more than 20 minutes in a session. Any longer and your skin may be damaged or suffer from frostbite. Wait 20 minutes before re-applying the cold compress.

When to use heat

Heat can unlock stiff and sore muscles and soothe arthritic joints. Muscle spasms also benefit from heat therapy. If your soreness lingers following an initial treatment with ice after an injury, you can switch to heat after three days to further the healing. Do not apply heat to a recent injury as the heat will ramp up the inflammatory response.

In a sense, heat has the opposite effect of ice. It opens the blood vessels so oxygen and other nutrients can rush to the affected area and promote recovery.

A heating pad or a moist, heated towel are two ways to apply heat therapy to achy muscles and joints. Soaking in a warm tub can loosen arthritic joints, too. Similar to ice therapy, limit the heat application to no more than 20 minutes at a time as skin burns could result if left on longer. And, never apply heat to an open sore.

Can you use both hot and cold?

Yes! There are times when both hot and cold therapy can be beneficial. Known as contrast therapy, hot and cold treatments can heal sore muscles after an intense workout. Athletes in particular use hot and cold therapy after a game.

However, contrast therapy should not be used immediately after an acute injury. Hot and cold therapy is also not recommended for those with a heart condition or diabetes. Check with your doctor to determine if this treatment is suitable for you.

While hot and cold therapy are great pain relievers and muscle relaxers, they are not a cure. These therapies provide only temporary relief. If the pain persists or you suspect a more serious injury, such as a broken bone or ligament tear, see an orthopedist for diagnosis and treatment. You may need physical therapy.

You don’t have to live with achy joints and muscles

Aches and pains are part of life. But if pain lingers and interferes with your daily life, don’t hesitate to stop into our Orthopedic Urgent Care! We are open Monday – Friday 8am – 5pm. Saturday 10am – 2pm.

Spinal Cord Stimulation Eases Pain, Boosts Function for People With Prosthetic Legs

by Comp Ortho | Jan 30, 2024 | Spine

People who’ve lost a leg due to injury or disease are often plagued by what’s known as phantom limb pain — discomfort arising in the area, despite the absence of the limb.

Now, researchers report that people who wear a prosthetic leg after amputation may have that pain eased, as well as improved sensation in their new foot, using spinal cord stimulation.

“We are using electrodes and stimulation devices that are already frequently used in the clinic and that physicians know how to implant,” said study senior author Lee Fisher, of the University of Pittsburgh. “We are leveraging those technologies to produce meaningful improvement in function and reduction of pain. That’s exciting and we’ve been building it for a while.”

The technology involves special pressure sensors that are placed on the prosthetic’s foot. These sensors trigger signals that are sent to the person’s spinal cord. The technology appears to ease pain and help users walk better, the research team said.

If proven successful, the spinal stimulation technology might help a wide range of people dealing with an amputation — those whose leg was amputated due to trauma, as well as those who fell prey to the nerve damage of advanced diabetes.

“We are able to produce sensations as long as the spinal cord is intact,” said Fisher, an associate professor of physical medicine and rehabilitation at Pitt. “Our approach has the potential to become an important intervention for lower-limb amputation.”

According to background information in a Pitt news release, over 1.5 million Americans now live with a lower-limb amputation. About eight of every 10 say they suffer from phantom limb pain in the missing leg and/or foot. Most of this pain does not respond to medication.

As well, many prosthetics don’t include the kind of sensory feedback functionality used by Fisher’s group. That makes balance more difficult when using a prosthetic.

The new technology essentially replaces severed connections between the spinal cord and the foot with the new cord-stimulation technology.

“A pair of thin electrode strands implanted over the top of the spinal cord in the lower back was connected to a cell phone-sized stimulation device delivering electric pulses of varying amplitude and frequency,” the researchers said.

Using this technology, Fisher’s team was able to help study participants walk or stand in real time over the three-month course of the study.

The participants appeared to gain real improvement in balance control, Fisher’s team reported Dec. 14 in the journal Nature Biomedical Engineering. That was true even under challenging conditions — for example, standing with eyes closed on an unstable, moving platform.

As a welcome bonus, participants also reported an average 70% reduction in their phantom limb pain, the investigators said.

How soon until patients everywhere might benefit? According to Fisher, with “proper support from industry partners, [this could be] translated into the clinic in the next five years.”

Researchers at Carnegie Mellon University and the University of Chicago collaborated on this research.

More information

Find out more about phantom limb pain at the Cleveland Clinic.

SOURCE: University of Pittsburgh, news release, Dec. 14, 2023

Arthritic Hands: What Works (and Doesn’t) to Ease the Pain?

by Comp Ortho | Jan 3, 2024 | arthritis, Hand

Millions of people who live with the pain and stiffness of arthritis in their hands get steroid or hyaluronic acid injections directly into their finger joints in the hopes of feeling better.

Now, a new review shows that even though these injections are widely recommended in treatment guidelines, they don’t really work.

Joint injections to relieve the symptoms of hand osteoarthritis were no better than dummy (placebo) injections, the study found.

That’s not all current treatment recommendations for hand arthritis seem to get wrong, either. Most also call for topical pain relievers as the first-line therapy for hand osteoarthritis, but the evidence on those is iffy, said study author Dr. Anna Døssing, a rheumatology resident at the Parker Institute in Copenhagen, Denmark.

So, what does relieve the pain of hand arthritis?

“Oral nonsteroidal anti-inflammatory drugs [NSAIDs] and oral glucocorticoids effectively reduce pain in people with hand osteoarthritis,” Døssing said. Of these, glucocorticoids (steroid) pills were most effective, the study showed.

Oral NSAIDs also improved function and grip strength, and oral steroids improved function and people’s health-related quality of life, a measure that encompasses physical and mental health status. People who took either of these medications reported improvements in hand symptoms and their overall health.

For the study, Døssing and her colleagues reviewed 65 studies of close to 5,250 people with hand osteoarthritis. The studies looked at 29 types of treatment for the condition.

Injections were found to be ineffective, but most people in the study received injections for osteoarthritis in the base of their thumb. Hydroxychloroquine, an arthritis medication that affects the immune system, was also found to be ineffective for hand arthritis, and the effectiveness of topical creams and gels for pain wasn’t clear, the study showed.

The findings were published Sept. 28 in the journal RMD Open.

The article reveals a “surprising lack of effectiveness of intra-articular glucocorticoids, a widely employed and traditionally fundamental treatment for hand arthritis, specifically thumb-base arthritis,” said Dr. Daniel Polatsch, co-director of The New York Hand and Wrist Center of Lenox Hill Hospital and an associate professor in the department of orthopedic surgery at Zucker School of Medicine/Northwell in New York City.

“This discovery stands in stark contrast to the prevailing beliefs and experiences of most hand surgeons, myself included, in our clinical practice,” Polatsch said.

He said that treatment for hand arthritis should be individualized. “I consistently advocate for commencing treatment with the option that carries the lowest risk,” he said. “Short-term usage of oral NSAIDs or glucocorticoids is a reasonable approach.”

That said, long-term use of these medications can cause side effects. Prolonged use of NSAIDs has been linked to bleeding ulcers. Oral steroids, when taken for prolonged periods of time, can cause high blood pressure, weight gain, thinning skin and infections.

“My recommendation is to engage in a discussion about the different treatment options with your health care provider and formulate a plan together,” Polatsch advised.

It’s also a good idea to see a hand surgery specialist if symptoms persist.

“A hand surgery specialist … can thoroughly assess the full spectrum of alternatives, including medication, splinting, hand therapy, injections and, as a final resort, surgery,” Polatsch said.

More information

HealthDay has more on arthritis symptoms.

SOURCES: Anna Døssing, MD, rheumatology resident, Parker Institute, Copenhagen; Daniel Polatsch, MD, co-director, The New York Hand and Wrist Center of Lenox Hill Hospital, and associate professor, department, orthopedic surgery, Zucker School of Medicine/Northwell, New York City; RMD Open, Sept. 28, 2023

What Are Back Spasms, and Can They Be Treated?

by Comp Ortho | Nov 20, 2023 | pain, Spine, Wellness

“Oh, my aching back!” Everyone has uttered these words at some point, in response to the sharp, sudden pain that comes with back spasms.

This article will explore the causes of back spasms, their symptoms and, most importantly, effective treatments. Whether you’re experiencing your first spasm or seeking ways to prevent future episodes, understanding the triggers and what to do is key.

What is a back spasm?

According to the Cleveland Clinic, back spasms can range from tiny twinges to crippling contractions that leave you unable to move. They occur when the muscles in your back contract involuntarily and intensely. The sensation can vary widely from person to person. For some, it may come on as a mild, dull ache or an occasional twitch; for others, it can escalate into sharp, excruciating pain that becomes debilitating.

What causes back spasms?

Many factors can contribute to these sudden and often painful muscle contractions. Understanding the underlying triggers is essential in both preventing and addressing back spasms.

The Cleveland Clinic provides this list of common back spasm causes.

Insufficient muscle usage — Prolonged periods of sitting, poor posture, lack of exercise and underutilizing back and abdominal muscles can result in weakness, making the muscles prone to spasms and discomfort.
Overexertion and excessive use of muscles — Athletes and individuals involved in heavy lifting activities may experience spasms due to muscle strain, which involves small tears in the muscle fibers, causing inflammation.
Dietary factors — Inadequate water, potassium and calcium intake can contribute to back spasms. These essential nutrients are vital for maintaining proper muscle function and preventing imbalances that can trigger spasms.
Mental and emotional well-being — Anxiety and stress can lead to muscle tightness, potentially resulting in spasms and discomfort.
Traumatic incidents such as falls or car accidents — The sudden impact or force applied to the back can strain the muscles, ligaments or even the spine itself, causing pain and spasms as a protective response.

Back spasm symptoms

Back spasm symptoms are like a distress signal from your body, alerting you to underlying issues. Recognizing these symptoms is crucial in addressing and managing back spasms effectively.

The Mayo Clinic lists these symptoms:

Back pain ranging from a muscle aching to a shooting, burning or stabbing sensation.
Pain can radiate down a leg.
Bending, twisting, lifting, standing or walking can make it worse.

Generally, back pain will subside after rest and home care. However, you should consult your doctor or health care provider if the pain:

Lasts longer than a few weeks.
Is severe and doesn’t improve with rest.
Spreads down one or both legs, especially if the pain goes below the knee.
Causes weakness, numbness, or tingling in one or both legs.
Is paired with unexplained weight loss.

Seek medical attention immediately if pain causes new bowel or bladder problems, is accompanied by a fever or follows a fall, blow to the back or other injury.

Back spasm treatment

Various treatments can help alleviate the discomfort and promote healing. The Mayo Clinic notes that treatment options for back spasms may include:

Applying ice or heat — The application of ice packs or heating pads can help reduce inflammation and soothe muscles. Cold therapy is generally recommended within the first 48 hours of a spasm, while heat therapy can be beneficial for relaxing tense muscles in the days that follow.
Over-the-counter pain medications — Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen sodium, can temporarily relieve back spasms by reducing pain and inflammation.
Prescription medications — In some cases, muscle relaxants may be prescribed to help alleviate muscle tension and provide relief from severe spasms.
Physical therapy — A physical therapist can design a personalized exercise program to strengthen the back muscles, improve flexibility and correct posture. A therapist may also utilize massage, manual therapy and electrical stimulation techniques to help manage pain and reduce spasms.
Alternative therapies —Complementary treatments like acupuncture, chiropractic care and yoga have shown promise in relieving back spasms for some individuals. These approaches focus on improving overall well-being, promoting relaxation and reducing muscle tension. However, according to the U.S. National Center for Complementary and Integrative Health, there’s low- or moderate-quality evidence that these practices may be helpful for chronic low-back pain.

How to stop back spasms

When back spasms strike, finding quick and effective ways to stop them becomes a top priority. Fortunately, there are several strategies you can employ to get on track to a pain-free day.

Stretch it out — Gentle stretching exercises can help relax muscles and relieve tension, potentially easing back spasms, according to Alberta Health Services.
Apply heat or cold therapy — The Mayo Clinic notes that heat helps reduce pain by relaxing and loosening tense muscles, which can help speed healing. Further, alternating between heat and cold packs can help reduce inflammation and soothe the affected area, providing temporary relief.
Practice good posture — Maintaining proper posture while sitting, standing and lifting can alleviate strain on back muscles, reducing the likelihood of spasms.
Stay active — Regular exercise, particularly activities that strengthen the core and promote flexibility, can aid in preventing future back spasms by improving muscle strength and stability.

Back spasms can be managed and alleviated

Back spasms can be a disruptive and painful experience, but they can be effectively managed and alleviated with the right approaches. Understanding the causes, symptoms and treatment options for back spasms empowers individuals to take control of their well-being and find relief.

From applying heat or cold therapy to practicing good posture and engaging in targeted exercises, there are various strategies available. Remember, if back spasms persist or worsen, it is important to seek professional medical advice to receive personalized guidance and ensure the most appropriate course of action for your specific condition.

Arthritic Hands: What Works (and Doesn’t) to Ease the Pain?

by Comp Ortho | Nov 14, 2023 | arthritis