FRIDAY, June 19, 2020 (HealthDay News) — If you’re working from home because of the coronavirus pandemic and expect to keep doing so, you need to be sure your work station is set up properly, an orthopedic specialist says.
You also need to take regular breaks to move around, according to Terrence McGee, a physical therapist at Johns Hopkins University School of Medicine in Baltimore.
In an office, many people have ergonomic support and opportunities for physical breaks. You might have walked to the water cooler or coffee machine, attended meetings or walked to co-workers’ desks, he noted in a university news release.
To help you adapt to working at home, McGee has some suggestions to improve the safety and comfort of your workspace.
When sitting at your desk, rest your feet flat on the floor. Use a foot rest if the desk height can’t be adjusted.
Your thighs should be parallel to the ground, with a two-finger space between the back of the knees and the chair, and 3 to 6 inches of space between your thighs and the desk/keyboard.
Place a small pillow or towel roll behind you for lower back support, he suggested. Your head should be level, facing forward, and in line with your torso.
The top of your computer screen should be at or slightly below eye level. The screen itself should be 18 to 28 inches from your eyes, or at arm’s length. If you feel you need to bring your eyes closer to your screen, consider seeing an eye doctor for an eyeglass prescription, or make your screen’s text larger, McGee said.
If you use a dual monitor, swivel your body in your chair rather than constantly turn your head to view the monitors. If you can’t adjust your chair, consider changing the orientation of the monitor from landscape to portrait.
When using the keyboard and mouse, relax your shoulders and place your forearms parallel to floor. Your wrists should rest in a neutral position (hand in line with wrist and forearm). Use soft pads or a wrist rest as needed, and keep the mouse within easy reach and next to the keyboard. Adjust mouse sensitivity for light touch. A cordless mouse is the best option, McGee noted.
Also, use a hands-free headset if you’re on the phone for more than two hours a day, and use a document holder to secure papers when typing.
It’s not good for your physical or mental health to stay seated all day. Stand and move from your chair at least once an hour, McGee advised.
Also, perform desk stretches or chair yoga in between work tasks, he added.
TUESDAY, June 16, 2020 (HealthDay News) — Patients with lower back problems often worry about how much time they’ll need to recover if they have surgery. A new study finds similar results for two common minimally invasive spine procedures.
Surgery may be recommended for degenerative conditions of the lower spine, such as a herniated disc or spinal stenosis.
Researchers at Hospital for Special Surgery in New York City compared 117 patients who had minimally invasive lumbar decompression surgery and 51 who had minimally invasive lumbar spine fusion surgery. All the procedures were performed by the same orthopedic surgeon.
“Our study is the first of its kind to look at return to activities and discontinuation of narcotic pain medication after single-level lumbar decompression or single-level lumbar spine fusion performed with a minimally invasive technique,” said senior investigator Dr. Sheeraz Qureshi, a spine surgeon at the hospital.
It took the 117 decompression patients a median of three days before they no longer required narcotic pain medication, and seven days for the 51 spinal fusion patients.
Among patients who drove before their surgery, decompression patients took a median of 14 days to resume driving, and 18 days for the fusion patients.
There was no statistically significant difference between the two groups in how long they took to return to work, according to the study.
The findings are important because standard open spinal fusion surgery generally requires a much longer recovery and slower return to activities than standard lumbar decompression, Qureshi noted.
“In our study, all the patients in both groups were able to resume driving and return to work within three weeks of surgery,” he said in a hospital news release.
“When you compare this time frame to that of standard open spinal fusion surgery, it’s really striking. Patients having a standard spinal fusion could take six months or longer for a full recovery,” Qureshi said.
Degenerative conditions of the lower spine are common causes of pain and disability, and surgery may be considered when initial treatments such as medication and physical therapy don’t provide relief.
Lumbar decompression surgery involves removal of a small section of bone or part of a herniated (bulging) disc that is pressing on a nerve. Spinal fusion is a more extensive surgery in which surgeons join two or more vertebrae together, sometimes using screws and connecting rods.
The findings were presented online earlier this year at a virtual meeting of the American Academy of Orthopaedic Surgeons. Data and conclusions released at meetings are usually considered preliminary until peer-reviewed for publication in a medical journal.
The American Academy of Family Physicians has more on low back pain.
SOURCE: Hospital for Special Surgery, news release, June 15, 2020
Carpal tunnel syndrome and cubital tunnel syndrome share similar symptoms, but they are distinct conditions affecting different nerves in the elbow and wrist.
If you’re experiencing pain and numbness in your fingers, you may assume you have carpal tunnel syndrome. But did you know another condition — called cubital tunnel syndrome — could also be the source of these symptoms?
Both carpal tunnel syndrome and cubital tunnel syndrome result from nerve compression; however, the damaged nerve for each is located in a different part of the body. In cubital tunnel syndrome, the ulnar nerve within the elbow becomes compressed due to injury or repeated bending of the elbow. The ulnar nerve sits inside the cubital tunnel, a passageway consisting of bone, muscle, and ligaments.
On the other hand, the compressed nerve causing carpal tunnel syndrome is the median nerve in the wrist. Repetitive motions of the hand and wrist (such as typing), fractures, and sprains are typically to blame. In addition, chronic conditions such as diabetes and arthritis are considered risk factors for carpal tunnel syndrome.
Despite some similarities — compressed nerves, hand pain, weakness when gripping objects — cubital tunnel syndrome and carpal tunnel syndrome are characterized by several differences. Knowing the symptoms for each can help you identify which condition you may have and determine the right treatment.
Carpal Tunnel vs. Cubital Tunnel
Both syndromes affect the hand and fingers, but the pain, tingling, and numbness of carpal tunnel syndrome is felt most acutely in the thumb, index finger, middle finger, and half of the ring finger. It’s also characterized by pain and burning in the hand and wrist that sometimes radiates up the forearm to the elbow.
Meanwhile, cubital tunnel syndrome is marked by numbness, pain, and tingling in the little and ring fingers as well as the inside of the hand. If you have cubital tunnel syndrome, you may notice these symptoms flare up at night when you bend your elbow for long periods as you sleep.
Diagnosing cubital tunnel syndrome or carpal tunnel syndrome begins with a physical examination. An orthopedist may also perform a nerve conduction study to assess nerve impulses in the wrist or elbow. Weak nerve activity in a certain area could indicate, for example, carpal tunnel syndrome.
Treating the Symptoms
Treatment options differ for each syndrome, although conservative therapies are recommended at first to reduce symptoms and restore function to the hand. Because cubital tunnel symptoms are more pronounced at night, you might be advised to wear a brace that straightens the elbow while you rest. Wrapping your arm in a towel to keep it straight can work as well.
If conservative treatments fail to relieve the nerve compression or muscle wasting is severe, surgery is another option. Two types of cubital tunnel surgery are currently performed: a medical epicondylectomy and an ulnar nerve transposition. In a medial epicondylectomy, the bony bump inside the elbow (the medial epicondyle) is removed. This allows the ulnar nerve to flex and straighten without pain. For an ulnar nerve transposition, the surgeon creates a new cubital tunnel and moves the ulnar nerve to the recreated tunnel.
Treating carpal tunnel syndrome non-surgically usually entails resting the hand, avoiding activities that aggravate symptoms, wearing a splint for several weeks, and applying ice to reduce swelling. Anti-inflammatories and steroids may also be prescribed. Once the pain subsides, you can practice exercises to stretch and strengthen the wrist and hand.
If these conservative treatments don’t alleviate carpal tunnel symptoms, surgery to relieve pressure on the median nerve by cutting the transverse carpal ligament may be necessary. This procedure is followed by physical therapy to strengthen the wrist.
What’s Causing Your Hand Pain?
If you’re experiencing hand and finger pain, you may be suffering from either cubital tunnel syndrome or carpal tunnel syndrome. The doctors at Comprehensive Orthopaedics can diagnose your condition and prescribe the proper treatment regimen. Whether through conservative therapy or surgery, our goal is to help our patients live pain-free. Contact us today for an appointment.
Don’t let elbow pain keep you from enjoying a day at the golf course.
Avid golfers eagerly anticipate the start of spring so they can once again head to the golf course and enjoy an afternoon in the sun. Yet as you inspect your clubs to make sure they’re in top shape for the first swings of the season, you should also pay attention to any aches and pains in your body.
If you’ve played golf for many years, you’ve probably heard the term golfer’s elbow — or even may have suffered from the condition. Golfer’s elbow, known medically as medial epicondylitis, stems from repeated movements that inflame the tendons in the inner elbow. A burning pain centered on the inside of the elbow is the most prominent symptom, but you may also experience stiffness in the joint, weakness in the wrist and hand, as well as numbness in the fingers.
Fortunately, golfer’s elbow can be prevented with a few simple measures. And even if you do experience pain in the inner elbow, it shouldn’t keep you off the links for long, as the condition generally responds well to conservative treatment methods.
Preventing Golfer’s Elbow
As with any sport or physical activity, proper warm-up is key to avoiding injury. For golfers in particular, that means strengthening your forearm muscles by lifting light weights or squeezing a tennis ball. You can also ask a golf instructor for tips on how to improve your form. If you lock your lead arm when you swing, for instance, you’ll put too much torque on your elbow and strain the tendons. Lastly, you might want to consider switching from older golfing irons to graphite clubs.
Treating Golfer’s Elbow
If you believe you may have golfer’s elbow, your doctor will perform a physical examination to assess your level of pain and stiffness by applying pressure to the joint and having you move your elbow, wrist, and fingers. An X-ray can help determine if there is another cause of the pain, such as arthritis or a fracture.
The first step in addressing golfer’s elbow is to stop playing golf or any activity that causes discomfort until the pain subsides. During this time, you can try some at-home treatments, such as covering the elbow with an ice pack three or four times a day for 15 minutes. Your doctor may also outfit you with a customized brace to provide extra support to the elbow tendons. Over-the-counter pain medication helps reduce discomfort, and in some cases, your doctor may recommend a steroid injection.
After a rest period of three to six weeks, you’ll begin physical therapy to stretch and strengthen the muscles and tendons and improve your range of motion. You can expect a complete recovery with conservative treatment in four to six months.
Surgery is only advised if conservative treatments have not been able to eliminate pain. In this minimally invasive operation, a surgeon cuts two small incisions into the elbow and views the joint through a telescope. Any damaged tendon tissue is then removed. Physical therapy follows about two months after the surgery, and full recovery takes between four to six months.
Get Back Into the Swing of Things
Summer is on it’s way, and if you’re a golfer, you’ll want to enjoy your favorite sport without any pain. At Comprehensive Orthopaedics, our staff of doctors will help you overcome any discomfort, and show you ways to keep your arms healthy for the swings you’ll take this season. Contact us today to set up an appointment.
TUESDAY, May 12, 2020 (HealthDay News) — People at high risk for knee arthritis don’t need to avoid jogging and other types of vigorous exercise, a new study suggests.
Some folks hold back on physical activity because they fear it will increase their chances of developing knee arthritis, so researchers from Northwestern University’s Feinberg School of Medicine in Chicago took a closer look.
“Our study findings convey a reassuring message that adults at high risk for knee [arthritis] may safely engage in long-term strenuous physical activity at a moderate level to improve their general health and well-being,” said study author Alison Chang, associate professor of physical therapy and human movement sciences.
The study included nearly 1,200 people from several U.S. cities, ages 45-79, who were at high risk for knee arthritis but had no evidence of the condition.
Obesity, previous joint injury, surgery, aging and chronic knee symptoms increase the risk of developing arthritis of the knee.
Participants were followed for up to 10 years. Chang and her colleagues found that long-term participation in strenuous physical activities such as jogging, swimming, cycling, singles tennis, aerobic dance and skiing was not associated with risk of developing knee arthritis.
In fact, those who did vigorous exercise had a 30% lower risk of knee arthritis, but that’s not considered statistically significant, according to the authors.
Lots of sitting wasn’t associated with either an increased or reduced risk of arthritis.
“People suffering from knee injuries or who had arthroscopic surgical repair of ACL or meniscus are often warned that they are well on the path to develop knee [arthritis],” Chang said in a university news release.
“They may be concerned that participating in vigorous activities or exercises could cause pain and further tissue damage. To mitigate this perceived risk, some have cut down on or discontinued strenuous physical activities, although these activities are beneficial to physical and mental health,” she said.
The bottom line? “Health care providers may consider incorporating physical activity counseling as part of the standard care for high-risk individuals at an early stage when physical activity engagement is more attainable,” Chang said.
The study findings were published May 4 in the journal JAMA Network Open.
The American Academy of Family Physicians has more on arthritis.
SOURCE: Northwestern University, news release, May 4, 2020