What to Do If You Wake Up in Pain

What to Do If You Wake Up in Pain

Feeling achy and stiff in the morning? Try these seven techniques to ease into the day.

Nothing is more restorative than a good night’s sleep. You wake up refreshed and ready to take on a new day. Yet, for some people, the early morning hours bring unwelcome neck and back pain.

Movement during the day promotes fluid secretion from your tissues, which in turn keeps your joints mobile. When you’re asleep, however, you’re not moving for an extended period of time, which can cause your joints and muscles to stiffen up.

For some people, morning pain and stiffness go away as the day goes on. For others, the pain lasts all day. If you find yourself waking up constantly in pain, try these seven tips for a pain-free morning:

1. Stretch

When you wake up, do some simple stretches to unlock your joints and muscles. Here are two to try:

  • Knee to Chest Stretch: Remain on your back in your bed, and pull both knees toward you until your feet are flat on the bed. Grab your right knee with both hands and pull toward your chest. Do the same with the left knee. Hold for about 30 seconds. Repeat two to three times.
  • Shoulder/Upper Back Stretch: Stand up and hold your right elbow with your left hand. Stretch your right arm across the front of your body, keeping your arm straight. Do the same with your opposite arm. Hold for 30 seconds, and do two to three repetitions.

2. Change Your Mattress and Pillow

Your morning pain and stiffness could be caused by your bed or pillow. Be sure to choose a pillow that aligns your neck parallel to the mattress so it isn’t bent up or down. As for your mattress, it should be firm, but not too firm.

3. Change Your Sleep Position

Sleeping on your stomach may be the root of your pain. If so, switch to your back and prop up your knees with a pillow to keep your spine in a neutral position. Side-sleepers can try inserting a pillow between their knees.

4. Exercise Regularly

An intense workout just before you slip under the covers is not advisable. However, a brisk walk or relaxing yoga during the day can loosen up your muscles and joints, setting you up for a pain-free morning. Typically, thirty minutes of exercise a day will tire you out so you can fall asleep faster.

5. Stay Hydrated

During the night, you lose water when you sweat, which can lead to dehydration. Dehydration stiffens your muscles and joints as your tissues are deprived of fluids. So instead of going for that cup of morning coffee, drink two glasses of water first to rehydrate your body.

6. Take Vitamin D

Most people don’t get enough vitamin D in their diet. But the vitamin is essential for bone and muscle health. Have your doctor test your vitamin D levels, and if you are deficient, take a vitamin D supplement regularly.

7. Visit a Physical Therapist

Lingering morning pain should be checked out by a physical therapist. Keep a log of where the pain is strongest and which actions seem to aggravate it. Your physical therapist can show you how to adjust your sleeping position to prevent pain and improve your posture. He or she can also recommend the right pillow and mattress for a restful night’s slumber.

Don’t Live With Pain

If you’re experiencing pain and stiffness in the morning, the orthopedic specialists at Comprehensive Orthopaedics can review your symptoms to determine the source of your discomfort.

How to Manage Arthritis Pain Without Surgery

How to Manage Arthritis Pain Without Surgery

Many types of arthritis can be managed effectively without surgery. Try these six at-home methods first.

Arthritis symptoms range from an occasional mild ache to debilitating pain. Osteoarthritis, the most common type of arthritis, develops when the cushion of cartilage between the bones in a joint wears away, leading to pain (particularly after exercise), stiffness, a cracking noise during movement, and decreased mobility.

A degenerative disease, osteoarthritis usually occurs later in life. However, injuries such as a dislocation or fracture can make a joint more susceptible to arthritis. Fortunately, managing arthritis pain doesn’t always mean surgery. You can reduce the pain and stiffness of arthritis with several proven at-home, non-surgical therapies.

6 Ways to Manage Arthritis Pain Without Surgery

Whether it’s your hip, knee, or shoulder, first-line treatment for arthritis typically entails non-surgical methods to alleviate pain and increase range of motion. Try these at-home remedies for arthritis pain:

ExerciseLow-impact aerobic exercises such as walking, swimming, biking, and using an elliptical strengthen the muscles surrounding your joints. These activities also get your heart rate up without putting too much stress on your body. However, strenuous exercises that involve jumping, twisting, or deep bending should be avoided. A physical therapist can model effective ways to exercise or perform routine daily tasks like walking up and down stairs so you don’t strain your joints.

Lose Weight. Extra weight increases pressure on your joints, particularly your knees. For example, when you walk, your knees bear nearly two times your body weight. The more you weigh, the more stress you put on your knees. Exercise is one way to lose weight and reduce joint pain, but your diet plays a role, too. A plant-based diet of fruits and vegetables is helpful in fighting arthritis-related inflammation. On the other hand, processed foods, red meat, saturated fats, sugar, and salt contribute to inflammation and weight gain.

Hot & Cold Therapy. To ease stiffness, take a warm shower or bath or wrap yourself in a heated blanket. To reduce pain and swelling, apply a cold compress of ice covered by a towel or a gel ice pack to the aching joint. Just make sure the ice doesn’t directly touch your skin.

Anti-inflammatories. NSAIDs (non-steroidal anti-inflammatory drugs) are available either over-the-counter (ibuprofen and naproxen) or by prescription (celecoxib and meloxicam). Each one is an effective pain reliever and can be taken before you start an activity that causes discomfort. NSAIDs are generally safe, especially if used for a short period of time. But check with your doctor before taking an NSAID to make sure the medication doesn’t interfere with other drugs you may be prescribed.

Assistive Devices. Supportive devices, such as a walker or brace, alleviate pain by lifting the pressure off the affected joints. Assistive devices can also help you more easily accomplish everyday activities. If the pain is centered in your hands, for example, toothbrushes and brushes with larger handles are easier to maneuver.

Reduce Stress. Dealing with a painful chronic condition like arthritis can cause stress and anxiety, which only increases the intensity of your pain. Meditation, yoga, and other relaxation techniques calm the mind and help you cope with stress and pain.

If these at-home remedies or physical therapy fail to relieve your pain, your arthritis may have progressed to a point where surgery or joint replacement is advisable. Fortunately, today’s minimally invasive arthroscopic procedures allow you to regain use of your joint after a brief recovery period.

Let Us Heal You

The physicians at Comprehensive Orthopaedics treat arthritis with a combination of surgical and non-surgical methods. Our goal is to relieve your pain and get you moving freely again. Contact us today for a consultation.

How to Reduce Joint Inflammation

How to Reduce Joint Inflammation

Pain and swelling due to joint inflammation can often be remedied with at-home treatments and lifestyle adjustments.

When your joints become damaged due to an injury or chronic condition like arthritis, blood rushes to the area and your immune system releases chemicals to fight the inflammation. This chain reaction causes swelling and pain in the joints.

If it’s in response to an injury, joint inflammation may quickly recede with at-home treatment. On the other hand, it may take a bit longer to address the chronic inflammation caused by arthritis.

Osteoarthritis develops when the cartilage cushioning the joint wears down over time, resulting in the bones rubbing against each other. Pain, stiffness, and a cracking sound when the joint moves are all symptoms of the condition. Chronic inflammation caused by arthritis is typically treated with pain medications, corticosteroid injections, hot and cold therapy, and physical therapy to improve muscle strength and flexibility. Depending upon the severity of the joint deterioration, a joint replacement may be recommended.

However, less severe joint inflammation can be managed with simple remedies and lifestyle changes. With the measures discussed here, you can reduce pain and swelling with at-home treatments.

5 Ways to Reduce Joint Inflammation

Here are five methods you can try to relieve your discomfort.

RICE method. If you think your joint inflammation is due to a sudden injury, the RICE (rest, ice, compression, and elevation) method is the first line of treatment to reduce pain and swelling. See an orthopedist if the pain and swelling don’t diminish after RICE treatment.

Oral Medications. Non-steroidal anti-inflammatory drugs, either over-the-counter or prescribed, can reduce joint pain. Ibuprofen, naproxen, aspirin, and Celebrex are all classified as NSAIDs. For arthritis, you may need a prescription anti-inflammatory.

Diet. What you eat can either increase or decrease inflammation. A diet high in processed foods, fried foods, refined sugar, and saturated fats found in corn oil and margarine is not only bad for your overall health, but tends to exacerbate inflammation, as well. When planning meals, follow the Mediterranean diet principles, which lean toward fish, fruits, vegetables, olive oil, beans, whole grains, and nuts. Limit your intake of red meat, poultry, cheese, yogurt, and sweets. Not a fish eater? Take a fish oil supplement made of omega-3 fatty acid twice a day at a dosage of 2.6 grams to fight inflammation.

Exercise. Although arthritis pain may make the thought of exercise unbearable, movement can actually help reduce inflammation. Talk to your doctor about the best exercises, but following a low-impact aerobic workout for at least 30 minutes five days a week along with some resistance training can be therapeutic. Combined with diet, exercise will lower your weight, which cuts down on the stress placed on your joints — especially the knees and hips.

Reduce StressElevated stress levels contribute to inflammation, as was documented in a 2017 study that found stress markers increased when psychological stress was heightened. Meditation, yoga, biofeedback, and getting enough sleep each night are proven methods to lower your stress levels.

Don’t Suffer From Inflamed Joints

At Comprehensive Orthopaedics, our orthopedic surgeons have helped hundreds of patients overcome the pain of inflamed joints due to injury or arthritis. We offer both surgical and non-surgical solutions for your joint pain.

What Shoes Work Best With Arthritic Knees?

What Shoes Work Best With Arthritic Knees?

WEDNESDAY, Jan. 13, 2021 (HealthDay News) — Lots of Americans suffer from painful arthritic knees, but a new study finds that wearing the right type of shoe may help ease discomfort.

Patients with knee arthritis will achieve greater pain relief by opting for sturdy and supportive shoes rather than flat flexible footwear, researchers in Australia found.

“A ‘sturdy supportive shoe’ is a shoe that gives stability to the foot, via motion control features such as arch support,” explained study author Rana Hinman, a professor of physiotherapy at the University of Melbourne. “It also has a thick, cushioned heel and a rigid sole that does not bend easily.”

In contrast, Hinman noted, “a ‘flat flexible shoe’ is more lightweight, contains no arch support or motion control features, has a low heel (i.e., flat) with minimal/no cushioning and has a flexible sole that bends easily.”

Roughly 1 in 4 adults over the age of 45 has arthritic knees, Hinman noted.

One U.S. expert unconnected to the study agreed that “bum knees” will probably feel better with special footwear.

“I think it’s pretty intuitive that a structured shoe will be more stable and better for arthritis patients,” said Dr. Jeffrey Schildhorn, an orthopedic surgeon at Lenox Hill Hospital in New York City. “I’ve found that to be true in my practice and in my life. But this study is the first to really look at this in a rigorous way, and to show with good science that this isn’t just anecdotal.”

Foot support matters

As the Australian team noted, people with creaky, painful knees are often advised to wear shoes with support. But there’s also a school of thought that flat flexible shoes may deliver greater benefit because they provide more of a “barefoot” experience.

The latter theory didn’t win out in the new study. After working with 164 knee arthritis patients in the Melbourne area, Hinman’s team found that “58% of people who wore sturdy supportive shoes experienced a meaningful reduction in knee pain on walking, compared to only 40% of the people who wore flat flexible shoes.”

Study participants were 50 years old and older. Prior to the study’s launch, all had experienced near constant knee pain in the prior month (rated at a 4 or greater on a pain scale of 11), and most had worn shoes that featured a mix of sturdy and flat characteristics.

Between 2017 and 2019, half were randomly assigned to wear a flat flexible shoe for at least six hours a day over six months, while the other half was assigned stable supportive footwear. (The team did not compare shoes distributed in the study with the ones patients regularly wore.)

All footwear was commercially available. For the flat variety, the brands included: Merrell Bare Access (for men and women); Vivobarefoot Primus Lite (men and women); Vivobarefoot Mata Canvas (men); Converse Dainty Low (women); and Lacoste Marice.

Stable variety brands included ASICS Kayano (for men and women); Merrell Jungle Moc (men); Nike Air Max 90 Ultra (women); Rockport Edge Hill (men); and New Balance 624 (women).

Each patient was able to switch between two brands throughout the trial. Investigators kept track of reported knee pain levels while walking, functional ability, overall quality of life indicators and overall physical activity levels.

In the end, the team determined that while stable supportive shoes did not restore greater mobility to patients than flat flexible shoes, they did offer a leg up on knee and hip pain reduction and improved quality of life.

‘A Rolls-Royce over potholes’

As well, Hinman noted that “sturdy supportive shoes were much less likely to cause adverse effects at the knee and other joints, such as ankle/foot pain [or] knee swelling.” Moreover, people who wore flat flexible shoes reported twice as many adverse effects as people who wore sturdy supportive shoes, she said.

The upshot: “Shoes are an easy option that can help people self-manage their knee osteoarthritis pain,” Hinman said. “Patients with knee osteoarthritis should think carefully about their footwear and choose shoes that are most likely to reduce their knee pain.”

Schildhorn agreed.

“For someone with knee arthritis,” he said, “a structured shoe is almost like a Rolls-Royce going over potholes. Because the problem with an arthritic knee is that the joints aren’t aligned correctly, and aren’t nearly as supple anymore. And it has cartilage with gaps, like cobblestones, which wear away.”

A structured shoe can absorb those issues, said Schildhorn. But an unstructured shoe or a bare foot “relies on all of the joints of the body to work just as they were designed. They all have to be aligned correctly, the ligaments have to be functional, and the joints have to be supple in order to absorb loads when walking in uneven areas. Because you need your body to be able to adjust to variances.”

The U.S.-based Arthritis Foundation agrees that patients should pay attention to the style and fit of the shoes they wear. But it cites mixed findings as to best practices.

For example, foundation experts acknowledge that stable shoes and boots (without heels) can indeed be helpful for some.

However, they also highlight prior knee research indicating that some flat shoes — such as flip-flops — may trigger less knee stress than more stable shoes. Others, however, such as loosely strapped sandals and so-called “foot gloves,” may prove problematic.

But the foundation has one piece of overriding advice: Never favor style over function and comfort.

The results were published Jan. 11 in the Annals of Internal Medicine.

More information

There’s more on shoe wear and arthritis at the Arthritis Foundation.

SOURCES: Jeffrey Schildhorn, MD, orthopedic surgeon, Lenox Hill Hospital, Northwell Health, New York City; Rana Hinman, PhD, professor, department of physiotherapy, University of Melbourne, Australia; Annals of Internal Medicine, Jan. 11, 2021

Copyright ©2020 HealthDay. All rights reserved.
What Jobs Are Toughest on the Knees?

What Jobs Are Toughest on the Knees?

Joint replacements for knee osteoarthritis are becoming more common, and now researchers have identified jobs that may lead to one.

Based on a review of 71 studies that included nearly one million workers, the riskiest occupations include agriculture, construction, mining, service jobs and housekeeping. And jobs that demand excessive kneeling, squatting, standing, lifting and climbing stairs all increase your odds.

A team of researchers from the University of Sydney in Australia, and the Universities of Oxford and Southampton in the United Kingdom found that:

  • Carpenters, bricklayers and floor installers have roughly three times the risk for knee osteoarthritis, compared with sedentary workers.
  • Farm workers have 64% higher odds for the condition, slightly higher than the 63% for builders and construction workers.
  • Housekeeping also carries a risk — with unpaid houseworkers facing up to 93% increased odds for knee osteoarthritis.
  • Some jobs were kinder to the knees, however. Workers in commerce, forestry, fishing, machinists, plumbers, electricians, technicians and postal workers did not have a statistically significant risk for knee osteoarthritis, the study found.

“Knee osteoarthritis is a leading cause of loss of work and disability worldwide and can necessitate invasive surgery including total knee replacement, so preventing occupational hazards is critical,” senior study author Dr. David Hunter said in a news release from the University of Sydney, where he leads the Institute of Bone and Joint Research.

Osteoarthritis develops as cartilage deteriorates and bone comes into contact with bone, causing pain and swelling, and limiting function, which affects lifestyle. It can follow an injury, but most of the time the cause is unknown, according to a New York orthopedic surgeon.

“There is a genetic component, but there’s also a lifestyle component,” said Dr. Jeffrey Schildhorn of Lenox Hill Hospital in New York City, who reviewed the findings. One of the biggest risk factors is being overweight or obese.

“I’ve seen arthritis in every walk of life,” he said.

Osteoarthritis is a disease of aging, so it’s not surprising that more people are suffering from it and that the number of joint replacements is soaring, because people are living longer, Schildhorn said. But, he added, there is no miracle cure.

“The thing with arthritis that makes it difficult to deal with is that cartilage has no true regenerative ability,” he said, suggesting that the best way to prevent it is to eat well and watch your weight. Stretching and exercises like yoga will also help keep joints limber, Schildhorn added.

Treatment can include pain medications, and physical or behavioral therapy. But when these don’t work, a knee replacement may be in order.

“Osteoarthritis is mechanical wear and tear,” Schildhorn said. “Some people have more resilient cartilage than others.” If it is very soft and flaky, no treatment is going to work and it has nothing to do with a person’s lifestyle — or their job, he said.

But employers can help by providing physical therapy and teaching workers how to do their jobs with less stress on their knees, Schildhorn said.

The report was recently published in the journal Arthritis Care and Research.

More information

Learn more about knee osteoarthritis from the American Academy of Orthopaedic Surgeons.

SOURCES: Jeffrey Schildhorn, MD, orthopedic surgeon, Lenox Hill Hospital, New York City; University of Sydney, news release, July 8, 2020; Arthritis Care and Research, July 8, 2020

Copyright ©2020 HealthDay. All rights reserved.
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In Many Cases, Hip Replacement Also Eases Back Pain

In Many Cases, Hip Replacement Also Eases Back Pain

THURSDAY, July 9, 2020 (HealthDay News) — If you have a bad hip and lower back pain, a new study suggests that hip replacement surgery may solve both issues at once.

Researchers at the Hospital for Special Surgery in New York City focused on 500 patients who underwent hip replacement surgery and followed up with them one year after the operation.

Over 40% reported pain in their lower back prior to hip surgery. Of that group, 82% saw their back pain vanish after surgery.

It was “completely gone,” said study author Dr. Jonathan Vigdorchik, a hip and knee surgeon at the hospital.

He said that experts in his field have studied the connection between the hip and back for years.

A hip replacement is a surgical procedure to replace a worn-out or damaged hip joint with an artificial one. On average, it is a highly successful operation, with 95% of patients experiencing pain relief, according to the Hospital for Special Surgery.

“It’s an outstanding procedure,” said Dr. Craig Della Valle, a professor of orthopedic surgery at Rush University Medical Center in Chicago. “There are very few things in medicine that are close to hip replacement in terms of how good of a medical procedure it is.” He wasn’t part of the study.

But Vigdorchik added that patients who have undergone some types of spinal surgery before a hip replacement face five times the rate of complications compared to the general population — for which the complication rate is less than 1%.

This knowledge prompted him to dive deeper into the hip-back interplay.

“We noticed that there are certain conditions where a hip condition can actually put undue stress on the back,” Vigdorchik explained.

He and his fellow researchers wanted to find out how effective a hip replacement can be in eliminating low back pain, and determine which patients are more likely to benefit.

The patients whose low back pain resolved after the surgery were those with “flexible spines,” according to Vigdorchik. When a person’s spine is flexible, a stiff or poorly functioning hip can drive the spine to move more than usual, causing pain.

Those with normal flexibility in their spine were also highly likely to have their pain resolved.

“Those are the patients whose back pain went away completely after their hip replacement, because their back pain was probably caused by their hip not functioning properly to begin with,” said Vigdorchik.

But the back pain in patients with stiff spines did not go away. Patients with stiff spines already have serious arthritis of the spine, and replacing the hip is unlikely to relieve their pain.

But how can you know if your back pain could be resolved with a hip replacement?

It’s not easy to figure that out on your own, according to Vigdorchik. “It really relies on a good physical exam, and then good X-rays,” he said.

Before a patient undergoes a hip replacement, surgeons will typically take an X-ray of the patient lying down.

In this study, researchers took X-rays of their patients standing up and sitting down, both before and after the surgery.

These X-rays allowed them to see how the hip and spine moved in relation to each other, and assessed the flexibility of their spine, as the patient switched from a standing position to a seated position.

Vigdorchik encouraged other surgeons to utilize these X-rays to identify patients whose ailing backs may be relieved by a hip replacement.

He also advised surgeons in the field to “look beyond just the hip.”

“Anytime they’re looking at the hip, they should also look at the back, and anytime they’re looking at the knee, they should also look at the hip,” Vigdorchik said.

The existence of an interplay between the hip and back is well known to experts, but Della Valle said that this study showed how consistent it is.

He said the study gives surgeons in the field “some tools to try to predict which patients you can tell, ‘Yeah, your back pain will get better,’ and others, well, maybe it won’t.”

The study was published online recently during a virtual meeting of the American Academy of Orthopaedic Surgeons.

More information

There’s more about low back pain at the U.S. National Institutes of Health.

SOURCES: Jonathan Vigdorchik, M.D., orthopedic surgeon, hip and knee replacement, Hospital for Special Surgery, New York City; Craig Della Valle, M.D., professor, orthopedic surgery, Rush University Medical Center, Chicago; AAOS 2020 Virtual Education Experience, March 26, 2020, online

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