by Comp Ortho | Jan 10, 2023 | Elbow, pain, Wellness
Bicep tears are common, but many people fail to realize that the pain they’re feeling is actually caused by their bicep, not their shoulder.
You may not realize it, but you put a lot of strain on your shoulders when lifting weights or playing common sports like baseball or football. Although the shoulder joint is strong and flexible, it sometimes buckles under the weight of overuse or a sudden injury. However, just because you’re experiencing shoulder pain, that doesn’t necessarily mean you’re experiencing an issue with the joint itself. A bicep tear can also cause severe shoulder pain.
That may seem surprising, since when you think of your bicep you likely think of your upper arm. And it’s true that your bicep muscle sits at the front of your upper arm, but that doesn’t mean it can’t cause pain elsewhere. In fact, your bicep works with your shoulder thanks to two tendons that attach the muscle to the scapula bone of the shoulder. Another tendon also links the muscle to the radius bone at the elbow. The muscle and tendons are what gives your shoulder its mobility. Although the tendons and muscle are durable, an injury or repetitive motions can lead to painful tears. At New York Bone & Joint Specialists, we’ve treated many bicep tears and can help you on the road to recovery.
What a bicep tear feels like
Bicep tears can either be partial or complete. Partial tears mean only part of the muscle or tendons are torn. In a complete tear, the bicep tendon tears into completely separate pieces.
Most often, tears are caused by an injury, such as lifting a heavy object or a fall. However, athletes who regularly perform overhead motions, such as throwing a baseball, are also particularly vulnerable to bicep ruptures. A bicep tear comes with some noticeable symptoms that can help you identify your injury as a bicep tear rather than a shoulder injury. These are:
Sharp pain. As your bicep tears, you’ll likely feel a sudden jolt of pain either near your shoulder or near your elbow. This pain occurs whether you suffered a partial tear or a complete tear.
Popping sound. Along with pain, the torn bicep may produce a popping sound when injured.
Bruising. After a tear, you may notice bruising, swelling, and a feeling of warmth in your upper arm that could extend to your elbow.
Lingering pain. A tear could develop over time due to overuse. In this case, instead of sudden, sharp pain, the pain and tenderness in the arm and shoulder will gradually increase if the tear isn’t treated.
Weakness in the shoulder and arm. A bicep tear weakens your arm and shoulder, such that you can’t perform routine tasks. One telltale sign of a bicep tear is that you cannot rotate the palm of your hand either up or down when your arm is straightened.
Abnormal bulge. When the tendons cannot hold the muscles in place, the muscles in the upper arm may bulge outward in what is termed the “Popeye muscle.” You may see a pronounced dent closer to your shoulder. too.
Bicep tear treatment
Treatment options vary depending on whether the bicep tear is a partial tear or a complete and based on the age and activity level of the patient. Tears of the tendons connected to the shoulder are most common, and are termed proximal bicep ruptures. The alternative is a distal bicep tendon tear, which occurs when the tendon attached to the elbow is injured.
Younger, active patients benefit greatly from arthroscopic surgery to repair the damaged tendon. Older, less active patients may opt for conservative therapy instead, which includes rest, icing, and non-steroidal anti-inflammatories. Once healed — whether using surgery or a conservative approach — you’ll undergo an extensive physical therapy program guided by the therapists to get your shoulder back to a normal range of motion. Although you’ll feel significant improvement in four to six weeks, a complete recovery usually takes three to four months.
Heal your bicep tear today!
An aching shoulder can greatly affect your quality of life. But the orthopedists at CompOrtho can diagnose and treat your shoulder, whether your injury is due to a bicep tear or not, and get you back to normal again. Contact us for a consultation.
by Comp Ortho | Aug 30, 2022 | pain, Spine, Wellness
When people have backaches bad enough to send them to the doctor, prompt physical therapy may be a wise choice, a new study suggests.
Researchers found that when those patients had “early” PT — within a couple weeks of seeing a doctor — they were less likely to need other, often pricey, types of medical care.
Over the next month to year, they were less likely to see a specialist or a chiropractor, land in the emergency room, need imaging tests like MRI, or receive injection pain medication into the spine.
Experts said the findings are in line with what they see in everyday practice.
“The sooner patients with acute low back pain get in to see the physical therapist, the sooner they get better and the less likely they are to need additional therapies,” said Dr. Catherine MacLean, chief value medical officer at the Hospital for Special Surgery in New York City.
MacLean, who was not involved in the study, said PT may directly ease back pain, and also give patients some peace of mind.
“My sense is that part of what’s going on is that the physical therapy is helping,” she said. “Additionally, I think reassurance that what they are experiencing is not serious and will resolve quickly is incredibly important and helpful to these patients.”
Low back pain is exceedingly common, and in general, experts recommend conservative, non-drug treatments to start. Guidelines differ on when to try PT, but some medical groups recommend that people start with “self-care,” like heating pads and gentle movement.
It’s true that low back pain often goes away “spontaneously,” said Richard Skolasky, the senior researcher on the new study.
So he and his colleagues focused on patients with a bout of back pain severe enough to send them to the doctor. That likely weeds out many people whose back pain would get better with the self-care route, according to Skolasky, director of the Johns Hopkins Spine Outcomes Research Center in Baltimore.
His team used a health insurance database to analyze claims from nearly 980,000 U.S. adults under age 65 who were diagnosed with acute lower back pain. About 11% were referred for early PT — meaning they had their first session within two weeks of their medical visit.
Over the next month, the study found, those patients were anywhere from 57% to 32% less likely to see a chiropractor or orthopedic or pain specialist, to need advanced imaging tests or pain-relieving steroid injections, or to end up in the ER.
Those differences persisted, though were smaller, over the next year. Early PT did not, however, ultimately cut people’s health care costs: The cost of two to three months of therapy may outweigh the savings from an MRI averted.
Still, Skolasky said, it’s “heartening” to see that people in early PT did not have to see other providers or have tests and procedures as often as other patients did.
Past research, he noted, has shown that prompt PT may lower the likelihood of acute back pain becoming chronic. Beyond that, patients may be better prepared the next time they have a back pain flare-up: One of the goals of PT, Skolasky said, is to teach people ways to manage the problem on their own.
That said, access remains an issue. PT is a time investment, Skolasky said, and patients can have a hard time fitting it into their lives. And in less populated areas with few providers, he noted, it may be difficult to find a facility within a reasonable distance.
In this study, patients in the Southeast and Midwest had particularly low rates of early PT. Skolasky speculated that the supply issue might partly explain that.
Despite some barriers, though, PT is worth a discussion, according to Skolasky.
“If your back pain symptoms are severe enough to see a doctor,” he said, “have a conversation about the non-drug options for treating them.”
Researchers lacked information on whether early PT helped people avoid pain medication — an important question, Skolasky noted. Guidelines on treating low back pain recommend trying non-drug options first.
The findings were recently published in the journal BMC Health Services Research.
More information
The U.S. National Library of Medicine has more on back pain.
SOURCES: Richard Skolasky Jr., ScD, MA, director, Johns Hopkins Spine Outcomes Research Center, and professor, orthopedic surgery, Johns Hopkins School of Medicine, Baltimore; Catherine MacLean, MD, PhD, chief value medical officer, Hospital for Special Surgery, New York City; BMC Health Services Research, July 2, 2022, online
Copyright ©2022 HealthDay. All rights reserved.
by Comp Ortho | May 17, 2022 | pain, Spine, Wellness
THURSDAY, May 12, 2022 (HealthDay News) — Persistent use of steroids and non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen to treat acute lower back pain may actually turn it into a chronic condition, a new study warns.
However, some experts who expressed concerns about the study published in the journal Science Translational Medicine pointed out that it was not a clinical trial, which is the gold standard for medical research, The New York Times reported.
The findings by the team at McGill University in Montreal are based on observations of patients, an analysis of a large patient database and an animal study.
The study results suggest we “need to think further about how to treat our patients,” lead investigator Dr. Luda Diatchenko, a professor who specializes in human pain genetics, told the Times.
Back pain is the most common type of pain, according to the U.S. Centers for Disease Control and Prevention.
The research is “intriguing, but requires further study,” Dr. Steven Atlas, director of primary care practice-based research and quality improvement at Massachusetts General Hospital, told the Times.
That opinion was echoed by Dr. Bruce Vrooman, a pain specialist at Dartmouth Hitchcock Medical Center in New Hampshire. But Vrooman also told the Times that the study was “impressive in its scope” and added that if the findings hold up in a clinical trial, it could “force reconsideration of how we treat acute pain.”
The study represents a “paradigm shift,” Dr. Thomas Buchheit, director of the regenerative pain therapies program at Duke University, told the Times.
“There is this unspoken rule: If it hurts, take an anti-inflammatory, and if it still hurts, put a steroid on it,” he said. But this study shows that “we have to think of healing, and not suppression of inflammation.”
Current guidelines advise people with back pain to begin with exercise, physical therapy, heat or massage, which can be as effective as pain medications but don’t cause the same side effects.
If those approaches don’t work, patients can try NSAIDs like ibuprofen, the guidelines advise. Acetaminophen (best known as Tylenol) is not an anti-inflammatory.
More information
Visit the National Library of Medicine for more on back pain.
SOURCE: The New York Times
Copyright ©2022 HealthDay. All rights reserved.
by Comp Ortho | Jan 20, 2022 | Hand, pain, Wellness, Wrist
As the weather gets cooler, many people are affected by joint pain in the hands and wrists due to arthritis or injury. Bodily extremities are prone to “shutting down” circulation to maintain core body temperature. This might save your life in extreme situations; however, it just causes pain under most circumstances. Anyone with hand and wrist joint arthritis will tell you the harsh reality of increased body aches in the winter months.
Why Do My Hands Hurt More in Winter?
Cold weather joint pain doesn’t always indicate a new or more significant problem. People with arthritis often have chronic pain from inflammation and swelling, and the pain is much worse in cold weather. Scientists think that barometric pressure may be to blame. When the temperature goes down, the barometric pressure drops. As a result, the tissues in your hands and wrists expand, creating internal pressure and pain.
Fortunately, there are ways you can prevent and minimize your joint pain. If your hands and wrists ache during cold weather, here are ten ways to manage and avoid pain.
10 Ways to Manage Cold Weather Joint Pain in Winter
You probably won’t be surprised to learn that heat and a healthy lifestyle are critical when you’re trying to manage cold weather joint pain in the hands and wrists. A few small changes could make a big difference in your quality of life!
1. Stay Active
As tempting as it is to snuggle up and watch Netflix all winter, movement can significantly ease hand and wrist pain during cold weather.
Staying active with regular stretching and exercise keeps your muscles and joints healthy and your circulation strong. Not moving leads to stiffness and increased pain. General movements, like walking, yoga, or house cleaning, stimulate blood flow and boost circulation throughout your body. To exercise your hands and wrists, stretch and move your fingers and bend and rotate your wrists. Here are nine exercises for your hands and wrists from the Arthritis Foundation you can try.
2. Apply Heat
Heat helps soothe the pain of arthritis in hands and wrists that cold weather brings on. Use a heating pad or heated gloves to keep your hands and wrists nice and toasty. As a preventative measure, keep your hands and wrists warm all the time in cold weather. Invest in clothing with deep pockets and high-quality mittens. Mittens do a better job of trapping heat than gloves.
3. Eat Healthy
Joint health is tied to overall health. Maintaining a healthy diet can help reduce pressure and keep inflammation down in the hands and wrists. Consider adopting a diet rich in foods that mitigate joint pain. As a bonus, the foods that help are heart-healthy and delicious. Check with your doctor before making any diet changes if you have a condition that includes dietary restrictions.
4. Warm Up with Turmeric Tea
Is there anything more comforting than a hot cup of tea on a cold day? Turmeric (or curcumin) is a natural anti-inflammatory used for centuries in Chinese medicine. Flavor your tea with honey, lemon, or your favorite flavors, and wrap your aching hands around a warm, soothing mug.
5. Wear Compression Gloves
Compression gloves apply gentle pressure to achy joints and keep your hands warm. Good quality compression gloves are soft and flexible enough to wear all the time, and fingerless compression gloves are available if you prefer your fingertips uncovered.
6. Hydrate
Even slight dehydration can make you more sensitive to pain. Make sure you drink plenty of water every day, but especially when the temperature starts to drop. Your hands and wrists will thank you.
7. Take Vitamin D
Vitamin D plays a significant role in making you feel good, and that includes managing your joint pain. Unfortunately, vitamin D deficiency is common in the winter months, as people are outside much less and getting less sunshine. A vitamin D supplement might mitigate cold weather hand and wrist joint pain when sun exposure is limited. Check with your doctor before taking any supplements and get advice on how much vitamin D supplement you should take.
8. Wash Dishes
It may sound nutty, but washing dishes in a sink filled with hot, soapy water involves movement and is relaxing and soothing. Use a moisturizing dishwashing liquid to leave your skin silky and soft. Other options include soaking your hands and wrists in a warm Epsom salt solution or taking a hot bath.
9. Use a Topical Pain Relief Cream
A wide variety of over-the-counter and prescription analgesic creams are available to help minimize cold weather joint pain in the hands and wrists.
OTC medicated creams may contain:
- Capsaicin
- Salicylates (aspirin)
- Counterirritants such as camphor and menthol
- An anesthetic (typically lidocaine)
Topical prescription options include NSAID creams or steroid-based ointments.
10. Stay Positive
The winter months are often hard on mental health. Research has shown that people who experience negative moods and depression are more susceptible to pain. Their perception of pain levels is often magnified beyond expected levels. In the winter months, it’s important to stay active, healthy, and social—all aspects that help improve mental and physical health.
When to Call Your Orthopedic Specialist for Winter Joint Pain
At CompOrtho, we believe everybody deserves to live a comfortable life and have the best possible care. When you have hand and wrist pain, the orthopedic team will help you get back to living your active lifestyle. Call us immediately if you have:
- Persistent swelling
- Redness
- Difficulty putting pressure on or using the joint
- Constant or severe pain in the joints
by Comp Ortho | Jan 18, 2022 | Hand, pain, surgery, Wellness, Wrist
Carpal tunnel can be a painful and even debilitating orthopedic condition. But it’s one that can be prevented with some simple lifestyle changes.
Carpal tunnel syndrome, a progressive condition marked by pain, numbness and tingling in the hands and wrists, is an extremely common condition. While it is most often associated with typing on a computer, carpal tunnel syndrome can strike anyone who performs repetitive tasks with their hands, such as cashiers, knitters, and assembly line workers. Or it can occur after an injury to the wrist or hand. Some pre-existing conditions, like diabetes and rheumatoid arthritis, are also associated with a greater incidence of carpal tunnel syndrome. Additionally, women tend to suffer from the condition at higher rates than men because their carpal tunnels are smaller.
That’s relevant to the condition because, as the name suggests, carpal tunnel syndrome is directly related to the carpal tunnel. In carpal tunnel syndrome, your median nerve, which spans the length of your arm and ends in the wrist, becomes compressed due to any of the reasons described above. That median nerve passes through the carpal tunnel, a narrow pathway of bone and ligament at the base of your hand, which is the reason for the condition’s name. Because the nerve controls the movements of your fingers apart from the pinky, the first sign of carpal tunnel syndrome is typically a tingling or numb sensation in the fingers. Some people may also experience pain and a burning sensation radiating up their arm to their elbow in addition to a weak grip.
6 Tips to Prevent Carpal Tunnel Syndrome
Obviously it is best to avoid carpal tunnel syndrome if at all possible. The good news is that you don’t have to switch jobs or give up your hobbies to avoid carpal tunnel syndrome. You can take measures to ward off the condition before the pain starts. Check out these 6 tips for ways to stop carpal tunnel syndrome in its tracks:
Go for a Neutral Wrist Position. Avoid bending your wrists sharply up or down whenever possible, including when you’re at work or simply in your daily life. Such exaggerated positions stress the nerve. Lift the pressure off by keeping your wrist in a straight, neutral alignment.
Lighten Up. You probably don’t realize it, but you may be striking your keyboard too hard. Go for a lighter touch and relax your hand and wrist as you type.
Take a Break to Stretch. Stopping your task for 10 to 15 minutes gives your hand and wrist a chance to rest. But make good use of your break time by stretching your wrist! One good exercise to try is to make a fist then release your fingers and fan them out. Stretch them as far as possible. Repeat 5 to 10 times.
Switch Hands. If you always perform a task with one hand, switch to the other if you can. This gives each hand and wrist a break from a continual and stressful motion. Of course this isn’t always possible, but make a point of switching wherever you can.
Change Your Desk Setup. How your desk and chair are arranged may be causing extra strain on your wrists. Ideally, you want your desk, chair, and keyboard to be arranged so that your forearms line up with your work surface. The idea is to avoid bending your wrists as much as possible. Also try to keep your elbows tucked to your sides when working at a desk.
Stay Warm. Cold air stiffens up joints and muscles. Although you may be unable to control the office thermostat, you can slip on a pair of fingerless gloves to keep your hands warm and limber.
Treating Carpal Tunnel Syndrome
If you suspect you have carpal tunnel syndrome, it’s time to go to the orthopedist for a proper diagnosis and treatment. Your orthopedist will begin by performing a number of physical tests to assess any nerve damage. Once they’ve assessed the extent of the condition, treatment can begin.
Carpal tunnel syndrome treatments typically begin with recommendations of conservative therapies including:
- Avoiding repetitive motions for two weeks or more.
- Applying ice packs to reduce swelling.
- Taking non-steroidal anti-inflammatories medications.
- Wearing a brace for four to six weeks to keep the hand and wrist immobile.
- Working with a physical therapist on strengthening and stretching exercises after pain subsides.
In severe cases not helped by conservative treatments, your doctor may recommend carpal release surgery. In this procedure, the transverse carpal ligament is dissected to release pressure on the median nerve and enlarge the carpal tunnel.
Don’t Live with Wrist Pain
Healthy hands and wrists are critical when it comes to performing important functions in your everyday life. So don’t let pain stop you from doing your job or enjoying your hobbies! If you believe you may have carpal tunnel syndrome, it’s important to see a specialist right away to get to the bottom of the condition. The orthopedists at Comprehensive Orthopaedics can diagnose your condition and discuss treatment options with you to get you pain-free once again.
by Comp Ortho | Dec 14, 2021 | pain, Spine, Wellness
Does your back stiffen up and ache frequently? It could be due to back spasms. Learn what they are and how to treat them.
Back pain is one of the most common orthopedic complaints among adults in the U.S. In fact, the Centers for Disease Control and Prevention found that around a quarter of adults reported lower back pain in the past three months alone. Much of that discomfort is likely caused by back spasms.
Back spasms are involuntary contractions of the back muscles. The spasms can feel like anything from a minor ache to a sudden, sharp pain or a tightening of the muscles so severe it prevents movement. Your back muscles may spasm after an acute strain, such as lifting a heavy object, or after twisting your back in an unusual way — as you might while playing a sport like golf or football. Certain underlying orthopedic conditions including arthritis, spinal stenosis (a narrowing of the spinal canal), or a herniated disc can also cause back spasms.
Fortunately, muscle spasms rarely need to be treated with surgery. Instead, the discomfort usually resolves on its own with the help of some conservative treatments.
How to Treat Back Spasms
If you experience a back spasm, it’s best to see a doctor. The doctor will begin by asking you when the pain began to determine what may have caused it. If the pain started after you moved some heavy objects, for example, your doctor will likely diagnose the spasm as resulting from a muscle injury. Knowing what caused the spasm can help you prevent others from happening in the future. If your doctor deems it necessary, they may also order imaging tests to see if there are any broken bones or arthritis that might have contributed to the muscle spasm.
Once your doctor determines what caused the spasm, they can suggest some at-home treatments suited to your condition. Treatment typically relies on reducing the pain associated with the back spasm and getting the muscles to relax. Common treatments include:
- Rest. Working out or attempting to carry out your normal activities following a back spasm will only strain your back muscles further. Take a day off from work and give your back some time to recover. If you must exercise, take a short walk. Walking speeds blood flow to the back, which promotes healing. Make sure that when you do walk, you stroll along an even path. Avoid uphill or downhill tracks that may aggravate your back pain.
- Hot & Cold Therapy. An alternating program of hot and cold therapy can alleviate your back pain and unlock tense muscles. To reduce inflammation, apply a cold compress to the back. To loosen tight muscles, apply heat, which will rush healing blood to the area. To avoid damaging your skin, make sure never to leave the hot or cold pads on for more than 15 minutes at a time.
- Medications. Back pain can be treated with over-the-counter nonsteroidal anti-inflammatory medications like ibuprofen, naproxen, and aspirin. Acetaminophen is not included in this list because while it can reduce pain, it won’t address inflammation. If your pain is severe, your doctor may prescribe muscle relaxants — but relaxants should only be used for a short period of time and you should be aware that they can cause side effects such as dizziness. If you need a more intensive intervention, another option is a trigger point injection into the knot of tight muscles. No matter which option you pursue, always consult with your doctor before taking any medication (including an over-the-counter drug) to ensure it doesn’t interfere with other medications you may be taking.
- Physical Therapy. You may not realize it, but weak abdominal muscles can contribute to back spasms. A physical therapist can model exercises to strengthen the back and abdominal muscles and prevent future spasms — but remember: you should only attempt these exercises yourself when the back spasms have passed and the muscles can endure strenuous activity. In addition to guided physical therapy, pay attention to your posture throughout the day. When you sleep, make sure your upper body is at a slight incline with a pillow propping up your knees. When you’re relaxing during the day, try to sit in a recliner with your body at a slight incline with your knees bent and your legs supported. If you’re working at your desk, avoid slouching as much as possible.
- Some Final Tips: To maintain the health and stability of your back, avoid staying in one position for too long. Back spasms are frequently the result of spending too much time in an awkward position. Also, remember to stretch and warm up your muscles before exercising. Cold muscles can stiffen from sudden movement and injure more easily. Make sure you also stretch after your workout to prevent your muscles from tightening. And be careful to always stay hydrated, whether you’re exercising or not. Your muscles need water to stay limber and keep from spasming.
Why Suffer From Back Pain?
If you experience back spasms or other back pain, there’s no reason for you to keep suffering. The physicians at Comprehensive Orthopaedics have helped many patients overcome persistent back pain. We’ll create a tailored treatment plan that will reduce your discomfort and help you feel your best, so you can enjoy your daily activities once again. Contact us today for a consultation.
