Friday, May 30th, 2014
May is Arthritis Awareness Month in the United States. Spearheaded by the Arthritis Foundation, Arthritis Awareness Month aims to make people more aware of Arthritis and the issues involved.
According to the CDC (Centers for Disease Control and Prevention), 22.7% of the adult population in the US have some form of arthritis. Middle-aged and older people with arthritis are significantly more likely to fall and, as we’ve spoken about before in this blog, falls are the leading cause of injury-related illness and death in the US.
In today’s installment, we’re going to talk about Osteoarthritis.
Osteoarthritis is the most common form of the disease and affects over 27 million Americans! The way you eat, exercise, sleep and whether you have bad habits such as smoking all contribute to developing osteoarthritis.
In osteoarthritis, the cartilage covering the ends of bones where they meet to form a joint to allow movement breaks down. As the cartilage wears away, the ends of the bones become exposed and rub against each other. This wearing away affects the shape of the joint so that it no longer functions well. You may notice a limp when you walk, or you may have trouble with stairs because additional stress is being placed on the joint.
Other problems often occur inside the joint as cartilage breakdown affects the joint structure. Fragments of bone or cartilage may float in joint fluid, causing irritation and pain. Osteophytes may develop on the ends of the bones, damaging surrounding tissues and causing pain. Fluid inside the joint may change due to these insults and the joint’s ability to absorb shock is compromised. Although inflammation is not a main symptom of osteoarthritis, it can also occur in the joint lining in response to the cartilage breakdown.
Symptoms of osteoarthritis vary, depending on which joints are affected. However, the most common symptoms are stiffness, particularly first thing in the morning or after resting, and pain. The most commonly affected joints are the lower back, hips, knees and feet. When those joints are affected you may have difficulty with activities like walking, climbing stairs and lifting. Daily activities that you used to enjoy may become too painful to continue. These issues are referred to as “Quality of Life” problems. If you love gardening or walking each evening through your neighborhood, pain may make them no longer pleasant occupations.
Other commonly affected joints are the neck and fingers, including the thumb base. When finger and hand joints are affected, osteoarthritis can make it difficult to grasp and hold objects or to do delicate tasks.
Your hips and knees are most affected by body weight. Being overweight puts additional pressure on these joints. For every pound you gain, your knees gain three pounds of added stress; for your hips, each additional pound translates into six times the pressure on these joints. Many years of carrying extra pounds can cause the cartilage that cushions your joints to break down. Obesity may lead to osteoarthritis on its own, or it may worsen its symptoms.
Repetitive movements or serious injuries to joints can lead to osteoarthritis. Even joints such as shoulders (non-weight bearing and usually unlikely to have osteoarthritis) can develop the disease after injuries or repeated stressful activities. Constant knee bending required by work such as landscaping or carpet installation, can make cartilage wear away more quickly than moderate use of these joints.
What can you do to improve the symptoms of osteoarthritis?
The team of healthcare professionals at Comprehensive Healthcare Group will develop a customized plan for you involving physical therapy, therapeutic exercises, neuromuscular reeducation, chiropractic, and acupuncture to ensure the best results.
Physical therapy is a specialty that combines exercises, neuromuscular reeducation and myofascial release to improve posture, strength, function, range of motion and to reduce pain. It boosts energy and mood as well. One of the best things you can do for your back specifically is to be physically active. Of course you’ve heard it before, but it bears repeating because it’s true! Exercise works well for easing the discomfort of osteoarthritis. A regular exercise program can ease pain and stiffness, strengthen muscles and bones, burn calories, improve flexibility, increase energy, improve sleep, boost your mood, and reduce your risk of cardiovascular disease. If your back is so stiff or painful that you can’t exercise, speak to your doctor or physical therapist about exercises that might be appropriate for you to begin. Physical therapy can bring relief and teach you lifelong exercises to prolong the benefits.
Acupuncture for osteoarthritis utilizes a form of traditional Chinese medicine that involves the insertion of thin, sharp needles at specific points on the body. Trials of patients show small but statistically significant improvement in pain intensity two and four weeks after a course of acupuncture.
Chiropractic uses spinal manipulation or adjustment to restore joint mobility by manually applying a controlled force into joints that have become hypomobile or restricted in their movement. Osteoarthritic joints that have been compromised can be restored to mobility alleviating pain, inflammation and muscle tightness.
The likelihood of developing osteoarthritis is high. If you already have it, symptoms can be relieved to a great degree. If you don’t have osteoarthritis, you can start now, be proactive and forestall this painful and debilitating condition.
Contact our healthcare professionals in Oceanside and Cedarhurst and we can help you address the discomfort of osteoarthritis.
Yours in Good Health!
Friday, May 16th, 2014
More than 2.8 million nonfatal workplace injuries were reported in 2012, according to estimates from the Survey of Occupational Injuries and Illnesses conducted by the U.S. Bureau of Labor Statistics. Hours lost for recuperation time from nonfatal injuries do nothing to help the worker or the employer. So, preventing injury and helping the worker return to the workplace are worthwhile goals. Repetitive stress injuries account for 60% of these job-related injures.
Carpal tunnel syndrome (CTS) also known as median nerve compression is the most common form of repetitive stress injury. CTS can affect clerical workers, computer programmers, data entry workers, sewers, electronics manufacturing line workers, cow milkers (!), gardeners performing hand weeding, musicians, supermarket checkout clerks and locksmiths. Women are three times more likely than men to develop carpal tunnel syndrome, perhaps because the carpal tunnel itself may be smaller in women than in men.
You may be asking how seemingly benign activities such as typing and clicking a mouse button or work in trades with repetitive fine motion of tools (e.g., screwdrivers) or use of vibrating hand tools could possibly be harmful. The three primary risk factors are poor posture, poor technique, and overuse.
CTS injury occurs when the median nerve that runs from the forearm to the hand becomes compressed inside a narrow tunnel formed by bone and ligament at the wrist. This tunnel contains nerves that conduct sensory and motor impulses to and from the hand. Prolonged repetitive, forceful, or awkward hand movements repeated many times over hours and days, months and years, eventually strain the muscles and tendons of the forearms, wrists, and fingers, causing microscopic tears and inflammation. The injured muscles tend to contract, decreasing range of motion necessary for unimpeded movement. The sheaths that cover essential tendons run out of lubrication because they aren't given enough time to rest and recuperate, resulting in chafing and pain. Due to this abrasion, tendons become inflamed and can pinch neighboring nerves. This cycle repeats itself over and over, and a long-term, chronic problem results.
Common symptoms of CTS include numbness and tingling in the hand, burning, weakness, decreased grip strength, inability to grasp small objects and even itching in the palm. Left untreated, the pain can move into the elbow, shoulder and neck.
The diagnosis of CTS begins with the doctor’s physical exam with a focus on your neck, arms, wrists, and hands. The exam is to help find out whether your symptoms are caused by compression of the median nerve as it passes through the carpal tunnel in the wrist.
Diagnosis of CTS is confirmed by performing certain tests to detect damage to the median nerve. A positive Tinel's test or Phalen’s test will indicate damage to the median nerve. Electrodiagnostic testing (EMG/NCV) measures how fast and how well the median nerve transmits messages to muscles and can indicate if there is nerve damage. X-rays, MRI, or ultrasound may also be ordered.
Once the diagnosis of median nerve compression has been confirmed, there are many nonsurgical treatment options. Our team at CHG specializes in the treatment of CTS with physical therapy modalities of electrical stimulation, therapeutic ultrasound, myofascial release, strength and conditioning exercises, ice and paraffin treatment. Kinesio taping is very beneficial and once applied in the office can be worn for days with significant relief. Specific exercises supervised by a physical therapist are also part of our program. Wrist splints can be worn to alleviate pain. You might be recommended to wear the splint after work and particularly during sleeping hours. Pain medication may be prescribed. Studies have shown nonsteroidal anti-inflammatory drugs (NSAIDs) to be ineffective for CTS.
Surgery may be necessary if the symptoms are severe and if the other measures do not provide relief. Surgery should not be the first choice for treatment. Even after surgery, a number of patients may still have some weakness of grip. Surgery is a last resort, but carpal tunnel surgery is among the most common surgical procedures in the U.S.
Have we answered your questions about CTS? Do you have any other questions for us? If you do, please fill out the contact form and we will be happy to respond to you individually.
Yours in Good Health!