Author Archives: aenriquez

What’s Worse: A Sprain, A Strain or a Fracture?

By  aenriquez  published  November 12, 2019

People often debate this ancillary medical question: Which is worse, breaking an ankle or spraining an ankle? For all of that, what’s the difference between the two?

 

To answer those questions, let’s review all the possibilities. From a medical point of view, the question “which is the worst” of two non-lethal injuries is the same as what injury limits functioning the most, which one hurts the most or which is the most disfiguring.

 

Furthermore, there are three types of medical designations for routine injuries of this type: Sprains, breaks, and strains. Here’s the difference between these three:

 

 Strain

 

A strain is caused by sudden over-stretching, twisting or of a muscle or a tendon or both. A tendon is a fibrous band of tissue that connects a muscle to a bone.

 

Strains can be severe, causing intense pain, muscle spasms, inflammation, loss of strength and cramping. A strain can be either mild or severe with the worse cases involving tearing of either muscles or tendons, including tendons that detach from muscles or bones.

 

Strains commonly occur at the back of the hamstring muscle, which runs along the back of your thighs. A hamstring can be pulled by overstretching the leg, which might occur in running and then either accelerating quickly or jumping suddenly. Hamstrings are common to any sport where running is required.

 

Healing from a strained muscle or tendon

 

Healing from a strain can take up to six months or more. One of the problems with these types of injuries is that fully healing takes so long that re-injury is common.

 

The long and the short comes down to the time it takes to heal and the risk of re-injury

 

Sprains

 

A sprain, technically, is an overstretching of ligaments, which connect two bones, often wrapping around two bones of a joint to hold the joint into place. As such, injuries to knees, ankles and other joints frequently are sprains, rather than strains.

 

A sprain can be very painful, causing the area to swell up and turn various shades of blue, black and yellow or red. The intensity of a sprain depends on the severity of the injury, which could involve rupturing a ligament or having it separate from the bone it is expected to support. Severe sprains might include dislocation of the joint.

 

Fractures or breaks

 

A broken bone can be very painful, but it is not always so. While a clear break is certainly painful, fractures can be very slight (often called a hairline fracture) and relatively small. There is usually some pain involved with a slight fracture, but the area could also experience numbness without much pain.

 

Severity

 

The severity of an injury is dependent on related factors. How much does it hurt? How much does treatment cost? How long does it take to heal? Is the injury likely to reoccur?

 

By several of these measurements sprains and strains could be said to be worse than breaks or fractures, if there is no surgery involved. Treatment of the fracture might be more expensive initially if a cast is required for stabilization, but severe sprains are also treated with stabilizing casts.

 

Here’s the breakdown. As far as pain, it is hard to conclude either of these is more painful than the other. A broken bone can be extremely painful at first, but a hamstring pull is often just as painful. A badly sprained ankle can also be painful. We have to consider this a virtual three-way tie.

 

The long and the short comes down to the time it takes to heal and the risk of re-injury. In this case, a sprain can take even longer to heal than a fracture or a broken bone and is far more likely to reoccur. A healed bone is almost as strong as one that never broke in the first place, whereas the soft tissue damage from a sprain or strain can persist for a long time, increasing the chances of re-injury.

 

How can you tell the difference?

 

Modern medical imaging (an X-ray or a CT Scan) is used to diagnose a sprain, strain or fracture, but you can make an educated guess when the injury occurs. Sprains and strains hurt primarily in an area of soft tissue, while bone pain (and swelling) occurs where the bone is the primary structure. Secondly, a broken bone or a fracture often results in numbness, where a sprain and/or strain do not.

 

 Help!

 

Any sprain, strain, fracture or break should be seen by a doctor as soon as possible to prevent further injury. Let us help you return to an active lifestyle with minimum pain. Call FXRX Orthopaedics and Bracing in Phoenix, Az., at 480-449-FXRX.

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Common Golfing Injuries

By  aenriquez  published  November 8, 2019

The game of golf has a reputation for being slow, deliberately careful and so non-violent. But many injuries occur when playing golf. Generally, these are repetitive use injuries that occur by repeating the same motion over and over until wear and tear gradually result in some type of injury.

 

Here is a list of three common injuries that golfers sustain playing the grand old game and some reasons that they occur.

 

  • Rotator cuff tear
  • Golfer’s elbow
  • Hook of hamate fracture

 

Golfer’s elbow is not restricted to golfers and maybe more commonly known as tennis elbow

Rotator Cuff Tear

 

The rotator cuff is the name given to a group of muscles and tendons that support the shoulder, basically holding the joint into place. The reason this is necessary is that the socket of the shoulder joint is not an all-encompassing structure; it is a shallow dish-shaped bone that has evolved because the shoulder is given a wide range of motion. The knee or the elbow (and many other joints) bend in only one direction, while the shoulder is relatively freewheeling owing to the structure of the joint.

 

A rotator cuff tear can be debilitating, causing severe pain when you try to lift your arm, especially if you try to lift your arm above your head. That is where the problem begins. A rotator cuff tear, it follows, mostly afflicts people who work repetitively above their heads, such as painters, sheet-rock installers, or carpenters. It is also common among baseball players, tennis players and swimmers.

 

Treatment

 

Once diagnosed, treatment usually starts with rest, putting ice or heat compresses on the shoulder and physical therapy designed to stretch the tendons and get them to relax. More involved treatment includes injections to help mitigate pain.

 

There are also a variety of surgical options for severe rotator cuff injuries, including arthroscopic tendon repair and open tendon repair, which is more invasive, requiring a longer surgical opening.

 

Golfer’s Elbow

 

Golfer’s elbow is not restricted to golfers and maybe more commonly known as tennis elbow. But it’s not restricted to just golfers and tennis players. It is associated with any activity that includes repeated striking of something by extending your forearm. As such, you can develop tennis elbow while roofing a house, as the many hammering motions can bring on this condition.

 

Golfer’s elbow is an affliction of a tendon but is mostly felt on the bony protrusion of your elbow or this area plus the upper portion of your forearm. While the injury is sustained by many relatively mild concussive strikes with the forearm (a golf ball or a tennis ball is not very heavy, after all), it can be very painful once you reach the threshold, and the injury develops.

 

Treatment

Treatment of golfer’s elbow includes taking time off from golf for a while to allow the tendon to heal. Frequently, ice compacts are used to reduce pain.

 

A conveniently placed brace – a band – is often deployed. This is positioned just under the elbow, and it re-positions the tendon, so it no longer sustains impact when you use it. This can be very effective.

 

Also, physical therapy, pain management, and other techniques are used. Rarely does this condition require surgery to correct, in part because it becomes too painful to repeat the motion and forces people to stop the painful activity and to give the area time to heal.

 

Hook of Hamate Fracture

 

The hook of hamate is a bone. It is the carpal bone at the base of the pinky or little finger on the outside portion of your wrist. A fracture of this bone can be defined as a broken wrist.

 

The fracture can develop from a sudden trauma or from repeatedly striking an object, such as a golf ball, with the same motion over and over. The pain can come on suddenly and result in the inability to grip tightly to an object.

 

Treatment

 

Once diagnosed with an X-ray or a CT Scan, a fractured wrist is often treated with a brace or a cast to restrict or stabilize movement. Pain management may also be required when the injury first occurs. Surgery is usually not needed.

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Carpal Tunnel Syndrome

By  aenriquez  published  October 28, 2019

Carpal tunnel syndrome is frequently associated with the age of computers due to the sudden increase in the number of people typing for long periods and due to the new configuration of keyboards. This painful nerve disorder is most often attributed to repetitive motion that puts pressure on the median nerve that goes through the carpal tunnel on its way from a forearm arm to one of your hands.

 

If you catch carpal tunnel early enough, it is possible to relieve pain and avoid further damage by holding your wrists at the proper angle when you type, which generally means raising your wrists higher when you type. Before computers came around, typists developed carpal tunnel on occasion, but typewriters were vertically tiered, making it more natural for the typist to hold their wrists in the correct position.

Persons with carpal tunnel often have difficulty sensing hot and cold with their fingers or hands

Changing position does not always relieve carpal tunnel syndrome, although you can buy a pad that is placed in front of your keyboard in a manner that holds your wrists higher. You should consult a doctor or a physical therapist before the condition grows worse, however.

 

What is Carpal Tunnel?

 

Carpal tunnel is damage to the median nerve due to pressure or repeated pinching placed on the nerve. Patients typically feel this syndrome through tingling fingers, numbness in hands or fingers, and a burning type of pain in the wrist.

 

Causes of Carpal Tunnel

 

While repetitive motion is often the cause of carpal tunnel, there are metabolic diseases that can raise someone’s risk of carpal tunnel or create carpal tunnel syndrome in the absence of repetitive motion. Possible causes include:

 

  • Diabetes
  • Obesity
  • Pregnancy
  • Arthritis
  • Hyperthyroidism

 

Diagnosis

 

Diagnosis begins with a discussion of your symptoms with a qualified physician. The doctor will then do a thorough study of your hand and fingers to test range of motion and pain. The tests may include having the patient bend their wrists. Delicate probes will be used to see if the patient can feel soft touches.

 

The doctor will also look for signs of muscle atrophy or cramping. If swelling has occurred, the wrist may look discolored and swollen, and it could feel warm to the touch. Also, the doctor may hand you a glass of warm or cold water to test your sensitivity to temperature. Persons with carpal tunnel often have difficulty sensing hot and cold with their fingers or hands.

 

Persons with carpal tunnel also lose strength and flexibility in their hands, causing them to develop “the dropsies.” If you find yourself dropping objects you formerly held with confidence, make an appointment to have that checked out.

 

Treatment

 

There are several options for treating carpal tunnel if it is caught early that can mitigate the pain or allow your median nerve time to heal on its own. It is important to intervene early, however, before the syndrome develops into a chronic condition. Treatment options for early stages of carpal tunnel include:

 

  • Wearing a splint or a brace on your wrist
  • Avoiding the repetitive motion for a while to give the nerve time to heal
  • Wearing a cast to stabilize the wrist
  • Acupuncture
  • Physical therapy – including changing position while you type
  • Chiropractic intervention
  • Pain management

 

Surgery

 

If the carpal tunnel becomes chronic or severely disabling, surgery may be tried to correct the problem. The most common surgery performed for carpal tunnel syndrome is called a carpal tunnel release. It involves cutting the band of tissue that surrounds the tunnel, which then relieves the pressure or pinching on that nerve. It takes up to three months to fully heal from this type of surgery.

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Rotator Cuff Surgery Includes Minimally Invasive Options

By  aenriquez  published  October 22, 2019

A rotator cuff tear is a common injury that occurs from either daily wear and tear of the shoulder or from a sudden trauma that occurs most often from a sports-related injury. The remedy for a rotator cuff tear is to rest the shoulder until it heals, although often surgery is required to repair the tendon or reattach it to the head of the humerus, which is the long bone of the upper arm.

 

The rotator cuff itself is a group of four muscles and tendons that allow for you to lift and rotate your arms. This group of muscles is complex, allowing for a wide range of motion for your arms, which is useful, of course, daily.

The three basic surgical options for rotator cuff repair are open shoulder repair, arthroscopic surgery, and mini-open surgery

Doctors assign two designations for rotator cuff tears. One is a partial tear, which refers to damage to a tendon. The second type is a complete tear. This refers to a tendon that has been torn free of the humerus bone and requires reattachment.

 

Symptoms

 

A rotator cuff tear can be painful, or it can be experienced as weakness in the shoulder with milder discomfort. The general symptoms are:

 

  • Difficulty raising an arm
  • Loss of motion in the shoulder
  • General weakness of the shoulder
  • Mild to severe pain
  • Pain that accompanies specific movement
  • An odd popping sound in your shoulder during movement

 

Treatment

 

Minor rotator cuff tears can be managed with applications of heat or ice to provide pain relief or improved comfort. Also, non-steroidal anti-inflammatory drugs, such as ibuprofen, are recommended. Muscle relaxing and pain medications can also be used during the healing process.

 

Fortunately, if surgery is required, there have been advancements in techniques and equipment over the years that allow for minimally invasive surgery to repair rotator cuff tendons. Not only does this allow for outpatient surgery in many cases, it means quicker recovery times. It also means lower costs.

 

Your doctor will recommend a specific surgery depending on several factors. These include the amount of damage to the tendon, the medical history of the patient, and the doctor’s experiences with the various procedures. Other circumstantial factors could also influence this decision, such as the overall health of the patient or time constraints.

 

Three Surgical Options

 

The three basic surgical options for rotator cuff repair are open shoulder repair, arthroscopic surgery, and mini-open surgery.

 

Open Shoulder Surgery

 

Most often performed in a hospital setting, open shoulder surgery includes a surgical incision that allows the surgeon to view the shoulder muscles and tendons directly. This surgery most often requires the surgeon to detach the deltoid shoulder muscle to get a view of the damaged tendon. As such, this is the more invasive of the surgical options.

 

While performing open shoulder surgery, the surgeon will take advantage of the opportunity to also remove any bone spurs that may have formed on the underside of the acromion. This procedure is called an acromioplasty.

 

This option is chosen when the damage to the tendon is significant, including injuries in which the tendon has become detached from the bone. It is also the option chosen if a tendon replacement is required.

 

Arthroscopic Surgery

 

For arthroscopic surgery, the incision is tiny, just large enough to allow the surgeon to use very thin surgical equipment to repair a damaged tendon. Most often, there are two points of entry. At one point, the surgeon inserts a tiny camera into the shoulder, which will be used to guide the surgical procedure, which the doctor views on a monitor. The second entry point allows for the surgical equipment to be inserted into the area.

 

This is usually done on an outpatient basis at a medical clinic or the doctor’s office.

 

Mini-Open Surgery

 

This surgery includes a combination of open shoulder surgery and arthroscopic surgery. The incision is usually about 3-5 cm long. The advantage of mini-open surgery is that as much of the surgical work is done through arthroscopic equipment so that the deltoid muscle does not have to be detached. However, the incision does allow the doctor to directly view what he is doing for parts of the surgery.

 

 

Rehabilitation and Recovery

 

As with any surgery, there is a period of rest and recovery, which is followed by a rehabilitation period in which the patient begins to adapt to new limitations or to regain strength and flexibility on a gradual basis. During early recovery, pain medication may be prescribed, although any use of opioid pain medication must include a discussion with your doctor on the dangers of pain medication addiction.

 

See a doctor

 

Contact a doctor or visit the emergency room in your area quickly if you suspect a bone infection is occurring. With any of the symptoms above, have a doctor check you out to decide on the necessary course of action.

 

In Tempe, call FXRX Orthopaedics & Bracing at 480-449-3979 for an appointment.

 

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What Causes Hip Pain?

By  aenriquez  published  October 17, 2019

Hip pain is most often associated with growing old. Painful joints just come with the territory. But hip pain can come at any age, and it is important to know when it you can try to take care of it yourself and when to see a doctor for more advanced treatment.

Many people, for example, suffer from bursitis that flares up from time to time, then settles down (or goes into remission) for long periods. When bursitis acts up, it can be difficult to walk even across a standard-sized room. The pain throws your usual gait way out of whack. But one of the ways to treat bursitis is to get that hip joint moving again, which allows the fluids to restore painless movements. By the time you can get to a doctor, the episode is over. Bursitis then stays dormant for a few days, weeks, or months.

Like any bones, a hipbone can fracture or break due to a twist, a fall or a collision

However, the pain of bursitis can undoubtedly be enough to send you the doctor’s office, where more sophisticated treatments are available. At FXRX in Tempe, Arizona, specialists can diagnose and treat bursitis with the most modern equipment and techniques available. It is always worth a visit to the doctors to discuss the best strategy for dealing with painful conditions.

Here are a few other disorders that strike the hip and should undoubtedly prompt you to seek professional help. These are conditions in which a cold compress and ibuprofen are not enough. For these ailments, seek professional advice.

  • Juvenile onset arthritis

This used to be called juvenile rheumatoid arthritis. This condition is painful for a short duration in many cases (a few weeks or months), but other cases are painful for a lifetime. It can lead to abnormal growth and joint problems.

  • Osteoarthritis

This condition can result in debilitating deterioration of the joint.

  • Psoriatic arthritis

While this condition starts with psoriasis of the skin, a common rash, when it appears near joints, the damage to the joints can be debilitating. Treatment should be sought before this condition gets out of hand.

  • Dislocation

A dislocated hip is painful and should be restored as soon as possible. A dislocation of the hip most often occurs as the result of a traumatic injury.

  • Hip fracture

Like any bones, a hipbone can fracture or break due to a twist, a fall or a collision. Medical attention is required to support healing when this occurs.

  • Hip labral tear

The labrum is a cartilage that protects the outside rim of your hip, cushioning the joint during regular use and providing a seal for hold the thighbone in place. However, it can deteriorate from overuse, which occurs among some athletes, ballet dancers, and the elderly.

  • Pinched Nerves

Several pinched or damaged nerves can result in hip pain. These include sciatica, the most extended nerve cell in the body, which runs from your lower back down to your legs. Nerves can also be pinched in the sacroiliitis joints, which are located where your lower spine connects to your pelvic. Another common nerve problem is called a meralgia parensthetica, which concerns the nerve provides sensation for the skin at your thighs.

  • Cancers

Leukemia and bone cancer can both bring about pain in the hips, but many kinds of cancer can become metastatic and lead to bone cancer.

  • Infections

Infections can also result in hip pain.

When To Seek Help

Seek help anytime pain in the hip becomes acute when you lose the ability to walk or raise a leg, when you cannot bear the pain and when the hip looks misshapen or deformed.

In Tempe, call FXRX Orthopaedics & Bracing at 480-449-3979 for an appointment.

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What Is A Torn Meniscus?

By  aenriquez  published  October 9, 2019

The meniscus is a C-shaped cartilage around the knee that separates the shinbone from the thighbone. Cartilage is a smooth tissue that helps keeps bone from rubbing against another bone. Bones rubbing neighboring bones leads to arthritis and other painful joint conditions.

 

A torn meniscus is a very common sports injury, as it is caused when someone twists on their knee with so much stress the cartilage is torn. It is commonly recognized by the popping sound it produces and the immediate pain that is the result.

 

Symptoms

 

A torn meniscus is quite painful and restricts movement of the knee anywhere from a bit to a major amount. Often it is difficult or impossible to straighten the knee with a torn meniscus. Other symptoms, while they may be self-explanatory, include:

 

  • Swelling and redness
  • Stabbing pain in the knee, especially during movement
  • Difficulty straightening the knee
  • Having difficulty moving the kneed to the extent it feels locked in place

Treatment of a torn meniscus usually starts with the basic approach of rest, ice and medication

Immediate treatment

 

Immediate treatment includes taking the weight off the afflicted knee, wrapping it to prevent movement and using crutches or a wheelchair if these are available. Seek medical treatment as soon as possible.

 

Diagnosis

 

The diagnosis cannot be confirmed with an X-ray, because cartilage is not dense enough tissue to show up on X-rays. However, X-rays can rule out bone trauma and, therefore, could help narrow down the diagnosis.

 

Magnetic resonance imaging (MRI) can present an image of both hard (bone) tissue and soft (cartilage), which allows it to return images of your meniscus.

 

The third technique for diagnosing a torn meniscus is the use of an arthroscope, which is a small camera with a light that is inserted into your knee. While exploring the knee, doctors could also move ahead with surgical procedures to repair the meniscus or remove damaged tissue.

 

Treatment

 

Treatment of a torn meniscus usually starts with the basic approach of rest, ice and medication. It often means taking a break from physical activities for a while.

 

Rest

 

Rest could entail the use of bandaging or braces to stabilize the knee while it heals. It may be wise to use crutches or a wheelchair to give the knee complete rest.

 

Ice

 

Ice is used to reduce swelling and help with the pain. Ice is best used for 15-30 minutes with the knee in an elevated position.

 

Medication

 

Over-the-counter, non-steroidal anti-inflammatory medication is often used. If the pain is severe, you can discuss with your physician use of more powerful medication.

 

Therapy

 

Physical therapists can work wonders with cartilage damage. This is useful when you heal enough to begin activities again in a manner that does not re-injure the meniscus.

 

Surgery

 

There are two strategies for surgery. Physicians first try to repair the meniscus. If this is not possible, surgeons will remove damaged tissue to allow the functioning cartilage to do its job unimpeded by irreparable tissue.

 

Seeking Help

 

A torn meniscus may require medical intervention to stabilize and repair the damage. In Tempe, call FXRX at 480-449-3979 to make an appointment with a specialist who has extensive experience with this injury.

 

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How To Use Crutches

By  aenriquez  published  September 20, 2019

A young man on crutches sprang past me at the dog park the other day. He was practically sprinting and it was a sight to see. He really knew how to use those things.

 

But sprinting on crutches is not only a bad idea for most of us, but it’s also a very dangerous idea. It is also rather difficult. This man was confident of his balance and the grip of the crutches and he was, well, in excellent shape – except for the fact that one knee was bandaged. Otherwise, he was iron-man fit. For most of us who aren’t track and field stars, crutches will get us places, but steadily, not at a sprint.

 

Even crutches at a reasonable pace require a bit of patience before you get the proper rhythm to make your way forward. But it all starts with the right fit for the crutches.

Crutches also have adjustable features that change the height and the distance to the grips

Fit the crutches properly

 

With very few exceptions, there is a standard way to fit crutches so that you can walk a modest amount without causing yourself further injury. The fitting standards are these:

 

  • Height of crutches should be two inches below your armpit
  • Height of the grips should be level with your hips.
  • You shoulders should lean forward when you are walking
  • The crutches should be close to your body to provide balance, but not splay out so much they slip as you move forward. Also, it’s more convenient to present a narrow profile while you use the crutches, so you don’t knock into people or things
  • Your elbows should be bent comfortably

 

Check Everything

 

Make sure you check the armpit padding, the grips, the rubber stoppers on the bottom that prevent slipping. All of these get worn out over time, especially the rubber stoppers. These can be easily replaced and they aren’t expensive. In contrast, using crutches that slip can be very dangerous, so check these items at least daily. Sometimes gum gets stuck on the bottom of your crutches and hardens there. The following day, the crutches start sliding on hard surfaces – so check the bottom of your crutches frequently.

 

Crutches also have adjustable features that change the height and the distance to the grips. Make sure all these items are secure. Check daily.

 

Normal use

 

Crutches are designed for you to take small steps. The further out you reach with the crutches, the higher the chance they will slip.

 

Small steps also allow you to put your weight on your hands as you walk. You should not be using your armpits to hold you up. Doing this quickly becomes quite painful from abrasion and from putting that much weight on your armpits. Your arms and hands, not your armpits, should be holding you up while you walk.

 

Rest

 

Crutches can be quite tiring. If crutches were an efficient way to walk, everyone would be using them. But, they are not. They will tire you out pretty quickly. When you get tired, stop and rest. Don’t overdo it, as this leads to another injury.

 

Standing, sitting

 

Getting in and out of a chair can be tricky. It is not recommended that you use the crutches to pull yourself up. That puts too much weight on one small spot, which could lead to a crutch going out from under you. Instead, use the chair or the table to pull yourself up. Then use the crutches to walk.

 

Stairs

 

If the stairs have secure enough handrails, it is highly recommended that you use these to help you climb stairs with the crutches as added support. It is also highly recommended that you have a “spotter” climb stairs with you – someone who can stay close to you and correct your balance if you start to fall.

 

Climbing downstairs is also tricky. Again, use the handrails, rather than your crutches. For going downstairs safely, it is recommended that you hold yourself upright and hop on the healthy leg down one stair at a time while holding the handrail. It is very dangerous to lean forward over a set of crutches while going down a set of stairs. If your balance goes past the tipping point, your crutches will pole-vault you forward in a very dangerous fashion.

 

It is also highly recommended that you use a spotter to get downstairs when you are relying on crutches to keep weight off one of your legs.

 

Environment

 

Finally, you can save yourself many hassles and headaches if you prepare your home for someone using crutches Clear out the center of each room to provide a clear path for someone on crutches. Move items to the walls or put them in storage temporarily.

 

Seek Help

 

Staff at FXRX Orthopaedics and Bracing have lots of expertise in the use of crutches. Call 480-449-3979 to make an appointment.

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Bunions Aren’t Cute If You Have Them

By  aenriquez  published  September 11, 2019

A bunion sounds like something small and quaint – a bit like something extra someone in Victorian times would sneak into a picnic basket. Oh, you brought bunions! How delightful.

 

Bunions, however, are not particularly delightful. In fact, they are painful, bony protrusions that form at the base of the joint of your big toe or your little toe, where they are referred to as “tailor’s bunions,” or “bunionettes.” These also sound quaint, but are, in fact, painful.

 

A bunion is an abnormal growth that is fairly common. About 18 million women in the United States over 21 years of age (about 8 percent) have bunions, while about 4 million men suffer from the same condition. The difference between genders is explained due to the shoes men and women choose to wear. But the condition is the same and it can hurt.

The bunion shows as a swollen, usually red, inflamed looking bump protruding outward

A growth at the base of the outer toes has nowhere to go if not outward. The middle toes block the protrusion from going inward, so the growth goes outward. While doing so, it forms an exposed outer nub that will be the first thing your foot collides with when it bangs up against something. It is, in effect, an exposed, readily accessible growth that is even visible. It forms a bump at the base of the large or the small toe that then turns the toe inward. The affected toes then start to crowd the middle toes, overlapping them or pushing them inward.

 

Symptoms

 

The symptoms of a bunion include pain in the first joint of the largest or smallest toes (the first and fifth metatarsophalangeal joints). The bunion shows as a swollen, usually red, inflamed looking bump protruding outward.

 

The skin around the bunion tends to become calloused over time, so the skin is likely to be thickened around a bunion. In addition, bunions usually present a dull pain and are vulnerable to bumping. The toes may become misaligned and bunions can make it difficult to find proper footwear that is not painful to wear.

 

What causes bunions?

 

There are a variety of causes for bunions. Genetics can be a contributing factor. Poorly fitting shoes or foot injuries can also lead to bunions. Other causes include:

 

  • Flat feet
  • Poorly fitting shoes especially shoes that squeeze toes together
  • Congenital defects
  • Arthritis and other joint diseases that cause inflammation
  • Foot injuries
  • Occupational issues that require specialized footwear. Dancers are specifically prone to bunions.

 

Treatment

 

Bunions and bunionettes will often retreat if the patient begins to wear the correct shoes, although orthopedic padding or shoe insteps could help the symptoms retreat even faster.

 

Padded socks can also be worn to protect the patient’s foot and help turn toes back to their proper alignment. Inflammation can be brought down with non-steroidal anti-inflammatory drugs. Heat is sometimes used to reduce swelling and alleviate pain.

 

In more serious cases, cortisone injections are used to reduce swelling and pain. Surgery is also a possibility for the most severe cases.

 

See a specialist

 

Bunions only sound cute. In reality, medical intervention is frequently required. See a specialist as soon as possible. Progressive conditions like bunions are best treated by starting a course of treatment as early as you can.

 

In Tempe, call FXRX Orthopaedics & Bracing at 480-449-3979 for an appointment.

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Joint Stiffness

By  aenriquez  published  July 11, 2019

Are you suffering from stiff joints? If you are, many people will say “Welcome to the club.” This is because stiff joints is a common symptom for many conditions from a cold or the flu to specific joint diseases.  It is also extremely common for the elderly to complain of stiff joints, which are almost as predictable as needing bifocals when you turn 45. If you see an elderly person having trouble bending over, then having more trouble picking up an object from the floor, give them a hand. Those aches and pains are real.

There are two general observations about growing old that contribute to those aches and pains, including stiff joints. One is simple wear and tear on cartilage, bursa, vertebral discs and other mechanisms that help joints move. These structures allow for easy movement by providing a fluid-like cushion or a smooth surface for bones to move without having them grind together. Bursa, for example, acts like very tiny water balloons that are wedged into joints, allowing for smoother motion. Cartilage, meanwhile, covers the ends of bones where they terminate at joints, providing a smooth, resilient surface for the bones to slide on. When the cartilage wears out, it is extremely slow to heal, partly because cartilage does not have a blood supply.

When cartilage wears out, it is extremely slow to heal, partly because cartilage does not have a blood supply

The second reason behind stiff joints as you age is the lack of fluids. As we age, we become drier. While water content in our bodies is also dependent on age and weight (thinner people have less water than heavier people when we are infants, our average water content is 75 percent to 78 percent. As adults, this drops to 50 percent to 65 percent. This loss of water affects mechanisms like your vertebral discs. These compact spongy cushions become less spongy as we age. Part of the reason: They become drier.

Here are just some of the diagnosable conditions that can result in a stiff joint.

  • Rheumatoid arthritis

Rheumatoid arthritis is an autoimmune disorder characterized by pain in the wrists, fingers, hands, and feet. The immune system in this disease attacks the lining of your joints, which often creates painful swelling and stiffness.

  • Osteoarthritis

As opposed to rheumatoid arthritis, which is an autoimmune disorder, osteoarthritis is a wear and tear condition. As we age, the cartilage that protects the ends of our bones begins to wear out, resulting in bone against bone movement.

  • Bursitis

Bursitis is another wear and tear condition. Bursae are tiny sacks that give joints cushioned movement. However, when these become inflamed, the result is a painful condition called bursitis.

  • Lupus

Lupus is an autoimmune disorder that can result in painful joints, especially in the knees, wrists, and fingers. People who suffer from lupus have good days and bad days, as the pain is intermittent.

  • Gout

Gout, which generally starts in the joints of the big toe, is a painful condition that is grouped together with arthritis, which it resembles.

  • Fibromyalgia

This chronic pain condition is usually associated with muscle pain, but many patients experience stiff joints, as well.

  • Polymyalgia Rheumatica

This is a joint disease that is rarely seen in people under 50. It results in stiff joints, mostly in the shoulders, neck, hips, fingers, and wrists.

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Are you or anyone you know suffering from joint stiffness? Let us help you return to an active lifestyle with minimum pain. Call FXRX Orthopaedics and Bracing in Phoenix, Az., at 480-449-FXRX.

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Decompression Laminectomy

By  aenriquez  published  July 2, 2019

The decompression laminectomy operation is a common back surgery in which the doctor removes vertebral bone that is putting pressure on nerves. The back part of the vertebral bone is the part that is removed and the operation could entail removal of that portion of vertebral bone from more than one vertebra. Other painful conditions, like bone spurs, can also be addressed during decompression laminectomy surgery.

The surgery is considered a major operation that requires the use of general anesthesia delivered through a facial mask. Patients are also given a sedative to help them remain calm and to increase the general anesthesia’s effectiveness. During the operation, the patient lies on his or her stomach to allow access to the back. Patients are frequently intubated, which involves putting a plastic tube through the patient’s mouth, past the vocal cords to the windpipe. This allows doctors to have air pumped in and out of the patient’s lungs during the surgery. This is done with a mechanical ventilator.

Spinal surgery can be done from the front or the back, but a decompression laminectomy is done from the back

The Surgery Itself

Spinal surgery can be done from the front or the back, but a decompression laminectomy is done from the back. It starts with the surgeon making an incision above the area where the pain originates. After the incision is made, the surgeon then moves the muscle and soft tissue in order to have a view of the patient’s spine.

After the correct area of the spine is exposed, surgeons then cut away bone spurs and any ligaments that are pressing on nerves. The surgeon could also cut away substantial portions of vertebrae that have been causing the patient pain or discomfort or limiting flexibility.

Spinal Fusion

Along with the decompression laminectomy, the patient may have to undergo spinal fusion. This entails “welding” two vertebrae together by use of bone grafts – one or several – that allow the adjacent vertebrae to heal together as one bone. Sometimes, the surgeon elects to use metal plates, screws and rods to ensure that the vertebrae are stabilized.

A spinal fusion restricts flexibility the patient had before surgery, but the movement is often the source of the pain. The patient sacrifices some movement while finding relief from the pain presented by a herniated disc or other conditions.

When the surgery is complete, the surgeon sews the wound back together and the patient wakes up as the mask is removed and the intubations tube is taken out.

Recovery Time

Recovering from a decompression laminectomy can take a while, although many patients, with their doctor’s approval, find they can go home the same day the surgery is performed.  You will be instructed on how much activity you can take on until healing is complete.

Others are not so lucky. According to Spine-Health, 70 percent to 80 percent of patients who undergo this operation feel immediate relief, while others find relief is slower to arrive.

Risks

There are also risks with this surgery, just as there is with other major operations. In the case of decompression laminectomy, the risks include:

  • Nerve root damage – the odds are 1 in 1,000 of this occurring
  • Cerebrospinal fluid leak – odds are 1 percent to 3 percent, but recovery from this is usually under 24 hours if the patient remains lying down
  • Infections – 1 percent of cases, although usually this can be dealt with by the use of IV antibiotics.

 

Make A Call

Are you or anyone you know suffering from back pain? Let us help you return to an active lifestyle. Call FXRX Orthopaedics and Bracing in Phoenix, Az., at 480-449-FXRX.

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