Monthly Archives: September 2013

I have a Lump on My Wrist and it Hurts!



Do YOU have a Lump on Your Wrist that Hurts?

You may have a ganglion cyst.  A ganglion cyst is a firm, fluid-filled lump that can suddenly appear on the front or back of the wrist or at the base of a finger. These cysts grow from normal tissue in the wrist and fingers, and range in size from a pea to a peach pit. Although ganglion cysts are common, they don’t spread, and they don’t become cancerous. They can occur after an injury, but many times it isn’t known why they grow. Ganglion cysts can change in size, and occasionally disappear on their own.

What are the Symptoms?

A ganglion cyst is sometimes painful, especially when it first occurs. Constantly using your hand or wrist can make the cyst enlarge and hurt more. Some hand and wrist movements, such as grasping things, may also be difficult.

How Does a Ganglion Cyst Develop?

Your wrist and hand are made up of many small bones that meet at joints. Tendons attach muscles to the bones at the joints. The tendons allow the joints to bend and straighten. Both tendons and joints are lined with tissue called synovium. This tissue produces a thick fluid that keeps the joints and tendons moving easily. Sometimes the tissue balloons out from the joint or tendons and forms a cyst. As the cyst fills with fluid and grows, it appears as a lump you can feel.

Where Do Ganglion Cysts Occur?

A ganglion cyst can occur anywhere on the hand near a joint. Cysts most commonly appear on the back or palm side of the wrist, or on the palm at the base of a finger. Your doctor can usually diagnose a cyst by examining the lump. He or she may draw off a little fluid or order an x-ray to rule out other problems.


Treating a Ganglion Cyst

Your doctor may just watch your ganglion cyst. Many shrink and become painless without treatment. Some disappear altogether. If the cyst is unsightly or painful, or makes it hard for you to use your hand, your doctor can treat it or, if needed, remove it surgically.

Nonsurgical Treatment

To shrink the cyst, your doctor may massage the fluid back into the surrounding tissue, or remove (aspirate) the fluid with a needle. If the cyst hurts, your doctor may also give you an injection of an anti-inflammatory, such as cortisone, to relieve the irritation. Your hand may then be wrapped to help keep the cyst from recurring.


If the cyst reappears after treatment, your doctor may remove it surgically. A section of the tissue that lines the joint or tendon is removed along with the cyst. This helps prevent another cyst from forming. Usually, only your hand or arm is numbed, and you can go home a few hours after surgery. Your hand may be in a splint for several days.

Our Specialists

The hand specialists at Blue Ridge Orthopaedic and Spine Center are skilled at repairing and rehabilitating hand injuries caused by damaged tendons, nerves, blood vessels and joints, as well as fractured bones and burns, cuts or other damage to the skin.  With most hand injuries, a hand surgeon will examine you, and then discuss possible treatments for your problem.

Technology has greatly improved the ability to restore function and appearance.  Before your hand surgery, talk to your doctor about recovery time, how long it will take you to return to your normal activities and the desired outcome.  Whether you need to be seen for a ganglion cyst or another type of hand injury the trained therapists and physicians of Blue Ridge Orthopaedic and Spine Center are here for you.  Our goal – Get YOU back to GOOD Health.

If you would like to schedule an appointment please call our hand specialists at 540-347-9220 or make an appointment online. Learn more about our Hand Specialty Services for more information on the comprehensive treatment we offer.

Is Aquatic Therapy for You?



Aquatic Therapy is a procedure which attempts to improve function through the application of aquatic therapeutic exercises which facilitates healing and return of function.  Water buoyancy decreases the amount of weight borne by the joints and can be very useful for patients with osteoarthritis, healing fractured bones or obesity.  Our Physical Therapy and Rehabilitation department provides this therapy through a cooperative arrangement with the Warrenton Aquatic and Recreation Facility. 

Think Aquatic Therapy might be for you?  Your physician will assess your condition and develop a treatment plan that is just right for you.  Our staff of Certified Physical Therapist’s specialize in Orthopedics’  and will work hard to restore you to full functionality by using evidence-based treatments.

Call Blue Ridge Orthopaedic and Spine Center today @ 540.347.9220 for more information or to schedule an appointment.  Visit to learn more about the comprehensive services Blue Ridge Orthopaedic and Spine Center has to offer!

Are you at Risk for Osteoporosis?



Osteoporosis is a disease of the bones in which there is a loss of bone density and destruction of bone tissue.  Even though you may not notice a difference in your bones, over time they will lose many important proteins that are vital to keeping your bones strong.  As a result, your bones will have less strength and you will be much more susceptible to fractures, especially if you fall.

According to this article from Krames Staywell,P00932 Osteoporosis affects over 10 million Americans over the age of 50, with women four times more likely to develop osteoporosis than men.

34 million Americans over the age of 50 have low bone mass which increases the threat for osteoporosis.  Loss of Estrogen is the number one cause of bone loss in women during and after menopause.  Woman can lose up to 20% of their bone mass in the five to seven years following menopause.

Other risk factors for osteoporosis –

  • Age – Bones will become less dense and lose strength with age
  • Heredity
  • Overall poor health
  • Tobacco Smoking
  • Race – White and Asian women are most at risk, even though all races may develop the disease
  • Alcoholism
  • Low body weight
  • Poor vision
  • Thyroid disease
  • Diabetes
  • Leukemia
  • Low levels of testosterone
  • Early menopause
  • Certain medications – Most associated medication risks are steroids and anticonvulsants, but there is evidence emerging with regard to other medications
  • Low calcium intake
  • Having a fracture occur as an adult

Many people are not affected with symptoms of osteoporosis and the disease is often referred to as the “silent disease.” Some people may have pain in their bones and muscles, particularly in their back.  On occasion, a collapsed vertebra may cause severe pain, decrease in height, or deformity in the spine.  Osteoporosis most often occurs in the hips, spine and wrists.

Blue Ridge Orthopaedic and Spine Center’s physicians, physical therapists, and pain management specialists have extensive experience treating nearly every kind of condition including osteoporosis.  We offer a range of non-operative treatment options as well as many minimally invasive options that are treated in our surgical center on an outpatient basis.  Please contact us today @ 540.347.9220 for more information or visit us @  Our number one goal – Get YOU back to GOOD health.


Have you heard of Compartment Syndrome?


You are probably asking yourself what in the world is compartment syndrome?  Compartment syndrome is a painful condition that occurs when pressure within the muscles builds to dangerous levels. This pressure can decrease blood flow, which prevents nourishment and oxygen from reaching nerve and muscle cells.

Compartment syndrome develops when swelling or bleeding occurs within a compartment. Because the fascia does not stretch, this can cause increased pressure on the capillaries, nerves, and muscles in the compartment. Blood flow to muscle and nerve cells is disrupted. Without a steady supply of oxygen and nutrients, nerve and muscle cells can be damaged.

Compartment syndrome most often occurs in the anterior (front) compartment of the lower leg (calf). It can also occur in other compartments in the leg, as well as in the arms, hands, feet, and buttocks.

Compartment syndrome can be either acute or chronic.

Acute compartment syndrome is a medical emergency. It is usually caused by a severe injury. Without treatment, it can lead to permanent muscle damage.

  • If pressure is not relieved quickly, permanent disability and tissue death may result. This does not usually happen in chronic (exertional) compartment syndrome.
  • Acute compartment syndrome usually develops after a severe injury, such as a car accident or a broken bone. Rarely, it develops after a relatively minor injury.  Conditions that may bring on acute compartment syndrome include:
  •  Fractures.
  • A badly bruised muscle. This type of injury can occur when a motorcycle falls on the leg of the rider, or a football player is hit in the leg with another player’s helmet.
  • Reestablished blood flow after blocked circulation. This may occur after a surgeon repairs a damaged blood vessel that has been blocked for several hours. A blood vessel can also be blocked during sleep. Lying for too long in a position that blocks a blood vessel, then moving or waking up can cause this condition. Most healthy people will naturally move when blood flow to a limb is blocked during sleep. The development of compartment syndrome in this manner usually occurs in people who are neurologically compromised. This can happen after severe intoxication with alcohol or other drugs.
  • Crush injuries.
  • Anabolic steroid use. Taking steroids is a possible factor in compartment syndrome.
  • Constricting bandages. Casts and tight bandages may lead to compartment syndrome. If symptoms of compartment syndrome develop, remove or loosen any constricting bandages. If you have a cast, contact your doctor immediately.
  • The classic sign of acute compartment syndrome is pain, especially when the muscle within the compartment is stretched.
    • The pain is more intense than what would be expected from the injury itself. Using or stretching the involved muscles increases the pain.
    • There may also be tingling or burning sensations (paresthesias) in the skin.
    • The muscle may feel tight or full.
    • Numbness or paralysis is a sign of late compartment syndrome. They usually indicate permanent tissue injury.
  • Acute compartment syndrome is a surgical emergency. There is no effective nonsurgical treatment.  Your doctor will make an incision and cut open the skin and fascia covering the affected compartment. This procedure is called a fasciotomy.

Sometimes, the swelling can be severe enough that the skin incision cannot be closed immediately. The incision is surgically repaired when swelling subsides. Sometimes a skin graft is used.

Chronic compartment syndrome, also known as exertional compartment syndrome, is usually not a medical emergency. It is most often caused by athletic exertion.


  • The pain and swelling of chronic compartment syndrome is caused by exercise. Athletes who participate in activities with repetitive motions, such as running, biking, or swimming, are more likely to develop chronic compartment syndrome. This is usually relieved by discontinuing the exercise, and is usually not dangerous.
  • Chronic compartment syndrome causes pain or cramping during exercise. This pain subsides when activity stops. It most often occurs in the leg.  Symptoms may also include:
    • Numbness
    • Difficulty moving the foot
    • Visible muscle bulging
  • Nonsurgical treatment. Physical therapy, orthotics (inserts for shoes), and anti-inflammatory medicines are sometimes suggested. They have had questionable results for relieving symptoms.

Your symptoms may subside if you avoid the activity that caused the condition. Cross-training with low-impact activities may be an option. Some athletes have symptoms that are worse on certain surfaces (concrete vs. running track, or artificial turf vs. grass). Symptoms may be relieved by switching surfaces.

Surgical treatment. If conservative measures fail, surgery may be an option. Similar to the surgery for acute compartment syndrome, the operation is designed to open the fascia so that there is more room for the muscles to swell.

Usually, the skin incision for chronic compartment syndrome is shorter than the incision for acute compartment syndrome. Also, this surgery is typically an elective procedure — not an emergency.

If you are interested in learning more about compartment syndrome please contact our specialist’s at (540) 347-9220 or visit for more information.  Blue Ridge Orthopaedic and Spine Center offers comprehensive musculoskeletal care to our patients.  We are the ONLY center in the region, to offer complete orthopaedic care for all orthopaedic injuries and treatments.

Here’s What’s Happening This Weekend!



Blue Ridge Orthopaedic and Spine Center will be @ Haymarket Days, Saturday September 21st, 9am-5pm.  Meet our newest family member, Dr. James Ward.  Great food, parade, vendors, beer garden, kids area, games and much more!  Don’t miss the fun.  Rain or shine!  Parade begins @ 9:30am.  For more information visit:  Hope to see you there!

Spiritual Care Support Ministries Annual Yard Sale will be held this Saturday, September 21, from 8:00 am – 2:00 pm, rain or shine in the Blue Ridge Orthopedic parking lot (52 W. Shirley Ave. in Warrenton), with more available next door at the SCSM Center (76 W Shirley Ave.). SCSM and friends are cleaning house! We have a large and varied supply of items to offer! All proceeds will go to support SCSM’s services to the local community providing short and long term support needed by those who are experiencing any kind of loss (grief, divorce, chronic illness, pet loss, etc.).  SCSM offers personal counseling, support groups, and special events for getting through the holidays.   All services are free of charge. Please call Chaplain Liz Danielsen or Kelly Kern at 540-349-5814 for directions or more information.

Wakefield Car Wash and Bake Sale

Sunday, September 22, from 11am-2pm.  Show your team support for the Wakefield Cross Country team!  Donations kindly accepted!