Monthly Archives: August 2014

Can’t put your finger on it? Numbness in Fingers can be tricky to diagnose.

femal hand Injury

Getting the Right Diagnosis for Numb Fingers

Article written by:  found on spine-health.com

Before starting treatment for pain and/or numbness in your hands, make sure you have the correct diagnosis: sometimes cervical radiculopathycan be confused for carpal tunnel syndrome (or vice versa), because the symptoms can be similar.

A common misdiagnosis

Dr. Steven Shoshany, one of our Spine-health verified physicians, brought this topic to my attention, because he feels many patients are being given a wrong diagnosis. His own family member had surgery to treat a supposed case of carpal tunnel syndrome, when in fact they were suffering from a cervical herniated disc. 

Carpal tunnel syndrome
Carpal tunnel syndrome occurs when the median nerve, entering the hand through a tunnel made by the wrist bones, is compromised, usually resulting in numbness in the thumb, index, and middle finger. Sometimes the numbness is worse at night, and in severe cases, it can cause weakness in the thumb muscles of the hand.

These symptoms can mimic cervical radiculopathy.

Cervical radiculopathy
Cervical radiculopathy (commonly known as a “pinched nerve”) occurs when a nerve exiting the cervical spine (neck), is irritated by compression or inflammation caused by a cervical herniated disc, cervical spinal stenosis, or cervical degenerative disc disease.

Depending on which nerves are being irritated, different symptoms may occur.

Patients typically experience pain, weakness, and numbness in the areas served by the damaged nerve-and that area can be the hand and fingers. If the damaged nerve serves the hand, the patient may experience numbness in the same areas as they would with carpal tunnel syndrome.

Diagnostic tools
Your physician should start out with a basic medical history and exam. Anerve conduction study can confirm or cast doubt on carpal tunnel syndrome. If the doctor suspects the numbness may be caused by cervical radiculopathy, imaging studies like MRIs can be helpful.

Treatment
Carpal tunnel syndrome is usually managed with NSAIDs and splints at night, and less frequently with steroids or surgery. Some doctors also have success treating this condition with cold laser therapy.

Treatment options for cervical radiculopathy vary widely, depending on the underlying cause as well as the severity of symptoms, and can include:

We thank Dr. Shoshany for bringing this important potential misdiagnosis to our attention, and we hope this will help our readers remember the importance of having an accurate diagnosis before opting for any treatment, especially surgery.

 

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Blue Ridge Orthopaedic & Spine Center has on-site state-of-the-art technology to diagnosis and treat orthopaedic conditions. For your convenience, both of our offices are equipped with in-office radiology departments. Not only does this facilitate rapid diagnosis but it is also convenient for patients who may be experiencing pain or disability at the time of their visit. To schedule an appointment with one of our board-certified and fellowship trained physicians, call our Warrenton  office at 540-347-9220 or our Gainesville office at 703-743-2814.

DIY Hot and Cold packs

How to Make Your Own Gel Ice Pack

or Moist Heat Pack

Article written by:  via Spine-Health.com

Sometimes the simplest solutions are the best. For example, heat or cold therapy can provide a surprising amount of pain relief for most types of back and neck pain.

Treatment for Back and Neck Muscle Strain
Low back pain is commonly caused by injuries to the muscles.

Muscle strains and pulls are some of the most common causes of back pain, and can be soothed with heat and cold therapy.

  • Cold packs help reduce inflammation and numb a painful area.
  • Heat packs help increase circulation to a specific area of the body and can promote healing.

It’s easy to make a hot or cold pack with materials you already have at home. Making hot or cold packs yourself is convenient, because one will be ready whenever you need it, and it could save you some money.

Homemade gel ice packs

These homemade gel ice packs are more comfortable than a bag of frozen peas, because they mold better to your body without the lumps and bumps. They can be made for under $3.

What you need:

  • 1 quart or 1 gallon plastic freezer bags (depending on how large you want the cold pack)
  • 2 cups water
  • 1 cup rubbing alcohol

Instructions:

  1. Fill the plastic freezer bag with 1 cup of rubbing alcohol and 2 cups of water.
  2. Try to get as much air out of the freezer bag before sealing it shut.
  3. Place the bag and its contents inside a second freezer bag to contain any leakage.
  4. Leave the bag in the freezer for at least an hour.
  5. When it’s ready, place a towel between the gel pack and bare skin to avoid burning the skin.

Another way to apply ice to the back is by freezing water in a cup, and then rubbing it on the affected back muscles to reduce inflammation.

Freeze ice in a Styrofoam cup for a do-it-yourself ice massage.
Homemade moist heat packs

Heat therapy increases circulation to aching muscles, and provides pain relief. There are two types of heat therapy, dry and moist.

Electric heating pads bring a dry heat, which some people find to be less comforting than moist heat. Moist heat packs are less dehydrating to the skin, and they allow heat to absorb better into the skin and relieve pain faster.

What you need:

  • Cloth container (sock, fabric)
  • 4-6 cups filling (e.g. uncooked rice, flax seed, buckwheat, oatmeal)
  • Needle and thread (optional, but recommended)
  • Flair (ribbon, fragrant oils; optional)

Instructions:

  1. Fill your container with the filling.
  2. Tie or sew the container shut.
  3. Add soothing aromatherapy before you microwave, if you want.
  4. Microwave container for 1-3 minutes.
Sock heat packs for low back pain
Socks can make a heat pack that is beneficial for back pain.

Whether you are using cold or heat therapy, do not apply them for more than 15 minutes at a time. The best way to apply either heat or cold is to alternate 15 minutes on and 15 minutes off for an hour or two.

For another easy DIY project for back pain relief, see How Tennis Balls and Duct Tape Can Morph into a Do-It-Yourself Massage for Lower Back Pain

 

BRO-Logo-colorBlue Ridge Orthopaedic & Spine Center has on-site state-of-the-art technology to diagnosis and treat orthopaedic conditions. For your convenience, both of our offices are equipped with in office radiology departments. Not only does this facilitate rapid diagnosis but it is also convenient for patients who may be experiencing pain or disability at the time of their visit. To schedule an appointment with one of our board-certified and fellowship trained physicians, call our Warrenton  office at 540-347-9220 or our Gainesville office at 703-743-2814.

Keep your shoulder healthy!

Rotator Cuff Tendonitis

Article written by: Peter F. Ullrich, Jr., MD

The rotator cuff is a set of four muscles (Supraspinatus, Infraspinatus, Subscapularis, and Teres Minor) that lie over the humeral head in the shoulder that help provide shoulder stability. These muscles can become inflamed and produce shoulder pain. The pain tends to be:

  • Generally worse at night or after activity
  • Shoulder motion causes pain and is limited
  • More common in athletes who do a lot of throwing
  • More common in older individuals (over 50)

If the pain is severe, it can be difficult to distinguish between rotator cuff tendonitis and cervical radiculopathy. In such cases, an injection of a numbing agent (such as Lidocaine) into the shoulder area can help. If the pain is completely relieved, then the cuff is probably the pain generator (not the nerve).

Tendonitis may be associated with a rotator cuff tear, which can be diagnosed with either an MRI scan or an arthrogram of the shoulder.

Treatment for Rotator Cuff Tendonitis

Treatment includes NSAIDs and physical therapy exercises to strengthen the rotator cuff.

For more severe cases, a steroid injection into the shoulder can help decrease the inflammation. If a tear is present, surgery may be necessary to repair the torn muscle/tendon.

shoulders lecture graphic

 

Join us on Thursday, August 21 at the Heritage Hunt Golf & Country Club in Gainesville where Dr. Ward will be talking about Shoulder Health and Rotator Cuff treatment. While there, you can register to win a $200 gift card! Visit broava.com/go/events to RSVP. The event is FREE! 

 

 

 

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Blue Ridge Orthopaedic & Spine Center has on-site state-of-the-art technology to diagnosis and treat orthopaedic conditions. For your convenience, both of our offices are equipped with in-office radiology departments. Not only does this facilitate rapid diagnosis but it is also convenient for patients who may be experiencing pain or disability at the time of their visit. To schedule an appointment with one of our board-certified and fellowship trained physicians, call our Warrenton  office at 540-347-9220 or our Gainesville office at 703-743-2814.

Treat your spine to some pampering this weekend!

It’s the weekend, time to relax, enjoy time with friends and family and indulge in good times. However, did you know that there are a few things that you can do that are pretty easy, massage therapy anyone, to take care of your spine at the same time? Just a little preventative care now, can make a big difference later.

3d rendered illustration - backache

11 Ways to Indulge Your Spine

courtesy of Spine-Health.com

Taking care of your back before serious problems arise is easier than you think. We have 11 ideas to help you give your spine the special treatment it deserves.

Our spines are made for movement. Watch: Lumbar Spine Anatomy Video

Make exercise a daily ritual
Research has consistently shown that exercise is the key to maintaining a healthy spine, and it helps rehabilitate injured spines. Our spines are made for movement, and even a simple exercise program that focuses on stretching and strengthening the back, hamstring, and abdominals can go a long way toward distributing nutrients into the spinal discs and soft tissues, accelerating the healing process, and keeping the discs, muscles, ligaments, and joints healthy. For more information, visit our Exercise Health Center.

Believe in the mind body connection
Take time to engage in mindful-meditation every day. Studies have shown this to be an effective tool for fighting chronic back pain. While the mechanism of pain perception is still a fairly mysterious topic, being able to tap into the mind-body connection may help you cope with pain. See Mindful Meditation vs. Chronic Pain

Maintain good posture while sitting
The spine is naturally built to curve, but slouching in a chair for eight hours a day at work can lead to muscle tension and lower back pain, and leg pain (sciatica).

As the discs in the lumbar spine (lower back) are already loaded three times more while sitting than standing, why make things even more difficult? Be sure to have an ergonomically-friendly office chair setup and to get up and stretch every 30 minutes or so.

For more information on preventing bad posture from becoming a habit and incorporating the right posture while not only sitting but walking, driving, standing, and lifting, see these Guidelines to Improve Posture.

Choose shoes wisely
The benefits of walking for the spine are plentiful, including strengthening the muscles that keep the body upright, nourishing spinal structures with necessary nutrients, improving flexibility, and strengthening the bones.

While walking, it’s important to have a flexible, comfortable pair of shoes that also serves as a stable base for the spine to stay in alignment. Here are some Guidelines for Buying Walking Shoes

Relax with heat therapy
Naturally your neck and back may feel sore at the end of a long day. Applying heat therapy is a great way not only to soothe spinal discomfort but to kick back and relax prior to going to sleep.

Try heating pads, wraps, warm gel packs, hot water bottles, or a bath/shower to benefit from heat therapy. Learn How to Apply Heat Therapy

Sleep on a supportive mattress and pillow
In ideal circumstances, nearly a 1/3 of the day is spent sleeping, which also serves as a time for the spine to rest after a hard day’s work. Still, an insufficient mattress can make rest a stressful time on the spine, and lead to some patients complaining of a stiff neck or back ache in the morning.

While sleep comfort is a matter of personal preference, taking into consideration a mattress that allows for correct support and sleeping positions can go a long way towards avoiding pain in the back and neck (cervical spine). See Choosing the Best Mattress and Pillow Support and Comfort.

Choose your food wisely
Your diet can make or break your overall health, and it can have an especially big impact on your spine health. Try sticking mostly to whole foods-foods you would find in nature- like vegetables, fruits, dairy, meats, grains, and legumes. Eventually make it your goal to eliminate all processed foods, and to only indulge in unhealthy treats once or twice a week.

Focusing on foods that are high in calcium (for bone strength and mass) and other nutrients and vitamins can help prevent osteoporosis, osteoarthritis and other conditions in the future. Similarly, maintaining a proper weight can reduce pressure on the spine and minimize back pain. For more information, visit our health center on Nutrition, Diet and Weight Loss.

Go for a swim

swimmer

Water therapy is especially advantageous for the spine because of the support the water gives to bones and joints during exercise. Buoyancy provides both mild resistance and support, thus reducing the risk of injury or pain during certain exercises.

Cold water soothes joint inflammation, while hot water stimulates circulation for stiff muscles and healing for minor muscle sprains or strains. For more information, get immersed in the following Water Therapy Exercise Program.

Literally Treat Yourself to Massage Therapy
Studies show that massage therapy is a legitimate treatment for some back pain. Massages offer several benefits, including improving blood circulation for the recovery of sore muscles, restoring spinal range of motion, helping with insomnia, and upping endorphins – the body’s natural chemicals that make patients feel good. See Massage Therapy for Lower Back Pain.

Resolve to quit smoking
Quitting smoking reduces the likelihood of lower back pain, which is reportedly 300 percent more likely in smokers than non-smokers. Resolving to quit is difficult, but there are many products, support groups, and strategies that have worked for thousands of people.

According to one study, smoking leads to degenerative spinal disorders and back pain as a result of damaging the vascular structures of spinal discs and joints. See why quitting smoking is a must-do for the spine in the following video: Stop Smoking!

Lift Correctly

lifting boxes
Improperly lifting heavy items can put the lower back muscles in abnormal positions that can produce painful muscle strains, and even cause the spinal joints to lock and the spinal discs to rupture.

Correct lifting is more than involving the knees, and should incorporate keeping the chest forward and the weight close to the body, and leading with the hips rather than the shoulders. Do you practice the right lifting techniques?

With all these suggestions in mind, what better day than today to start getting active and making these changes!

 

BRO-Logo-colorBlue Ridge Orthopaedic & Spine Center has on-site state-of-the-art technology to diagnosis and treat orthopaedic conditions. For your convenience, both of our offices are equipped with in-office radiology departments. Not only does this facilitate rapid diagnosis but it is also convenient for patients who may be experiencing pain or disability at the time of their visit. To schedule an appointment with one of our board-certified and fellowship trained physicians, call our Warrenton  office at 540-347-9220 or our Gainesville office at 703-743-2814.

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