Health Tips - Orthopaedic/Joints
A Baker's cyst - The cyst is also called a popliteal cyst. There is a bulge and a feeling of tightness behind the knee. The pain worsens when the knee is fully extended or there is increased activity. It is usually the result of increased fluid production, secondary to arthritis or a cartilage tear. Symptoms may include swelling behind the knee, knee pain or stiffness.
Treating the underlying condition usually relieves the swelling and discomfort. Though unlikely, other causes of a bulge behind the knee may be a tumor or a popliteal artery aneurysm. Non-invasive imaging test, such as an ultrasound or a magnetic resonance imaging (MRI) scan may confirm the diagnosis.
Many times a Baker's cyst will disappear on its own. A Baker's cyst may rupture and fluid leaks into the calf region, causing sharp pain in the knee and swelling of the calf. These signs and symptoms often resemble those of a blood clot (DVT). In instances where the cyst is very large and causes a lot of pain, the doctor may:
- Order physical therapy
- Surgically drain the fluid
- Prescribe anti-inflammatory medication
- Administer a steroid injection into the knee
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Frozen Shoulder (Adhesive Capsulitis) - If there is stiffness or pain in your shoulder when you attempt to move it through its normal range of motion, you may have adhesive capsulitis.
The painful stage: At first, your shoulder may ache and feel stiff. Then it may get very painful. This stage lasts 3 to 8 months.
The adhesive stage: During this stage, you may have less pain, but your shoulder keeps getting stiffer. This stage lasts 4 to 6 months.
The recovery stage: This final stage usually lasts about 1 to 3 months, but is not very painful. It becomes very hard to move your shoulder even a little bit. Then after a while, the stiffness slowly goes away. You can move your shoulder again and with time you should be able to do many more activities. As your shoulder movement increases, you may still have pain at times – especially at night.
Your doctor will tell you about exercises you should do to help break up the scar tissue in your shoulder. You may need to see a physical therapist to help you with these exercises. Sometimes you may need more aggressive therapy.
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Heel Spurs/ Plantar fasciitis Heel spurs and plantar fasciitis often co-exist. The exact relationship between both is not entirely understood. Plantar fasciitis is the inflammation of the tissue that extends from the heel to the ball of the foot. A heel spur is a hook of bone that forms on the calcaneus (heel bone). Heel spurs are most often seen in middle-aged or older men and women who are often overweight. A heel spur causes inflammation and irritation of the plantar fascia.
- Symptoms: Worse early in the morning shortly after getting out of bed because the plantar fascia is tight, however, as you begin to walk around, the pain usually subsides.
- Treatment of heel spurs is the same as treatment of plantar fasciitis.
- Rest: Staying away from aggravating factors – e.g. jogging or prolonged standing.
- Ice: Reduces inflammation and pain.
- Exercises/ Stretches: Relaxes the tissue around the heel bone.
- Anti-inflammatories: Tablets and injections (steroids) are used to control inflammation and pain.
- Shoe inserts (as prescribed by podiatrist): Often have a dramatic effect on the condition.
- Night splints: Worn while sleeping and prevents the arch of the foot from contracting.
- Surgery: In less than 5% of patients where conservative treatment has been tried for a year and symptoms persists a surgical procedure – plantar fascia release – may be considered.
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Lower Back Pain (LBP) Myths and Facts - Part I
Myth: LBP is harmful or can cause permanent harm.
Fact: Very rarely will LBP result in permanent disability. After returning to work and normal activity it is normal to feel some pain.
Myth: Feeling depressed and withdrawing from social activities is okay when you have LBP.
Fact: You should do as many of your normal activities as your pain allows. It is important to keep active and do things with friends and family.
Myth: I can hardly move. Something must be seriously wrong with me.
Fact: Many persons suffering with LBP believe that something MUST BE seriously wrong especially if the pain is severe. In greater than 98% of cases there is no serious cause for your LBP.
Myth: If I just take it easy for a week or two and rest in bed, the pain will go away.
Fact: Resting in bed is not helpful and can actually make your back pain worse over time. Stay as active as possible, even if moving around is painful. This will help you feel better sooner.
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Lower Back Pain (LBP) Myths and Facts - Part II
Myth: I have to see my doctor right away.
Fact: If this is your first attack of LBP, the best person to see is your family doctor (i.e. GP). He or she will make sure nothing is seriously wrong and give you advice about how to manage your pain.
Myth: Going back to work too soon after hurting my back will make the pain worse and it will take me even longer to recover.
Fact: Most people benefit from returning to work. There is nothing wrong with returning to your job before your back feels completely better.
Myth: I must have hurt my spine in some way. I probably need an X-ray.
Fact: Because most cases of acute LBP is related to muscles, joints and ligaments and not to the bones in the spine, back X-rays (which only show bones) are not very useful. It’s important not to expose you to unnecessary radiation. MRIs and CT scans are not often useful in accurately identifying the cause of LBP, when these tests are done they should be compared to the patient’s clinical picture.
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Rheumatoid Arthritis - Traditionally it has been accepted that Rheumatoid Arthritis (RA) is a crippling collagen vascular disease. In that in the past, most persons who suffer from RA inevitably ended up with debilitating arthritis – especially of the hands.
However, recent studies have shown that the combination of methotrexate and etanercept improves remission and radiographic non-progression rates in patients with early, moderate to severe RA within 1 year compared with treatment of methotrexate alone. In other words all stages of RA are responsive to this combination therapy.
This combination treatment also increases the ability of patients to remain a productive member of the workforce, which has implications for patients, employers, and society as a whole.
The COMET trial showed that patients who received combination therapy have a nearly 3-fold reduction in work stoppage compared with those who took the traditional therapy of high-dose methotrexate alone.
The results of the COMET trial suggest that remission is an achievable goal in patients with early severe RA within the first year of therapy with etanercept plus methotrexate. Furthermore, these outcomes appear to be achieved without exposing patients to significant additional risk.
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Sprains Part 1 Your ligaments are tough, elastic-like bands that attach to your bones and hold your joints in place. A sprain is an injury to a ligament caused by excessive stretching. The ligament can have tears in it, or it can be completely torn apart. Sprains occur most often in your ankles, knees or the arches of your feet. Sprained ligaments swell rapidly and are painful. Generally the greater the pain, the more severe the injury. Seek medical attention if;
- You heard a popping sound when your joint was injured, or you can't use the joint. This may mean the ligament was completely torn apart. On the way to the doctor, apply a cold pack.
- You have a fever, and the area is red and hot. You may have an infection.
- You have a severe sprain. Inadequate or delayed treatment may cause long-term joint instability or chronic pain.
- You aren't improving after the first two or three days.
