Thursday, 21 of September of 2017

Category » Arthritis

Do Your Knees Ache? Here’’s What You Need To Know

 

 

shutterstock_137018378If your knee pain makes you limp when you walk or you dread going up and down stairs, you might be one of the millions of people with osteoarthritic knees. In fact, the Arthritis Foundation says the knee is one of the most common spots for osteoarthritis to develop. But you don’t have to let knee pain limit your enjoyment of life. According to the Centers for Disease Control, “many people with OA are not being proactive because of the misconception that arthritis is an inevitable part of aging and that the aches and pains are simply something you must learn to live with.

Here are 4 things you need to know about this chronic condition:

1. What is osteoarthritis? It’s a medical condition that damages the cartilage, bones, fluid and lining of the joint. Cartilage covers the ends of the bones in the knee joint. Without this protective cushion, the bones can rub against each other, causing friction and pain. Over time, fragments of bone or cartilage may break lose and float around. Spurs may develop on the end of the bones and the joint lining may become inflamed. All of this leads to swelling, tenderness, stiffness and pain.

2. What causes it? According to the Arthritis Foundation, osteoarthritis is no longer thought of as simply a “mechanical process” where the joint wears out due to age. Instead, the current view is that osteoarthritis has multiple risk factors, including a predisposition based on family history; being overweight, which can put pressure on the knee joint; traumatic injury or accident; chronic overuse and stress to the joint.

3. Is there a cure? At the present time, there isn’t a cure for osteoarthritis, but there are number of treatment options, both surgical and nonsurgical. Exercise, over the counter medications and topical creams can help early stage disease. Injections and prescription drugs may help more advance conditions. But chronic pain and disability is best relieved through joint replacement surgery.

4. How is it diagnosed? The doctor will conduct a physical exam, which includes inspecting your knee for swelling, warmth or tenderness, and evaluating how far you can extend your leg without discomfort. X-rays can identify a narrowing of spaces in the joint and other evidence of joint disease. It can also rule out other conditions, such as bone fracture. If needed, more advanced imaging techniques, such as CT scan, ultrasound or MRI may be considered.

If OA knee pain is affecting you quality of life, call us today at 239-036-6778 to schedule a consultation. For more general information on osteoarthritis, go to www.kaganortho.com.


Osteoarthritis vs. Osteoporosis vs. Rheumatoid Arthritis

 

 

Many people frequently confuse the terms osteoarthritis, osteoporosis and rheumatoid arthritis. They each affect the musculoskeletal system, but they are very different medical conditions.

Orthopedic surgeons treat osteoarthritis, which is a degenerative condition of the cartilage, a rubbery tissue that covers the ends of the bones and cushions the joints in the hips, knees, shoulders and other parts of the body. As osteoarthritis wears away the cartilage, the bones rub together, causing inflammation, tenderness, pain and stiffness. Bone spurs can also develop.

Initial treatment for osteoarthritis may include medication, hot or cold treatments, physical therapy and steroid injections.  At more advanced stages, patients can find relief through arthroscopy or joint replacement surgery.

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Photo Credit: Medicine Net Inc.

 

Rheumatoid arthritis is an autoimmune disorder that causes painful inflammation of the lining of the joints – the synovial membrane, whose function is to protect and lubricate the joint. Rheumatoid arthritis tends to affect the fingers, hands and toes first before the larger joints in the knees, hips, ankles, elbows and shoulders. In advanced cases it can cause severe joint deformity. Internists and physicians specializing in rheumatology treat rheumatoid arthritis. If surgery is required, an orthopedic surgeon may perform a joint fusion or joint replacement.

Osteoporosis is a crippling bone disease that primarily affects the elderly and causes bones to become porous, brittle and weak. Over time, the bones can be so fragile that that it doesn’t take much for them to break – even bending over to pick something up, sneezing or twisting can be a problem. Primary care physicians generally treat this medical condition, but an orthopedic surgeon may need to surgically repair fractures, especially hip fractures.

For more information about musculoskeletal conditions and treatment options, call 239-239.936.6778 or visit www.kaganortho.com.


Arthritis of the Hand, Wrist & Fingers

 

 

 

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Think of the demands we place on our hands, wrist and fingers nearly every waking moment. From grasping, pulling, twisting, turning and bending to texting and typing, our hands are constantly busy. Over the next few weeks, we’ll talk about medical conditions like osteoarthritis, ganglion cysts and trigger finger and how they can affect our hands and interfere with quality of life. Today’s blog will be about osteoarthritis: causes, symptoms and how to live with it.

The joints in the hand, wrist and fingers, just like the knees, hips and shoulders, can be damaged by osteoarthritis. The  loss of cushioning cartilage creates pain, stiffness and swelling, making it hard to bend the fingers or turn the wrist. Did you know that swelling results from the body’s attempt to make up for the loss of cartilage by producing extra fluid in the joint lining? However, the swelling stretches the joint covering, which is uncomfortable. The swelling may also make the joint hot to the touch.

What causes all of this to happen? Age can definitely be a factor, but so can heavy usage and an injury like a fracture. The American Academy of Orthopedic Surgeons reports that an injured joint is seven times more likely to become arthritic, even if the injury is properly treated.

Treatment

The main goal of treatment is to relieve pain and swelling. Anti-inflammatory drugs such as Tylenol and Advil and prescription drugs such as Celebrex can be helpful. So can the use of finger or wrist splints; application of hot or cold, topical creams, special therapeutic exercises and steroid injections.

Surgical treatment is less common for hand, wrist and finger osteoarthritis. However, the AAOS reports that the development of tiny instruments make arthroscopy of the small joints of the hand and wrist now possible. In addition, some orthopedic surgeons specializing in hand surgery are performing joint fusion or joint replacement of the wrist and finger knuckles.

The first step in diagnosing osteoarthritis of the hand is to schedule a consultation for a physical exam and X-rays. For more information, go to www.kaganortho.com or call 239-936-6778.


Tips for Living With Arthritis

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Anyone with osteoarthritis or who has a loved one with the disease knows that it can get progressively more painful over time as the smooth cartilage covering joints in the shoulders, knees, hips, wrist and fingers is affected.

While surgery to replace the joint may ultimately be the best solution, here are some tips from the American Occupational Therapy Association and Arthritis Foundation to make living with arthritis more manageable day to day:

  • Apply a heat pack or cold pack to the painful joint before and after performing activities.
  • Use a pillow to elevate the painful joint and provide support while you sleep.
  • Install a raised toilet seat and grab bars in the bathroom.  Similarly, sit in a chair with arms to help you stand up.
  • Remove throw rugs to prevent tripping.
  • Don’t lift heavy items. Use a cart with wheels to move laundry, garbage cans, grocery bags and other items.
  • Replace doorknobs and faucets in your house with lever-style handles that are easier to turn.
  • Take frequent breaks and pace yourself when doing activities that put strain the joint.

Here are a few additional lifestyle suggestions from the Arthritis Foundation:

Maintain a healthy weight and control blood sugar: Extra weight puts added stress on weight-bearing joints, such as the knees and hips. In addition, new studies show that high blood sugar levels, which increase the risk for diabetes, may trigger inflammation, which can damage cartilage.

Stay physical: It’s the best non-drug treatment for improving pain and function. Exercise stretches the joints and keeps them more flexible, while also strengthening the muscles surrounding the joint. You don’t have to join a gym; just take a walk.

Play it safe if you play sports: Wear protective gear soccer, hockey, rollerblading, baseball and similar sports that can strain joints. Injured joints are nearly seven times more likely to develop arthritis.

For more information about joint pain or other orthopedic-related conditions, go to www.kaganortho.com. To schedule a consultation call 239-936-6778.


What Is MIS Joint Replacement?

The trend toward bigger is better may apply in some areas of popular culture, but definitely not in the field of medicine, especially for joint replacement surgery.

MIS joint replacement is a minimally invasive surgical technique in which the surgical incision used to open the body is very tiny, just 2.5- to 3.5 inches. In contrast, traditional joint replacement surgery calls for a much larger incision – typically 12- to 14-inches.

But here’s the interesting twist. Whether the surgeon uses traditional surgery or a minimally invasive technique, the device used to replace the arthritic hip, knee or shoulder is always a full-size, traditional plastic or metal implant.

How is that possible? Technology.

Standard operating procedure calls for the surgeon to make a large incision and then retract the tissue, giving him a large surgical field in which to operate and insert the new artificial implant.

The new MIS technique uses a completely different approach. First, miniature specialized surgical instruments have been developed that are small enough to inset through a tiny incision.

Then, to overcome the restriction of a dramatically reduced surgical field, the specialized surgical instruments are equipped with a light source and video capability. Video images of the interior structure are sent in real-time to a monitor, giving the surgeon highly magnified 3D images of the operating field.

Performing minimally invasive surgery not only requires the right surgical instruments, it also takes training and certification to learn the surgical skills and manual dexterity required to become proficient in minimally invasive techniques.

In addition, the surgeon has to have a successful practice and track record that allows him to consistently perform the technique to keep his skills up to date and his surgical outcomes good.

Not everyone is a good candidate for MIS joint replacement. But the advantages of this new advance are extensive. The benefits include less blood loss, reduced trauma to the body, fewer days of hospitalization and faster overall recovery. Minimally invasive techniques are definitely a positive trend for the future of orthopedic care.

Want to find out more about minimally invasive techniques to treat joint pain? Go to www.kaganortho.com/learn-more. If you have chronic osteoarthritis that doesn’t respond to nonsurgical treatment, ask your doctor if you a good candidate for MIS joint replacement.

The trend toward bigger is better may apply in some areas of popular culture, but definitely not in the field of medicine, especially for joint replacement surgery.

MIS joint replacement is a minimally invasive surgical technique in which the surgical incision used to open the body is very tiny, just 2.5- to 3.5 inches. In contrast, traditional joint replacement surgery calls for a much larger incision – typically 12- to 14-inches.

But here’s the interesting twist. Whether the surgeon uses traditional surgery or a minimally invasive technique, the device used to replace the arthritic hip, knee or shoulder is always a full-size, traditional plastic or metal implant.

How is that possible? Technology.

Standard operating procedure calls for the surgeon to make a large incision and then retract the tissue, giving him a large surgical field in which to operate and insert the new artificial implant.

The new MIS technique uses a completely different approach. First, miniature specialized surgical instruments have been developed that are small enough to inset through a tiny incision.

Then, to overcome the restriction of a dramatically reduced surgical field, the specialized surgical instruments are equipped with a light source and video capability. Video images of the interior structure are sent in real-time to a monitor, giving the surgeon highly magnified 3D images of the operating field.

Performing minimally invasive surgery not only requires the right surgical instruments, it also takes training and certification to learn the surgical skills and manual dexterity required to become proficient in minimally invasive techniques.

In addition, the surgeon has to have a successful practice and track record that allows him to consistently perform the technique to keep his skills up to date and his surgical outcomes good.

Not everyone is a good candidate for MIS joint replacement. But the advantages of this new advance are extensive. The benefits include less blood loss, reduced trauma to the body, fewer days of hospitalization and faster overall recovery. Minimally invasive techniques are definitely a positive trend for the future of orthopedic care.

Want to find out more about minimally invasive techniques to treat joint pain? Go to www.kaganortho.com/learn-more. If you have chronic osteoarthritis that doesn’t respond to nonsurgical treatment, ask your doctor if you a good candidate for MIS joint replacement.

 


NSAIDs for Joint Pain

NSAIDs or non-steroidal inflammatory drugs are the number one choice for everything from headaches, colds, muscle aches and stiffness to minor orthopedic injuries like a sprained ankle or pulled muscle.

According to the American Academy of Orthopedic Surgeons, NSAIDs are also the most commonly prescribed medication for joint pain related to osteoarthritis in the hip, knee, elbow and shoulder.

Chances are that at some point in your life, you’ve benefited from taking an NSAID, which includes the familiar list found in most people’s medicine cabinets: aspirin, ibuprofen, Motrin, Advil and Aleve, all of which are available over the counter without a doctor’s prescription. Relafen, Celebrex and Naproxen are also NSAIDs, but require a doctor’s prescription.

How NSAIDs Work For Joint Pain

NSAIDs relieve pain and discomfort, lower fevers and reduce inflammation, which is why they are so effective for joint pain caused by osteoarthritis, a degenerative inflammatory disease that breaks down the cartilage cushioning the bones.

More specifically, NSAIDs block an enzyme called clocooxygenase or COX from being released by the body. There are two forms of COX: COX-1 helps maintain kidney function and protects the lining of the stomach from stomach acid, while COX-2 is produced when joints are injured or inflamed.

A Few Precautions

As with all medications, NSAIDs have potential side effects. For NSAID’s that means possible gastrointestinal stomach upsets, including ulcers and GI bleeding. To reduce this risk, it is generally recommended that you take NSAID medications with food and to not exceed the recommended dosage.

NSAIDs can also prevent blood clotting, which makes them helpful for people at risk for heart attack and heart disease. But the drugs’ anti-blood clotting properties can also make them a problem for people with heart disease who already take blood-thinning drugs. Because of these possible medical concerns, your doctor may prescribe an NSAID like Celebrex, which only blocks the action of COX-2 – it does not affect the lining of the stomach or interfere with blood clotting.

If you are unsure about whether it is safe to NSAID medications – or which ones, ask your doctor. While ultimately, patients with severe joint pain may need surgery to gain adequate pain control and restore mobility, most of the time non-surgical treatment that includes NSAID medication can be very effective, at least in the initial stages of osteoarthritis.

For more information about joint pain, go to www.kaganortho.com/learn-more.


Symptoms of Osteoarthritis of the Hip

Pain, tenderness and stiffness in your hip – what’s going on? Unlike a major trauma from a car accident or fall, the discomfort from osteoarthritis of the hip can be subtle at first. You may notice a twinge of pain or an achy feeling in your hip after tennis, a long walk or a day of yard work.

Over time, the symptoms can become more pronounced. Rather than just hurting after exercise or chores, your hip may give you trouble when you get out of bed in the morning and after you’ve been standing or sitting for long periods of time. Eventually, the discomfort may even wake you up at night, prompting you to change positions to get more comfortable. As osteoarthritis progresses, some people experience a dull ache nearly all the time, causing them to walk with a limp and making it hard to climb stairs or get up from a chair.

According to the American Academy of Orthopedic Surgeons, the most common symptoms of osteoarthritis include:

  • Pain in the hip that may radiate to the lower back or down the leg
  • Tenderness and swelling in the hip area
  • Stiffness and loss of flexibility in the hip joint, making it hard to move and remain active
  • Crackling, creaking or a grating sensation in the joint
  • Bone spurs may form around the edges of the joint

If you have been living with symptoms of osteoarthritis for a while, it’s time to see the doctor. About 10 million Americans have osteoarthritis, making it a very common complaint. You don’t have to live with the pain or allow it to put a limit on your enjoyment of life.

For more information about osteoarthritis of the hip, go to www.kaganortho.com/learn-more.


Staying Flexible As We Age

As the American Academy of Orthopedic Surgeons (AAOS) notes, while there may be not be a fountain of youth, staying active through regular exercise that promotes stretching and flexibility can offer many anti-aging benefits. Aerobic activity that raises the heart rate is important for fitness and conditioning, but stretching is just as vital for good health.

Gentle exercise stretches the muscles, reduces tightness and tension, and increases blood flow. It promotes flexibility in the joints, which improves our range of motion and can lessen many common aches and pains. The repetitive motion of exercise also promotes the body’s natural process of lubricating joint surfaces, says the AAOS.

Here are additional reasons why stretching and staying flexible is important no matter what your age.

Regular exercise and stretching helps maintain balance, which reduces the risk of falling.

Exercise stimulates muscle growth, counteracting the tendency to lose muscle mass with age. Muscles that are toned and strong reduce stress on the joints.

Stretching improves the flexibility and elasticity of tendons and ligaments, lowering the risk of sports-related injuries.

Exercise increases bone mass, density and overall strength, which may prevent osteoporosis and decrease the potential for fractures later in life.

When stretching, the Mayo Clinic suggests following proper technique for the best results. Perform a low intensity exercise like brisk walking for five to ten minutes to warm up muscles before stretching, making sure that when you are stretching, you don’t bounce or push it until you feel pain, which can cause small muscle tears. Stretch the calves, thighs, hips, lower back, neck and shoulders – the major muscle groups. And remember to stretch both sides of the body equally.

Not all exercise is equal. The AAOS cautions again being a “weekend warrior.” Fast-paced, competitive activity on the weekends only can do more harm than good and can put you on the path for developing injuries ranging from stress fractures to torn or inflamed tendons and ligaments. It’s much better to take a short time every day for gentle stretching and moderate exercise.

Orthopedic surgeons are doctors who specialize in treating musculoskeletal injuries that affect the bones, muscles, ligaments and tendons, joints and cartilage. Dr. John Kagan has more than 20 years experience treating patients of all ages with orthopedic-related conditions. Learn more about his expertise at www.kaganortho.com.


Diagnosing Osteoarthritis

When swelling, pain and stiffness in your knee, shoulder or hip sends you to the doctor, what can you expect? The first step in diagnosing whether you have osteoarthritis is a physical exam. The doctor will look at the affected joint for signs of swelling, muscle weakness, tenderness and warmth; whether there is a grinding noise (which could show bone on bone friction caused by a loss of cartilage); and the extent of your range of motion – how easy or difficult it is for you to raise your arm, flex your knee or walk. The doctor will also ask about your medical history, including how long you have had the pain.

The next step is typically an X-ray to look at the bones and surrounding tissue to see whether there is evidence of deterioration. Additional tests, including a Magnetic Resonance Imagining (MRI) scan and arthroscopy may be ordered to help the doctor evaluate whether the osteoarthritis is in the early stage or late stage of disease.

MRI is a high-tech medical test that uses a magnetic field and radio waves, unlike X-rays and CT Scans, which use radiation. The images from the MRI scan are extremely precise and clear, making this test a good choice to evaluate degenerative changes to the bone, cartilage and surrounding tissue, such as the presence of excess fluid in the joint, the development of bone spurs, whether there is narrowing of the space in the joint and the level of deterioration of the cartilage.

Once osteoarthritis is confirmed, the doctor may suggest arthroscopy. Arthroscopy is a minimally invasive procedure in which a tiny medical scope is inserted into the joint through a small incision. The doctor can then look at the interior of the joint directly and determine the best method of treatment, which could range from minor repairs to total joint replacement.

For a list of orthopedic procedures performed to alleviate joint pain and stiffness, go to www.kaganortho.com


Frequently Asked Questions About Arthritis

What is arthritis?
Arthritis is a medical condition that causes inflammation of the joints, the areas in the body that make it possible for us to move, bend, twist and turn. Over time arthritis can lead to deterioration of the cartilage, bone and connective tissue of the joint. Cartilage is a vital component of a joint. This tough fibrous tissue covers and cushions the bones, preventing them from rubbing against each other.

What’s the difference between osteoarthritis and rheumatoid arthritis?
Osteoarthritis (OA) is sometimes called the “wear and tear” disease because it is a degeneration condition that causes the joint to break down and the cartilage to wear away. While there is no way to reverse the loss of cartilage, orthopedic surgeons can relieve pain and prevent disability with a range of surgical and nonsurgical options.

Rheumatoid arthritis (RA) is an autoimmune disease in which the body’s white blood cells mistakenly attack the lining of a joint, causing inflammation and pain. RA usually is found first in the hands, fingers and feet. A rheumatoid specialist usually treats this type of arthritis.

How common is arthritis?
Some estimates show that arthritis may affect more than 46 million adults in the U.S. It is the leading cause of disability. According to the Arthritis Foundation, evidence of arthritis has been found from as early as 8,000 B.C. and has even been identified in dinosaur bones. Osteoarthritis is more common than rheumatoid arthritis.

What causes osteoarthritis?
Osteoarthritis can result from injury to the joint related to a work or car accident, from repetitive stress on the joint caused by sports activities or certain occupations, or it can simply be a function of age. It is more common in older people than younger people.

What are the symptoms of osteoarthritis?
Typical symptoms include stiffness, swelling or tenderness in a joint, as well as limited range of motion and loss of flexibility. Some people may experience a crunching sensation or sound because the loss of cartilage causes the bones to rub together, creating pain.

 For more information about osteoarthritis and treatments to relieve pain and disability, go to www.kaganortho.com or call 239-936-6778.



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