woman performing occupational therapy exercises for arthritis

Occupational Therapy for Arthritis Management

Did you know that nearly 25% of American adults suffer from arthritis? That’s approximately 54 million Americans! Luckily, you don’t have to resign yourself to a life of constant pain. Occupational therapy is a particularly powerful tool for arthritis management. But, before we examine why, let’s take a closer look at this broad class of joint disorders.

What is Arthritis?

Arthritis refers to a group of more than 100 medical conditions that cause accelerated joint breakdown and irritation. Specifically, an arthrosis refers to the meeting point of two bones for the purpose of movement, whereas the suffix -itis indicates inflammation. Hence, arthritis is a term that refers to joint dysfunction, pain, and tenderness.

Technically, arthritis specialists divide the disorder into both inflammatory and noninflammatory subtypes based on the mechanism of the disease. Yet, all forms of arthritis can result in inflammation. Let’s examine the two most common types of arthritis to discover why:

  • Rheumatoid Arthritis (RA): RA, or inflammatory arthritis, occurs when the immune system misidentifies its own tissues as foreign pathogens and mounts a defense. In a healthy immune system, inflammation serves an important function in healing. It signals the immune system to dispatch healing agents to the site of an injury or infection. In an immune system that has gone awry, however, uncontrolled inflammation can lead to adverse consequences, such as joint deterioration. As you can see, in this case, inflammation causes the disease; it is not a byproduct of the condition itself.
  • Osteoarthritis (OA): OA, also known as noninflammatory or degenerative arthritis, occurs when our joints wear down over time as the result of overuse or mechanical injury. More specifically, our joints are lined with lubricated cartilage to minimize friction during movement. As this cartilage begins to erode away from constant use, symptoms such as inflammation, pain, and swelling can occur. By far the most common type of arthritis, OA affects 32.5 million Americans each year.

Other Common Causes of Arthritis

Aside from these two primary agents, other common causes of arthritis include:

  • Juvenile Idiopathic Arthritis (JA): A childhood form of arthritis that arises from an underlying autoimmune disorder
  • Systemic Lupus Erythematosus (SLE): An inflammatory autoimmune disease that can attack any part of the body, including your joints
  • Gout: A form of metabolic arthritis in which the body struggles to remove excess uric acid from the blood, leading to painful urate crystal formation in the joints
  • Ankylosing Spondylitis (AS): At least partially genetic in origin, an inflammatory disease leading to fusion of the spinal vertebrae, aka, bamboo spine
  • Psoriatic Arthritis (PsA): An arthritic condition that occurs in conjunction with psoriasis, a scaly red rash with peeling white patches
  • Reactive Arthritis: A type of arthritis that develops in response to an infection elsewhere in the body, often affecting the knees, ankles, eyes, and urethra
  • Septic Arthritis: Refers to joint inflammation that results from a diffuse bacterial infection in the bloodstream (i.e. sepsis) which introduces pathogens directly into the joint

A Brief Note on Fibromyalgia

You may now be wondering… But, what about fibromyalgia?

Fibromyalgia results in symptoms of widespread pain that mimic arthritis in presentation. However, fibromyalgia is caused by defects in our brain’s pain processing center. These misfirings amplify minor sensations of discomfort into more severe signals of pain. Although not technically classified as a form of arthritis, fibromyalgia is best addressed by an expert in pain management. For more information about cutting-edge treatments for fibromyalgia, contact one of our pain management specialists today!

Recognizing the Symptoms of Arthritis

With over 100 different conditions contributing to arthritis, needless to say, symptoms can vary quite extensively from patient to patient. So too can the joints affected. Osteoarthritis, for example, most commonly affects the joints of the spine, knees, hips, and fingers. Rheumatoid arthritis, on the other hand, frequently attacks the smaller joints of the wrists, hands, and feet.

Generally speaking, however, the symptoms of arthritis may include:

  • A dull, aching pain in the affected joint(s)
  • Swelling (also known as joint effusion) of the soft tissues supporting the joint
  • Joint stiffness that worsens after periods of inactivity (e.g. upon first waking up in the morning)
  • Redness at the site of joint inflammation
  • Reduced endurance or tolerance for pain-provoking activities
  • Loss of ability to participate in certain activities of daily living (e.g. climbing stairs, sitting for prolonged periods of time without experiencing pain)
  • Crepitus, the grinding or crackling sensation created by bone-on-bone contact
  • The formation of bone spurs, the bony equivalent of a callus, around the joint
  • Evidence of visible bone deformities (e.g. nodules that form around the finger joints)

In addition, certain types of arthritis, such as RA or lupus, may be accompanied by fever or fatigue. As your condition worsens, you may find yourself unable to perform many of the activities of daily living that you once took for granted. For example, an individual with severe arthritis in the hands may lose the dexterity required to button a shirt.

When it comes to relearning activities such as these, this is precisely where an occupational therapist becomes indispensable.

What is an Occupational Therapist?

Occupational therapists equip patients with adaptive strategies that enable a successful return to the activities of daily living (or ADLs). In OT speak, ADLs are alternatively referred to as occupations, because these tasks reflect how we occupy our time.

Whereas physical therapists may focus on restoring movement in a particular joint, occupational therapists endeavor to restore a patient’s quality of life. Often, this means supporting a patient to come to terms with a particular injury/disease and devising strategies to help that patient lead a fulfilling life.

Let’s consider a recent spinal cord injury as an example. When a patient sustains a spinal cord injury, many aspects of his or her life change overnight. With limited use of the arms, for example, the patient may need to relearn certain activities, such as feeding or dressing.

But, what about the things that really make life worth living? The hobbies and activities that the patient finds personally meaningful? OTs assist patients to identify these meaningful activities and then implement a series of techniques to optimize the experience. These techniques may include the use of one-on-one training, environmental modifications, adaptive equipment, social and emotional support networks, and/or patient advocacy.

Needless to say, occupational therapists are masters at adaptation. Especially when it comes to learning how to manage a disease such as arthritis.

Goals of Occupational Therapy for Arthritis Management

So, you’ve been referred to an occupational therapist for arthritis management. What comes next?

Your OT will likely perform an initial assessment to establish your baseline levels of pain, range of motion, strength, and activity tolerance. In addition, your OT will endeavor to discover the activities at which you excel (despite your arthritis) as well as the tasks which seem particularly challenging.

During this initial assessment, hold back nothing. If you struggle with essential tasks, such as bathing or achieving a good night’s sleep, let your OT know. But, don’t forget to mention the things you love doing—like gardening or surfing the web—that you’ve found limiting due to your arthritis.

Also, don’t be surprised if your OT wants to know about how your condition affects other aspects of your life, such as your social relationships or mental health. Your OT will want to address your arthritis from a holistic perspective. This means examining not only the activities that allow us to achieve independence, but also the essential support systems that allow us to truly flourish.

All of this crucial information will enable your OT to create a profile of your unique treatment goals. Although the goals of each individual will vary, you can expect to see some basic overlap in specific treatment techniques.

Specific OT Treatment Strategies for Arthritis Management

Remember: Arthritis is caused by over 100 different medical conditions that manifest in similar but different ways. And, each patient has a specific set of goals that he or she hopes to achieve in order to live a meaningful life. Therefore, an effective OT treatment plan for arthritis must be highly individualized.

Nevertheless, common OT treatment strategies for arthritis management include:

  • Introduction of heat & ice therapy to reduce pain, alleviate joint stiffness, prime muscles for future exercise, and relax muscle spasms.
  • Inflammation control methods (e.g. RICE = Rest of an affected limb via immobilization techniques like splinting, Ice application, Compression, & Elevation of the affected joint to reduce swelling).
  • Specific exercises designed to increase functional independence during the activities of daily living and leisure. These exercises may focus on building strength, enhancing flexibility and range of motion, increasing activity endurance, and improving fine and gross motor control, etc.
  • Custom-made orthotics for hands and feet
  • Introduction of assistive devices, such as easy-grip utensils, buttoning aids, handrails, grab bars, reachers, etc.
  • Ergonomic evaluation of work and home environments with appropriate modifications
  • Activity adaptations to facilitate participation in beloved leisure activities
  • Exploration of community supports for individuals with arthritis or chronic illness

Your Arthritis Relief Journey Begins NOW

Arthritis is a common outcome of aging. But, being diagnosed with arthritis doesn’t mean that you’re resigned to a life of chronic pain.

At the Injury Care Center, our pain management physicians collaborate with a team of allied professionals, including physical, occupational, and massage therapists. Working collaboratively, we ensure that every patient in our care receives a treatment plan suited to his or her specific needs. This means going the extra mile to suss out your treatment goals and empower you with the tools to achieve them. With over 30 years of experience, discover why the Injury Care Center is consistently rated the best in the biz!


man with knee injury

8 Common Types of Knee Injuries

Approximately 40% of all sports-related injuries affect the knee joint, making knee injuries the most common orthopedic complaint seen by injury care specialists. Moreover, nearly 20% of adults above the age of 60 will experience chronic knee pain.

Needless to say, your knees take a constant beating. From flexion to extension, pivoting, and compression, your knees absorb stress from multiple planes of movement. In order to be so mobile, the knee must possess a certain level of laxity.

However, just as a rubber band can lose its elasticity, so too can the ligaments and tendons that hold together the muscles and bones of your knee. When these structures become too mobile, it sets the stage for a knee injury to occur.

Let’s take a closer peek at the anatomy of the knee to learn why.

Examining Your (Not-So-) Basic Knee Anatomy

The knee joint is formed by the meeting of your femur (or thighbone) and your tibia (or shinbone). Your patella, or kneecap, covers and protects the joint, like a tiny helmet.

Classified as a hinge joint, your knee moves primarily backward and forward, retaining some limited flexibility for inward and outward rotation. Imagine, for example, the hinges on a door. The door primarily opens and closes, but if you apply enough force with your hands, you can still jiggle the door upward and downward in its frame.

All hinge joints contain cartilage, which lines the bones, and a viscous lubricant, known as synovial fluid. Synovial fluid coats the joint anatomy, allowing the structures to glide past one another during movement. Without synovial fluid, your bones would grind together like the components of an engine without oil. This would lead to the accelerated breakdown of the joint as well as chronic pain.

In addition to cartilage and bones, your knee contains ligaments and tendons that hold the joint together like a series of bungee cords. Ligaments connect bone to bone, whereas tendons connect muscle to bone. As we will see, many knee injuries involve damage to our ligaments and tendons, which easily pop or tear under excessive pressure.

Without further ado, here are the 8 most common types of knee injuries:

1. Anterior Cruciate Ligament (ACL) Tears

Under your kneecap, you have two ligaments that criss-cross, the anterior and posterior cruciate ligaments, aka your ACL & PCL. The anterior cruciate ligament is so named because it crosses in front of its posterior counterpart. Your ACL prevents your shinbone from sliding off the femur, leading to hyperextension.

However, sometimes, particularly during sports, such as basketball and soccer, that involve pivoting or landing, the ACL can tear. When this occurs, you may hear an audible pop in the joint accompanied by sudden swelling.

A doctor will assign your ACL injury a grade of 1-3, with grade 1 indicating overstretching, grade 2 signifying a partial tear, and grade 3 confirming a complete rip. For grade 1 and 2 injuries, nonsurgical interventions should be sufficient to ensure proper healing. For grade 3 injuries, however, surgery will most likely be required to repair the ligament and restore function.

Note: PCL injuries are rather rare and often occur as the result of multi-ligament injuries. In other words, typically the PCL is relatively stable unless another ligament tears first, increasing the PCL’s vulnerability.

2. Medial Collateral Ligament (MCL) Tears

Your medial collateral ligament (MCL) connects your femur to your tibia on the inside of your knee. Although the ligament is located toward the medial plane of your body, direct blows to the outside of the knee typically cause this type of injury. That’s because a high-impact collision to the outer knee knocks the entire joint sideways and inward.

When you tear your MCL, you may feel or hear a popping sensation. Subsequently, you may struggle to straighten your leg or notice pronounced instability in your knee joint.

Although there is some debate regarding whether MCL injuries are more common than ACL tears, or vice versa, MCL tears tend to be less serious. Usually, an MCL injury can be managed with non-operative solutions, such as physical therapy or bracing.

3. Lateral Collateral Ligament (MCL) Tears

Your lateral collateral ligament (LCL) connects your thighbone to your fibula, the narrow bone that runs parallel to your tibia. Unlike the MCL, your LCL is located on the outside of your knee.

Normally, an LCL tear occurs when a patient sustains a blow to the inside of the knee. This could occur when absorbing a tackle during football, jumping and landing improperly, or over-torquing the knee.

As with any knee ligament injury, you may experience localized pain and swelling at the site of the injury as well as an inability to straighten out the knee.

Complete LCL tears require surgery to repair; however, partial sprains often respond to conservative interventions. These may include rest, heat/ice application, supportive knee devices, or physical therapy, etc.

4. Torn Meniscus

Your menisci are two C-shaped (or semi-lunar) strips of cartilage that pad the knee joint, where the knobs of your femur meet the grooves of your tibia. Specifically, the menisci function to absorb shock during joint movement (aka, articulation).

Believe it or not, your knee absorbs up to 4x your body weight every time you take a step. Needless to say, the menisci—two primary players at the center of all the action—undergo quite a bit of wear and tear. Especially if the patient participates in sports like tennis that involve a lot of pivoting.

If you injure your meniscus, you may experience pain, localized swelling, decreased range of motion, and joint instability. In addition, a portion of the crescent-shaped cartilage may tear away, creating what is known as a bucket-handle tear. In other words, instead of resembling a C-shape, your meniscus will assume a D-shape. Sometimes, this flap of cartilage even blocks the knee joint, disrupting the knee’s normal range of motion.

Depending on its severity, meniscal tears are treated with rest, NSAIDs, conservative therapies (such as physical therapy), and occasionally, arthroscopic surgery.

5. Patellar Tendinitis

Your patellar tendon connects the bottom of your kneecap (aka, your patella) to your tibia. Despite its name, your patellar tendon is actually a ligament because it attaches two bones together instead of a muscle and a bone. The patella itself connects to your quadriceps muscles to enable the extension of your knee. Since the key function of the patellar tendon is to straighten out the leg with the aid of your quads, this may explain the misnomer.

At any rate, patellar tendinitis occurs when tiny tears appear in your patellar tendon. This can happen as the result of injury, particularly from jumping and landing improperly. (In fact, some doctors alternatively refer to patellar tendinitis as jumper’s knee.) However, certain chronic diseases (e.g. lupus, diabetes, etc.) can disrupt healthy blood flow to our tendons, leading to inherent tendon weakness.

Symptoms of patellar tendinitis include pain and swelling around the bottom of the kneecap, knee buckling, or displacement of the kneecap. The primary nonsurgical treatment method for addressing patellar tendinitis is physical therapy, but your injury may require surgical tendon repair, especially if the kneecap becomes unmoored.

6. Knee Fractures

Speaking of the patella, a knee fracture occurs when this tiny, misshapen sphere of bone sustains a break. A knee fracture can range in severity from minuscule cracks to complete breaks in the patella that lead to the displacement of the kneecap. Often, these injuries result from slip and fall accidents onto the knee or dashboard-to-knee blows during a car accident.

As with other broken bones, you may experience swelling and bruising around the kneecap. With more unstable fractures, you may even temporarily lose your ability to walk. Generally, the healing process will involve wearing a supportive cast and limiting the amount of weight you apply to the leg. However, fractures involving kneecap displacement often require surgery to reattach the kneecap to the appropriate tendons, etc.

7. Knee Dislocations

We’ve already discussed kneecap (or patella) dislocations several times thus far. However, knee dislocations involve displacement of the femur where it meets the tibia. These injuries, while exceedingly rare, tend to be incredibly dangerous. In fact, a knee dislocation can even lead to loss of the limb.

Most often, knee dislocations occur as the result of extreme hyperextension. This can happen in the context of a high-velocity accident (such as a fall from a considerable height) or a low-velocity collision (e.g. an athletic injury).

Needless to say, this injury doesn’t manifest in subtle ways. The knee joint appears grotesquely deformed following the accident and immediate swelling and bruising will develop, causing severe pain. In addition, some knee dislocations result in serious collateral damage, such as nerve compression, arterial tearing, or blood clot formation.

Almost universally, your doctor will opt for surgery. A number of techniques may be used depending on the anatomical structures involved. For example, you may not only require open surgery to realign and secure the bones but also, arterial and cartilage repair.

8. Knee Bursitis

The human body contains approximately 140 bursae, tiny fluid-filled sacs that resemble water balloons. These flexible sacs serve as cushions between high-friction areas of bony anatomy and connective tissue within our moveable joints.

In the knee, for example, the prepatellar bursa serves as a cushion between your kneecap—at the most highly bendable part of the knee joint—and your skin. However, all told, there are 30 different bursae in your knee that can become inflamed.

An inflamed bursa often produces a visible lump where swelling occurs. In addition to pain, the knee may feel stiff or difficult to bend. If the bursitis is being caused by infection, the knee may feel warm to the touch and the patient may spike a fever. In particular, a fever from bursitis could signify sepsis and should be regarded as a medical emergency.

If you’ve been diagnosed with bursitis, you may be able to manage your condition with at-home methods such as rest or anti-inflammatory medications. Your doctor may treat moderate cases of bursitis with cortisone injections or bursal aspiration (i.e. fluid removal via needle drainage). More serious cases of bursitis may require antibiotic therapy or surgical removal of the bursa altogether.

Reclaim Your Life from Chronic Knee Pain

Like back pain, knee injuries are difficult to ignore. Luckily, you don’t have to.

At the Injury Care Center, our multidisciplinary team of experts consists of award-winning pain management specialists, physical and occupational therapists, chiropractors, and licensed massage practitioners. We employ a multi-modal approach to ensure that you receive the finest standard in injury care. After all, you deserve the same access to cutting-edge equipment afforded to elite athletes.

With over 30 years of experience, we invite you to find out why our pain management experts are consistently rated the best doctors in Pennsylvania (and the United States)!


man receiving massage from massage therapy

Conquering Lower Back Pain with Massage Therapy

Suffering from stubborn lower back pain that isn’t responding to medication? Massage therapy might be the answer.

Massage therapy involves gentle or firm palpation (i.e. touch) of the body’s soft tissues for medical purposes. Using various techniques and levels of pressure, your massage therapist will manipulate sore muscles, fascial adhesions, inflamed tendons/ligaments, and more.

The overarching goal of massage therapy is pain reduction. However, patients may be surprised to learn that massage therapy also boasts the following benefits:

  • Enhances flexibility and range of motion in stiff joints
  • Improves blood flow to an injured area, stimulating the healing process
  • Encourages and supports a robust immune system response
  • Relieves anxiety, depression, stress, and insomnia
  • Boosts endorphins, our body’s natural reserve of painkillers
  • Offers a safe alternative to potentially habit-forming medications
  • Releases muscle tension, spasms, and fascial adhesions, common culprits of lower back pain
  • Stimulates the lymphatic system to assist in toxin removal
  • Instills a sense of overall wellness and contentment

The verdict is in: Not only does massage therapy work, it works well.

According to the American Massage Therapy Association, 88% of participants reported experiencing significant pain reduction after undergoing a course of massage therapy. And, 70% agree: Massage therapy should be regarded as a legitimate form of interventional medicine.

Relaxing Soft Tissues with Massage Therapy

Every day, roughly 31 million Americans suffer from lower back pain, making it the leading cause of disability in the United States.

Needless to say, lower back pain can result from a host of different causes. However, certain lower back conditions respond exceedingly well to massage therapy. These include:

  • Muscle/Tendon Strains & Ligament Sprains: When a muscle or tendon (the connective tissue that attaches a muscle to bone) suffers a tear, doctors refer to this as a strain. In contrast, when a ligament (the soft tissue that connects two muscles) rips, physicians call this a sprain. Massage therapy, which specifically targets soft tissues, stimulates blood flow to the area, accelerating healing.
  • Myofascial Pain Syndrome (MPS): MPS is a chronic pain condition characterized by frequent discomfort in localized areas of muscle, known as trigger points. Indeed, the prefix myo- means muscle. Fascia refers to the connective tissue bands that enwrap and bind your muscles together. When these bands stick together—in fascial adhesions—the underlying muscles can become compressed, generating pain. Specific massage therapy techniques target these adhesions, releasing the muscles from this vice-like grip.
  • Pinched Nerves & Sciatica: A pinched nerve develops when adjacent bony anatomy or soft tissues (e.g. muscles, cartilage, etc.) impinge upon a spinal nerve, resulting in pain. Specifically, your sciatic nerve is the largest and longest nerve in your body, extending from your lumbar spine (or lower back) to your toes. When your sciatic nerve becomes pinched, you may experience searing pain that radiates from your buttocks, down either side of your leg(s), and into your feet. Because irritated tissues (such as the piriformis muscle in your buttocks) often contribute to sciatica, massage is an ideal modality for releasing these locked-up tissues.

 

Massage Uses Beyond the Lower Back

However, massage isn’t simply indicated for lower back pain. In reality, a variety of medical conditions respond positively to massage therapy. Consider embarking on a course of massage therapy if you suffer from any of the following conditions:

  • Migraine headaches
  • Sports or repetitive stress injuries
  • Fibromyalgia (or diffuse musculoskeletal pain and chronic fatigue)
  • Bulging, herniated, or collapsed discs
  • Osteoarthritis
  • Muscle spasticity and contractures
  • Rotator cuff injuries or frozen shoulder
  • Whiplash Associated Disorders (WAD)
  • Jaw pain from temporomandibular joint (TMJ) dysfunction
  • Neurodegenerative disorders, such as Parkinson’s
  • Anxiety, depression, or insomnia

...among many other uses.

Which Type of Massage Therapy is Best for Me?

Needless to say, your massage therapist has many different tools in his or her arsenal of therapeutic interventions from which to choose. The best technique for you will depend on your specific injury, goals, and comfort. However, some of the most effective massage techniques for pain management include:

Trigger Point Therapy

During trigger point therapy, your massage therapist applies firm pressure to knots that have developed inside tender muscles. Using fingertips, knuckles, or sometimes, even elbows, your therapist will apply localized pressure to the trigger point for approximately 30 seconds. Doing so, forces the knots to release, relaxing muscle spasms and thus resolving pain.

Myofascial Release

Like trigger point therapy, myofascial release involves manipulating trigger points. However, unlike trigger point therapy, myofascial release involves applying gentler pressure over larger swatches of the body for 5-7 minutes at a time. Instead of pressing firmly on specific knots, your massage therapist will stretch the fascia, releasing any adhesions that may have developed.

Craniosacral Massage

Craniosacral massage concentrates on relieving tension that builds up around the skull (i.e. cranium), spine, and sacrum (i.e. pelvis). Focusing on these specific areas is thought to restore cerebrospinal fluid (CSF) to adequate flow levels, improving immune system function. Suffering from migraine headaches or sacral pain? Then, this may be the intervention for you.

Sports Massage

Sports massages emphasize the specific muscles that are used to perform a particular task, for example, running and jumping in basketball. They can also be used as a form of rehabilitation, following a repetitive stress injury. Whether you use sports massage to enhance performance, prevent injury, or reduce pain, the session is geared toward functional improvement.

Deep Tissue Massage

During a deep tissue massage, your massage therapist applies firm pressure via long strokes to resolve tension in your body’s deep connective tissues. Although similar to myofascial release, this technique involves applying even harder pressure. Your massage therapist will special pay attention to any tender spots—not those simply involving fascial adhesions.

Swedish massage

Swedish massage is widely regarded as the gentlest of the massage techniques. And, for good reason. The overarching goal of Swedish massage is stress reduction, not necessarily pain management. But, luckily, the two go hand-in-hand. Your body repairs itself much faster when its flight-or-fight systems aren’t running on overdrive. As an added perk, you’ll also sleep better too.

Lymphatic Drainage Massage

As previously mentioned, your lymphatic system assists in toxin removal. But, sometimes, it requires a little kickstart to get it operating adequately. A lymphatic drainage massage purports to do exactly that. During this technique, your massage therapist will concentrate on specific areas of the body where lymph fluid tends to accumulate. Encouraging the body to drain that blocked fluid removes large accumulations of toxins from the body.

Qualifications to Become a Massage Therapist

Becoming a massage therapist requires undergoing a rigorous course of study from a state-accredited massage therapy institution. In addition to mastering the intricacies of musculoskeletal anatomy and physiology, a massage therapist must take additional coursework in body mechanics, bodywork, ethics, and more.

After completing the didactic portion of the program, prospective massage therapists must obtain a certain number of clinical hours performing hands-on work. The required number of hours varies according to state licensing requirements. After a student has logged the requisite hours, the student must then pass a state licensing examination.

If the massage therapist wishes to perform more specialized techniques, additional certificate work may be required per state guidelines. Thereafter, evidence of continuing education must be submitted to maintain licensure.

When looking for a massage therapist, be sure to check out their certifications. Every massage therapist specializes in a variety of different techniques. You likely won’t find the same exact mix of services offered from practice to practice.

Interested in Pursuing Therapeutic Massage for Pain Relief?

If you’ve been suffering from lower back pain, massage therapy just might be the answer. With dozens of techniques from which to choose, it’s not a matter of how simply when. When are you going to take your pain relief journey to the next level?

At the Injury Care Center, our massage therapists collaborate with a team of pain management physicians, physical and occupational therapists, and chiropractors. As with most things in life, we believe that the best approach to pain relief is the multidisciplinary one. At ICC, we give you the best of all worlds, relying on our unique strengthens to devise customized treatment plans that truly deliver BIG results.

For superior outcomes in pain management, contact one of our patient advocates today!


happy running couple after epidural steroid injection

Your Guide to Epidural Steroid Injections (ESIs)

An epidural steroid injection (ESI) involves administering a powerful anti-inflammatory agent, known as a corticosteroid, into the epidural space. Specifically, a corticosteroid is a manufactured medication that mimics the function of cortisol.

You may be asking… But, isn’t cortisol (aka, the “stress” hormone) something that we’re supposed to avoid?

In this instance, the answer is not exactly. 

Corticosteroids reduce inflammation by dampening your body’s immune system response. Although a well-functioning immune system is essential for healing, your body can actually over-respond to a perceived threat or insult, such as an injury. When this occurs, the inflammation that results can, unfortunately, cause more harm than good.

Remember, that mild inflammation serves a purpose. Think of it as evidence that your body is working overtime to heal itself. But, chronic inflammation signals a problem. It can result in tissue damage that counteracts the body’s attempts to heal itself.

When used appropriately, epidural steroid injections give the body a much-needed break from pain and accelerate healing. But, timing is key. Given this, you want to enlist the guidance of a pain management expert who truly knows this intervention inside and out. For best results, contact our orthopedic experts at the Injury Care Center and embark on your relief journey today!

Ideal Candidates for Epidural Steroid Injections (ESIs)

An Epidural Steroid Injection (ESI) works best for patients who suffer from chronic nerve pain. A variety of orthopedic conditions can lead to nerve compression. Some of the top culprits include:

  • Degenerative Disc Disease: Disc degeneration occurs when the spongy discs that sit between your vertebrae begin to break down from aging or overuse. When these discs collapse, bone-on-bone contact can occur, pinching the nerves that radiate between these adjacent vertebrae.
  • Herniated Discs: A herniated disc occurs when an intervertebral disc ruptures, releasing its internal contents into the disc space. This gel-like material reduces the real estate typically allotted for nerves, leading to neurological symptoms of discomfort.
  • Sciatica: Your sciatic nerve, i.e. the longest nerve in your body, extends from your lower back down to your toes. When this nerve becomes pinched, the sufferer experiences searing pain from their buttocks, down the backside of either leg, and into his/her feet and toes.
  • Spinal Stenosis: Stenosis is a widely used medical term that means narrowing. Spinal stenosis, therefore, occurs when key passageways that permit the exit of nerves from the spinal cord become constricted. With less room for the nerves to exit, they can suffer dysfunction, generating symptoms of pain and incapacity.
  • Spondylolisthesis: Also referred to as a slipped vertebra, spondylolisthesis occurs when a vertebra slides forward over the vertebra beneath it. As the spine shifts out of alignment, the vertebrae can impinge upon adjacent nerves.
  • Arthritis: Arthritis refers to inflammation of the arthroses (or movable joints). It results in a number of adverse effects, including the thickening of ligaments and the growth of bone spurs. In particular, bone spurs are tiny protrusions that develop in response to overuse and can compress nerves.

 

How is an Epidural Steroid Injection (ESI) Performed?

An epidural steroid injection involves delivering a corticosteroid medication directly to the source of a patient’s pain. In this instance, that means injecting the medication into the epidural space, a fat-filled region that cushions the spinal cord and its nerve roots.

Typically, your doctor will perform this minimally invasive intervention in an outpatient facility. Before administering the ESI, your doctor will use a local anesthetic to desensitize the area. If you are feeling anxious about the procedure, inform your doctor. Some physicians may prescribe a mild sedative, such as Valium, to counteract your nerves.

During the procedure, you will be awake to communicate with your doctor. Next, using x-ray fluoroscopy to visualize the bones, your doctor will achieve proper needle placement to deliver the medication.

There are multiple ways in which your doctor can approach your spine. Depending on your condition, the following approaches may be employed:

  • Transforaminal: Foramina are passageways through which the spinal nerves radiate outward to the body. A transforaminal approach, therefore, involves passing the needle through the foramen to deliver medication directly to the nerve roots.
  • Interlaminar: The lamina is the bony sheath that covers the backside of your spinal cord. An interlaminar approach delivers medication near the posterior spine, which may be more appropriate for conditions that involve diffuse inflammation, such as arthritis.
  • Caudal: Caudal means tailbone and, in this instance, refers to the lowest point on the epidural space. This approach is most appropriate for conditions that affect the lumbar spine and sacrum, such as sciatica.

Before administering the medication, your doctor will inject a contrast dye into the target region. Doing so ensures that the medication will reach the correct tissues. Then, the steroid itself is deposited into the epidural space. In total, the procedure should only last for roughly 15-45 minutes.

Recovering From an Epidural Steroid Injection (ESI)

Following a brief period of observation, you should be able to return home. Because some patients experience mild side effects from ESIs, you will likely be required to appoint a driver. Common side effects following the injection may include:

  • Nausea
  • Dizziness
  • Facial flushing
  • Water retention
  • Anxiety
  • Headache

 
Within 24 hours, however, the side effects should subside, allowing you to return to your daily routine. If you experience any of the following serious side effects in the days following your procedure, contact your doctor immediately:

  • Difficulty breathing or swelling of the throat/tongue (indicating a possible allergic reaction)
  • A high-grade fever (signaling the possibility of infection)
  • Migraine headaches that worsen when upright
  • Sudden weakness in the lower extremities or incontinence
  • Low blood pressure or a heart rate less than 60 beats per minute (bpm)

 
However, the likelihood of experiencing serious complications with an ESI is exceedingly rare. In general, you can expect to enjoy pain relief that lasts for up to an entire year.

Advantages of Choosing Epidural Steroid Injections

Epidural steroid injections boast numerous benefits when administered to a well-vetted candidate. Like many other minimally invasive procedures, you can expect to enjoy the following benefits unless complications arise:

  • Outpatient or same-day treatment
  • No incisions, scarring, or bleeding
  • Less postoperative pain
  • Fewer complications
  • Speedier recovery times
  • Enhanced accuracy (thanks to the use of fluoroscopic guidance and contrast dye injection)

 
Unique to this particular procedure, you may also notice the following perks:

  • Nearly instantaneous pain relief that lasts up to a year in duration
  • Less need to rely on potentially habit-forming medications like opioids
  • Increased tolerance for therapeutic interventions, like physical or occupational therapy
  • May obviate the immediate need for surgical intervention, particularly if the body can heal more effectively during this time of reduced pain

 

Several Important Caveats About Epidural Steroid Injections…

Epidural steroid injections aren’t for everyone. Truth be told, certain patients should avoid this type of intervention altogether. Contraindications to ESIs include the following conditions/situations:

  • History of a previous allergic reaction to a corticosteroid or contrast dye
  • Known bacterial infection near the site of injection or diffusely spread throughout the body
  • Pregnant women (unless fluoroscopy is omitted)
  • Patients with diabetes mellitus, bleeding disorders, or certain heart problems

 
As always, provide a detailed account of your medical history to your doctor before taking any new medication or undergoing a procedure.

And, remember: ESIs work best when combined with a multimodal approach to treatment that involves other conservative interventions, such as chiropractic care. In fact, the primary purpose of an ESI is to enable a patient to participate in additional treatments, such as physical therapy, that would otherwise be too painful. It is these other interventions in conjunction with the ESIs that really accelerate healing in patients with inflammatory conditions.

Your Healing Journey Begins NOW

Ready to discover if you’d make a suitable candidate for epidural steroid injections? Contact one of our dedicated patient advocates at the Injury Care Center of Philadelphia today.

Our pain management specialists are skilled in tried-and-true pain interventions, such as ESIs, facet blocks, trigger point injections, and more. In addition, our pain management physicians collaborate with industry-leading experts in physical and occupational therapy, interventional massage, and chiropractic manipulation to optimize your outcomes. Using a combination of medication management and nonsurgical treatments, we will design a multi-modal treatment plan that resolves your pain and restores your quality of life.

With ESIs, timing is key. Don’t miss your window - Contact our injury care experts today!


man with neck pain from whiplash injury

Whiplash Injury Symptoms & Treatments

A whiplash injury occurs when a sudden jolt snaps the head back and forth on the delicate axis of your neck. Imagine, arcing a whip—in this analogy, the ligaments and muscles of your neck—backward and then explosively cracking it forward.

The same high-intensity movement associated with lashing a whip occurs during a collision to the soft tissues that support your neck. Even if the collision occurs at a low velocity. 

That’s right: Even a rear-end car collision at 5-10 mph can strain the fibrous ligaments, spongy discs, dense nerves, and muscles of your neck.

And, unlike other traumatic injuries, whiplash injuries can be particularly nasty in that the full effects may not manifest themselves until days, weeks, or even months after your accident.

Think you might have a whiplash injury? Continue reading to discover how these injuries occur and warning signs that it’s time to see a doctor.
 

What Causes a Whiplash Injury?

When we think of whiplash injuries, we most often associate the precipitating event with auto accidents. However, whiplash injuries can result from any abrupt force that causes the head to snap backward and then forward. Common causes of whiplash injuries include:

  • Motor vehicle accidents: By far the most common cause of whiplash injuries, any rear-end collision can result in neck trauma. Whether the vehicle involved in the collision is a car, truck, boat, or ATV, etc., is less important than the actual injury itself.
  • High-impact sports: Whiplash injuries occur commonly during high-impact sports, such as football, basketball, soccer, wrestling, gymnastics, and martial arts or boxing. On rarer occasions, whiplash injuries can also occur during lower impact activities, such as diving, cycling, or horseback riding.
  • Slips & Falls: During a slip and fall accident, the back of the head may rebound off of the floor, resulting in a whiplash injury.
  • Physical Abuse: Likewise, a violent blow to the head/body or being shaken by the shoulders can strain the muscles and ligaments of the neck.

Essentially, any accident involving a rapid acceleration-deceleration event can result in a whiplash injury. But, what exactly does this entail for the sufferer? Keep reading to find out.
 

What Types of Neck Injuries are Associated with Whiplash?

Whiplash refers more to the mechanism that causes the injury rather than the injury itself. In reality, a variety of injuries can result from whiplash. These may include:

  • Ligament Sprains & Muscles Strains: When a ligament tears, it is referred to as a sprain, whereas a torn muscle is called a strain. With whiplash injuries, the muscles and ligaments of the neck become hyperextended and then hyper-flexed during an extremely brief period. A matter of mere seconds. This can lead to overstretching of the soft tissues that support the neck and instantaneous injury.
  • Cervical Herniated Discs: Between each vertebra of your spine lies a spongy intervertebral disc that serves to absorb impact. When the impact in question is too much, the fibrous exterior of the disc can tear, releasing its gel-like internal contents into the intervertebral space. This often results in pain and as we can see in the next bullet point, pinched nerves.
  • Pinched Nerves: The material from inside a cervical herniated disc can pinch nerves in its vicinity, resulting in symptoms of neurological pain. Additionally, swollen tissues in the area can also impinge upon adjacent nerves, generating discomfort.
  • Fractures & Dislocations: During a hyperextension-hyperflexion event, the cervical spine (i.e. neck) may suffer a fracture or dislocation. A fracture involves the breaking or splintering of a bone, whereas a dislocation involves the snapping of a ligament that holds two bones together. When a dislocation occurs in the neck, it creates significant joint instability and the probability of further injury.

 

Whiplash Injury Grading System

Whiplash injuries can vary quite a bit in severity. As such, doctors have developed the following grading system that takes the above injuries into consideration:

    1. Grade 0: No symptoms.
    2. Grade 1: Neck soreness/discomfort.
    3. Grade 2: Neck pain AND evidence of mild to moderate musculoskeletal damage (i.e. ligament sprains & strains, herniated discs, etc.).
    4. Grade 3: Neck pain AND neurological evidence of disruption. This includes evidence of pinched nerves and significant loss of range of motion or muscular weakness in the extremities.
    5. Grade 4:Severe neck pain AND spinal fractures/dislocations.

 

Common Symptoms of Whiplash Injuries

Whiplash injuries, as you may now suspect, can lead to a host of painful symptoms. In fact, doctors refer to this diverse body of symptoms as whiplash-associated disorders (WAD). You may notice symptoms of WAD immediately after your injury or even days, weeks, or months later.

Consider, for example, that a herniated disc often causes pain only if it impinges upon adjacent nerves. You may not notice pain in the first couple of weeks after your injury. But, all it takes is something to shift slightly out of place for a nerve to become pinched.

Common symptoms of Whiplash-Associated Disorders may include:

  • Neck pain, particularly at the base of your neck, and/or shoulder and arm discomfort
  • Neck stiffness or tenderness when attempting to move the head
  • Muscle spasms in the neck, upper back, or shoulders
  • Headaches, including migraines, or dizziness
  • Arm or hand weakness, numbness, or burning
  • Excessive fatigue or memory and concentration issues
  • Vision difficulties and/or tinnitus

It’s no secret: Whiplash injuries can completely disrupt your life. But, you don’t have to white-knuckle your way through the pain. Our whiplash injury experts at the Injury Care Center will explain our whiplash injury diagnostic process as well as our multi-modal approach to eliminating your pain in the next sections.
 

Diagnosing Your Whiplash Injury

Not only will your doctor what to know about the events directly preceding your injury, but he or she will also want to assess the severity of your physical impairment. Initially, this will involve a simple examination. Your doctor will measure the degree of motion in your neck, arms, and shoulders and ask you to rate your pain. If evidence of neurological involvement exists, your doctor will assess function in your arms, including hand strength, reflexes, and sensation.

If warranted, your doctor will order several imaging tests to pinpoint the exact injuries associated with your whiplash. These tests may include:

  • X-rays: An x-ray of your cervical spine can reveal any fractures or dislocations that may have occurred during your accident.
  • CT scan: A CT scan uses multiple x-ray images to generate cross-sectional images of your bones and muscles, which can reveal muscle damage if present.
  • MRI (Magnetic Resonance Imaging): An MRI uses magnetic fields and radio waves to generate a visual representation of your spine that includes soft tissues. A powerful tool, an MRI allows your doctor to take a closer look at your muscles, discs, nerves, spinal cord, and more.

After your doctor confirms your diagnosis of WAD, he or she will develop a multidisciplinary treatment plan that best suits your individual injuries. As you will learn in the following sections, the treatments prescribed will vary according to the severity of your injuries.
 

Treating Low-Grade Whiplash Injuries

Non-serious or mild whiplash injuries may improve with at-home interventions. If you have sustained a mild whiplash injury, your doctor may recommend:

  • Rest: An initial period of rest allows your body to heal safely without the potential for reinjury. Just make sure not to rest for too long - Too much inactivity can actually worsen your pain in the long run.
  • Ice & Heat Therapy: Applying ice to an injury serves to alleviate inflammation, whereas heat application increases blood flow to an area. Blood carries important immune system agents that function to accelerate the healing process.
  • OTC Medications: Over-the-counter medications, like Tylenol or Ibuprophen, can temporarily eliminate any discomfort you may be experiencing.
  • Exercises: To reduce stiffness and increase range of motion, your doctor may recommend certain exercises, including neck rotation and shoulder rolls. Never embark on an exercise program without first consulting your physician. Certain exercises may actually worsen your pain.

 

Treating Moderate-Grade Whiplash Injuries

If at-home methods just aren’t cutting it, you don’t have to simply grit your teeth and bare it. Interventions, such as medications and targeted therapies, exist that can help you control more severe pain. Common pain management techniques of whiplash-associated pain include:

  • Prescription-Strength Pain Medications: Certain medications, like SSRIs and opioids, can disrupt pain signals to the brain, resulting in relief. Bear in mind that many of these medications are considered habit-forming. As such, they should only be administered exactly as prescribed by your physician.
  • Muscle Relaxants: These medications dampen the activity of skeletal muscles, which reduces stiffness and spasms. Like opioids, these medications are only intended for short-term use.
  • Epidural Steroid Injections (ESI): During an ESI, your doctor injects a powerful anti-inflammatory agent, known as a steroid, into your epidural space. (The epidural space is the area that lies between your spinal cord and the vertebral canal.) Doing so delivers medication directly to the site of the injured nerve root. However, effects are temporary and multiple shots are required.
  • Facet Joint Injections: A facet joint connects the posterior side of two vertebrae. During a facet block, your doctor injects a pain medication, such as a steroid, directly into the facet joint to alleviate pain.
  • Trigger Point Injections: Typically reserved for more severe cases of whiplash, a trigger point injection involves administering an anesthetic directly into the affected muscle. The anesthetic not only numbs the muscle but also interrupts pain signals traveling from the muscle to the brain.

 

Therapies for Moderate-Grade Whiplash Injuries

But, medications aren’t the only techniques that prove effective for treating whiplash injuries. Additionally, a number of therapeutic interventions are shown to alleviate whiplash pain. Of these, some of the most common techniques include:

  • Physical Therapy: We’ve already mentioned that your physician may request that you perform certain exercises to minimize your pain and maximize your recovery. But, when simple at-home techniques don’t work, physicians call in the big guns: physical therapists. Physical therapists are doctors who specifically work with injured patients to improve their mobility, flexibility, and strength while reducing pain. Instead of a few generic exercises, a physical therapist will devise a program that specifically targets your unique injuries.
  • Chiropractic Care: A chiropractor uses a variety of techniques, including spinal adjustments, instrument-assisted manipulations, and TENS, to realign and relax the spine. Additionally, your chiropractor may recommend ergonomic interventions to alleviate your pain.
  • Occupational Therapy: Severe whiplash injuries that involve fractures and dislocations and may require relearning some of the activities of daily living. This is exactly where consulting an OT becomes handy. OTs specialize in restoring a patient’s ability to execute everyday tasks, such as dressing or performing transfers.
  • Massage Therapy: Sore muscles often respond well to massage techniques such as myofascial release, cranial-sacral work, and trigger point massage. In particular, patients who pursue massage therapy as an early intervention for chronic whiplash pain report better outcomes than those who do not.

Rarely, whiplash injuries may occur with other problems that necessitate surgery. For example, if you sustain a cervical herniated disc that doesn't respond to conservative interventions, then your doctor may recommend surgery. Likewise, fractures and dislocations may require minimally invasive surgical techniques to restabilize the spine. Your doctor will let you know if you are a candidate for surgery.
 

Conquering Whiplash Pain

If you’ve been suffering from chronic neck pain as the result of a whiplash injury, your relief journey begins today. At the Injury Care Center (ICC), our multidisciplinary team consists of pain management specialists, physical, occupational, and massage therapists, and chiropractors.

Research shows that a multimodal approach to pain management is the best approach when it comes to addressing whiplash. At ICC, we will work collaboratively to accurately diagnose the source of your pain and develop a cross-specialty plan of intervention to eliminate your whiplash pain. Don’t white knuckle your way to recovery - Contact one of our dedicated patient advocates today!


spinal stenosis with pinched nerve

Pain Management Techniques for Spinal Stenosis

Spinal stenosis occurs when the passageways that house our spinal cord and nerves become constricted. Whether this occurs due to a herniated disc, bone spur, or another anomaly, the outcome is essentially the same. The nerves that feed our limbs become compressed, leading to the classic symptoms that we associate with nerve irritation.

What Causes Spinal Stenosis?

Typically, unless you sustain an acute injury, spinal stenosis doesn’t usually occur overnight. Instead, it’s caused by the gradual deterioration of the spine, particularly in patients older than 45. For example, common age-related causes of spinal stenosis include:

  • Osteoarthritis with Bone Spurs: Osteoarthritis occurs when the protective cartilage that lines our spine begins to erode from excess friction. Without this smooth, rubbery barrier, our vertebrae knock into one another instead of gliding smoothly. Needless to say, your body doesn’t like this. In an effort to compensate for this lost cartilage, your body produces bone spurs—tiny outcroppings of bone that protrude into all the wrong places. These bone spurs often develop in the foramina, a series of holes that allow your nerves to exit from your spine. The end result: nerve impingement and chronic pain.
  • Thickened Ligamentum Flavum: The ligamentum flavum, located on the posterior of the spine, allows you to stand upright. As such, this tiny structure bears a tremendous load. Over time, this structure can harden, bulging into the spinal column and pinching adjacent nerves.
  • Herniated Discs & Degenerative Disc Disease: Disc degeneration is another unsavory aspect of aging. Your intervertebral discs, a fibrocartilagenous material, serve to cushion your spine from jolts and bumps. As we age, however, these discs tend to lose their flexibility and dry out (or desiccate). Ultimately, this means a higher probability of sustaining a rupture, aka a disc herniation. When an intervertebral disc ruptures, it releases its internal contents into the joint space, causing obstructions that lead to pinched nerves.

 

Non-Age-Related Causes of Spinal Stenosis

Spinal stenosis can also occur as the result of several conditions that don’t directly involve wear-and-tear of the spine. These may include:

  • Spinal Injuries: Any abrupt trauma—whether a slip and fall, motorcycle accident, or sports injury—can lead to spine damage that creates occlusions in the spinal passageways.
  • Cancerous Growths: Spinal tumors can be extradural (located outside the sheath surrounding the spinal cord) or intradural-extramedullary (located inside the aforementioned barrier). Regardless of placement, tumors take up prime real estate in the spine, often leading to nerve compression.
  • Spinal Deformities: Abnormalities in the orientation of the spine (such as scoliosis or kyphosis) create unhealthy bends and twists in the spine. As the spine folds backward on itself, the nerves can suffer bending and dysfunction.

 

Do I Have the Symptoms of Spinal Stenosis?

Spinal stenosis has certain tell-tale symptoms, depending on the location of the nerve impingement. Common symptoms of spinal stenosis include:

  • Nerve Pain: Also known as radiculopathy, nerve pain often presents itself as an icy-hot or burning sensation in the limbs. In addition to this pins-and-needles sensation, you may also experience numbness or muscular weakness in the extremities.
  • SciaticaLumbar spinal stenosis (i.e. affecting the lower back) may or may not involve sciatica, aka pinching of the sciatic nerve. Your sciatic nerve, the largest nerve in the body, runs from your lower back all the way down to your feet. When this nerve becomes compressed, you may feel an electric jolt of searing pain from your hip to your feet.
  • Cervical Radiculopathy: Cervical radiculopathy affects the neck, where spinal nerves supply sensation to the fingers and arms. Aside from a burning or tingling sensation in the arms, this can disrupt hand strength, leading to interruptions in simple tasks like gripping a coffee mug.
  • Loss of Fine & Gross Motor Control: Your nerves relay signals from your brain (the site of intention and awareness) to your limbs (where we execute most of our movements). However, a pinched nerve cannot transmit these messages properly, leading to disruptions in motor control. Both fine (small muscle groups that control tasks such as buttoning a shirt) and gross (large muscle groups that coordinate activities such as walking) motor control may suffer as a result. This may even affect your balance.

In severe cases of spinal stenosis, you may even lose bowel or bladder control. This phenomenon, known as cauda equina syndrome, is considered a medical emergency. Without prompt treatment, you could suffer dire consequences like permanent leg paralysis. If you notice numbness in your saddle region—the area of your body that would touch a saddle during horseback riding—seek immediate medical attention.

Diagnosing Spinal Stenosis

So, you’re pretty confident that you have spinal stenosis. What comes next?

Your medical provider will perform a detailed analysis of your medical history and symptoms, including a visual inspection of the injured area with light palpation (or touch). Because spinal stenosis affects both balance and motor control, your doctor may ask you to perform certain simple tasks. These may include watching how you walk for any gait disruptions or an assessment of handgrip strength.

If your doctor feels confident that you might have spinal stenosis also, he or she will order a series of follow-up tests. These visualization techniques may include:

  • Magnetic Resonance Imaging (MRI): An MRI uses a combination of magnetism and radiofrequency currents to generate detailed images of the body’s soft tissues. This technique is ideal for detecting issues such as spinal cord or nerve damage, herniated discs, pinched nerves, etc.
  • CT Scan: A CT scan uses computer technology to combine multiple x-ray images of a body part into a 3D representation. Like an MRI, a CT scan allows for the visualization of soft tissue structures.
  • X-ray:An x-ray enables your physician to obtain a closer look at the vertebrae of your spine. Because spinal stenosis is often caused by issues that affect bony anatomy—bone spurs, injuries, etc.—this simple technique can reveal quite a lot.

 

At-Home Treatments for Spinal Stenosis

If you’ve been diagnosed with spinal stenosis, your doctor will recommend the least invasive form of treatment that suits your situation. An estimated 85-90% of patients will improve through the use of non-surgical interventions, such as physical therapy. A rare few, however, will go on to require surgery.

Before attempting any of these self-remedies at home, please consult with your medical provider. Suggested at-home treatments for spinal stenosis may include:

  • Ice & Heat Application: If you’ve ever played sports, you’re probably familiar with this technique. Applying ice to a sore area has a numbing effect that reduces tenderness and inflammation. In contrast, heat application increases the blood flow to an area, drawing healing factors in the blood directly to the site of the injury. But, don’t overdo it. As a rule of thumb, apply ice/heat for 15 minutes no more than once an hour. Alternate between these modalities as recommended by your doctor.
  • Rest: Certain activities, for example, spinal extension, tend to irritate spinal stenosis. As such, your doctor may recommend modifying your activities. This could include adding forward flexion poses into your daily routine to allow your spine to rest.
  • Exercise: Although your doctor will suggest pain-relieving hacks such as the above to relieve your spinal stenosis, you should not succumb to complete inactivity. An inactive spine is a stiff spine. Work with your doctor or a physical therapist to develop a regimen of exercises, including flexibility training and core work, that best suit your situation.
  • NSAIDs: Taking non-steroidal anti-inflammatory drugs, such as ibuprofen or acetaminophen, can relieve mild pain and inflammation. As always, take over-the-counter medications only as directed by your physician.

 

Nonsurgical Pain Management Techniques for Spinal Stenosis

Sometimes, at-home remedies simply don’t cut it. Luckily, there are a plethora of empirically-proven nonsurgical treatments that you can access through your healthcare provider. Some of these interventions include:

  • Physical Therapy: As we’ve already mentioned, exercise is key in spinal stenosis pain management. A physical therapist will develop exercises that enable you to augment musculoskeletal strength, enhance flexibility, and improve coordination.
  • Occupational Therapy: An occupational therapist assists patients with strategies that help them to rebuild functional independence. Usually, this involves exercises, adaptations, and modifications for performing the activities of daily living, or ADLs. For instance, following a spinal cord injury, an OT may help a patient relearn how to dress or make transfers from a seated to standing position, etc.
  • Chiropractic Care: Does your spinal stenosis result from misalignment of the spine or a bulging disc? If so, a skilled chiropractor may be able to help. Manual manipulation of the spine via a technique called HVLA (high-velocity, low-amplitude thrust) can relieve stress on the nerves by correcting spinal position.
  • Massage Therapy: Achy muscles from spinal stenosis? Studies suggest that deep tissue massage, acupressure, and cranial-sacral therapy can provide temporary relief. For best results, repeat visits to a licensed massage therapist are recommended.
  • Medication Management: If over-the-counter medications such as ibuprofen don’t provide you with sufficient relief, your doctor may suggest prescription-strength drugs. These medications, which include opioids, anti-seizure medications, and antidepressants, require careful monitoring by a licensed professional. In particular, opioids contain addictive properties that necessitate proper medication management by an ethical physician.
  • Steroid Injections: Steroidal injections involve the administration of a corticosteroid via a needle at the site of irritated nerves. This technique, while effective, provides only temporary results. Follow-up shots are required to achieve ongoing relief.

 

Finding the Right Customizable Solution for You

When it comes to spinal stenosis, not every patient is a proper candidate for nonsurgical treatments. In some cases, surgical interventions, like decompression procedures, may be required to restore your quality of life.

But, there is some good news:

85-90% of patients will be able to manage their spinal stenosis symptoms using only conservative treatments.

Your recovery potential, however, greatly improves when you enlist a team of qualified professionals who collaborate to craft a treatment plan that best suits your specific needs.

At the Injury Care Center, our multidisciplinary team of experts includes pain management physicians; physical, occupational, and massage therapists; and chiropractors. This gives you something that other injury care centers simply don’t have: a multi-modal approach to addressing spinal dysfunction.

Give yourself the care that you deserve today. Contact one of our patient advocates at (877) 444-2422. Your back will thank you!


chiropractic services beyond spinal manipulation - tens

Chiropractic Services Beyond Spinal Manipulation

Interventional pain management for the spine has come a long way since its humble beginnings. When we think about chiropractic services, for example, we often think of chiropractic adjustments, a form of spinal manipulation that involves high-velocity, low-amplitude (HVLA) thrusts in an effort to realign the spine. But, did you know that chiropractors have a host of other tools in their arsenal—from electrotherapy to ultrasound—that can help patients attain much-needed relief from chronic back pain?

Generally, speaking, a doctor’s philosophy is always to utilize the most effective, yet least invasive, approach to resolving a patient’s adverse symptoms. In extremely severe cases, achieving effective relief may require minimally invasive surgery. However, in the vast majority of instances, conservative treatments provide a more desirable end result than any form of surgical intervention. The less physical trauma that we enact to our bodies via surgery, the less likely we are to experience adverse and long-term consequences such as nerve damage.

Today, we are going to explore one of those conservative avenues a little bit more closely: chiropractic services. Although many patients believe that chiropractic services are limited to massages and skeletal manipulation, you will find that this isn’t always the case. While these chiropractic services are assuredly critical, you may find that lesser-known techniques such as hydrotherapy greatly alleviate your pain. At the Injury Care Center of Glenolden, PA, we offer you the latest advancements in interventional pain management. Don’t let your musculoskeletal pain get the best of you. We deliver customizable solutions that will pinpoint the exact cause of your pain and permanently root it out. For more information, contact one of our patient advocates at (877) 444-2422 today!

What is a Chiropractic Adjustment?

Before we discuss services that extend beyond simple chiropractic adjustments, we should begin by explaining what this term means. Perhaps, you’ve heard chiropractic adjustments referred to by many different names. Some doctors refer to this essential service as chiropractic manipulation, manual manipulation, or spinal manipulation. More simply put, a chiropractic adjustment refers to a process by which a practitioner applies some form of force to realign vertebrae that possess abnormal motion problems.

The primary goal of this branch of chiropractic care is to reduce subluxation, a term that describes the abnormal position of vertebrae and their apparent loss of function. It is also very important that the patient’s range of motion is increased while simultaneously alleviating nerve irritability.

Chiropractic adjustments vary widely in their method of implementation, but typically involve the following:

  • The chiropractic doctor delivers a short burst of high-impact thrust to the affected vertebra.
  • This is coupled with a perceivable release of joint cavitation, otherwise known as cracking of the joints. This release of gas (the audible pop) typically results from the release of nitrogen, oxygen, and carbon dioxide, which in turn helps to alleviate pressure inside the affected joints.
  • Typically what comes next is a small period of temporary discomfort followed by a sensation of relief. Usually, the spasming of surrounding muscles is the root cause of this reported discomfort.

It should also be noted that joint cavitation does not always occur during chiropractic adjustments. Usually, this phenomenon occurs because the patient is not sufficiently relaxed prior to the administration of treatment. To combat this, chiropractors often employ tactics such as allowing the patient to rest or applying ice/electrical stimulation.

What Else Can Chiropractors Do?

As we mentioned earlier in this blog, you might be surprised to know just how many tools a chiropractor has in his or her arsenal. After all, natural therapies and alternative treatments to traditional medicine pre-date the ancient Greeks. Needless to say, there has been sufficient time to learn what works best.

Here are a few other ways that chiropractors can address their patients’ needs:

  • Ultrasound: This technology utilizes sound waves to apply deep heat therapy to various structures within the human body (such as the joints and soft tissues). Think of it like a telekinetic thermal massage that reaches deep within the body to places normally inaccessible to human hands.
  • Hydrotherapy: Water is an extremely useful tool, as it can be used to apply heat (increasing circulation) or cold (reducing inflammation). Through the use of tools such as hot baths, saunas, or cold wraps, a chiropractor harnesses the power of hot and cold therapy to enhance blood flow, stimulate healing, and numb any residual discomfort.
  • Electrodes: It is a well-known fact that electrical muscle stimulation can reduce both inflammation and muscle spasms while also relieving back pain. Transcutaneous electrical nerve stimulators (TENS) are the most common form of electrode-based therapy. It is widely believed that TENS can help block pain signals sent by the nervous system, while also releasing endorphins.
  • Diathermy: Diathermy induces heat to soft tissues and joints through the use of high-frequency electromagnetic currents. Inducing heat in this fashion helps relax the muscles as well as the connective tissues. Additionally, diathermy can catalyze the recovery process by increasing blood flow to affected areas.

Of course, there are many other forms of chiropractic treatment available as well. Traction, infrared radiation, cold laser therapy, lifestyle modifications, and custom-designed exercise regimens are just a few additional techniques your chiropractor may use.

The Synergy Between Chiropractic Therapy & Exercise

In medicine, it’s best to take a multi-faceted approach— especially when relying on conservative treatment avenues to pain relief. With chiropractic care, the benefits of cardiovascular and strength exercises to patients suffering lower back pain cannot be overstated. That being said, it is extremely important to discuss what qualifies as an appropriate exercise for you—especially if you have a history of cardiovascular problems or injuries. Exercising is vital, but with the caveat that you should only do what your body can tolerate.

Exercising, when done properly, therefore, is almost never a bad thing. And with acute or chronic back pain, this is no exception. The goal of such exercises is to strengthen the lower back while simultaneously improving the patient’s quality of life. As added benefits, exercise also promotes proper digestion, allows you to maintain a toned body, and enhances cardiovascular fitness.

There are many different types of exercises that you can perform as a patient. The best exercises for you will depend on what classification you fall under as a chiropractic patient (either flexion or extension).

  • If you’re a flexion-based patient, you will find that the best exercises involve tasks such as pulling the knees close to the chest, performing posterior pelvic tilts, or bending forward from a seated pose.
  • On the other hand, extension-based patients will enjoy any exercises such as prone press-ups. This type of exercise is great for restoring the natural curvature of your lower back.

For best results, have a lengthy discussion with your chiropractic doctor to determine what set of exercises best suits your needs. Of course, it doesn’t hurt to do your own research on the matter as well. But if you are seeing a chiropractic doctor, make sure that you utilize their expertise!

Contact Us

Have you been suffering from lower back pain for a period of two weeks or more? Have over-the-counter pain medications only provided you with the bare minimum relief? If so, it may be time to get in touch with a chiropractic specialist. At the Injury Care Center, our staff consists only of experts at the top of their craft. We highly value each patient as an individual and we consider the specific needs presented in each and every person’s case. Don’t let your back problems get the best of you. Contact our team of patient advocates today!


patient undergoing physical therapy for herniated disc

Physical Therapy for Herniated Discs

If you’ve recently been diagnosed with a herniated disc, you might find yourself wondering, “How can I avoid surgery at all costs?”

Any qualified doctor worth his or her salt will attempt to help you do just this—employ the least invasive treatment methods possible before even broaching the topic of surgery. Of course, there are some notable exceptions to this rule that will necessitate immediate surgery. However, often, avoiding surgery means undergoing a course of physical therapy for your herniated disc.

Remember: Your spine is one of the most complicated structures in the human body. There are a plethora of moving parts, neural pathways, and connective tissues. Naturally, as is the case with anything that has many moving parts, the spine is prone to a host of medical problems as time goes by. Some of these conditions are benign (such as a pinched nerve), while others can be debilitating or even crippling (such as a spinal deformity). In rare cases, these medical conditions may even warrant surgical intervention.

Typically, this is not the case though.

With a combination of passive (e.g. deep tissue massage) and active (e.g. targeted exercises) treatments, you can jumpstart the healing process and develop healthy habits for life. Sometimes, all it takes is a gentle touch and the guidance of a professional PT to feel lightyears better than you ever thought possible. But, first, let’s discuss what a herniated disc is before we explain why herniated disc patients make such excellent candidates for physical therapy.

 

What Exactly is a Herniated Disc?

Including your sacrum and coccyx, the typical human spine consists of 26 stacked bones known as vertebrae. In between these bones lie rubbery cushions (or intervertebral discs). These discs serve a similar function to the oil in an automobile engine—they keep the bones from grinding together during our everyday movements. A spinal disc consists of a tougher exterior that surrounds a much softer, jellylike center (called the nucleus pulposus).

Over time, the outer layer of these discs can wear down. Cracks may even appear. And, when this happens, the soft, inner nucleus may leak out, applying pressure on nearby nerves. As you can imagine, this herniated disc material takes up unnecessary real estate, resulting in sensations of pain, numbness, or weakness in the extremities.

Despite this, many people with herniated discs experience no symptoms at all. That being said, consider contacting a doctor for your herniated disc if:

  • You experience pain in the arm or leg. Usually, patients report feeling herniated disc pain in their thigh, calf, or buttocks when sustaining a herniated disc in their lumbar spine or lower back. Sometimes, this pain even radiates all the way down to their foot. If your pain primarily affects your arm, then you’ve likely sustained a herniated or bulging disc in your cervical spine or neck region. As you can guess, where you experience your pain depends highly on which part of your spine has suffered the injury.
  • You feel numbness or tingling. Herniated disc material can leak into the intervertebral space, impinging on nerves that feed the extremities. A pinched nerve often causes the sensations of numbness or tingling that we associate with a herniated disc.
  • You feel weakness. Likewise, there’s a good chance that these pinched nerves also happen to serve one or more nearby muscle(s). This may cause the patient to become unsteady on his or her feet or impact his or her ability to lift even the lightest of objects.

 

Causes of & Risk Factors for Herniated Discs

Most of the time, a herniated disc results from the natural wear-and-tear associated with aging. Practitioners in the medical community refer to this process as disc degeneration. This gradual breakdown, in turn, makes our intervertebral discs less flexible, increasing the likelihood that they will sustain tears or ruptures. In fact, even a minor strain while moving from a sitting to standing position can lead to disc damage in an elderly patient.

Unfortunately, it can be very difficult for doctors to pinpoint the exact cause of a herniated disc. That being said, there are certain risk factors associated with the condition. These include:

  • Occupation: As to be expected, those with physically demanding jobs are at a much greater risk of developing a herniated disc than others. This especially true for any jobs that routinely require lifting, pushing, pulling, bending sideways, or twisting the torso. All of these little insults accumulate, leading to disc degeneration over time.
  • Body Weight: The spine supports a lot of weight, even in people who are underweight. Obesity only adds to the load that the spine supports, naturally applying more stress to the discs in your back.
  • Smoking: Research suggests that smoking adversely affects the oxygen supply to the discs of your spine, accelerating disc degeneration.

 

Herniated Discs & Physical Therapy

In all but the most severe cases, conservative care often leads to the best results when it comes to treating herniated discs. In fact, treatments, such as physical therapy, are often much more effective for a herniated disc than surgery or pain medications such as opioids.

Generally speaking, you will collaborate with a physical therapist who will put you on a specific treatment program to speed up your recovery. Typically speaking, your PT will give you a long list of viable exercises and treatments that you can perform in your own home. Through physical therapy, you will find yourself able to return to your normal lifestyle and activities. While it depends greatly on the patient and the severity of his/her condition, you may start to notice significant results within as little as 2 to 8 weeks.

Within the first day or two after you have been diagnosed with a herniated disc, your physical therapy will likely advise you to do the following:

  • Rest the affected area by avoiding any activities that exacerbate negative symptoms in your extremities.
  • Try not to spend too much time in bed.
  • Stay active around your house, making an effort to go on a few short walks each day. Gentle movement, such as walking, will help alleviate any pain or stiffness you might be experiencing.
  • For more immediate relief, you can try applying ice packs to the affected area for 20 minutes a day, every 2 hours.
  • Make sure that if you do sit down, you do so in chairs with firmer cushioning. Softer chairs and easy couches may make your symptoms worse.
  • Stay in touch with your physical therapist regularly throughout this process.

 

Physical Therapy: A Few Exercises That Might Work For You

Before you go any further, we still recommend that you talk to your physical therapist before trying any of these exercises. Depending on the nature of your case, some of these may or may not be good for your herniated disc. That being said, here’s a couple of exercises that may help you:

  • Neck stretches: Begin by sitting upright in a firm chair. Start by moving your chin toward your chest and then back against the headrest. Next, move your left ear to your left shoulder, followed by moving your right ear to your right shoulder. Repeat this several times to obtain the best results.
  • Towel hamstring stretch: Begin by lying flat on the floor while raising one leg toward the ceiling. (Use a yoga mat for added comfort.) Next, take a towel and wrap it around the foot of the raised leg. While holding the towel, pull the leg toward the body and hold it there for 15-30 seconds. Repeat this exercise several times on both legs.
  • Back flexion stretch: Lie on your back and begin by pulling both knees toward your chest. Again, you can use a yoga mat for added comfort. While holding this position, move your head forward toward your knees until you can feel a stretching sensation in your mid- and lower back. Repeat this activity several times for maximum effectiveness.

These are just a few exercises that you can try. Remember, your mileage may vary. As such, it is always best to discuss what exercises are right for you with your physical therapist. Performing an exercise improperly may make your situation even worse. As always, exercise caution when exercising.

Contact Us

Have you been experiencing pain in your back or extremities for a period of two weeks or more? Have conservative options failed to address your negative symptoms? If so, it may be time to get in touch with one of our specialists at the Injury Care Center. Our staff prides themselves on crafting personalized treatment plans for each and every patient. We strive to use the least invasive form of treatments that are viable for your specific case. Don’t let your back pain control your life. Contact one of our devoted patient advocates at (877) 444-2422!


nerve pain in leg from sciatic nerve impingement

How to Relieve Nerve Pain in Your Legs

Have you been suffering from sharp, burning pain that radiates down through your leg? Do you experience numbness or tingling in your lower extremities? Does it feel like your leg muscles are becoming progressively weaker?

Most importantly— Are negative symptoms such as these controlling your life?

If you answered yes to one or more of these questions, you may have a pinched nerve in your leg. While nerve damage may seem a little bit scary, conservative treatments—even things you can do in the comfort of your own home—can relieve these troublesome symptoms.

First, however, let’s start by taking a closer look at what causes nerve pain in the leg.

What Causes Nerve Pain in the Leg?

You may be surprised to learn that leg pain often originates from the spine. In particular, your spinal column houses your spinal cord—the main superhighway connecting your brain to your body. It’s here that nerve roots exit through openings in the vertebrae to create a vast network that allows us to function normally, innervating our extremities.

Injuries or the aging process may compromise your spine, however. As a result, your nerves may become inflamed or even compressed by nearby anatomy.

Specifically, some of the more common causes of lower body nerve pain include:

Sciatica

Sciatica is the most common form of nerve pain to affect the leg. Be aware, however: Sciatica is not an actual disorder. Instead, it’s a term that doctors use to describe pain that occurs when the sciatic nerve becomes pinched, irritated, or inflamed.

The sciatic nerve is the largest and longest nerve in the body. It starts in the lower back (lumbar spine) and exits through the pelvis. From there, the sciatic nerve branches out to the hip joint and through the leg to enable feeling and movement throughout the lower body.

So what causes sciatica?

The most common causes of sciatica include:

  • Herniated lumbar discs: The rubbery cushions (known as intervertebral discs) between each of your vertebra can rupture with age or injury, applying pressure to nearby nerves that supply sensation to the legs.
  • Degenerative disc disease: As we age, intervertebral discs can lose their shape as they dry out. This can lead to disc herniation and a host of other problems, such as lumbar radiculopathy.
  • Spinal stenosis: Arthritis and aging can result in a narrowing of the passageways through which nerves exit the spinal cord. When this happens, nerve impingement may occur.
  • Bone spurs: Osteoarthritis may cause an overgrowth of bone on a lumbar vertebra. These bony protrusions can directly apply pressure on the lumbar or sciatic nerves.
  • Spondylolisthesis or spondylolysis: Slipping or cracking of the vertebrae can compromise the structure of the spine, leading to pinched nerve pain in the legs.
  • Piriformis syndrome: This large muscle near the sciatic nerve can tighten from over- or underuse and cause nerve compression.

 

Other Causes of Pinched Nerve Pain in the Leg

However, injury or damage to the sciatic nerve is just one form of nerve damage that may be causing your symptoms. Here are a few other conditions that present similar leg symptoms:

  • Peripheral Neuropathy: Usually caused by diabetes, this condition involves damage to nerves in the peripheral nervous system—nerves that supply sensation to the feet and legs.
  • Peroneal Neuropathy: The peroneal nerve is located near the knee and has a tendency to become compressed as the result of injuries to the knee or hip.
  • Lumbosacral Radiculoplexus Neuropathy: Your nerves require a blood supply to stay healthy. Diabetes or inflammation can damage small blood vessels in the legs, reducing the nerve’s blood supply and causing dysfunction.
  • Neurogenic Claudication: This is a fancy term that means “nerve pain that originates directly from spinal nerves and affects the legs.” Often, sufferers of neurogenic claudication will experience difficulty walking or report that their legs feel like lead weights.
  • Cauda Equina Syndrome: Compression of a group of nerves that extends from the spinal cord in the lower back to the legs and bladder. This syndrome is usually accompanied by loss of bowel or bladder control and requires immediate medical attention to avoid permanent paralysis of the legs.

 

What Symptoms Are Associated with Nerve Damage?

When a nerve is compressed, it can cause symptoms that extend beyond the damaged area. Nerve pain in the leg, as you’ve learned, can be caused by a variety of factors. That being said, many nerve injuries exhibit similar symptoms.

Typical symptoms include:

  • Pain: Including burning, shooting, “electrical”, or radiating pain felt throughout the lower body.
  • Pain after certain activities: Prolonged sitting or standing, as well as activities like walking, climbing stairs, or rising out of a chair, may increase pain.
  • Numbness or tingling: Loss of sensation in the leg muscles, calf, foot, and/or toes.
  • Weakness: Decreased muscle function in the hip, leg, thigh, foot, or toes.
  • Foot drop: Difficulty lifting the foot, also known as foot drop.
  • Loss of balance: Feeling unstable and more prone to falls.

Since symptoms alone may not determine the cause of your pain, it is essential to obtain an accurate diagnosis prior to starting any new treatments.

Diagnosing Nerve Pain in the Leg

One of the best ways to relieve nerve pain is to find out exactly what is causing it. Symptoms of various nerve conditions often overlap. By knowing exactly what is causing your discomfort, you can take more proactive steps toward pain relief.

But, how do you find out what’s causing your leg pain?

For most individuals, this starts with a trip to your doctor or spine care specialist.

During a consultation, your doctor will inquire into your medical history. This includes reviewing:

  • When your pain started
  • The events that led up to your pain
  • What your pain feels like
  • Other symptoms that you’re experiencing
  • What makes your symptoms better or worse
  • Your current medical conditions
  • Any related injuries or physical traumas
  • Your lifestyle and working habits
  • Your family history of medical conditions
  • Any current medications or supplements that you’re taking

Once your medical history is established, your doctor will perform a thorough physical examination. Your doctor will check for pain in different regions of your lower body (back, buttocks, thigh, leg, etc.). In addition, your doctor will note any swelling, skin changes, muscle weakness, or reflex activity through a variety of simple tests.

After the initial consultation, your doctor will have obtained a better idea of why you are experiencing leg pain. That being said, some additional tests and diagnostics may be necessary to achieve an accurate diagnosis.

Diagnostic imaging, such as MRIs, CT scans, or X-rays may confirm or rule out certain conditions. In particular, imaging tests are useful for detecting bone fractures, tumors, herniated discs, bone spurs, and other spinal conditions.

Likewise, your doctor may order a diagnostic nerve block. This test involves the injection of an anesthetic solution near the suspected nerve. If you experience symptom relief after undergoing a nerve block, it can confirm the origin of your pain.

A myelogram may also be a helpful tool in the diagnostic process. Using a special dye, a radiologist can visualize if anything is pressing against your spinal cord, nerve roots, or nerves. This includes ruptured discs or a slipped vertebra.

I’ve Been Diagnosed with Nerve Pain...Now What?

Once you have obtained an accurate diagnosis, your treatment team can start suggesting conservative approaches for pain relief. Unless your symptoms are severe or causing you immediate danger—such as cauda equina syndrome—non-surgical approaches are often recommended.

Here are some things you can do for yourself (with a doctor’s approval) to relieve nerve pain.

Stretch

Simple stretches can improve your range of motion and spinal flexibility. Stretching can become part of your everyday routine and help you build core strength. Talk to your doctor or a physical therapist about which stretches might be best for your condition.

Exercise

It may seem impossible to exercise when you are in pain. But movement can actually help with your symptoms. Of course, you don’t want to overdo it. Skip the heavyweights and marathon training. But a little bit of low-impact exercise every day can strengthen your spine, core, and supportive muscles. In addition, exercise releases the body’s natural pain killers, also known as endorphins.

Get Enough Sleep

The body repairs itself during sleep. When you’re experiencing nerve pain, aim to get 7 to 8 hours of quality sleep each night. Also, find a sleeping position that doesn’t apply unnecessary pressure to the affected nerve.

Be Mindful of Your Posture

Good posture removes pressure from your spine and promotes spine health. Long hours hunched over a desk or staring at your devices affects your posture. Talk to your doctor or a physical therapist about proper posture techniques.

Use Heat & Ice Therapy

Alternating between a heating pad and an ice pack can relieve painful symptoms. Ice application, for example, assists in inflammation reduction. Heat, on the other hand, encourages blood flow and promotes healing. When you’re experiencing pain, try using an ice pack for at least 15 minutes, once per hour. Then, follow this with applying a heating pad for 15 minutes, every 2 to 3 hours. To protect your skin, use a barrier between the hot and cold packs.

Try Over-the-Counter Medications

Non-steroidal anti-inflammatory drugs (or NSAIDs) such as aspirin, ibuprofen, and naproxen function to relieve pain and inflammation. Talk to your doctor about your options and always use medications as directed.

Physical Therapy

A physical therapist can provide insights into why you are experiencing pain—such as poor posture or a weak core. Your physical therapist will create a plan of action that includes stretching, target exercises, and aerobic activities.

Alternative Therapies

More holistic approaches like yoga, massage, or acupuncture have proven effective for some patients who experience lumbar nerve pain. Spine manipulation by a licensed chiropractor, for example, may also be an effective non-invasive treatment.

With time and proper care, many nerve pain symptoms eventually go away on their own. If you’ve tried these conservative treatments without experiencing relief, it may be time to consult with a specialist for more comprehensive treatment options.

Obtain An Accurate Diagnosis and Plan for Pain Relief

The Injury Care Center wants to help you feel better. Our diverse team has the education and experience to accurately diagnose your nerve pain issues. Once you receive a proper diagnosis, we will tailor a custom-made treatment plan to your individual needs and lifestyle.

Did you know that most spine disorders can be treated without surgery? In fact, we have a team of conservative treatment experts (including physical therapists, pain management specialists, chiropractors, and rehab doctors) ready to help you return to the things you love doing.

Ready to take the next step...without pain? Contact one of our patient advocates today!


man with synovitis in wrist

Signs You Might Have Synovitis

Suffering from joint pain can prevent you from enjoying your life. Every movement you make becomes a constant reminder that something just isn’t right. While you may be tempted to shrug off that dull pain, ignoring the issue may cause more harm than good in the long run.

After all, the underlying causes of joint pain often include both chronic and debilitating conditions. Although synovitis is a fairly common cause of joint pain, for example, the presence of synovitis may also indicate a more serious issue that requires immediate attention. As such, recognizing the signs of synovitis and acting promptly can be crucial in safeguarding your health.

Let’s take a closer look at synovitis and how you can access effective treatments to alleviate your discomfort.

 

What is Synovitis?

Synovitis refers to inflammation of the synovium, a membrane that lines your joints. This protective tissue is very thin and produces a liquid—known as synovial fluid—that nourishes and lubricates your joints.

When the synovium becomes irritated or inflamed, it thickens, producing excess synovial fluid and leading to pain.

 

Understanding the Synovium

Many of your joints are surrounded by a capsule. This bubble-like structure consists of a tougher outer layer and a softer inner layer. This inside layer is known as the synovium.

The synovium performs two main functions:

  • It determines what can pass into the joint space, and
  • Creates synovial fluid.

In fact, you can find synovial fluid inside both layers of the joint capsule. This viscous liquid assists in lubricating the joints to reduce friction during motion.

The inflammation of the synovium—aka, synovitis—is usually a secondary condition caused by another ailment such as arthritis or an injury.

 

Top Causes of Synovitis

Just about anyone can develop some type of synovitis. This even includes children!

For example, otherwise healthy people can experience synovitis by overusing a particular joint. Athletes, for instance, may develop the condition after sustaining an injury. Likewise, those who perform jobs that require heavy lifting or other repetitive movements are also more prone to synovitis.

Furthermore, certain medical conditions can also trigger synovitis. These conditions include:

  • Gout: A type of arthritis that results from having too much uric acid in the blood. This condition can affect just about any joint in the body, but it usually occurs in the big toe.
  • Inflammatory arthritis: Inflammation of the joints can cause your body’s immune system to attack excess synovium. This response can cause a breakdown of the joint’s cartilage.
  • Rheumatoid arthritis: A progressive autoimmune disease that causes the joints and organs to swell.
  • Lupus: An autoimmune disease that causes the body to attack itself and destroy otherwise healthy tissues.
  • Rheumatic fever: Some untreated streptococcal infections—like scarlet fever or strep throat—may trigger synovitis.
  • Tuberculosis (TB): This highly contagious bacterial infection usually affects the lungs. Likewise, TB bacteria can also cause swelling and inflammation in the joints.

In rare instances, some children may develop a temporary form of synovitis known as transient or toxic synovitis. This condition, which commonly occurs in children ages 3- to 10-years-old, involves hip pain—usually just on one side. Transient synovitis, as the name suggests, is typically only a temporary condition.

 

What are the Signs of Synovitis?

Synovitis can be tricky to diagnose. However, the main symptom that patients experience is joint pain. This pain can come and go and may even be felt in different joints of the body. Synovitis that occurs due to overuse or injury, however, remains in the same joint.

For some patients, there may be no visible indicators of synovitis. You experience joint pain but not notice any outward swelling of the joints. Other patients, however, may notice a little swelling or redness in the affected area.

Other symptoms associated with synovitis may include warmth, tenderness, or a joint that feels “spongy.” Joint stiffness and limited motion may also be present, feeling its worst in the morning.

 

Where Does Synovitis Commonly Occur?

Synovitis can affect just about any joint. There are, however, some common locations where synovitis can develop. Joints that are usually affected by synovitis include the:

  • Hips
  • Shoulders
  • Wrists
  • Fingers
  • Knees
  • Ankles
  • Toes

 

Is Synovitis Serious?

Untreated synovitis can lead to permanent joint damage. Over time, this condition may even destroy nearby bone and cartilage in the joint. But that’s not all. Synovitis can also damage other structures that support the joint like the tendons—the tissues that connect our muscles to our bones.

As the condition progresses, a damaged joint may even become deformed or fuse together entirely. As a result, normal range of motion and mobility may become difficult or even impossible to negotiate.

 

Diagnosing Synovitis

The symptoms of synovitis often mimic other joint conditions like labrum tears or articular cartilage damage. To make matters even more confusing, synovitis is often caused by another issue (e.g. arthritis or gout). Consulting with a doctor to obtain an accurate diagnosis is the best way to determine which treatment will work best for your situation.

 

How is synovitis diagnosed?

A thorough physical examination and review of your medical history is often the first step in diagnosing synovitis. Often, your medical history will alert your doctor to any conditions that might be causing your synovitis. Your doctor will ask you questions about your joint symptoms and activities that aggravate your pain. In addition, you may also be asked if you are experiencing any other symptoms like weight loss, fever, or chills.

During the physical exam, your doctor will take a closer look at the joint for any visible symptoms of synovitis. Your doctor may also conduct a series of muscular strength tests to detect any pain or loss of movement. Likewise, the physical exam can also alert the doctor to any issues with ligaments or tendons.

A physical exam alone, however, may not be enough to reach an accurate diagnosis. More decisive visualization techniques may be used, such as:

  • Magnetic resonance imaging (MRI): This diagnostic imaging technique allows the doctor to achieve a clearer view of your synovium. An MRI can even detect early-stage synovitis before more serious symptoms develop.
  • Musculoskeletal ultrasound: The same technology that gives you the first glimpse of your developing baby can also enable your doctor to take a closer look at any abnormalities that exist in the joints, muscles, or tendons.
  • X-rays: Bone abnormalities can be easily detected with x-rays of the suspected joint.
  • Complete blood count (CBC): If the cause of your synovitis is a condition such as rheumatoid arthritis, analyzing the blood can help to confirm a diagnosis.
  • Joint biopsy: A procedure to remove some of the fluid in the joint. Synovial fluid affected by synovitis is easily detected with a joint biopsy.

Once you have received an accurate diagnosis, your doctors can determine how best to treat your synovitis and any underlying causes.

 

I’ve Been Diagnosed with Synovitis...Now What?

Conservative treatments are often effective for less serious cases of synovitis. Taking a break from activities that aggravate the pain is usually the first step. You may also be asked to apply cold packs or elevate the area depending on which joint is affected. Nonsteroidal anti-inflammatory medications (NSAIDs), like ibuprofen, may also help to reduce pain and swelling.

Those suffering from synovitis due to arthritis may be prescribed medications to help manage their condition. If your synovitis results from gout, certain medications can be administered to reduce the uric acid levels in your body.

Likewise, you can access physical therapy to restore function to an affected joint. If your synovitis is due to overuse or injury, a physical therapist can recommend certain exercises or activity modifications to prevent future issues.

 

Corticosteroid Injections for Synovitis

If conservative treatments don’t seem to help, your doctor may elect to try steroid injections. These injections use a hormone—cortisone—that the body produces naturally via the adrenal glands. When this hormone is injected directly into the joint, it can reduce inflammation.

For best results, your doctor will use x-ray imaging (aka fluoroscopy) or ultrasound to achieve proper needle placement into the joint. This step is crucial to ensuring that any adjacent nerves do not suffer damage as a result of the injection.

To prevent the patient from experiencing any pain during the injection, your doctor will administer a local anesthetic prior to the procedure. Although you will likely experience some tenderness in the days following the procedure, any pain should be mild and short-lived.

If you have excess fluid accumulating around the joint, your doctor may take this opportunity to extract the material.

 

Surgery for Synovitis

Surgery may also be an option for more severe cases of synovitis. Depending on the location and severity of your condition, your surgeon may use open or minimally invasive techniques. The procedure in question, a synovectomy, removes the affected synovium from the joint.

After surgery, your joint may be immobilized with a removable cast. Physical therapy can help with the recovery process. A physical therapist works to restore range of motion to the joint and teach you how and when you should use it.

What you need to know about a synovectomy:

  • This procedure is usually only recommended after a patient has attempted conservative treatments for six to twelve months.
  • A synovectomy may not cure the disease, just help manage symptoms.
  • In some cases, a synovectomy may only provide temporary relief.
  • Risks of a synovectomy include infection and bleeding in the joint.

 

Ready to Get Relief for Your Synovitis?

As you can see, treating synovitis is not always easy. You want to make sure you have a team of doctors that can accurately diagnose and treat your joint pain.

The Injury Care Center is dedicated to providing you with effective treatment for all orthopedic issues. Our team takes the time to get to know you, your condition, and your treatment goals. From there, we work with you to tailor a treatment plan that suits your specific needs.

At the Injury Care Center, we use the latest technology and research to provide you with cutting-edge pain management techniques. To reclaim your life from chronic pain, contact the Injury Care Center today!


Laser Therapy for Musculoskeletal Pain

Laser Therapy for Musculoskeletal Pain

Laser Therapy for Musculoskeletal Pain  Physical Therapists are highly skilled medical professionals and movement specialists, trained in Anatomy and Physiology, as well as Kinesiology.

The job duties of physical therapists include rehabilitation and strengthening for a varying number of musculoskeletal, cardiovascular, and neurologic conditions including but not limited to orthopedic injuries, arthritis, pre-operative, post-operative, Parkinson’s Disease, CVA, MS, etc.

Physical Therapists will perform skilled evaluations to determine extent of injury, determine the resultant impairments such as decreased strength, decreased range of motion, and determine an appropriate plan of care aimed at decreasing pain and improving function.

The Injury Care Center (ICC) provides medical services to those injured at work, in a motor vehicle accidents, and others.

The team at the ICC includes multiple board-certified physicians and specialists.

They provide specialty-trained physical therapists and chiropractors while working to collaborate with specialists in orthopedics, neurologists, pain management and psychologists as well as diagnostic groups for MRI, CT Scans, EMG, FCE, Concussion and balance testing.

Pain is a very complex and liming factor that often impacts an individual’s performance at home, work, and in recreation.

Individuals experiencing musculoskeletal pain from arthritis, a work related or motor vehicle injury may experience increased difficulty walking, bending, lifting, and performing simple daily tasks such as opening and jar or going to the grocery store.

Physical Therapists often employ the use of modalities to not only promote or accelerate the healing process, but to manage and decrease pain levels.

One modality utilized in physical rehabilitative settings, including the ICC, includes low level laser therapy.

This has been shown to reduce inflammation and edema, induce analgesia, and promote healing in a range of musculoskeletal pathologies. Low Level Laser Therapy, commonly referred to as (LLLT), and sometimes known as Low Level Light Therapy is low intensity light therapy.

The effect of the Laser is nonthermal, but rather photochemical.

The light from the Laser stimulates biochemical changes within cells and can be compared to the process of photosynthesis in plants, where the photons are absorbed by cellular photoreceptors and triggers chemical change.

Patients typically do not feel warmth, as the applicator is applied over skin similar to a flashlight.

Treatment times typically last anywhere between 30 seconds to 1 minute.

Laser at low doses has been shown to enhance cell proliferation of fibroblasts, keratinocytes, endothelial cells and lymphocytes to promote healing.

LLT can also enhance neovascularization, promote angiogenesis and increase collagen synthesis to aid in the healing of acute and chronic wounds.

  • Application site of Laser treatment generally includes:
  • At the site of injury to promote healing, remodeling and reduce inflammation.
  • Lymph nodes to reduce edema and inflammation.
  • Nerves to induce analgesia (pain relief).
  • Trigger points to reduce tenderness and relax contracted muscle fibers.
  • Contraindications and precautions to laser treatment include
  • Avoid aim laser beams into the eyes
  • Do not treat over the site of any known primary carcinoma or secondary metastasis in any patient with cancer.
  • Do not treatment in pregnant women over the developing fetus
  • Use caution in patients with epilepsy, or photosensitive individuals.

Over 4000 studies have concluded the benefits and indications of use of Laser therapy in management and treatment of acute and chronic musculoskeletal pain.


Benefits of Stretching to Manage Pain

Benefits of Stretching to Manage Pain

Physical Therapists are highly skilled medical professionals and movement specialists, trained in Anatomy and Physiology, as well as Kinesiology. The job duties of physical therapists include rehabilitation and strengthening for a varying number of musculoskeletal, cardiovascular, and neurologic conditions including but not limited to orthopedic injuries, arthritis, pre-operative, post-operative, Parkinson’s Disease, CVA, MS, etc.

 

How A Physical Therapist Can Help You

Licensed physical therapists can be found in a range of healthcare settings including outpatient offices, private practices, hospitals, rehab centers, nursing homes, home health, sports and fitness settings, schools, hospices, occupational settings, government agencies, and research centers.

Physical Therapists will perform skilled evaluations to determine extent of injury, determine the resultant impairments such as decreased strength, decreased range of motion, and determine an appropriate plan of care aimed at decreasing pain and improving function.

A typical physical therapy plan of care will aim at improved mobility and movement. The Injury Care Center (ICC) provides medical services to those injured at work, in a motor vehicle accidents, and others. The team at the ICC includes multiple board-certified physicians and specialists.

They provide specialty-trained physical therapists and chiropractors while working to collaborate with specialists in orthopedics, neurologists, pain management and psychologists as well as diagnostic groups for MRI, CT Scans, EMG, FCE, Concussion and balance testing. Orthopedic physical therapy treats musculoskeletal injuries, involving the muscles, bones, ligaments, fascia’s, and tendons.

It is suitable for medical conditions such as fractures, sprains, tendonitis, bursitis, chronic medical problems, and rehabilitation or recovery from orthopedic surgery. This includes injuries from car accidents, on the job, or personal injury such as a slip and fall. Patients may undergo treatment with joint mobilizations, manual therapy, strength training, mobility training, and other modalities.

Pain is a very complex and liming factor that often impacts an individual’s performance at home, work, and in recreation. Individuals experiencing musculoskeletal pain from arthritis, a work related or motor vehicle injury may experience increased stiffness, difficulty walking, bending, lifting, and performing simple daily tasks such as opening and jar or going to the grocery store.

Decreased function, and increased pain can, in turn, lead to inactivity. Inactivity can cause further stiffness or restriction to range of motion, soft tissue extensibility, and normal human movement. 

 

What Type of Stretching is Right For You?

Typically physical therapists will recommend stretches as a main intervention to improve muscle length, improve posture, and decrease complaints of pain and stiffness. Following a principle of TERT (Total End Range Time) research has proven that in order to change the length of soft tissue, a gentle sustained stretch of 2 minutes is most beneficial. Bouncing or “ballistic” stretching, holding for quick counts of 5 seconds, has been found to have no benefit. 

 Muscles can become tight as result of soreness and stress. When muscles become tight, it is important to stretch these muscles to increase blood flow reduce tension. Once these previously tense muscles are stretched, movement becomes more fluid-like and soreness is reduced. Flexibility

Stretching improves flexibility. The more you stretch, the more you move your muscles, and the more flexible you become. Over time, stretching will become easier for your body which results in improved flexibility. Stretches are effective with, posture, preventing injuries, increasing nutrients, and reducing muscle soreness. Stretches will help to encourage improvement anatomical alignment, leading to less slouching.

The more that muscles are prepared for increased movement or demand for exercise, the more the likelihood of injury is decreased. When muscles are warm and stretched, movement becomes easier and more fluid-like which helps with injury prevention. This stimulates water and synovial fluid at the joints, which act as lubricant for improved gliding and joint mechanics. Stretches will also increase blood and nutrient supply to muscles.

Because stretching allows blood to flow through the body, the nutrients in the blood are being carried and spread out all throughout the body as well. An increased blood and nutrient supply also helps reduce soreness.

The more frequently stretching is performed, the more benefits the body and the mind will receive. Stretching is a great way to take a break from a busy work day to recharge the body and mind. This in turn will help overall energy levels and feelings of invigoration. This is especially important following a motor vehicle accident or any work related injury. 

Stretching can be broken into two categories: Static and dynamic stretches. Dynamic stretches follow the SAID principle (specific adaptations of imposed demand) which essentially states that if you are going to play soccer, you should play soccer to stretch and warm up beforehand.

If you are going to be running, you should perform light jogging or other dynamic plyometric activity to stretch and warm up. This properly prepares the muscles for the activities that they are going to be performing. 

Static stretches include maintaining a still, prolonged position for most ideally, a count of 2 minutes. This static stretching is most beneficial following increased activity or exercise. Some specific exercise classes and lifestyles aim at stretching an improved length: these include yoga and Pilates. These are great changes that anyone can add to their routine with proper education and training.

Stretching should not be a time consuming task. It can take as simple as 10 minutes out of each day, at 2-3 days a week to achieve the most benefits. Irregular stretching schedules do not allow to maintain a consistent range of motion. Getting in the habit of performing stretches multiple time a week will increase flexibility. 


Are People Getting More or Less Hurt in Auto Accidents_

Are People Getting More or Less Hurt in Auto Accidents?

According to the World Health Organization, 1.35 million people die in auto accidents every year in the United States. Your likelihood of getting hurt in an auto accident depends on where you live, socio-economic factors, the kind of vehicles involved, and whether or not you were wearing your seatbelt when the accident happened. Due to the increased safety of motor vehicles made after 2009, people are getting less hurt in auto accidents today than in the past. However, even if you drive a car manufactured after 2009, there are still factors that can increase or decrease your chances of getting hurt in an auto accident

 

Fewer People are Getting Hurt in Auto Accidents

A recent study analyzed over 31,000 people who were involved in auto accidents between 1998 and 2015. The data revealed that car drivers and riders are more than half as likely to sustain serious injuries in car accidents when the car involved was manufactured in 2009 or later. This study controlled for height, weight, BMI, the driver’s age, and the closeness to the steering wheel.

 

Factors that Increase or Decrease Your Risk of Injury in Auto Accidents

Failure to use safety devices can increase your risk of injury in an auto accident. For example, the following actions can help keep you safer during an accident:

  • Using a helmet that fits well while riding a motorcycle will decrease your risk of death in an accident by 42%.
  • Wearing a helmet that fits well while riding a motorcycle will decrease your risk of head injuries in an accident by 69%. 
  • Wearing a seatbelt will decrease the likelihood of getting hurt in an auto accident by 45-50%. Additionally, wearing a seatbelt will decrease your risk of serious injuries and death by 25%. 
  • Properly using a child safety car seat will decrease a child’s risk of death by 60%.

 

Women are More Likely to Get Hurt in a Car Accident

According to a University of Virginia study in 2011, women are nearly 50% more likely to be seriously injured or killed in an auto accident. Additionally, women are 73% more likely to suffer serious injury or death in a car accident than men. Women continue to be more vulnerable to serious injuries in car accidents than men, even when they wear a seatbelt. This difference is the most noticeable when women are riding in the front seat when the accident takes place. 

Unfortunately, nobody knows exactly why women are at greater risk of suffering an injury than men. Perhaps it is because women’s pelvises are generally wider and more shallow then the pelvises of men. Perhaps the reason has to do with the distribution of fat in men and women, which is starkly different. Women often have more weight around their thighs and waist, whereas men often have more weight around their belly. 

Finally, female test dummies are often only 5 feet tall, weighing 110 pounds. On the one hand, it can be beneficial to use extremes in size for testing purposes. On the other hand, the size of the female test dummies used does not accurately represent most women in the United States.

 

Unsafe Roads Increase Your Risk of Injury in a Car Accident

The safer the roads, the lower the rate of car accidents. Cities and municipalities have a responsibility to design roads with the safety of all drivers in mind. Safe roads have adequate space on the side of the road for emergency vehicles and law enforcement vehicles. Cities should also put effort into making footpaths, crossing points, cycling lanes, and intersections safe for pedestrians and drivers alike. 

If you suffered an injury due to a dangerous road condition or a poorly designed road, you may be entitled to compensation for your injuries. Hazardous road conditions can include missing guardrails, road debris, potholes, and cracks. In some cases, those injured by a car accident caused by hazardous road conditions have a right to bring a lawsuit against the state, county, or city government responsible for maintaining the roads. Depending on the facts of your case, you may be able to bring a lawsuit against the contractor or government agency responsible for the hazardous road conditions. 

 

Unsafe Vehicles Cause Traffic Accidents

The safety of the motor vehicle involved in the crash directly affects the likelihood of a serious injury. Vehicle manufacturers must meet certain safety standards. Manufacturers must meet front and side-impact regulations, including electronic stability control. Manufacturers must also ensure that seat-belts and airbags are fitted for all vehicles. When manufacturers do not provide these basic safety functions, they put drivers and passengers at an increased risk of injury. When manufacturers create motor vehicles with unsafe design defects, they may be liable for any car accidents that result in injuries. 

 

The Most Common Auto Accident Injuries 

The five most common car accident injuries include head injuries, broken bones, back injuries, whiplash, and psychological injuries. Head injuries range from mild to incredibly severe. The force of the accident, the location of the victim’s head, and whether or not the head impacted with an object will factor into the severity of the head injury. Massive head injuries can cause brain swelling and bleeding that can result in death if not treated. Head injuries are often difficult to diagnose because the symptoms do not show up immediately. 

Broken bones are another common injury caused by auto accidents. The more pressure applied to the bone, the more easily it could break and cause open wounds. Compound fractures happen when the bone penetrates out of the skin. The treatment for compound fractures often includes surgery and extensive physical therapy. 

Whiplash happens when the force of the car accident causes the neck to rapidly snap back-and-forth. Injuries from whiplash are common in rear-end accidents. The pain from whiplash accidents can often show up days or even weeks after the car accident. If you have experienced back or neck injuries from a car accident, chiropractic care can help. Contact the Injury Care Center today to discuss your chiropractic care options.


Five Tips for Dealing with Canes

Five Tips for Dealing with Canes

Many people in the United States depend on walking canes to help them walk. Using a cane can help you compensate for an injury or a physical disability. If you are experiencing instability while walking, you may be wondering if you could benefit from using a cane. There is no simple yes or no answer as to when you should start using a cane. 

Discussing the issue with a medical professional or physical therapist can help you decide when it is time to start using a cane. One of the key benefits of using a cane is preventing dangerous falls. Here are a few tips for choosing and using a cane to help you walk. 

 

Determine Whether or Not You Would Benefit From Using a Cane

Deciding to use a cane can be difficult. Many people put off using a cane because they associate using one with getting older. However, it is essential to look at a cane as a helpful medical tool. If you are considering using a cane, you may want to ask yourself these questions:

  • Do you decide to not do things because you are worried about risking a fall or feeling like you cannot physically complete the task?
  • Are you unable to easily walk down a flight of stairs? Do you need help doing so or do you need to hold the railing the entire way up or down the stairs? 
  • Do you ever get the feeling that you will fall when you walk without assistance?
  • Does walking without assistance cause you pain in your joints and limbs?
  • When you walk, do you constantly look for a fixture to grab to help you balance and to steady yourself?
  • Are you more tired than you would like to be after walking unassisted? Does walking unassisted require a significant amount of physical exertion? 

 

Choose a Cane That is the Proper Height for Your Body

Getting the right height on your cane will help you tremendously. A cane of the right height will reduce undue pressure on your arms, wrist, and shoulder. How do you know the right height for you? Stand with your arms by your sides and relax. Check the position of your wrist bone. The height of your wrist bone should be where the top of the handle of your cane reaches. If you are having a challenging time measuring yourself or determining which size walking cane to purchase, your medical professional can help measure you. They can also help you order the correct size of walking cane.

 

Choose the Correct Type of Walking Assistance

You know you need a walking device, but you do not know which type of device is the best option for you. Should you choose elbow crutches, or a walking cane to assist you as you walk? Elbow crutches provide more support for an individual’s body than a walking cane. After seeking out an evaluation with your medical professional or physical therapist, you will better understand which type of assistance is best for your body. One of the benefits of elbow crutches is that they give people a higher level of mobility and allow for a faster gait. Elbow crushes also support greater weight than walking canes alone. 

Walking canes come in a variety of designs and styles. Some walking canes even fold up so you can easily transport them. Today’s marketplace has a wide variety of walking canes and accessories. Whether you would like a pop of color on your walking cane or extra support, many online and retail stores offer all of the accessories you need to get the most out of your walking cane. Walking cane accessories include walking cane tips, supportive bases for quad canes, tripods, wrist straps, and holders for your walking cane. 

Supportive bases can help owners of walking canes walk more safely. Cane base tips grip the ground and make the walking cane stay in contact with the ground longer. This extra grip allows for extra stability. Additionally, self-standing walking cane bases allow the cane to stick straight up and stand on its own. This can be helpful because you will not need to lean your cane up against a wall when it is not in use. Using a self-standing base will give you more freedom, convenience, and safety while walking. 

 

Use the Correct Posture When Walking With a Cane

One of the most important aspects of using a walking cane is to use the correct posture. As much as possible, attempt to keep your back straight when walking with a cane. Do not stretch your cane farther than your leg will naturally go. As you walk with your cane, make sure your cane and your opposite foot hit the ground at the same time. Then, move your healthy leg without hunching forward.

Learning to walk with healthy posture will take some time. However, taking the time to work on walking with your cane while using the correct posture will help you avoid back and neck injuries down the road. Hunching your neck and back over your cane can cause serious soft-tissue damage and pain. 

 

Visit a Chiropractor Regularly

Whether you need to use a cane for a disability or while recovering an injury, chiropractic care can help greatly. Chiropractic care is a safe and pain-free treatment that helps you restore balance and alignment to your body. Shoulder pain and back pain is common when it comes to using a walking cane, but a chiropractor can adjust your alignment and leave you feeling better than you did when you came into the office.

Everyone can benefit from chiropractic care. In some cases, using chiropractic care can help boost your immunity, improve your breathing, and reduce your need for pain medication. If you use a walking cane, you can benefit from regular chiropractic care. Contact the Injury Care Center today to learn more about our chiropractic treatment options. 


Physical Therapy after Rotatory Cuff Injury

Physical Therapy after Rotatory Cuff Injury

What Is A Rotatory Cuff?

The rotator cuff is a group of muscles and their subsequent tendons that are extremely important for shoulder motion and strength. Having an injury to one or more of these muscles can be extremely impactful on an individual’s life.

Understanding the anatomy of the shoulder and rotator cuff is important. The rotator cuff is comprised of four muscles and their tendons.

They are as follows:

  • supraspinatus muscle
  • infraspinatus muscle
  • teres minor muscle
  • subscapularis muscle

All of these muscles perform or assist in various movements of the shoulder and upper arm. There are many different ways these muscles and tendons can be injured.

For example, lifting heavy objects, pushing or pulling items, reaching for and carrying items, and accident falls can cause injury to these muscles or tendons.

 

How Do Rotary Cuff Injuries Occur?

Sometimes, the injuries to the rotator cuff muscles can occur over time in your job.

There are other times when the injury is a more acute or rapid insult.

Common symptoms for a rotator cuff injury can include but are not limited to swelling, pain, loss of motion, stiffness, and weakness throughout the affected arm.

Determining the extent of injury to the rotator cuff is essential to the correct application of a rehab program.

A sprain or strain to the muscles or tendons usually responds well to a conservative approach in the rehab setting.

Occasionally a tear to the tendons can also be helped with a conservative approach. Significant tearing with severe mechanical symptoms may require surgery.

In either occasion, conservative care or post-operative care, The Injury Care Center can and will assist with recovery of these impairments.

 

How To Treat A Rotary Cuff?

Normally, a rehabilitation program at one of our facilities will begin with an evaluation by one of our expert physicians. Once a plan of care has been established, including any pain managements and prescription for rehab, you may be evaluated by one of our experienced and caring rehab professionals.

Pending the status of your injury, whether you have had surgery or not, we will come together to decide what plan of action will work best for you. Whether or not you have had surgery, we will normally begin a rehab program with palliative modalities. What this may mean would be an application of heat or ice, TENS, and ultrasound to start out with.

These tools are used to decrease pain and stiffness so that we can begin a program of stretching and strengthening. Once your symptoms are decreased, we will begin light range of motion exercises. These are used to ensure your arm is moving the way it was prior to your injury.

Overhead motion is important to everyday life, especially if you require it for returning to work. Obtaining the motion is important, however, it would not mean much if we did not also incorporate strengthening into the program. This will be important to make sure your injury does not reoccur, and you have ample strength to return to your prior level of function.

Strengthening may consist of theraband use, machine use, and functional training. Each progression in your program will depend on your symptoms and your presentation to the rehab professional. If your work injury was severe enough to require a surgery to the rotator cuff, your rehab program will be different pending the extent of the surgical intervention.

You may be required to wear a sling after your surgery and rest for about six weeks before starting any rehab program. This is normal. Once you are able to begin a rehab program, we will bring you in for a physical therapy evaluation. You may be only able to perform passive range of motion at the evaluation.

If that is the case, we will need to move your arm for you to assess your available range of motion. In addition to assessing your passive range of motion, we will also be looking at your incisions and how they have healed and any swelling/bruising accompanying the post-surgical site.

Again, modalities may be applied once you begin a rehab program to relieve pain and stiffness. After being in a sling for several weeks, it is very common to have the stiffness throughout the shoulder and neck region. Patient’s will then be provided with some passive stretching techniques.

Your rehab provider will instruct you in the proper form and performance of these stretches to ensure you are not increasing any stress on the repaired site. As you progress in the rehab program, you will most likely have regular check ins with the physician at the Injury Care Center as well as your surgeon.

The surgeon may clear you for more exercises as your injury heals. The rehab experts at our facilities are well educated in the techniques appropriate for you and your recovery. As we progress to strengthening, we will target your rotator cuff and shoulder muscles to improve your overall function.

Importantly, we will begin a work reintegration program when you are both cleared by the surgeon and physician and ready pending re-evaluations by your rehab provider. A work reintegration program will be essential when attempting to return to work as we will be able to assess your capability to perform work related duties in a controlled environment.

 

The Injury Care Center Can Treat You

AT each of our facilities, we are equipped with various tools to assist in this progression. These tools include, but are not limited to, biofeedback and a work training station. Biofeedback will be used to ensure you are performing these lifting techniques with proper form and do not re-injury yourself.

As you progress in your work integration program, we will work together to plan a return to work when you are healed and in no danger of re-injury. We look forward to assisting you in each and every step of the recovery process!


Top 5 Reasons You Can't Lose Weight photo 900x600

Top 5 Reasons You Can’t Lose Weight

You want to lose weight, but you can’t. Why?

You hear it all the time. “New year, new me.” “Starting next month, I’m going to lose weight.” “You see that new celery juice diet? My cousin lost 30 lbs doing it! I’m starting tomorrow!” Is this you? Unfortunately, it probably is. And that’s nothing against you, that’s just what the numbers tell us.

The latest projections forecast that by the year 2030 over half of the world’s population will be overweight! If that doesn’t stop and make you think, then I don’t know what will. But why is it SO hard? Not accounting for environmental and other factors (like good ol’ Uncle Sam!), here are the top 5 reasons you can’t lose weight.

 

1) You’ve been told to “listen to your body”

“If you’re hungry, eat! Don’t deny your body!” “Your body wouldn’t lie to you!” Look, I agree that these are nice things to say to yourself or to someone else when they need someone to co-sign off on their indulgent behaviors but it simply isn’t true. You shouldn’t “listen to your body.” Our brain, digestive system, and the hormones that control them are not designed to keep you in shape. They are designed to keep you alive.

We crave the saltiest, sweetest, and fattiest foods simply because they are the foods that are typically highest in calories, and more calories roughly equates to more life sustaining energy. Or at least that’s what our bodies think. The fact is we were never meant to be surrounded by such an excess of food, and the complex and vast intricacies that control our hunger levels are not compatible with instant access to these high calorie foods. Unfortunately, there is nothing “intuitive” about weight loss.

 

2) You’re not tracking what you eat

Once again, there is nothing “intuitive” about losing weight. If you are just eating intuitively, or simply “trying to make good choices,” chances are you still have no real idea how much you’re eating. The unfortunate truth is that the #1 factor in helping you lose weight is tracking your intake. This means what you eat and how much you eat of it. To some this may sound terrible, but relax, it doesn’t mean you need to track forever.

Once you have a good handle of how much you are eating, you can just follow that plan. For most, this takes two to four weeks to achieve. Think of it like running a business; no business lasts if they’re not tracking what they spend and what they make in a day, a week, a month, a quarter and even a year. Remember: what gets tracked gets measured, and what gets measured gets improved!

 

3) You’re sabotaging yourself

Sadly, a common reason many people can’t lose weight is because they are shooting themselves in the foot, and they don’t even realize it. Will power is a finite and fickle thing. And it is being drained all day long with every decision you make. So, when you get home after a long day, you’re much more likely to grab the easy pre-packaged snack than cook or eat something healthy. How do you prevent this common pitfall? Simple: don’t buy the crap! Honestly, if people were to just not buy unhealthy items to have in their house, they wouldn’t need to use up all their imaginary will power not giving in to the temptation.

If the temptation isn’t there, you have nothing to give in to! Another common mistake is not preparing any food for themselves for the next day. If you’re in an office setting where lunch is provided, chances are there isn’t going to be much in the way of healthy options. And if you’re on your own for lunch, healthier options are just harder to find and more expensive, so save yourself some time and money and prepare ahead of time. With all the delicious but high calorie food available around Philadelphia, this is imperative. Lastly would be the fact that many people neglect sleep in their weight loss efforts. It’s been proven that the less sleep you get, the hungrier you’ll be, and plus you’ll be more tired and have less energy to avoid unhealthy obstacles. (Remember that will power thing?) Get to sleep on time!

 

4) You’re acting like a light switch instead of a dimmer switch

What the heck does that mean? Let me explain. A light switch has two settings: Off/On. There is no in between. It is binary. A dimmer switch has different degrees that can be adjusted to allow more or less light depending on preference. What does this have to do with losing weight? Well, a lot of people are successful with their diet efforts… until they’re not. Meaning, they do well for a time, but the minute they fall off track, they’re done for and go into a downward spiral.

They let one piece of cake or one bad meal totally compromise their efforts. They’re either ON the diet totally, or they’re completely OFF. It doesn’t have to be this way. You can fall off and get back on. You can adjust yourself like a dimmer switch. It’s ok to mess up for a meal, or a day, or heck even a week. You can get back on track and keep moving forward despite a setback. Set backs are part of it.

 

5) Your friends and family are negatively influencing you

This might be the toughest one to swallow. Your loved ones may say that they have your best interest in mind, but more often than not, they don’t. People are people and people will occasionally try and knock you down a peg just to feel better about themselves. No one is perfect and that’s just human nature, so forgive them and move on when they say things to try and discourage you. You need to be able to hold strong and not allow yourself to fall into the trap of just going with the crowd.

Now, on the other hand, you should also not push your new dietary preferences onto others you’re eating with so as to completely inconvenience them – that’s a surefire way to start an argument. Either politely decline offers of unhealthy food and use a line like “no thanks, that doesn’t really agree with my stomach” and move on. No need to go into a monologue of why the way you eat is the way all humans should and your diet would surely bring world peace if everyone adopted it.

 

Need a helping hand?

Weight loss can be very difficult, for a multitude of reasons, not just 5. Sometimes seeking professional help is more than warranted.
We offer nutritional consulting at the Injury Care Center. Call today to schedule a complimentary consultation!


Tips for Dealing With Walkers

Tips for Dealing With Walkers

Modern walkers are medical devices that allow people who have mobility issues to safely walk around. If someone is at risk of falling, or they break a bone in their leg or ankle, their physical therapist may recommend using a walker. At the Injury Care Center, we help our clients decide if they need a walker. We also help them choose the best type of walker that will fit their needs and body type. Our injury centers offer doctors, chiropractors, and physical therapists who use the best evidence-based equipment and medicine. We give each client the attention he or she deserves. 

 

Choose the Right Type of Walkers

There are several different types of walkers. Selecting the right type of walker will help you be as mobile as possible. Your medical doctor or physical therapist can help you determine which walker is right for your mobility needs. The following are common types of walkers that people with mobility needs frequently use:

  • A standard walker has four legs. The legs have non skid, rubber tips on the ends of them. You pick this walker up to move it as you walk. 
  • Two-wheel walkers have two wheels and two straight front legs. You need to pick this walker up to move it.
  • Three-wheeled walkers provide support and balance like four-wheel walkers, but they are lighter in weight and easier to maneuver.
  • Four-wheeled walkers are for people who do not need to lean on the walker for balance. These walkers are the fastest moving of all of the walkers, and newer devices come with brakes where the handle bars are to help people slow down when necessary.
  • A knee walker is meant to rest your knee and is useful for people who are recovering from knee or ankle injuries. After surgery, many doctors will require patients to use a knee walker for a certain period of time. Using this walker allows you to move around without putting weight on your injured knee or foot. 

 

Protect Your Back by Not Leaning Over Your Walker

Individuals who use a walker may already suffer from some back challenges or difficulties. When using your walker, ask your physical therapist to adjust the height of your walker so it is optimal. When a walker's height is too low, you will be more tempted to hunch over your walker. When the height of the walker is too high, it can be difficult to maneuver the walker properly. When walking with the walker, protect your back by staying upright as you move around. Make sure that you step into the walker, do not just walk behind it. Also, do not push the walker too far in front of you. If you do so, you will always be chasing your walker, causing you to hunch over more and injure your back. 

 

Check Your Surroundings to Avoid a Slip and Fall in Your Walker 

Even though walkers provide people with mobility who would not otherwise be able to get around, they can still be dangerous. Every year, approximately 1.5 million people are injured from a fall accident. Some of those slip and fall accidents happen to people using walkers. According to the National Center for Injury Prevention, nearly 50,000 people age 65 and older become injured from falls every year while using walking aids that land them in the hospital for treatment. Additionally, people using walkers are seven times more likely to fall than those using a cane. 

How should you go about preventing a fall in your walker? When using your walker, always check for objects on the ground that could cause you to trip. Wear shoes with low heels that have good grips so that you are less likely to slip. Ask for help if you come across floor surfaces that are slippery, uneven, cracked, or carpeted. Another great way to avoid falling with a walker is to receive training on how to use your walker. If you are not already in physical therapy, you may wish to engage in some physical therapy lessons focused on using your walker. 

 

Make Sure Your Walker Fits Your Body Height

One of the most important tips for using a walker is to take the time to ensure that it has the proper fit. When you first get the type of walker recommended by your health care practitioner, you will need to adjust the walker to meet your needs. Every walker comes with an owner’s manual and we recommend reading yours thoroughly after you first receive your walker. If you have questions while reading the manual, be sure to ask your medical practitioner. Here are a few tips for fitting your walker to your body:

  • Make sure the walker’s legs are locked and that the folding mechanism is in a locked position.
  • Make sure the hand grips do not move around and that they are tight on the bars. 
  • If you plan on using a basket on your walker in which to place small items, be sure to install the basket according to the instructions in the owner’s manual. 
  • Make sure your walker supports your leaning weight, not your standing weight. Those who need extra weight support can purchase a bariatric walker.
  • If you are a tall person, you may need to purchase a walker that is specially designed for adults with taller frames. The same goes for those who are shorter in stature. Your physical therapist should be able to help you choose the right type of walker. 

 

Maintain Your Walker as You Use it

If you use your walker every day, it will probably receive some wear and tear. Be sure regularly check your walker over to make sure it does not have any damaged or broken parts. Check to make sure that the rubber tips on the legs of the walker are not missing, worn, or ripped. 

 

Contact the Injury Care Center

If you think you may need a walker, or you need help learning to use your walker, we can help. The Injury Care Center offers individualized and effective medical practices to help you live your best life. Reach out to us today. 


The Road to Recovery_ Stories of People Healing and Succeeding

The Road to Recovery: Healing and Succeeding After A Major Injury

Many people that we treat at the Injury Care Center have suffered injuries sustained during car accidents. If you have been injured in a vehicle, it can be easy to feel like you have lost control or lost your way, but our injury care specialists can help you on your road to recovery. 

If you are suffering after an accident, first it is important to note that you are not alone. More than six million car accidents occur each year in the United States. According to the National Highway Traffic Safety Administration, about 27% of all vehicle accidents result in nonfatal injuries. These injuries can cause immense pain or lead to permanent disabilities. Indeed, nearly three million drivers suffer injuries and about two million drivers suffer permanent injuries from car accidents each year.

While you are not alone, each story is different. Here we want to share with you some individual success stories that might help ease your emotional suffering and help set you on a path toward a successful recovery. 

 

Michael's Story: A Stricken Cyclist 

On July 11, 2015, around 8:30 am, Michael was riding his bicycle near Fulshear, Texas. The town is relatively rural and located just outside Houston. Michael had traveled this exact route many times before as he trained to compete in the Ironman competition. It was a cool morning with a light breeze and Michael says he felt strong as he increased his speed down what he believed to be the carless road. 

A blue minivan was also speeding up - the driver took a turn at roughly 30 miles per hour directly in front of the path of Michael's bike. 

Michael remembers yelling and attempting to move away from the car, but the collision still came. Michael remembers lowering his left shoulder to brace for the hit - like a football player.  He suffered a direct impact. His bike was snapped in two pieces. His left shoulder and the left side of his body smashed into the panel of the van, he rolled across the front of the vehicle gathering glass as he did, and finally landed hard on the ground on the other side of the car.  A man rushed to help - a former Army medic who was biking in the area; he stabilized Micheal until paramedics arrived.  

Michael had broken nine ribs and fractured his left knee and left shoulder blade. His left lung collapsed; he had a concussion. Lacerations covered his left arm with the deepest cuts in my upper arm muscles. After a helicopter ride, he was admitted to Hermann Memorial Trauma Center near downtown Houston and was classified as a Level 2 Trauma patient. 

From the moment of admission, his recovery began. Michael remembers that the time in the hospital and the immediate time after returning home his focus was simple — survive. The left side of his body was motionless as he was unable to move his leg or lift his arm.  

Michael struggled to come to grips with his condition. The doctors, physical therapists, and nurses worked with him to build up strength with breathing exercises. \ He then began to be able to sit upright and get out of his bed. Michael struggled with not only the physical rehabilitation but the mental stresses, as well. He was diagnosed with acute post-traumatic stress and felt sad, depressed, and helpless. He joined a support group, which helped him recover. 

18 months after the accident, Michael completed the Austin Half-Marathon. He struggled with cramping and pulsating rib pain and considered dropping out of the race, but he took one step at a time - thinking of all he had been through - and finished. 

 

Jeff's Story: The New Normal

On May 3, 2012, Jeff survived a near-fatal car accident when his truck was hit by another truck that failed to stop at a four-way flashing-red stoplight near his home. Jeff's vehicle was forcibly pushed into, or rather from his description, "around" a concrete utility pole. Jeff suffered two impacts - the first when the trucks hit and the second when his truck careened into the utility pole. The second impact, caused Jeff to suffer a severe traumatic brain injury. 

Jeff has little memory of the first few weeks of his recovery. His first real recollection is doctors and other medical professionals telling him to find his "new normal," and he realized his life was forever changed due to the trauma. Jeff liked his “old” normal, though, so he refused to give up on the dreams and goals that he had set before the accident. 

Filled with determination, he reached for the stars, but after a few months, what the doctors had offered was realized. The "normal" Jeff was accustomed to was not returning. Jeff was stuck with a heavy emotional load. 

Working through his physical injuries and his brain injury required the help of friends and family. Jeff says, "when change inevitably comes, I think it's important to know when to give up on what used to be and how to grab hold of what is now."

 

Courtney's Story: Roadside to Recovery 

On November 11, 2016, Courtney was leaving work when her car broke down. It was between 7:00 pm and 8:00 pm when she pulled to the side of the road to investigate her vehicle troubles. She was hit by a vehicle driving at highway speed - around 60 miles per hour. 

One witness who called 911 said that she watched the driver cross the fog line, or white line, and hit Courtney and her car. When paramedics arrived, Courtney was transported to St. John's Hospital in Springfield, Illinois. Her injuries included a C2 fracture, T and L fractures in her back, as well as two broken fingers, a broken left shin bone, and a severely injured right hip and right knee. 

Courtney has endured multiple surgeries and endless hours of rehabilitation. She has said that recovery is one of the hardest things she has ever done. She moved from wheelchair to walker to crutches and is making the most of her medical team’s support system and her family's devotion to helping her succeed. 

 

Contact the Injury Care Center

If you have been injured in a car accident, the doctors and staff at the Injury Care Center are here to help. We want to make sure that your recovery is individualized and effective. Our team embraces many different methodologies and our number one goal is to provide excellent patient-centered care. Reach out to us today.