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The Centeno-Schultz Blog


Blackberry Thumb

With the advent of texting as a means of communication, there appears to be an increase in the number of cases of thumb pain.     A common cause of thumb pain is arthritis of the carpometacarpal joint ( CMC).  This is where the metacarpal bone of the thumb attaches to the trapezium bone of the wrist. … Continued

Does Whiplash Occur in Canada?

It appears that the Canadian health system has close links to the American insurance companies.  In years past the American insurance companies did not recognize whiplash and its attendant disabling pain.  Rather they banded together to create the concept of  M.I.S.T.  (Minor Injury Soft Tissue Injury).  The concept held that whiplash was a psychosocial phenomenon.  … Continued

Biceps Tendon Repair

Shoulder pain can arise from many causes including osteoarthritis, loss of cartilage and damage to the supporting muscles and tendons.  Shoulder arthroscopy is often deemed essential to repair torn or degenerative tendons.  Often during shoulder arthroscoppy one or more tendons is mechanically re-attached to the bone in an effort to remove the “damaged” or diseased … Continued

Narrowing the knee joint space

Have you been told that your knee x-ray shows narrowing of the joint space and therefore your should have arthroscopic knee surgery?  Before you schedule for knee arthroscopic surgery or arthritis knee surgery consider the following facts. A study in the New England Journal of Medicine recently demonstrated that knee arthroscopy in patients with osteoarthritis … Continued

Meniscus knee surgery

As a pain physician I am committed to identifying the source in a given patient so that the appropriate treatment can be provided.  We have learned that degenerative discs identified on  MRI of the lumbar spine are NOT  by default the origin of a patient’s back pain .  Degenerative lumbar discs are part of the aging … Continued

X-Rays: Only Part of the Picture

As an interventional pain physician, I have the opportunity to evaluate patients who are seeking alternatives to arthroscopic hip, hip resurfacing surgery and total hip replacement surgery.  Most patients want to avoid having the top of the femur sawed off and replaced with a metal prosthesis. Most patients come with x-rays and a history of … Continued

Knee cartilage surgery

Cartilage  is a dense connective tissue found in the knee  where it provides a protective surface.  It is composed of cells called chondrocytes.  Unlike other tissues,  articular cartilage does not contain blood vessels and therefore has poor regenerative qualities.  Injury to the articular cartilage of the knee can be the result of trauma, meniscal knee surgery where a … Continued