AC Joint Impingement
AC joint Impingement is a painful condition that occurs when the space beneath the acromion bone is narrowed. This narrowing can result in irritation of the rotator cuff tendons and bursa. A bursa is a fluid-filled sac that reduces the friction on tendons and muscles as they cross bony surfaces. A tendon is thick collagen tissue that connects muscles to bones. The rotator cuff tendons provide important support and enable movement in the shoulder. If severe, impingement can cause tears in the rotator cuff tendons. Patients with AC joint impingement typically have pain with elevation of the arm and or while lying on the shoulder.
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Heel pain is one of those issues that can affect most of what you do in a day and can be disabling. A common cause of heel pain is the Achilles tendon. What is the Achilles tendon? What is Achilles tendonitis? What are the different injuries? Is stem cell therapy for Achilles tendonitis a viable option?
Where & What Is the Achilles Tendon?
A tendon is a thick fibrous band of connective tissue that connects a muscle to bone. There are more than 30 million tendon and ligament injuries annually. The Achilles tendon, which is the thickest tendon in the body connects the calf muscles to the heel bone. It consists of the gastrocnemius and soleus muscles that unite to form a thick band that is immediately above the heel tab on your shoe. It enables the downward movement of the foot and bending of the knee.
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The Anterior Cruciate Ligament (ACL) is one of four major ligaments in the knee. It is an important stabilizer of the knee and prevents the shin bone (tibia) from sliding in front of the thigh bone (femur).
The ACL is susceptible to injury. It is most likely to be injured during activity or by impact.
A torn ACL is a common injury for athletes at all levels, but it is most common for people who are active or who experience impact injuries to the knee.
ACL injuries can happen to anyone of any age, condition, or ability, and it can be injured in many ways. Examples include abruptly changing direction, slowing down while running, landing incorrectly, or getting struck by someone or some object.
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Your ankle is located where the distal ends of the tibia and fibula bones (lower-leg bones) meet the talus bone at the foot. Between these bones are the ankle joints (e.g., tibiotalar, tibiofibular, subtalar, etc.). The ankle joint also consists of strong supporting tendons and ligaments. If you consistently experience ankle pain with walking or running or carrying a heavy load, this could be tendon inflammation, ligament instability, or arthritis in one of those joints.
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Ankle Tendon Tear
Have you been told you have an ankle tendon tear and need surgery? Do you really need this procedure or will less invasive injections do the trick? Let’s review ankle tendon surgery and who needs it and who doesn’t.
The ankle has many tendons that come from leg muscles. They help stabilize the ankle and move the foot up, down, left, and right.
The ankle tendons include:
FHL (Flexor Hallicus Longus)
FDL (Flexor Digitorum Longus)
These can be torn in trauma or due to wear and tear.
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To understand annular tears, let us first review the anatomy of the spine. The lumbar spine is comprised of 5 boney building blocks called vertebral bodies. Sandwiched between the vertebral bodies are the lumbar discs. Each disc is comprised of an outer fibrous ring, the annulus fibrosis that surrounds the inner gelatinous center, which is called the nucleus. The disc absorbs the forces of daily living. The annulus has multiple layers of collagen that provide important support. The annulus is similar to the sidewall of a tire which provides important stability for the tire. Through trauma or degeneration, the outer annular fibers can become injured and or weakened.
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Arthritis in Shoulder
The shoulder is a truly remarkable joint. It allows you to reach out into virtually all directions: overhead, forward, and backwards. Unfortunately, like other joints in the body the shoulder is susceptible to irritation and injury.
Osteoarthritis is the most common cause of disability in the United States, affecting up to 32.8% of patients over sixty years of age (1). Shoulder arthritis is a common condition estimated to be as high as 16-20% in the middle aged and elderly population (2). Shoulder arthritis can compromise range of motion, strength and be a source of debilitating pain. This blog will review the shoulder.
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Atlantoaxial Instability (AAI)
Instability simply means that bones move around too much, usually due to damaged ligaments. In the spine, this can cause nerves to get banged into and joints to get damaged. In the craniocervical junction, instability can cause the upper cervical spinal nerves to get irritated, leading to headaches. In addition, the C0-C1 and C1-C2 facet joints can also get damaged. In addition, there are other nerves that exit the skull here that can get irritated, like the vagus nerve, which can cause rapid heart rate. What’s the Difference Between CCI and AAI? CCI refers to instability in any part of the craniocervical junction…
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Avascular Necrosis of the Shoulder
Avascular Necrosis is essentially a lack of blood flow, eventually resulting in necrosis, or dying of the bone. This happens in multiple joints. And today we are talking specifically about the shoulder. So talking about AVN in the shoulder, patients typically come up with two main questions. Number one, can this heal on its own? And if not, how long or how fast will this progress? Now we classify AVN in multiple different stages: Number one: we have stage one, where it is very normal X-ray — usually, typically, someone just has pain with activity. Is the bone itself continues to deteriorate, then we start getting some changes on your X-ray.
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A Baker’s cyst can cause knee pain. A Baker cyst is swelling caused by fluid from the knee joint protruding to the back of the knee.
They are NOT a true cyst since it has communication with the synovial sac. They typically arise from degenerative changes or injury to the articular cartilage (arthritis) or meniscus.
At the Centeno-Schultz Clinic, we believe that baker’s Cysts are simply a barometer of the health of the knee joint. In a healthy knee, there are absent whereas with injury and degenerative changes they are common. They arise between the tendons of the medial head…
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Basal Joint Arthritis or CMC / Carpometacarpal Arthritis
The thumb is also referred to as the CMC joint. It is composed of two bones. The Carpal bone is denoted by the letter C. The second bone, the MC is the MetaCarpal bone. So your thumb is made up of the Carpal and MetaCarpal bones that come together and form a joint. The joint is lined with cartilage which allows the two bones to slide smoothly against one another. The thumb joint is held together by multiple thick ligaments. Ligaments are thick pieces of connective tissue that connect one bone to another. This joint is a saddle-shaped joint that experiences significant forces through activities of daily living.
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It is an entrapment syndrome, like carpal tunnel syndrome in your hand. This is an entrapment of a nerve in your foot, right around your heel, on the inside part compressing a branch of your tibial nerve called your inferior calcaneal nerve, and that is the Baxter’s nerve. Now, the inferior calcaneal nerve is the first branch of the lateral plantar nerve, which is a branch off your tibial nerve. It lives between a muscle belly called your abductor hallucis muscle, as well as the medial calcaneal tuberosity, which is a small bump where a common heel spur occurs in the foot.
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Bulging Disc In Thoracic Spine
A bulging disc in the thoracic spine is a serious medical condition that occurs when the outer layer of the disc weakens, causing it to bulge outward and put pressure on nerves and the spinal cord. The disc has two components, a soft center and a thick outer layer, and weakening or tears in the outer layer can lead to a bulge. Symptoms include pain, numbness, and weakness in the affected area. The thoracic spine is that portion of the spine that resides below the neck and above the low back. It is commonly referred to as the mid-back. A bulging…
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Calcific tendonitis, also known as calcifying tendonitis, is a condition characterized by the formation of calcium deposits in a tendon, most commonly in the rotator cuff tendons of the shoulder. These deposits are not due to injury or trauma but rather occur spontaneously. Tendons, the thick connective tissues that link muscles to bones, aren’t usually calcified. However, in calcific tendonitis, calcium builds up in these tissues, which can result in inflammation and severe pain. This condition tends to occur more commonly in adults between 30 and 60 years old, and it’s more prevalent in women than in men.
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Carpal Tunnel Syndrome
The carpal tunnel is a tunnel-like structure in the wrist that the median nerve travels through. There are also carpal ligaments that form the roof of the tunnel and flexor tendons that also run through the tunnel. The median nerve is a branch that generates off the brachial plexus from the cervical spine in the neck. It stretches down through the arm, the wrist, and all the way into the thumb. The flexor tendons provide stability and help bend the thumb and fingers. When something causes the tunnel to narrow or the medial nerve somehow becomes compressed in the wrist, this can lead to carpal tunnel syndrome (CTS).
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Cervical Facet Syndrome
Cervical facet syndrome, also known as cervical facet joint pain, is a condition that occurs when the facet joints in the cervical spine become inflamed or damaged. The facet joints are small joints located between the neck vertebrae, which help to provide stability and facilitate movement. When these joints become irritated or injured, they can cause pain and discomfort in the neck and surrounding areas. Symptoms of cervical facet syndrome can include neck pain, stiffness, headaches, and even radiating pain into the shoulders, arms, and upper back. Treatment options for cervical facet syndrome may include physical therapy, medications, injections, or in some cases, surgery.
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Cervical Medullary Syndrome
Cervical Medullary Syndrome is a clinical condition that occurs as a result of inflammation, deformity, or compression of the lower part of the brain. Symptoms can be extensive with fluctuating severity based upon the extent of the underlying injury. For example, mild irritation of the brainstem may cause only mild, intermittent symptoms. The upper cervical spine and brain are complex with multiple structures. These structures reside within the skull and protective confines of the cervical spine. Neither expands to accommodate inflammation, injury, and disease. Rather the delicate tissues of the brain and spinal cord are irritated or compressed. The 4 major conditions that cause cervical medullary syndrome are…
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Common Cervical Radiculopathy symptoms include neck pain, arm pain, shoulder pain radiating down arm to fingers, numbness, tingling, and weakness. Cervical Radiculopathy is a clinical condition in which a nerve or nerves in your neck become irritated or compressed. It is also known as ” a pinched nerve,” The causes are discussed below. It can affect individuals of any age with peak prominence between ages 40-50 years of age. Cervical Radiculopathy is due to spinal nerve inflammation, irritation, or compression. The most common causes of Cervical Radiculopathy are: Disc Injury – The disc is an important shock absorber. Unfortunately, it is susceptible to injury.
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Chondromalacia is the knee usually causes pain, typically around the kneecap or deep in the kneecap. You can also have some grinding sensations or crepitus which are sounds and noises coming from around the knee with certain motions. Typically, pain and grinding sensations are worse with bending the knee, especially for prolonged periods of time, kneeling on the knee, walking downstairs, or running downhill. Standing after prolonged sitting or an immobility period where the knee is bent can cause some discomfort as well. Some people may experience swelling, others may experience locking or catching in the knee, feeling the knee wants to give out, or a feeling of weakness….
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Craniocervical Instability is a medical condition characterized by injury and instability of the ligaments that hold your head onto the neck. Common symptoms of Cranial Cervical Instability include a painful, heavy head, headache, rapid heart rate, brain fog, neck pain, visual problems, dizziness, and chronic fatigue.CCI or neck ligament laxity treatment options depend upon the severity of the instability and clinical symptoms. When appropriate, conservative care should always be the first-line treatment.
Craniocervical Instability Surgery is often recommended when conservative care fails. This involves a fusion of the head to the neck which is a major surgery that is associated with significant risks and complications…
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Degenerative Scoliosis, also known as Adult-onset Scoliosis, is a medical condition that involves a side bending in the spine. The bending can be mild, moderate, or severe with side-bending to either the right or the left. The term degenerative means generalized wear and tear and is common as we get older. Degenerative scoliosis is the curvature of the spine that occurs as a result of degeneration of the discs, small joints, and building blocks. The Degenerative Scoliosis curve is often located in the low back and forms a ‘C” shape. There is a convex and a concave side. The convex side is the open side where it curves outward.
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EDS in Children
Ehlers-Danlos Syndrome (EDS) refers to a group of disorders that affect the body’s connective tissue including skin, tendons, and ligaments. It is a hereditary disorder which means you are born with it. EDS has many different signs and symptoms which can vary significantly from patient to patient. It most commonly affects the skin, joints, and blood vessels. The estimated prevalence for all EDS varies between 1/10,000 and 1/25,000. The three most common types of EDS are: Hypermobile, Classic, and Vascular. We have used these skills and knowledge to treat the loose ligaments commonly found in EDS in children. Treatment options include bone marrow concentrate (BMC) and PRP.
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Ehlers-Danlos Syndrome (EDS)
Disorders that affect and weaken the connective tissues such as tendons and ligaments. It is a hereditary disorder which means you are born with it. EDS has many different signs and symptoms which can vary significantly depending upon the type of EDS and its severity. It most commonly affects the skin, joints, and blood vessels. Joints are typically hypermobile with excessive joint range of motion because of a defect in collagen formation. In most cases Ehlers-Danlos syndrome is inherited. That is to say that you are born with it. The two main ways EDS is inherited are: autosomal dominant inheritance and autosomal recessive inheritance…
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Facet Joint Syndrome
Injury or inflammation of the cervical facet can led to neck, shoulder and headache pain – called “cervical facet syndrome.” Cervical facet syndrome largely involves a joint in the posterior aspect of the cervical spine. It functions to provide stability and guide motion. cervical facet joint injection for cervical facet syndrome Cervical facet pain is common in patients who have sustained a whiplash injury, trauma to the neck or undergone cervical fusion. Physical examination is typically significant for restriction in range of motion along with pain. Each joint has a distinct referral pattern illustrated below. The Centeno-Schultz Clinic are experts at diagnosing and treating cervical facet dysfunction. Injury to the joint is not commonly detected by conventional radiographic studies.
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Facet Synovial Cyst
A facet cyst, also known as a synovial cyst, is a fluid-filled sac that forms in the facet joint of the spine. The facet joints are small joints located between the vertebrae of the spine that provide stability and enable movement. Facet cysts typically develop due to degeneration and wear and tear of the facet joint, which can cause the joint capsule to stretch and weaken. This weakened capsule can then allow synovial fluid, which normally lubricates and nourishes the joint, to leak out and form a cyst. Facet cysts can cause various symptoms such as back pain, leg pain…
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Failed Back Surgery Syndrome
Failed Back Surgery Syndrome also called failed back is a clinical condition in which patients who have undergone low back surgery continue to have pain and dysfunction. Said another way the surgery that was intended to reduce pain and increase function FAILED. That is right, the surgery failed. You had the surgery, struggled with the pain postoperatively, diligently participated in physical therapy and yet the pain and limitation are still there. Unfortunately, this occurs frequently. Estimates range from 20-40% of patients who undergo low back surgery will develop Failed Back Surgery Syndrome. Pain is the most common symptom of Failed Back Surgery Syndrome…
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Frozen shoulder, also known as adhesive capsulitis, is a painful loss of shoulder movement and range in motion. The incidence of frozen shoulder is 3-5% in the general population and up to 20% in those with diabetes. The peak incidence is between 40-60 years of age. The exact mechanism is poorly understood. In general, the capsule becomes inflamed, thickened, and contracted with pain and significant restriction in range of motion. causes are poorly understood but risk factors include trauma, prolonged immobility, systematic diseases such as diabetes, stroke, connective tissue disease, and heart disease. Other causes include post-surgery, chronic inflammation causing stimulation of myofibroblasts
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Tendinopathy is a group of tendon disorders. The most common form of Tendinopathy is Tendinosis (1). Tendinosis is a degenerative condition that is characterized by collagen degeneration and micro-trauma in the tendon due to repetitive overloading. Gluteal Tendinopathy is a clinical condition in which there is moderate to severe debilitating pain due to injury of the Gluteal tendons. It is the most common Tendinopathy in the lower leg (2) and is more common in women (3). In most cases, physical examination alone is sufficient to diagnose Gluteal Tendinopathy. If symptoms continue despite conservative care, other studies may be warranted which include ultrasound and MRI.
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Your hamstrings are the thick muscles in the back of your thigh that are responsible for the movement of your hip, thigh, and knee. The hamstrings are made of three distinct muscles: Semitendinosus, Semimembranosus, and Biceps Femoris.
What is Hamstrings Tendinopathy?
Tendons are thick pieces of connective tissue that connect muscle to bone. They function to transfer the force generated by muscle contraction into movement.
Hamstring tendinopathy, also known as a “calf strain,” is an injury to the affected tendon. It usually occurs when you bend your knee or extend your leg, putting too much force on the hamstring tendon….
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Herniated Cervical Disc
Cervical disc herniation refers to the displacement or protrusion of the intervertebral disc in the cervical spine, which can potentially compress the spinal cord or spinal nerves. Cervical disc herniations can be categorized into three main types based on their location: median, paramedian, and lateral herniations.
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Herniated Thoracic Disc
A herniated thoracic disc is especially difficult because there are not as many treatments available as there are for disc herniations in other areas of the spine. To understand Thoracic Disc Herniations, though, we first need to cover thoracic spine anatomy and function. With disc herniation, the annulus fibrosus get small tears throughout the annulus. An annulus is a bunch of concentric fibers, so, as the fibers get damaged and cut, the pressure that is built up within the nucleus pushes the now weakened annulus outward, creating a bulge or herniation. The disc begins to weaken via mild degeneration/tearing of the annular fibers…
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Hip Labral / Labrum tear
A tear in the hip labrum can cause a number of different symptoms. The most common is anterior hip or groin pain which may radiate down to the level of the knee (3). Pain develops gradually and typically is dull in character made worse with walking, pivoting and running. Hip labral tears are easily seen on MRI. Unfortunately, it’s importance as a source of pain must be questioned. Why? Research has demonstrated that many patients with no hip pain have labral tears on MRI (4-5). In one study, Duthon et al demonstrated that 69% of patients without hip pain had labral tears.
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Interstitial Cystitis has been called many names, such as Painful Bladder Syndrome, Urethral Syndrome, Trigonitis, and Bladder Pain Syndrome. Some characterize it into Hunner Lesion Interstitial Cystitis, which is described as having irritating lesions on the bladder wall seen with cystoscopy (scope looking into the bladder) or Non-Hunner Lesion Interstitial Cystitis, in which no such lesions on cystoscopy. The cause or etiology of the disease is not known or not clearly recognized.IC or BPS predominantly affects women with an average age of onset of 40 years or older. It does affect men, but it is less common, and very rarely would affect children.
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In the human body, a joint is simply where 2 ends of bone come together. At the ends of these bones, there is a thick substance called “Hyaline Cartilage” that lines the ends. Hyaline cartilage is extremely slippery which allows the two ends of the bone to slide on top of each other. Then there is a capsule that connects the two ends filled with “synovial fluid” that acts as a further lubricant to make it more slippery!
Arthritis in the knee is defined by loss of the hyaline cartilage plus other changes that happen to the bone such as additional bone being laid down (bone spurs/osteophytes). The cartilage layer is worn down to the point of exposing the underlying bone they cover…
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Bursitis is the inflammation of the bursa around the joints. Each year, 1 of every 10,000 individuals globally develops bursitis in the knee and elbow. Bursitis can occur in the shoulders, elbows, hips, knees, and feet.
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Knee instability is a condition that results when the knee joint is unstable and does not move or function normally. This can cause the knee to feel like it is going to give out or buckle. Knee instability can be caused by a variety of factors, including trauma or injury to the knee, ligament injury, arthritis or other degenerative diseases of the knee, weakness or instability of the muscles around the knee, muscle atrophy, injury to another joint in the body creates an imbalance. Knee stability, and stability in general, is very important. Lack of knee stability can lead to more problems over time, such as pain and arthritis…
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Lateral Epicondylitis / Tennis Elbow
Lateral epicondylitis otherwise known as tennis elbow is an overuse injury involving the extensor muscles that originate on the bony prominence (epicondyle) on the outside (lateral) aspect of the elbow. It is more properly termed tendinosis that specifically involves the origin of the extensor carpi radialis brevis muscle. In a study, Nirschl and Pettrone attributed the cause of lateral epicondylitis to be tearing in the origin of the extensor carpi radialis brevis (ECRB) muscle (1).
The extensor carpi radialis brevis (ECRB) muscle originates from the lateral epicondyle. It functions to move the wrist so that the hand moves away from the palm and towards the thumb.
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What is an LCL Sprain?
A strain or tear to the lateral collateral ligament (LCL) is known as an LCL injury. The LCL is a band of tissue that runs along the outer side of your knee. It aids in keeping the bones together while you walk, ensuring that your knee joint remains stable.
How you feel and what type of treatment you’ll require depends on how severely your LCL has been stretched or torn. If it’s only a minor sprain, self-care at home might help. However, if it’s a significant tear or sprain, you may need physical therapy, an injection-based procedure, or surgery….
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A strain or tear to the lateral collateral ligament (LCL) is known as an LCL injury. The LCL is a band of tissue that runs along the outer side of your knee. It aids in keeping the bones together while you walk, ensuring that your knee joint remains stable.
How you feel and what type of treatment you’ll require depends on how severely your LCL has been stretched or torn. If it’s only a minor sprain, self-care at home might help. However, if it’s a significant tear, you may need physical therapy, an injection-based procedure, or surgery. Orthopedists categorize LCL tears into 3 grades…
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The medial collateral ligament AKA MCL is a thick, strong band of connective tissue on the inside portion of your knee. It connects the top part of the tibia (shin) to the bottom part of the femur (thigh). This is a vital ligament that works along the lateral collateral ligament (LCL), anterior cruciate ligament (ACL), and posterior cruciate ligament (PCL) to bring stability, structure, and movement to the knee. The MCL provides support and stability for the inside (medial) aspect of the knee. MCL sprains are a common injury in sports such as football, hockey, and skiing. The ligament can…
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The medial collateral ligament AKA MCL is a thick, strong band of connective tissue on the inside portion of your knee. It connects the top part of the tibia (shin) to the bottom part of the femur (thigh). This is a vital ligament that works along the lateral collateral ligament (LCL), anterior cruciate ligament (ACL), and posterior cruciate ligament (PCL) to bring stability, structure, and movement to the knee. The MCL provides support and stability for the inside (medial) aspect of the knee. MCL tears are a common injury in sports such as football, hockey, and skiing. The ligament can…
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Medial Epicondylitis / Golfer’s Elbow
Golfer’s elbow involves tears in the ulnar collateral ligament and pain or soreness on the inside of the elbow. The bony bump you feel there is the medial epicondyle of the humerus (upper arm bone). There are five forearm muscles that attach at this point, all of which are involved in helping to flex or rotate the forearm and wrist. Pain can get worse when you throw a ball, grip a dumbbell, turn a screwdriver, and other movements that involve the fingers, hand, wrist, and/or elbow. Tennis elbow is similar, however, it refers to the outside of the elbow, at the lateral epicondyle.
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The meniscus is a c-shaped piece of cartilage in the knee that functions as an important shock absorber. It is sandwiched between the thigh and shin bone. There are two menisci per knee. One on the inside portion of the knee (medial) one on the outside aspect (lateral).
The knee meniscus is susceptible to injury. The most common injury is a tear in the meniscus. Not all meniscus tears however cause pain. When symptomatic a meniscus tear can cause pain, swelling, and restriction in range of motion.
Tears in the knee meniscus can arise from trauma or degeneration. There are many different types of meniscus tears based upon locations….
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We see many patients with osteitis pubis every year, but very few have been offered effective osteitis pubis treatment. So what is this diagnosis? What causes it? How can it be easily treated? Let’s dig in.
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What is the Patellar Tendon? A tendon is a piece of connective tissue that connects muscle to bone. It serves to move the bone or a given joint. The patellar tendon is a major tendon in the knee. It is located at the bottom of the kneecap (patella) and stretches down to the shin. The patellar tendon enables you to extend your knee, kick, run, and jump. What is Patellar Tendinitis?
Patellar tendinitis is an irritation and inflammation of the tendon that connects your kneecap (patella) to your shinbone. Patellar tendinitis, also known as jumper’s knee, can affect anyone. The most common symptom is pain at the shin or lowest part of the kneecap…
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The kneecap is also known as the patella. The thigh bone is the femur. The patellofemoral joint is formed by the kneecap and the grooved surface of the thigh bone. The patella slides up and down in a grooved track in the femur. The groove is more specifically called the trochlear groove. Like a train that travels on a track, under ideal conditions the patella tracks up and down in the trochlear groove.
What is Patellofemoral Syndrome?
Patellofemoral syndrome is a medical condition characterized by discomfort in the front of the knee and around the patella. Patellofemoral syndrome may also be known as “jumper’s knee” or “runner’s knee.”…
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The Posterior Cruciate Ligament is one of the paired ligaments in the middle of the knee. It is made up of 2 separate bundles: The two bundles of the PCL, and the ALB (anterior lateral bundle), and the PMB (posterior medial bundle), function synergistically to provide stability. The PCL functions as one of the main stabilizers of the knee joint and serves primarily to resist excessive posterior translation of the tibia relative to the femur. The PCL also acts as a secondary stabilizer of the knee preventing excessive rotation specifically between 90° and 120° of knee flexion. A PCL sprain happens when force is applied beyond…
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Your heel pain initially was mild and aching. It is now a constant forest fire at the base of your heel. Each morning you take your first step with great trepidation knowing that the searing pain is literally a step away. Medications, rest, and physical therapy have not helped. Your doctor is concerned and thinks you may have Plantar Fasciitis. What is Plantar Fasciitis? What are the symptoms of Plantar Fasciitis? What are the risk factors? Is Plantar Fasciitis simply inflammation? What are the treatment options for Plantar Fasciitis? What to do for Plantar Fasciitis so bad I can’t walk? Beware as not all heel pain is Plantar Fasciitis.
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Rotator Cuff Tear
Are you plagued by shoulder pain that has now transitioned from intermittent to constant and keeps you up at night? Are daily shoulder movements, such as dressing and reaching for objects in the kitchen cabinets, painful? Is your range of motion decreasing as your pain is increasing? You may have a full- or partial-thickness rotator cuff tear. Has conservative therapy in the form of heat, ice, stretching, rest, and acupuncture failed to provide significant relief? Has an MRI demonstrated a full-thickness or partial-thickness tear of the rotator cuff? What to do? If left untreated, full-thickness and 26% of partial-thickness tears will progress.
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Slipping Rib Syndrome
Slipping Rib Syndrome can be incredibly painful and is often misdiagnosed. It is also known as rib dislocation, rib subluxation, Tietze syndrome, Davies–Colley’s syndrome, rib-tip syndrome, painful rib syndrome, costochondral separation, and clicking or moving rib syndrome. It is very common for athletes involved in contact sports to get a slipped rib. Trauma causes stretching and sometimes tearing of the ligament attachments of the rib, creating instability. We also see this in many of our motor vehicle accident patients, caused by the seat belt and/or airbag. Once damaged, it can take several weeks to resolve (4-12 weeks). After 3 months, if the rib continues to…
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Spinal instability is a condition that occurs when the spinal column is not able to maintain its normal alignment and function under normal loads. It can be caused by various factors such as trauma, degenerative changes, infections, tumors, or congenital abnormalities. In a stable spine, the bones, discs, ligaments, and muscles work together to support and protect the spinal cord and nerve roots. However, in an unstable spine, the structures that support the spine may be damaged or weakened. This can lead to abnormal movement and excessive stress on the spinal cord and nerves. In most cases, bone and joint problems…
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Thoracic Degenerative Disc Disease
Degenerative disc disease is a clinical condition that refers to the gradual deterioration of the discs located in the thoracic spine and the associated symptoms. Pain, weakness, muscle spasms, and restriction in range of motion are common. Degenerative disc disease can occur at each level of the spine: cervical, thoracic, and lumbar. Studies have demonstrated that degenerative disc disease in the thoracic spine most commonly occurs in the third to fourth decades (1) and occurs most frequently in the lower thoracic segments from T7-T12. Thoracic degenerative disc disease has four main stages that start with mild symptoms and progress in severity…
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Thoracic Outlet Syndrome
The thoracic outlet is an area around the collar bone where the nerves that come from your neck meet up with the blood vessels from your heart and together supply the entire upper extremity (shoulder and arm). These blood vessels (subclavian artery and vein) and nerves (brachial plexus) travel from the base of your neck to your armpit (axilla) and are considered the “thoracic outlet”. Now that you know what the thoracic outlet is, what is thoracic outlet syndrome? Simply listening to a patient’s history and completing a physical examination is all that is needed to diagnose TOS. But more involved imaging such as X-rays…
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Thoracic radiculopathy is a painful medical condition that affects both men and women alike. Pain, paresthesia, decreased sensation, and weakness are the major symptoms. Radiculopathy refers to the whole complex of symptoms that can be caused by irritation or compression of a nerve root in the spine. Thoracic radiculopathy is irritation or compression of a thoracic spinal nerve. Causes of radiculopathy in the thoracic region are thoracic disc injuries, thoracic facet arthritis, ligament thickening, facet cyst, unstable rib attachments, and bone spurs. Diagnosis of thoracic radiculopathy can be difficult. Treatment options vary upon severity and when appropriate should always start with conservative care.
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Thoracic Spine Hemangioma
Hemangiomas are benign tumors composed of abnormal blood vessels. They can occur anywhere in the body but most commonly appear on the face, scalp or back. They can also occur in the vertebral bodies in the spine where they are referred to as vertebral hemangiomas. The vertebrae are the boney building blocks that stack one upon another that make up the spine.
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Thoracic Spine Sprain
Thoracic spine sprains are a frequent problem that can occur when the ligaments in the middle back area get injured. This can lead to troublesome symptoms like pain, stiffness, and muscle spasms, making it difficult to move comfortably and perform your everyday activities.
The good news is that there are treatment options readily available, ranging from simple techniques like applying heat or taking over the counter medication, to more advanced regenerative treatments like Platelet-Rich Plasma (PRP) and bone marrow concentrate.
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The thoracic spine, also known as the mid back, is that portion of the spine that is below the cervical spine (neck) and above the lumbar spine (low back). Thoracic spondylosis is a degenerative condition of the thoracic spine. The thoracic spine, also known as the mid back, is composed of many important different structures that work together to provide stability and movement. Thoracic spondylosis is a degenerative condition affecting the middle region of the spine, known as the thoracic spine. The major causes include: aging, genetics, poor posture, repetitive strain, and more. Symptoms can be mild, moderate, or severe…
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Simply put, ulnar neuropathy refers to the compression or damage to the ulnar nerve in the arm. It affects up to 6% of the population, based on reports.The ulnar nerve is one of three main nerves in the arm that run from the shoulder to the hand and is responsible for providing sensation to the small and ring fingers and for controlling the movement of specific hand muscles. When the ulnar nerve is damaged or compressed, it can lead to a range of symptoms, including pain, numbness, weakness, and tingling in the affected hand. The symptoms of ulnar neuropathy can…
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