by Jeffrey R. Carlson, MD
I have been an Orthopaedic Specialist at OSC since 1999. During that time, I have seen thousands of patients who have presented with various complaints of pain and dysfunction. Recently, I was asked to name the top problems for which we treat patients at OSC and the causes for those problems. Here is my list:
- Back Pain – Did you know that 80% of us will seek medical care at some point in our lives due to back pain? This certainly holds true at OSC, where we see back pain issues constantly. Back pain is usually not caused by a problem with the spine, but is most often caused by a muscle strains/sprains due to overuse or cumulative micro-injuries.
- Treatment – muscle relaxants may be prescribed, along with oral steroids or injectable steroids. Heating pads, ice packs, hot baths and massages may also be therapeutic. Activities should be modified, but no bed rest! Physical Therapy may also be recommended to strengthen weak core muscles.
- Prognosis – Almost all back muscle strain issues resolve within 1-2 weeks, without any further intervention.
- Neck Pain – Neck pain is most commonly caused by Osteoarthritis and that is what causes snap, crackle and pop sounds when you rotate your head or tilt the head forward or backward. Sometimes, bone spurs can develop as a result of the body trying to relieve pressure on areas of the cervical spine. These bone spurs can press on spinal nerves or the spinal cord.
- Treatment – Anti-inflammatory medications, either OTC or prescription will be given to reduce inflammation. Heating pads, ice packs, hot baths and massages may also be therapeutic. Physical Therapy may also be recommended to strengthen weak neck muscles. If no improvement is seen, oral steroids or injectable steroids may be used. If arthritis is severe and unresponsive to conservative treatment, outpatient surgery may be required to remove bone spurs and to address arthritic changes to the vertebrae, including fusion or laminectomy.
- Prognosis – most neck pain will resolve with conservative treatment. Only about 5% of neck pain cases will require surgical intervention.
- Knee Pain – The reasons we see patients for knee pain vary from sports injuries to the aches and pains that come from aging. The number one cause would be osteoarthritis, the type of arthritis that comes from wear and tear on the knee joint from everyday activities. The number two reason would be a torn meniscus. Menisci are cartilage pads inside the knee joint that can tear from an injury or just because they are getting worn. Because most of the meniscus has a poor blood supply, they don’t tend to heal well. They can cause the knee to catch or lock as well as make the knee unstable. It is estimated that 60% of people over the age of 65 have a tear in their meniscus, which may or may not cause any pain.
- Treatment – Anti-inflammatory medications, either OTC or prescription will be given to reduce inflammation. Activity modification and the use of heating pads or ice packs will help. Physical Therapy may also be recommended to strengthen weak leg muscles and to help stabilize the knee. If no improvement is seen, oral steroids or injectable steroids may be used. Outpatient Arthroscopic Surgery may be suggested if conservative treatments don’t work, where the surgeon will either repair, trim or remove the torn meniscus.
- Prognosis – most knee pain from a torn meniscus will resolve with conservative treatment.
- Hip Pain – Bursitis tops the list for all of the conditions that can cause hip pain. The bursa are fluid-filled sacs that provide cushion for our muscles and tendons as they move over bone and joints. These bursa can become inflamed from overuse or too little use, causing pain. They can even become infected in severe cases. Bursitis tends to affect women more than men, as their hips take more stress due to their shape for childbirth.
- Treatment – Anti-inflammatory medications, either OTC or prescription as well as injectable steroids will be used to reduce inflammation. Rest and the use of ice packs will help. Physical Therapy may also be recommended to stretch and strengthen muscles that support the hip. If the bursa are infected, antibiotics will be prescribed and the bursa may be drained by needle aspiration. In very rare cases, the bursa may be removed surgically.
- Prognosis – most hip pain from bursitis will resolve with conservative treatment and a program of stretching.
- Shoulder Pain – Shoulders take a lot of stress during the course of our lifetime and as a result, they can become injured, inflamed and painful. Rotator Cuff Tears (not rotary cup) are the 1# shoulder problem for which folks seek care at OSC. The Rotator Cuff is actually four muscles that combine to form a large tendon, which enables you to lift and rotate your arm. It also helps to stabilize the shoulder. Tears can occur from an acute injury or just day-to-day living. Small tears often become larger, necessitating the need for treatment.
- Treatment – OTC or prescription anti-inflammatory medications, as well as injectable steroids will be used to reduce inflammation. Rest and the use of ice packs will help. Physical Therapy may also be recommended to stretch and strengthen muscles that support the shoulder. Most tears will not heal on their own, and it will be up to the patient to decide whether to live with it or have their torn rotator cuff surgically repaired.
- Prognosis – Some shoulder pain and weakness from rotator cuff tears will resolve with conservative treatment. Some patients will require outpatient surgical treatment to find pain relief and restoration of function.