January 9th, 2012  Posted at   Pain Management
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If spine surgery is done for the right reasons, the initial result may be fantastic. For instance if the patient has a herniated disc and exhausts conservative treatment then a discectomy procedure may give excellent results very quickly.

Studies actually show that results after a discectomy are well over 90% excellent. But what about those patients that have a great result initially and then those results deteriorate over time? Why does that happen?

Result deterioration occurs for a number of reasons. First reason to mention is that if surgery is done around a nerve root and it is decompressed surgically, scar tissue may end up enveloping the nerve root and cause damage which can lead to patients having significant pain. The scar tissue that grows around the nerve roads can be removed but more scar tissue will come right back. So another surgery is not always the answer.

It can be very frustrating for patients as it is not so easy to get a great spine surgery result, the patient had one, and then disappeared. The “cherry on top” frustration is that another surgery will not fix the problem, so the person may need interventional procedures such as epidural injections and maybe a spinal cord stimulator. A spinal cord stimulator does not fix the problem causing the pain, but if it cannot be fixed why not mask the pain?

An additional reason for pain to return is adjacent segment instability after a spinal fusion. When a spinal level is fused, the bones are welded together. The disc between the bones that used to absorb shock can no longer do that, so those stresses either go up or down to adjacent spinal levels.

Pain can begin to get worse from the arthritis and degeneration of the disc occurring. This may end up leading to another spine surgery becoming necessary. Unfortunate but commonly seen. This is unavoidable, as spinal fusion for certain conditions is the gold standard. If it’s performed, the incidence of adjacent segment degeneration approaches 20% within a few years, and about 1/4 of spine surgery patients will need an additional procedure within 5 years of the first one. Read more… »

January 8th, 2012  Posted at   Pain Management
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Remember the morning you woke up and suddenly you could not turn your neck straight and you were thinking how to cure a stiff neck? Pain in the neck muscle region, more commonly termed as stiff neck, is a very usual but awful experience that we all have had at some point in our lives.

Causes Of A Stiff Neck

Muscle strain is the most common way to get a stiff neck. The prime cause is the distortion of the muscle called the levator scapula, which connects the shoulder of a man to his neck. There are various ways in which the levator scapula can be disturbed. They are:

- Strained sleeping position.

- Extensive strain due to physical exercise.

- Wrong posture while sitting in front of a desktop or laptop.

Continuous pain in the neck in addition to headache, nausea, vomiting and sleepiness is a symptom towards Meningitis. Stiff necks are also caused by disorders such as “Cervical Herniated Disc” (Also called Osteoarthritis). It generally is interconnected and leads to muscle spasm and stiffness in joints.

Remedies

Minor short-term strains in ligaments heal in a comparatively shorter duration of time. It always comes in handy to know some natural methods in treating this type of pain. Solet us go through 5 of the best, easy ways on how to cure a stiff neck using natural remedies.

1) Applying ice packs:

Every 24 hours an ice pack should be applied to the neck to reduce inflammation.

2) Applying heat wraps:

The warmth helps in better blood circulation thus reducing the inflammation and stimulating the healing process. Continuous low heat wraps are pretty effective as well.

3) Applying hot water bags:

Just like heat wraps, a hot water bag once every hour is a very useful remedy for a stiff neck.

4) Getting a massage:

A gentle massage from your Chiropractor always helps in the circulation of blood which in turn helps with the healing process.

Or one can go with the more conventional way:

5) Applying medicines: Ointments and oils are an effective method to kill the pain easily and methodically. Read more… »

January 7th, 2012  Posted at   Pain Management
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Multidirectional instability of the shoulder, MDI for short, refers to symptomatic instability of the shoulder and more than one direction. Typically this involves either anterior or posterior instability based on which direction involves the most symptoms. Activities that are repetitive such as baseball pitching, swimming, gymnastics or volleyball may lead to a gradual soft tissue elongation in young patients and resulting instability. Along with the anterior or posterior instability, most patients have symptoms from instability of the inferior glenohumeral joint.

Multidirectional instability is more common in patients who are female and in younger athletes. Often times patients are not able to point to a discrete incidents of trauma or a frank dislocation. The initial symptom that patient experiences may simply be pain which may make it difficult to diagnose. With activity however, patients may experience a dead arm, numbness and tingling in the arm, weakness or early fatigue.

On physical examination patients may have increased translation of the shoulder downwards. Also a physical examination there are multiple tests that the orthopedic surgeon can perform to see if instability is symptomatic anteriorly or posteriorly. Sometimes patients of multidirectional shoulder instability also have hyper laxity in general so this should be evaluated as well.

Additional diagnoses that should be looked at in patients where multidirectional instability is thought to be occurring include impingement syndrome, rotator cuff tear, thoracic outlet syndrome, biceps tendinitis, and cervical disc herniation.

MDI treatment should be centered around dedicated physical therapy. Strengthening and endurance of the rotator cuff along with the muscles around the scapula should be the focus of this treatment. As opposed to traumatic unidirectional instability, patient to have MBI experience much more success with physical therapy. If the patient fails 6 to 12 months of considerable conservative treatment, surgery can then be opted for. Read more… »

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