Back pain can occur for numerous different reasons. Trauma, aging, incorrect body mechanics or normal wear and tear can all injure the spine. Back pain usually responds to nonsurgical treatment, such as anti-inflammatory medicine, ice, heat, massage or physical therapy. Most people get better in four to six weeks. Surgery may be considered only when nonsurgical options have not been successful after six months to a year.

The type of surgery to treat back pain will depend on the nature of the injury. Some types of back pain cannot be treated, even with surgery. Conditions that may require surgery include scoliosis (curvature of the spine), kyphosis (humpback deformity), spondylolisthesis (segment of the spine slips forward), spinal stenosis (narrowing of the spinal canal), radiculopathy (herniated disk causes nerve irritation and inflammation) or degenerative disk disease. There are several different kinds of back surgery.

Spinal fusion involves fusing together two vertebrae (bones) in the spine. This procedure can help relieve pain by eliminating painful motion between vertebrae and providing stability. A bone graft is typically used to help the bones fuse together; screws or rods may be inserted to keep the spine stable while healing. The procedure can be performed though the abdomen, side, back or a combination. Full recovery may take a year or longer.

A diskectomy may be done to remove the herniated part of a disk to relieve pressure on a nerve that is causing irritation or inflammation. This procedure often involves removing most or part of the back portion of the vertebra to access the ruptured disk.

When nerve pressure caused by spinal stenosis is causing pain, the bone overlying the spinal canal can be removed during a surgical procedure called a laminectomy. This enlarges the spinal canal and reduces pain.

Vertebroplasty is another form of back surgery that is done to help stabilize fractures and relieve pain. This procedure involves injecting bone cement into compressed vertebrae.

Disc replacement may be necessary in cases when a disk that has degenerated or been injured must be replaced with artificial parts, similar to a hip or knee replacement. This procedure may be a treatment alternative to spinal fusion to allow the spinal segment to retain some degree of flexibility while maintaining more normal motion.

As with any surgery, it is important to weigh all your options or even get a second opinion. To prevent persistent back problems, exercise to keep the muscles in your back and abdomen strong and flexible, lift heavy items properly with your legs, maintain a healthy weight, don’t smoke and have good posture. For more information about surgical options for back pain, talk with your doctor or call 866-381-BONE or a free referral to a spine surgeon near you.

The ACL is one of four ligaments that attach the thighbone to the shinbone. It runs diagonally in the middle of the knee and serves two purposes: prevent the shin bone from sliding out in front of the thigh bone and provide rotational stability to the knee. Most ACL injuries happen during sports activities that involve sudden stopping combined with a change in direction while running, jumping, pivoting or overextending the knee. The ACL also may tear following a blow to the side of the knee, such as from a football tackle. About half of ACL injuries occur along with a torn meniscus, the cartilage in the knee between the thighbone and shinbone. A common long-term complication is the early onset of osteoarthritis in the affected knee.

A torn ACL will make a loud popping sound, cause significant pain and begin swelling within hours of the injury. The knee will continue to feel unstable even after the swelling subsides. If you have injured your knee, you should wrap your knee with an elastic bandage and elevate the joint above the heart, apply ice about every two hours for 20 minutes at a time, and take pain relievers. Avoid moving the knee and do not return to sports or activities until your injury has been evaluated by a doctor.

Diagnosis of an ACL injury usually can be made following a physical exam. However, an X-ray may be done to look for any possible fractures or a magnetic resonance imaging scan can be ordered to look for damage to other ligaments or cartilage in the knee. Treatment will vary depending on the severity of the injury. A partially torn ACL may require going to physical therapy, modifying your activities and using a knee brace. This treatment approach usually will last at least three months.

An ACL that is completely torn cannot be sewn back together. Rather, the ligament can be surgically reconstructed using a piece of tendon taken from another part of the leg. Rehabilitation and wearing a knee brace will be necessary after surgery. Most people are able to return to sports activities in about six months.

To reduce your chance of an ACL injury before you hit the basketball court, head out to the soccer field or sign up for some flag football, you might want to keep these tips in mind:

• Stay in shape year-round and incorporate conditioning exercises into your routine.
• Make sure you use the right gear and that it fits properly.
• Women should strengthen their hamstrings and quadriceps.
• Use proper techniques while participating in sports or exercising.

For more information about ACL injuries, talk with your doctor or call 1.866.381.BONE for a free referral to an orthopedist near you.

Most back pain is caused by muscle weakness resulting from a combination of overuse, muscle strain and injury to the muscles, ligaments and discs in the back. The pain usually follows an injury to the back, but pain may be caused by degenerative conditions such as arthritis, osteoporosis or other bone diseases, viral infections or congenital abnormalities.

You are at risk for back pain if you:

• Are older than 30.
• Are pregnant.
• Feel stressed or depressed.
• Have a low tolerance for pain.
• Have arthritis or osteoporosis.
• Have bad posture.
• Smoke, don’t exercise or are overweight.
• Have a job that requires a lot of heavy lifting, bending or twisting, or whole body vibration (like driving a truck or using a sandblaster).

Pain may be acute, lasting less than one month, or chronic, lasting more than three months. Occasionally, low-back pain may indicate a more serious medical problem. If pain lasts more than three months, see a physician to rule out serious problems. Similarly, call your doctor if your back pain is accompanied by fever; redness or swelling on the back or spine; pain traveling down your legs below the knee; weakness or numbness in your buttocks, thigh, leg or pelvis; burning with urination or blood in your urine; worse pain when you lie down or pain that wakes you at night; very sharp pain, or bladder or bowel incontinence. Also consult a doctor if your pain was the result of a severe blow or fall.

Your doctor may send you to a physical therapist to alleviate symptoms and strengthen your muscles. If your pain lasts longer than one month, your doctor may refer you to an orthopedist (bone specialist) or neurologist (nerve specialist).

Most back pain, however, does not require a doctor’s intervention and will go away on its own.  In the meantime, minimize physical activity only in the first few days to reduce inflammation and calm symptoms. For the first six weeks after pain begins, avoid activities and exercise that involve heavy lifting or twisting, such as football, golf, ballet, lifting weights and jogging. After two or three weeks, resume light cardiovascular exercise such as walking, riding a stationary bike or swimming. These exercises promote healing by improving blood flow and strengthening the muscles in your stomach and back.

You may want to apply ice to the injured area for the first 48 to 72 hours; after that, apply heat. Over-the-counter medications such as ibuprofen or acetaminophen help reduce pain and inflammation. While sleeping, try lying on your side in the fetal position with a pillow between your legs, or lie on your back with a pillow underneath your legs.

In some cases, surgery may be needed to treat chronic back pain. Surgical procedures include:

• Spinal fusion to “weld” vertebrae together into a single, solid bone.
• Disc replacement that removes the damage disc, replacing it with artificial parts.
• Spinal laminectomy that removes damaged parts of the lamina and opens the spinal column.

To reduce the likelihood of experiencing back pain, follow these recommendations: 

• Exercise regularly, and always stretch beforehand.
• Maintain proper posture and avoid slouching.
• Make sure your work surface is at a comfortable height.
• Sit in a chair with good lumbar support and proper position and height for the task. Switch sitting positions often and take breaks to walk around or stretch.
• Wear comfortable, low-heeled shoes.
• Avoid lifting very heavy objects. When you do lift heavy objects, lift with your knees, keep your head down and in line with your back, and keep the object close to your body.
• Don’t smoke, as it reduces blood flow to the lower spine and causes disc degeneration.

Back pain can occur for numerous reasons. Trauma, aging, incorrect body mechanics, or normal wear and tear can all injure the spine. Back pain usually responds to nonsurgical treatment, such as anti-inflammatory medicine, ice, heat, massage or physical therapy. Most people get better in 4 to 6 weeks. Surgery may be considered only when nonsurgical options have not been successful after 6 months to a year.

There are several different kinds of back surgery and the type of surgery to treat back pain will depend on the nature of the injury. Some types of back pain cannot be treated, even with surgery. Conditions that may require surgery include:

• scoliosis (curvature of the spine)
• kyphosis (humpback deformity)
• spondylolisthesis (segment of the spine slips forward)
• spinal stenosis (narrowing of the spinal canal)
• radiculopathy (herniated disk causes nerve irritation and inflammation)
• degenerative disk disease

Spinal fusion involves fusing together 2 vertebrae (bones) in the spine. This procedure can help relieve pain by eliminating painful motion between vertebrae and providing stability. A bone graft is typically used to help the bones fuse together; screws or rods may be inserted to keep the spine stable while healing. The procedure can be performed though the abdomen, side, back or a combination. Full recovery may take a year or longer.

A diskectomy may be done to remove the herniated part of a disk to relieve pressure on a nerve that is causing irritation or inflammation. This procedure often involves removing most or part of the back portion of the vertebra to access the ruptured disk.

When nerve pressure caused by spinal stenosis is causing pain, the bone overlying the spinal canal can be removed during a surgical procedure called a laminectomy. This enlarges the spinal canal and reduces pain.

Vertebroplasty is another form of back surgery that is done to help stabilize fractures and relieve pain. This procedure involves injecting bone cement into compressed vertebrae.

Disk replacement may be necessary in cases when a disk that has degenerated or been injured must be replaced with artificial parts, which is similar to a hip or knee replacement. This procedure may be a treatment alternative to spinal fusion to allow the spinal segment to retain some degree of flexibility while maintaining more normal motion.

As with any surgery, it is important to weigh all your options or even get a second opinion. To prevent persistent back problems, exercise to keep the muscles in your back and abdomen strong and flexible, lift heavy item properly with your legs, maintain a healthy weight, don’t smoke and maintain good posture. For more information about surgical options for back pain, talk with your doctor or call 1.866.381.BONE for a free referral to a spine surgeon near you.

Strains and sprains are the most common type of injury that result from physical activity. A sprain is the stretching or tearing of a ligament. Ligaments are fibrous tissues that connect one bone to another in a joint.  A strain is an injury to a muscle or a tendon. Tendons are fibrous cords that attach muscle to bone. 

According to the National Institutes of Health, sprains most often are the result of falling on an outstretched arm, sliding into a baseball base, landing on the side of the foot, or twisting a knee with the foot planted.  A strain is caused by twisting or pulling a muscle or tendon. The back and hamstrings are common sites for strains.

Symptoms and Treatment

Pain is the most common symptom of both sprains and strains. The intensity of pain will vary depending on the severity of the injury. Other symptoms include swelling, bruising and the inability to move the injured joint. 

Treatment for sprains and strains includes efforts to reduce pain and swelling and to restore function to the injured area (rehabilitation). Initial treatment should occur as soon as possible after the injury. Experts recommend rest, ice, compression and elevation (RICE) for care of sprains and strains during the first 24-48 hours. 

Following these steps should decrease swelling and ease your discomfort:

• Rest: Avoid activities that cause pain or discomfort and swelling.
• Ice: Icing an injury will prevent further swelling and ease spasms.
• Compression: To help combat swelling, compress the injured area with an elastic bandage.
• Elevation: Elevating the injured body part also will help reduce swelling.  Be sure to elevate when sleeping.

You may also want to take an over-the-counter pain medication such as ibuprofen (Advil, Motrin or others) or acetaminophen (Tylenol or others) to manage pain. 

Individuals with a mild strain or sprain should see a gradual improvement in two to four days. If swelling, pain or joint instability continues, you may have a more severe injury. You should see a physician as this may require additional treatment and you should see a physician. 

Prevention

A strain or sprain can happen to anyone, but here are some tips to help reduce your risk of injury:

• Avoid exercising or playing sports when tired or in pain.
• Maintain a healthy, well-balanced diet to keep muscles strong.
• Maintain a healthy weight.
• Practice safety measures to prevent falls.  For example, keep stairways, walkways, yards, and driveways free of clutter; anchor rugs; and salt or sand icy sidewalks and driveways in the winter.
• Wear shoes that fit properly.
• Replace athletic shoes as soon as the tread wears out or the heel wears down on one side.
• Do stretching exercises daily.
• Be in proper physical condition to play a sport.
• Warm up and stretch before participating in any sport or exercise.
• Wear protective equipment when playing.
• Run on even surfaces.

In addition to advanced age and osteoporosis, other risk factors associated with hip fractures include:

• being Caucasian or Asian
• a lack of calcium and vitamin D in the diet when younger
• physical inactivity
• tobacco and alcohol use
• use of certain medications

Environmental factors, such as loose rugs or a cluttered living space, also could increase the chance of falling. A hip fracture causes pain in the outer upper thigh or groin area, as well as the inability to bear weight on the side of the injury. The hip area may become stiff, show signs of bruising or swelling, and a significant level of discomfort could occur after any attempt to rotate or flex the hip.

Most hip fractures are diagnosed following an X-ray, which shows where the fracture occurred in the hip, as well as the location and severity of the fracture.  Treatment is determined based on the patient’s overall health and age. Most hip fractures are treated surgically using one of three methods:

• Inserting metal screws into the bone, if it is properly aligned, to hold it together as it heals. This is called internal fixation.
• Replacing part of the femur, the long bone that extends from the pelvis to the knee. This method, called hemiarthroplasty, calls for removing the head and neck of the femur and replacing them with a metal prosthesis.
• Replacing the upper femur and pelvic bone socket with a prosthesis. This is called a total hip replacement.

Patients typically do better if they undergo surgery soon after the hip fracture occurs. They may be encouraged to get out of bed the day after surgery with help from a physical therapist, who also will work with patients to help them regain strength and start walking again. After a hip fracture, most patients are hospitalized for approximately one week and then may either be discharged home or referred to a nursing home if they are unable to live independently. Physical therapy rehabilitation usually takes approximately three months.

People at risk for hip fractures can take steps to reduce their chances of falling.

• Women should have a bone density test to measure bone mass and make sure they get enough vitamin D and calcium in their diet.
• Engage in weight-bearing exercise to help strengthen bones and prevent falls.
• Avoid excessive amounts of alcohol and do not smoke.
• Take medications as prescribed to treat osteoporosis.
• Wear shoes with non-skid soles and avoid high heels and shoes like sandals and bedroom slippers that flop when you walk.
• Check your home for trip hazards like throw rugs, electrical cords and clutter.
• Make sure your home and outside walkways are well-lit so you can see where you are walking.
• Talk to your doctor or physical therapist about whether assistive devices may be needed to help you keep your balance. 

For more information about hip fractures, talk with your doctor or call 866-904-WBMC for a free referral to a specialist near you, or use our convenient contact form.

Most back problems can be treated without surgery. Your doctor may suggest limiting your activity and prescribe some pain medications or anti-inflammatory medicines. You may start seeing a physical therapist for exercises designed to strengthen the back or for other treatments.

What About Back Surgery?

If a severely pinched nerve, a compressed spinal cord or an instability in the spine causes your back problem, then your doctor may suggest surgery. Surgery may be indicated if you have symptoms of nerve damage including pain radiating down the legs or arms; pain, numbness, weakness or tingling in the arms or legs; or a loss of bowel or bladder control.

Back surgery is used for these conditions:

• Herniated disk
• Disk degeneration
• Spinal stenosis (narrowing)
• Fractures
• Infections or tumors
• Spinal deformity

Back surgery techniques are improving. Today, your doctor may be able to use less invasive surgery techniques to treat your condition. It’s important for you to talk with your doctor about your options and which procedures are recommended and why.

Preventing Back Problems

You can take these steps to prevent recurrent back problems:

• Exercise regularly to keep the muscles in your back strong and flexible.
• Stretch before exercising to help warm up your muscles.
• Avoid standing or being in one position for too long.
• Maintain your proper body weight since excess weight strains your back muscles.
• Use proper lifting and moving techniques.
• Get help if an object is heavy or an awkward size.
• Don’t twist when lifting.
• Avoid smoking.
• Remember what your mother said, “Don’t slouch. Sit up straight.”

Rotator cuff injuries, whether from repetitive stress or trauma, are not uncommon. Injury may occur gradually, as in the case of tendonitis or bursitis. Tendonitis is an inflammation of the tendons due to overuse or overload. Bursitis is an inflammation of the bursa, a fluid-filled sac located between the shoulder joint and rotator cuff tendons. Not surprisingly, athletes and construction workers frequently experience rotator cuff injuries due to the repeated, significant strain put on rotator cuff muscles. A sudden strain or tear may also occur after an event such as falling on an outstretched hand. Poor posture, weak shoulder muscles and age-related degeneration may increase a person’s risk of rotator cuff injury.

Symptoms of a rotator cuff injury include shoulder pain, especially during movement or when sleeping on the affected side, tenderness or weakness, and loss of shoulder mobility. A click or pop may also be heard or felt when the shoulder is moved. Movements that involve overhead motion, such as getting dressed or combing hair may become difficult and painful after this type of injury.

A trip to the doctor’s office to diagnose a rotator cuff injury may be necessary if shoulder pain lasts longer than two days or if pain prohibits normal activities, such as reaching overhead or engaging in sports. Identifying a rotator cuff injury is usually done following a physical examination and medical history review. Imaging tests such as X-rays, magnetic resonance imaging (MRI), ultrasound or arthrogram (when dye is injected into the shoulder and X-rays are then taken) may be used to help detect a full or partial tendon tears.

Treatment of a rotator cuff injury typically depends on the severity of the injury, as well as the patient’s age, overall health and duration of the condition.  Minor shoulder problems can be treated with strengthening exercises and anti-inflammatory medications such as ibuprofen, aspirin or acetaminophen; occasionally a steroid injection into the affected area can help reduce inflammation, decrease pain and increase joint mobility.

An ice pack placed on the shoulder for 15 to 20 minutes every two to three hours during the first day or so after an injury can help reduce inflammation and pain. A heating pad can then be used for 20 minutes at a time to help relax tightened and sore muscles. Exercising the shoulder should begin slowly to prevent stiff joints.

Surgery may be necessary for younger patients with small tears that can be successfully repaired to reduce the probability of the tear getting progressively worse. Tears caused by acute, severe trauma should be surgically repaired immediately.

Preventing a rotator cuff injury is much less painful than treating one. Regular shoulder exercises can not only strengthen muscles and tendons, but also protect the shoulder’s range of motion. Other ways to help prevent injury include maintaining good posture and taking breaks at work or play to rest the shoulder if the job or activity is physically demanding.

Back pain can occur for numerous different reasons. Trauma, aging, incorrect body mechanics, or normal wear and tear can all injure the spine. Back pain usually responds to nonsurgical treatment, such as anti-inflammatory medicine, ice, heat, massage or physical therapy. Most people get better in 4 to 6 weeks. Surgery may be considered only when nonsurgical options have not been successful after 6 months to a year.

The type of surgery to treat back pain will depend on the nature of the injury. Some types of back pain cannot be treated, even with surgery. Conditions that may require surgery include scoliosis (curvature of the spine), kyphosis (humpback deformity), spondylolisthesis (segment of the spine slips forward), spinal stenosis (narrowing of the spinal canal), radiculopathy (herniated disk causes nerve irritation and inflammation), or degenerative disk disease. There are several different kinds of back surgery.

Spinal fusion involves fusing together two vertebrae (bones) in the spine. This procedure can help relieve pain by eliminating painful motion between vertebrae and providing stability. A bone graft is typically used to help the bones fuse together; screws or rods may be inserted to keep the spine stable while healing. The procedure can be performed though the abdomen, side, back or a combination. Full recovery may take a year or longer.

A diskectomy may be done to remove the herniated part of a disk to relieve pressure on a nerve that is causing irritation or inflammation. This procedure often involves removing most or part of the back portion of the vertebra to access the ruptured disk.

When nerve pressure caused by spinal stenosis is causing pain, the bone overlying the spinal canal can be removed during a surgical procedure called a laminectomy. This enlarges the spinal canal and reduces pain.

Vertebroplasty is another form of back surgery that is done to help stabilize fractures and relieve pain. This procedure involves injecting bone cement into compressed vertebrae.

Disk replacement may be necessary in cases when a disk that has degenerated or been injured must be replaced with artificial parts, which is similar to a hip or knee replacement. This procedure may be a treatment alternative to spinal fusion to allow the spinal segment to retain some degree of flexibility while maintaining more normal motion.

As with any surgery, it is important to weigh all your options or even get a second opinion. To prevent persistent back problems, exercise to keep the muscles in your back and abdomen strong and flexible, lift heavy item properly with your legs, maintain a healthy weight, don’t smoke and have good posture. For more information about surgical options for back pain, talk with your doctor or call 1.866.381.BONE for a free referral to a spine surgeon near you.

Arthroscopy is usually done on the knee, shoulder, elbow, wrist, hip or ankle to diagnose disease and injuries of the bones, cartilage, ligaments, muscles and tendons. It may be done as a definitive examination after X-rays or other imaging studies are inconclusive. Conditions frequently found during an arthroscopic examination include:

• Inflammation of joint linings
• Cartilage tears or damage
• Infections in the joint
• Ligament tears
• Bone spurs or loose bone fragments
• Scarring or tissue overgrowth in the joints

Arthroscopy also can be used to treat some problems associated with arthritis, to help see if a disease is getting better or worse or to evaluate if a treatment is working.

Depending on the joint being evaluated and the suspected problem, arthroscopy will require the use of general, spinal or local anesthetic. No food or drink is allowed 12 hours before the procedure. In general, arthroscopy begins when the area is cleaned. An incision is then made into the joint, and sterile fluid is introduced to distend the joint for a better view. A pressure band, or tourniquet, also could be applied to restrict blood flow.

The arm or leg may be placed in a traction device to isolate the joint and allow the surgeon better access to the surgical site from different angles. If corrective surgery is performed during the arthroscopy, specially designed instruments can be inserted into the joint through additional incisions. Depending on the type of procedure being performed, arthroscopy can take between 30 minutes and 2 hours.

Incisions are closed with stitches or sterile adhesive strips after the procedure is finished. Recovery may take several hours before the patient can be discharged. At home, the joint may require ice to help reduce swelling and pain. It will probably feel stiff and sore for several days. Splints, slings or crutches could be recommended on a temporary basis for comfort and to protect the joint. Physical therapy and rehabilitation may be prescribed to help strengthen affected muscles and improve joint function. 

Depending on your doctor’s recommendation, most light activities, such as desk work, can be resumed within a week, followed by more strenuous activities in two weeks. It may take several weeks for the joint to recover fully. Excessive use of the joint too soon can cause swelling and increase the risk of injury.

Arthroscopy is considered a low-risk procedure, with complications occurring in less than one percent of all arthroscopic procedures. As with any operation, you should consult with your physician about surgical risks and benefits.  For more information about arthroscopy, talk with your doctor, or call 1.866.381.BONE for a free referral to a specialist near you.