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Women And Musculoskeletal Disorders

Women are at least twice as likely as men to develop some musculoskeletal disorders of the upper body. That’s the finding of scientists at Ohio State University.

“Women have a significantly higher prevalence –- anywhere from two to ten, even eleven times higher than men -- for many of these disorders,” says Delia Treaster, a former doctoral student at Ohio State who conducted the research. “The question now is, why? Is it biomechanical, physiological, psychological, or what? Most likely, it is due to a combination of factors.”

Musculoskeletal disorders (MSDs) affect the muscles, tendons, ligaments, and joints, and include such diverse problems as low back pain, repetitive strain injuries of various sorts, and joint injuries. One 1998 study found that 15 percent of the American working population suffered one or more MSDs, and that this rate could increase to 18 percent within the next 30 years.

To Treaster, the study underscores the need to prevent MSDs from happening in the first place. One way to do that is through better workplace design, equipment selection, and work practices.

“MSDs can be difficult to diagnose,” says our medical director, “and women need to be aware that they could develop these disorders, especially as they grow older. At Spine and Sports Medicine we can perform clinical tests to help determine the causes of the pain and establish a course of treatment to get you back to your normal self.”

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Posted by Spine and Sports Medicine on 1:34 PM


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Plantar Fasciitis: ‘Flip-Flop Disease’

Sometimes known as “flip-flop disease,” one of the most common foot problems dealt with at Spine and Sports Medicine is called plantar fasciitis. A painful inflammatory condition caused by excessive wear to the connective tissue (the plantar fascia) that runs along the bottom of the foot, it is a common problem among people active in sports, especially runners. Because the normal foot has an arch, this tight band of tissue is at the base of the arch. In this position, the plantar fascia acts like a bowstring to maintain the arch of the foot. Obesity, weight gain, jobs that require a lot of walking on hard surfaces, and shoes with little or no arch support (think flip-flops!) are also associated with the condition. The pain usually is felt on the underside of the heel, and is often most intense with the first steps of the day.

Spine and Sports Medicine can set up a course of treatment to help keep you on the move and pain-free. Fortunately, the majority of cases of plantar fasciitis respond favorably to non-operative treatment. However, the recovery time varies tremendously from patient to patient. While some patients may be healed after 6 weeks of treatment, others may require 6 months or longer for recovery. Typically, the methods of treatment include anti-inflammatory medication, icing, stretching, heel inserts, activity modification -- and no more flip-flops!

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Posted by Spine and Sports Medicine on 6:39 AM


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Painters, Pitchers, and Power Lifters – All at Risk for Rotator Cuff Injuries

Rotator cuff injuries are among the most common and painful shoulder-related injuries in adults, especially in people who exercise a lot. The rotator cuff (or musculotendinous cuff) in the shoulder is made up of tendons and muscles covering the shoulder joint. The rotator cuff helps to keep the shoulder in place and also works to lift and move the shoulder. Rotator cuff injuries treated at Spine and Sports Medicine are seen as a range from an impingement -- which occurs when the shoulder blade rubs or “impinges” on the rotator cuff when the arm is lifted -- all the way through a complete tear. In the mid range, the rubbing of the rotator cuff can cause injuries such as tendonitis, bursitis (inflammation of the bursa, which covers the rotator cuff), or a partial tear. Rotator cuff injuries are linked to limiting of movement of the shoulder and a dull ache in the upper arm and shoulder. At first the pain is mild but can become stronger over time. Rotator cuff injuries are common in people who lift their arms a lot, especially in athletes and in workers with heavy lifting duties.

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Posted by Spine and Sports Medicine on 3:40 AM


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Sciatica – Getting to the Root of the Problem

The term sciatica describes the symptoms of leg pain and possibly tingling, numbness or weakness that travels from the low back through the buttock and down the large sciatic nerve in the back of the leg. The clinical diagnosis of sciatica is referred to as a "radiculopathy," which means simply that a disc has protruded from its normal position in the vertebral column and is putting pressure on the radicular nerve (nerve root) in the lower back, which forms part of the sciatic nerve.

“An important thing to understand is that sciatica is a symptom of a problem -- of something compressing or irritating the nerve roots that comprise the sciatic nerve -- rather than a medical diagnosis or medical disorder in and of itself,” says Dr. Kessler. “This is an important distinction because it is the underlying diagnosis (vs. the symptoms of sciatica) that often needs to be treated in order to relieve sciatic nerve pain.”

In addition to standard medical treatments, several alternative treatments have also been shown to provide effective sciatica pain relief for many patients, including acupuncture, massage therapy and chiropractic manipulation, all of which can be provided in the comfortable New York City offices of Spine and Sports Medicine.

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Posted by Spine and Sports Medicine on 3:25 AM


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Shark Cartilage, My Wife, and the Benefits of Glucosamine and Chondroitin Sulfate

A number of years ago, my wife had some issues related to stiffness in her joints. A nutritionist she was seeing suggested she take glucosamine and chondroitin sulfate supplements to help restore her flexibility. While research has yielded conflicting findings about their effectiveness, she began to recognize some benefits in a relatively short period of time.

Glucosamine and chondroitin sulfate are produced in the human body and are involved in the production and maintenance of cartilage that cushions joints. Glucosamine sulfate is thought to help with cartilage formation and repair, while chondroitin sulfate helps give cartilage its elastic properties and is thought to have an anti-inflammatory effect, which can help to reduce the painful swelling in the joints that occurs when the exposed bones in the joint rub together.

Both glucosamine and chondroitin sulfate are sold as dietary or nutritional supplements. They are extracted from animal tissue: glucosamine from crab, lobster or shrimp shells; and chondroitin sulfate from animal cartilage, such as tracheas or shark cartilage. So, even though I joke with my wife that she has begun growing a tiny fin in the small of her back, she has a much greater range of motion and far less overall stiffness.

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Posted by Spine and Sports Medicine on 3:56 AM


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Neck Pain from a Wig?

Only in Hollywood… A recent entertainment newspaper report indicated that the wig that Keira Knightley flaunts in her upcoming 18th century movie, “The Duchess,” was so heavy that a resting post was specially made for her to rest her neck between takes. In the movie, Knightly plays a scandalous aristocrat Georgiana Cavendish, Duchess of Devonshire, and in keeping with the part, had to pull on a sky-high Marie Antoinette-style wig for several key scenes.

Wig or no wig, neck pain is no picnic.

Any part of your neck -- muscles, bones, joints, tendons, ligaments or nerves -- can cause it. Pain may also come from your shoulder, jaw, head or upper arms. Muscle strain or tension often causes neck pain. “The problem is usually overuse, such as from sitting at a computer for too long,” says Dr. Kessler. “Sometimes you can strain your neck muscles from sleeping in an awkward position or overdoing it during exercise. Falls or accidents, including car accidents, are another common cause of neck pain.”

Treatment depends on the cause, but may include applying ice, taking pain relievers, getting physical therapy or wearing a cervical collar.

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Posted by Spine and Sports Medicine on 9:37 AM


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Sweet Dreams?

You have probably spent over 25% of your life sleeping. With that much of your life spent under the sheets, it makes sense that proper sleep and a good mattress can go a long way towards mitigating back pain and improving your health.

However, approximately two-thirds of patients with chronic back pain suffer from sleep disorders and a new study indicates that frequently interrupted sleep can make a person more susceptible to pain by altering the body's natural systems that regulate and control pain.

During the study, researchers tested the pain thresholds and pain inhibition of 32 women subjects. Those in a group that had been woken up eight times during the night showed an increase in spontaneous pain, while those in control groups who slept undisturbed did not, showing that disrupted sleep impairs natural pain control mechanisms that are thought to play a key role in the development, maintenance, and exacerbation of chronic pain.

“A sleeping disorder associated with chronic back pain should always be addressed as part of a multi-disciplinary, chronic pain treatment approach,” says Dr. Kessler. “As with any symptom of a chronic pain syndrome, the sleep disruption should not be treated in isolation without taking into account proper treatments for the chronic back pain problem that is part of the cause of the sleeping problem.”

In many cases, the right mattress can certainly help, and for those with chronic pain, getting continuous, undisturbed sleep is key to controlling the pain.

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Posted by Spine and Sports Medicine on 3:44 PM


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Death, Taxes, and Degenerative Disc Disease

Certain as death and taxes, degenerative disk disease happens to everyone. However, not everyone who has degenerative changes in their lumbar spine has pain. Many people who have "normal" backs have MRIs that show disc herniations, degenerative changes, and narrowed spinal canals. Yet, every patient is different, and not everyone develops symptoms as a result of degenerative disc disease.

One of the most common causes of back pain and neck pain, and also one of the most misunderstood, degenerative disc disease is not actually a disease -- it is part of the normal aging of the spine. In this condition, the discs in the spine -- pillow-like pads that separate the interlocking vertebrae that make up the spine and act as shock absorbers --eventually lose their cushioning. The breakdown of the discs can result in back or neck pain, as well as osteoarthritis, herniated disc, or spinal stenosis.

When we are born, each disc is comprised of about 80% water, which gives it its spongy quality and allows it to function as a shock absorber. As we age, the water content decreases and the disc becomes less effective. Additionally, the proteins within the disc also change composition, and most of us will develop tears into the annulus fibrosus (the outer hard core of the disc). Unlike other tissues of the body, there is very little blood supply to the disc, so once a disc is injured, it cannot repair itself, and a spiral of degeneration can set in, known also as Spondylosis.

“Pain from DDD is initially treated with ice or heat and with nonprescription medications,” says medical director Brian Kessler, MD. “Further treatments depend on whether the damaged disc has resulted in other conditions. Physical therapy and exercises are often recommended, and in some cases surgery may be recommended if the pain is severe and disrupts a person’s ability to participate in everyday activities.”

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Posted by Spine and Sports Medicine on 1:19 AM


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Running Again

“I've been running for years,” says Spine and Sports Medicine patient Joanie R. “Until recently, I've been pain free. But, my exercise was compromised by the pain I was feeling in my ankles.”

Running injuries are very specific due to the repetitive nature of the sport, and ankle injuries are the most common sport-related injuries. Many common conditions affect runners, including tendonitis, bursitis, shin splints, ankle and Achilles problems, and more.

“Common foot and ankle injuries include sprains, strains, and stress fractures or bone injuries,” says Dr. Kessler. “Many of these injuries are overuse injuries -- injuries that result from inadequate conditioning or excessive training that places too much stress on the foot and ankle.”

Warning signs of a serious problem that merits immediate evaluation at our offices in Manhattan include the following: pain which increases during the run, locking or catching sensations in the ankle, especially after an injury, recurrent sprains or instability of the ankle, swelling across the front of the ankle joint, and localized bone tenderness, among others. When in doubt, have it checked out!

“I started treatment at Spine and Sports Medicine,” says Joanie, “and although it took some time and a commitment on my part, I am back to running again. They are very professional and motivated me to stay with the program.”

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Posted by Spine and Sports Medicine on 5:20 AM


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How To Be a ‘Beautiful Person’

The idea of sticking needles into one’s face may be hard to imagine, yet more and more people who want to slow signs of aging, particularly in their faces, but don’t want to undergo surgery or to inject chemicals, are having facial acupuncture. The aim is to tackle wrinkles, muscle tension that may be causing unsightly lines, as well as systemic issues standing between you and glowing skin. In Chinese Medicine the state of physical health, emotions, and spirit is reflected on the skin, particularly on the skin of the face.
The non-surgical Mei Zen Facial Rejuvenation Acupuncture procedure, is a holistic, natural and comprehensive skin rejuvenation program designed to restore, revitalize and relax. Mei Zen means “beautiful person” in Chinese and many are taking this route to change not only their external appearance, but also to improve total body wellness. “I like the idea of using a natural approach to ‘halt’ the aging process without using toxic chemicals like Botox and Restylane,” says an interested patient. “I've used both (don't tell anyone) and I would have loved to find a healthier alternative.” That alternative is now available, right in the New York City offices of Spine and Sports Medicine. In the past 2,000 years, more people have been successfully treated with acupuncture than with all other health modalities combined. Today acupuncture is practiced widely in Asia, the Soviet Union, and in Europe, and is now being used more and more in America. Acupuncture treatments can be given at the same time other techniques are being used, such as conventional Western medicine, osteopathic or chiropractic adjustments, and homeopathy. So, call for an appointment and “get beautiful.”

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Posted by Spine and Sports Medicine on 3:49 PM


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Osteoarthritis - Degenerative Joint Disease

Osteoarthritis is one of the issues New York’s Spine and Sports Medicine addresses on a daily basis. With a wide range of symptoms, osteoarthritis is the most common form of arthritis, causing joint pain, swelling and reduced motion.

A degenerative condition most commonly associated with people over the age of 45, some question whether regular athletic activity -- for example, the impact of feet hitting the pavement or hands hitting a punching bag -- can damage joints and result in osteoarthritis years later. Researchers considered the question of whether people who participate in regular athletic activities, but have not sustained any known injury, are at risk for developing osteoarthritis, and in a 1997 article in Osteoarthritis and Cartilage concluded that the condition can occur prematurely in certain sports including soccer, rugby, racket sports, track and field, and long-distance running. Recreational sports done at a "reasonable" level, however, do not increase risk, according to researchers.

“There's no known cure for osteoarthritis,” says Dr. Kessler, “but treatments can help to reduce pain and maintain joint movement so that you can go about your daily tasks. Taking steps to actively manage osteoarthritis may help you gain control over your osteoarthritis pain.”

Therapies that manage osteoarthritis pain and improve function include exercise, weight control, rest, pain relief, alternative therapies and, in some cases, surgery.

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Posted by Spine and Sports Medicine on 2:52 PM


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What Is TMJ – and How Can I Treat It?

Are you a pencil chewer, a jaw clencher? Have pain or tenderness in the jaw, aching pain in and around your ear? “You may want to give us a call,” says Spine and Sports Medicine Medical Director Brian Kessler, M.D. “Jaw pain may be an indicator of temporomandibular joint disorder, known as TMJ -- an acute or chronic inflammation of the temporomandibular joint, which connects the lower jaw to the skull.” TMJ disorders cause tenderness and pain in the temporomandibular joint — the joint on each side of your head in front of your ears, where your lower jawbone meets your skull. This joint allows you to talk, chew and yawn, and because it combines a hinge action with sliding motions, is one of the most complex joints in your body. Between 5 and 15 percent of people in the United States experience pain associated with TMJ disorders, according to the National Institute of Dental and Craniofacial Research, with women between the ages of 30 and 50 most likely to develop TMJ disorders.

“Determining the cause of a TMJ problem is important,” says Dr. Kessler, “because it is the cause that guides the treatment. TMJ problems do not fall clearly into one medical area, so we use a multidisciplinary approach to find the best treatment possible for every patient, often working with specialists from pain management, neurology and physical medicine right in our offices in Manhattan.”

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Posted by Spine and Sports Medicine on 2:44 PM


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