Orthopedic Conditions

Whether orthopedic conditions, spinal conditions or injuries develop gradually or strike suddenly, they can affect anyone—at any age and from any walk of life. Fortunately, Frye Regional's Advanced Orthopedics and Spine Surgery Center is ready with state-of-the-art technology, board-certified specialists, and dedicated nursing and technical teams. Full-spectrum care is now available in the Greater Hickory Metro area.

From the beginning, we take care to educate you on your options, what to expect, and what you can do to help in your own healing and rehabilitation process.

Managing Neck and Back Pain

The human skeleton has 206 bones, of which 33 are in the vertebral, or spinal column that extends from the skull to the pelvis. Problems with these bones, along with muscles, joints, disks and nerves, can cause neck and back pain resulting in a wide range of symptoms. Although uncomfortable, most episodes of back or neck pain are not serious and rarely require surgery.

There are many causes of neck pain. Overuse can result in muscle strain, worn joints may lead to osteoarthritis, and nerve compression due to stiffened or herniated disks and bone spurs could reduce the amount of space for nerves to split off from the spinal cord. Injuries also can cause neck pain, as can certain diseases, including rheumatoid arthritis, meningitis, or cancerous tumors in the spine. Treatment for neck pain should begin as soon as possible to minimize discomfort and prevent further aggravation.

Self-care measures that can help relieve neck pain include taking over-the-counter pain relievers, such as aspirin, ibuprofen, naproxen sodium or acetaminophen. Alternating heat and cold also may help by using an ice pack to reduce inflammation and then taking a warm shower to relax sore muscles. Lying down occasionally can give the neck a chance to rest from holding up the head. If these treatments do not work, a doctor may prescribe medications, such as muscle relaxants or prescription pain medications, or therapy, including neck exercises and stretching, traction or short-term immobilization.

Back pain usually is due to strained muscles or ligaments, improper or heavy lifting, or a sudden awkward movement. Structural problems, such as a bulging or ruptured disk, arthritis, sciatica, irregular curves in the spine, or osteoporosis, also can cause back pain. Symptoms can range from muscle ache and limited flexibility, to shooting pain and inability to stand. Back pain typically improves in a few weeks with proper attention and home treatment.

Back pain that comes on suddenly most often gets better without any treatment. However, aspirin, acetaminophen or ibuprofen can be taken to help ease the pain. A muscle relaxant may be prescribed if mild to moderate back pain is not relieved by over-the-counter pain relievers. Heat can be applied to reduce muscle spasms or cold packs may be used to reduce swelling and numb deep pain. Physical therapy and exercise can help reduce pain and strengthen back and abdominal muscles. Cortisone injections may temporarily decrease inflammation around nerve roots near the spinal cord.

Alternative treatments are available for both neck and back pain. However, it is important to discuss the benefits and risks of acupuncture, chiropractic and massage with a physician before starting any alternative therapy.

Neck and back pain may be avoided by improving your overall physical condition and practicing good body mechanics. For the neck, adjust the desk and chair so your computer monitor is at eye level, don’t tuck the phone between your ear and neck when talking, and stretch frequently. For the back, exercise regularly, build muscle strength and flexibility, and maintain a healthy weight.

Osteoporosis

Osteoporosis is a very common disease that makes the bones weak and more likely to break easily. According to the National Institutes of Health, more than 53 million people already have osteoporosis or are at high risk due to low bone mass, placing them at risk for more serious bone loss and fractures. It cannot be cured, but osteoporosis can be detected by a painless test and treated through lifestyle changes and medications.

The human bone looks something like a honeycomb, with the body constantly depositing new bone and removing old bone. Bone mass usually peaks around age 30, at which time the body starts removing more old bone than forming new bone. A person is diagnosed with osteoporosis when the spaces inside the honeycomb become larger resulting in decreased bone density and strength. Osteoporosis does not cause any symptoms, and those with the disease usually do not know they have it until they experience a collapsed vertebra or fracture.

People at increased risk for developing osteoporosis tend to be those who are women, Caucasian or Asian, over the age of 50, small-boned and have a family history of the disease. Other risk factors for osteoporosis include regular consumption of alcohol, smoking and certain medications, including glucocorticoids, long-term use of some anti-seizure drugs, gonadotropin-releasing hormone drugs for endometriosis, certain cancer treatments and excessive use of antacids that contain aluminum. For these people, a bone density test typically is recommended to identify osteoporosis, determine the rate of bone loss, predict risk for broken bones and measure effects of treatment. The test, which does not require any preparation, is similar to having an X-ray but with considerably less exposure to radiation.

Treatment for osteoporosis usually focuses on preventing fractures by eating a proper diet, exercising regularly and taking fall precautions. Medications also may be prescribed to reduce bone loss, increase bone density or reduce the risk of fracture. A healthy diet includes eating foods high in calcium and vitamin D, such as dairy products, dark green, leafy vegetables, sardines, tofu, almonds, egg yolks, saltwater fish and liver. Both men and women should get 600 IU (International Units) of vitamin D daily. Women over the age of 50 should get 1200 milligrams of calcium daily while men should get 1000 milligrams daily.

Weight-bearing exercise can help make bones and muscles stronger and slow down the rate of bone loss. Recommended activities done three to four days a week may include walking, hiking, jogging, playing tennis, climbing stairs or dancing. To reduce the risk of falls, rooms should be kept free of clutter, and carpets and area rugs need to be anchored to the floor. Rubber-soled shoes are suggested for better traction and a cane or walker can help with added stability.

Osteoporosis is not an unavoidable part of aging. It can be prevented and treated. Even if you have already been diagnosed with the disease, you can take steps to slow its progression and reduce the risk of falls.

For more information about osteoporosis, talk with your doctor, of visit the National Institute of Arthritis and Musculoskeletal and Skin Diseases website at www.niams.nih.gov.  

What are Sprains and Strains?

Strains and sprains are the most common type of injuries that result from physical activity. A sprain is the stretching or tearing for a ligament, fibrous tissue connecting one bone to another in a joint. An injury to a muscle or a tendon, fibrous cords that attach muscle to bone, is known as a strain.

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 restoring function to the injured area (rehabilitation).

Initial treatment should occur as soon as possible. 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 that requires 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.
 

Anterior Cruciate Ligament (ACL) Injuries

If you think a sprained ankle is painful, then you definitely don’t want to have an anterior cruciate ligament (ACL) injury in the knee. It not only gets high marks on the pain scale, but also can take weeks, and even months, to heal.

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 and 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.
 

Replacing Worn Joints

Joint replacement surgery involves replacing a damaged joint with a new one called a prosthesis. These new joints usually are made of special metals, such as stainless steel or titanium, and durable, wear-resistance plastic. Prostheses are designed to be accepted by the body and resist corrosion, degradation and wear so they can last at least 10 to 15 years.

Joint replacement is usually considered after exercise, walking aids, physical therapy or medications cannot relieve pain and improve mobility. Surgery for hip replacement patients, for example, can help lessen problems walking up and down stairs or make it easier to stand from a seated position. Joint damage is caused by osteoarthritis, injuries, other diseases, joint wear caused by years of use, bone tumor or blood loss due to insufficient blood supply. Symptoms of joint problems include pain, stiffness and swelling.

Before surgery, the surgeon evaluates the patient’s range of motion and joint strength, takes a medical history and reviews medications currently being taken. Blood tests and X-rays also can be ordered. The doctor may put a small, lighted tube called an arthoscope into the joint to check for damage. In some cases, only the damaged parts would be replaced, not the entire joint. During a hip replacement surgery, diseased or damaged bone and tissue is removed and a metal stem and attached ball is then inserted into healthy bone and tissue that are left intact.

New joints can be cemented into place to hold the new joint to the bone, or the prosthesis can be placed without cement so bone can grow and attach to it. A prosthesis is designed to duplicate the mechanical properties of the joint being replaced. A prosthetic knee, for example, will be flexible enough to bend without breaking and strong enough to bear weight.

Most hip and knee replacement patients are discharged from the hospital three to five days after surgery. Patients will be encouraged to stand and start walking soon after surgery with a walker or crutches. Pain from sore muscles or surgery can be helped with medication and usually disappears in a few weeks or months. Physical therapy exercises will help regain motion in the joint.

Most joint replacement surgeries are successful. However, if problems do arise, most can be treated. Possible complications from joint replacement surgery include infections, blood clots, loosening, dislocation or wear of the new joint, or nerve and blood vessel injury. Hip replacement patients also may experience a change in leg length or joint stiffening. Following hip replacement surgery, most patients eventually will be able to swim, play golf or bike ride comfortably, but high-impact sports such as basketball and running would not be possible.

Joint replacement surgery is becoming more common in the United States, with more than 1 million Americans having a hip or knee replaced annually.