- Men's Health, Orthopedics, Senior Care, Women's HealthGeneral Page Tier 3BlogSometimes it’s hard for you to pinpoint the source of your pain when it comes to back and hip problems. This can lead to problems in diagnosis, and without the proper diagnosis, your treatment is often ineffective. It’s likely my hip causing me pain Most true hip problems are, surprisingly, felt in the groin. The common culprit is osteoarthritis in the hip joint. In addition to the groin pain, you’ll often experience: Pain when walking, pivoting and other physical activities. Relief when sitting, although you may have stiffness. Limping You’ll usually have a history of loss of motion at the hip, which can make it difficult for you to put on shoes and socks or to cut your toenails. You may also have difficulty getting in and out of cars, and going up and down steps. Your groin pain may extend down the front of the thigh as far as the knee. Hip arthritis may rarely present as knee pain rather than groin pain. But, if your pain radiates past your knee, there’s numbness or tingling in the leg, or weakness such as dragging your foot, hip arthritis is not the cause. It’s likely my back causing me pain When the pain is in the middle of the lower back, or when your back tightens up so that you can hardly move, there is generally no problem with the diagnosis. This is particularly true when the pain radiates into the leg, especially below the knee, and is associated with numbness, tingling or weakness. However, not all back symptoms are so straightforward. I often see patients with pain in one or the other buttock, and they almost always tell me they have a hip problem, but most of the time pain in the buttock actually originates in the lower spine. This is called referred pain, similar to when a heart attack patient complains of pain in the left arm. Your lower back can refer pain from an impinged nerve to both your buttocks and legs. And, where it refers the pain to depends on which joint in your spine is causing the issue. A lot of lower back problems that show as hip pain are caused by a herniated disc that presses on nerves in the spinal column. This produces pain known as sciatica, which you’ll often feel in the hip. You may have a herniated disc in your lower back if your pain: Shoots down your leg below the knee, with numbness, tingling or weakness. Becomes worse when you sit or bend. Improves when you stand or walk. Treatment Both back and hip pain may respond to anti-inflammatory medication like ibuprofen or naproxen. Physical therapy often helps back pain, and a lightweight back support may also be useful. If these initial measures fail to provide relief, targeted cortisone injections may be helpful. This is where a correct diagnosis is so important. You’ll often feel no relief if the wrong area is injected. If you’re experiencing back and neck pain, you can find out what factors may play a role and get recommendations for follow-up steps by taking a free back pain assessment at askAAMC.org/SpineHealth. Author Stephen Faust, MD, is the Co-Director of AAMC Orthopedics where he specializes in total joint replacements and spine care. You can reach his practice at 410-268-8862. Originally published October 9 , 2017. Last updated July 5, 2018.0
- OrthopedicsGeneral Page Tier 3BlogIf you’re suffering from a back condition and considering surgery, then chances are you’ve heard about laser spine surgery. TV and Internet ads suggest a quick, easy treatment for patients with chronic pain. The idea of a less invasive procedure to cure pain is very enticing. The marketing of laser surgery is so successful that my patients routinely ask about the use of lasers, despite limited medical evidence and their relative infrequent use in spine surgery. The truth is, laser spine surgery seen in ads usually refers to minimally invasive surgery or a spinal injection using a needle. Neither necessarily means a surgeon will use a laser. Newer techniques in spine surgery are less invasive. When possible, we attempt to preserve as much of the muscle, soft tissue and spinal anatomy as possible. Compared to traditional techniques, which require larger incisions, modern techniques – or minimally invasive surgery – allow for an easier initial recovery and can often be performed as a same-day surgery. No laser is involved. The use of lasers in surgery has been around for decades. In spine surgery, the use of lasers is only a small portion of procedures. Some surgeons will use a laser in spine surgery to remove tumors or tissue around a nerve. But most painful conditions of the spine involve degenerative conditions like arthritis — where a laser is rarely needed or effective. Medical research on the use of lasers for specific conditions, such as disc herniation, may be effective in some patients. However, this limited approach may not address the underlying cause of pain, such as spinal instability or deformity. Because of this, symptoms may return for some patients, requiring additional surgery to solve the problem. Evaluating your options for spine surgery If you’re evaluating surgical options for your condition, perhaps what’s more important than the technique is surgeon experience. You should seek a fellowship-trained surgeon and hospital that regularly perform both traditional and minimally invasive techniques in order to achieve the best result. Spine treatment is very individualized to specific symptoms and at times can be complicated. A thoughtful, experienced surgeon recommends the most appropriate treatment for each individual patient. Unfortunately, there isn’t a single, easy cure for back pain. If the treatment sounds too good to be true, it’s worth your time to get a second opinion before having spine surgery. Author Chad Patton, MD, is medical director of The Spine Center at AAMC and a spine surgeon with AAMC Orthopedics. To reach his practice, call 410-268-8862. Originally published May 30, 2017. Last updated June 18, 2018.0
- OrthopedicsGeneral Page Tier 3BlogArm injuries in youth sports continue to increase at an alarming rate. In particular, baseball and softball players are at significant risk of overuse injuries during their playing careers. In fact, it is estimated that up to 35 percent of baseball players will experience elbow or shoulder pain each year. Although throwing injuries occur in position players, pitchers are especially at risk for injury. It’s important that parents, coaches, doctors and the athletes understand the risk factors and preventative measures, and work together to decrease pitching overuse injuries. Overuse injury is often the result of specializing in one sport and is the main factor in the rise of arm injuries in throwing sports. Overuse leads to muscle fatigue and weakness, which can alter throwing mechanics and cause injury. In addition, muscles protect the bones and ligaments of the shoulder and elbow during the throwing motion by absorbing the energy of the throw. When the arm is fatigued, the risk of ligament rupture or fracture increases. As the season progresses, the risk of fatigue and injury increases. The total number of throws, not the type of pitch thrown, is the most important risk. Many baseball associations recommend daily, weekly and yearly pitch limits, as well as mandatory rest periods. Throwing too many pitches with insufficient rest is more likely at weekend or showcase tournaments. For example, a 12-year-old who throws 50 pitches on the first day of a tournament should not pitch again until day four. Referenced from “The Bare Minimum: Baseball” (Essential Training for the Baseball Athlete Youth through College) Everyone involved is responsible for preventing pitching overuse injuries. The American Sports Medicine Institute has common sense suggestions to limit overuse: Follow pitch limit guidelines during the season. Pitch on only one team per season. Don’t allow pitchers to play catcher during the same season since these two positions throw the most during a game. Refrain from overhead throwing for three months and competitive pitching for four months each year. It can be hard to take the necessary rest periods when a lot of kids now play year-round baseball. I suggest the months of November through January as ideal time in our area of the country for this essential rest. Players should realize that a good conditioning program for their legs, core, and rotator cuff muscles is crucial to protect the shoulder and elbow from excessive force during the throwing motion. In addition to strengthening, a shoulder stretching program focused on the posterior shoulder capsule is also helpful in preventing arm injuries. Armed with this information, coaches, parents, and players can work together to limit overuse and enjoy a full, injury-free season. Authors Cyrus Lashgari, MD, is an orthopedic surgeon with AAMC Orthopedics. To reach his practice, call 410-268-8862. Originally published March 19, 2018. Last updated March 28, 2019.0
- Heart CareGeneral Page Tier 3BlogEvery 40 seconds, a person in the United States suffers a heart attack. Heart disease is the leading cause of death in both men and women. In my clinical practice, I treat a wide range of heart attack patients, ranging in age from their 30s to 90s. While most of my patients have multiple risk factors for heart disease, others lack traditional risk factors. In fact, I have treated marathon runners and Navy SEALs for heart attacks. No one is “safe” from a heart attack. That’s why it is critical to be aware of warning signs and to seek treatment to minimize damage to heart muscle. What is coronary artery disease, or CAD? The heart is a muscular pump that transports blood to the body, and the coronary arteries deliver oxygenated blood to the heart. Fatty plaque deposits can develop within the arteries and block delivery of blood to the heart. During a heart attack, a plaque ruptures, causing a life-threatening narrowing that damages the heart from lack of blood flow. What are heart attack symptoms? When your heart lacks oxygen, you can develop chest pain that sometimes radiates to the arms, neck or back. If your chest pain becomes more frequent, intense, longer, and/or occurs at rest, you should seek medical attention. Notably, women, diabetic, and elderly individuals sometimes experience “atypical” symptoms. These can include shortness of breath, fatigue or weakness, back pain, jaw pain, nausea and indigestion. When in doubt, get checked out. Opening up narrowed arteries quickly can minimize heart injury. The best and safest way to get to the hospital is by calling 911 and taking an ambulance. How is a heart attack diagnosed? When you arrive at the hospital, doctors will check an electrocardiogram and your blood work to screen for a heart attack. If doctors are concerned that you’re having a heart attack, they may recommend a heart catheterization. This is where a small tube is placed in an artery. The doctor then takes pictures of the coronary arteries to look for blockages. What are the treatment options? If the doctor finds a severe blockage or several blockages, they may recommend stents, which prop open an artery where it narrows. If there are multiple severe blockages, doctors may recommend heart surgery. In addition to these procedures, medications also play a crucial role in improving blood flow to arteries and preventing plaque buildup. What are CAD risk factors? There are certain risk factors you cannot change, such as age and genetics. But there are other risk factors you can control with aggressive therapy and lifestyle modification. These include diabetes, high blood pressure, high cholesterol, obesity, and tobacco use. Exercise, a heart-healthy diet, avoiding tobacco, and taking prescribed medications are the cornerstones for a heart healthy lifestyle. If you have a heart attack, controlling cardiac risk factors is essential for preventing another heart attack. Recognizing CAD symptoms early and getting timely treatment minimizes heart damage. Controlling reversible risk factors for coronary disease also helps prevent heart attacks. Author Elizabeth Reineck, MD, is an interventional cardiologist at AAMC. Originally published March 26, 2018. Last updated March 27, 2019.0
- Behavioral Health, Heart CareGeneral Page Tier 3BlogWhile heart attacks are physical health problems, many people don’t realize they can create mental health issues as well. Feeling depressed after a heart attack isn’t uncommon. According to the American Heart Association, up to 33 percent of heart attack patients experience depression. When someone has a heart attack they’re typically doing something, such as running or walking up stairs. After the heart attack they may be afraid their heart is delicate and hesitate to complete common activities. Most heart attack patients experience feelings of shock or sadness after a heart attack, but some people can slip into a deeper depression. If these emotions continue for several weeks, it’s time to seek help. Because depression can affect physical health, addressing symptoms quickly can help avoid other problems down the road. I tell patients, “You’re going to go back to your usual life, as long as you take the right steps.” These steps include faithfully taking prescribed medications, eating a healthy diet and exercising. And cardiac rehabilitation can help. Cardiac rehab provides a safe environment to start increasing physical fitness. AAMC’s Outpatient Cardiopulmonary Rehabilitation Program includes counseling to help patients improve their health and reduce the risk of future heart problems. Oftentimes, patients who choose to participate in cardiac rehab have better outcomes than those who don’t. Family members and loved ones also play an important role in helping heart attack patients recover. If you think you know someone experiencing post-heart-attack depression, look for these warning signs: -Extreme changes in appetite -Extreme changes in sleeping patterns -Avoiding previously enjoyable activities -Insomnia -Restlessness -Fatigue -Feelings of worthlessness -Feelings of excessive or inappropriate guilt -Trouble concentrating Encourage people who show these signs to seek help. For some, support groups are a healthy environment to cope with depression after a heart attack. AAMC’s healthy hearts cardiac support group is available for those who have experienced heart issues. Call 410-507-3766 for more information. Heart attack patients can experience the same quality of life as they did before their heart attack, but sometimes they need to take extra steps to get there. Author Baran Kilical, MD, is a cardiologist and cardiac electrophysiologist with Anne Arundel Medical Center. Originally published Feb. 23, 2016. Last updated March 27, 2019.0
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