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Men’s Health Month

Men, on average, have life spans that are five years shorter than women, and make half as many yearly doctors’ visits. From childhood, many men are encouraged by society to suppress emotional or physical discomfort and to “suck it up.” While these conceptions of masculinity are shifting, many men are still encouraged to ignore concern over injury or discomfort. These factors can be a special challenge as you are tasked with providing preventative medicine and the early detection of diseases. Men’s Health Month is an important opportunity to highlight these challenges and barriers to men’s health and the importance of stressing prevention, detection, and education.

1. Screening

Many patients may not know that testicular cancer can occur as early as age 15 or may be unaware that they can perform self-exams. Others may understand the seriousness of prostate cancer but fear the prospect of a rectal exam and are unaware that there are alternatives like blood tests that can also be used as screening tools.

2. Mental Health

We know that telling someone to “man up” will not alleviate emotional distress or eliminate mental health disorders. This kind of language serves to prevent many from seeking the help they need. Creating a safe, stigma-free space for men to voice their mental health concerns and seek resources is especially important.

3. Sexual Health & Hormone Balance

Encouraging men to be tested for sexually transmitted diseases is important. Additionally, while erectile dysfunction or lack of libido might be uncomfortable to discuss, these symptoms should be addressed, and may also indicate broader health concerns, like hormone imbalance.

Testosterone & Men’s Health

While it can be hard to talk about, low testosterone can have a serious impact on overall male physical and emotional health. Erectile dysfunction and low libido maybe symptoms underlying a testosterone dysfunction, which can have broad-ranging implications on overall health. Unfortunately, only 5% of men with testosterone insufficiency receive hormone replacement therapy (HRT).

By providing patients with the BioTE method of Hormone Optimization, the patient utilizes a comprehensive diagnostic technique that pairs blood testing of total and free testosterone measurements with a clinical survey that puts the numbers into a context built around the individual patient. There is no one “magic” number, every man is different, and treating each patient as unique is vital to providing the right solution to each patient.

Low testosterone may have a wide range of influences on overall health and well being. These can include low energy levels, insomnia, weight gain (especially around the midsection), brain fog, loss of muscle mass, decreased libido, decreased sexual performance (erectile dysfunction), joint pains, and mood disturbances, including irritability.

As testosterone decreases, there is also an increase in inflammatory cytokines in the brain, leading to more free radicals and oxidative stress. This causes damage to the endothelium, brain cells, and mitochondria, restoring testosterone levels increases blood flow to the brain, decrease beta amyloid deposition in the brain, and decreasing inflammatory cytokines. Many patients have reported an increase in mental clarity.

Optimizing testosterone using the BioTE Method of Bioidentical Hormone Replacement Therapy, may help alleviate the challenges associated with low testosterone. While the benefits of optimizing testosterone maybe overwhelmingly positive, seeking new care can be intimidating. After receiving testosterone replacement, many patients report:

Less body fat, especially around the mid-section

Increased energy levels

Retention of muscle mass

Heightened mood

Increased libido and sexual function

Learn more at https://www.central-mo-orthopaedics.com/

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Herniated Disk Treatment

When it comes to the majority of patients, a herniated lumbar disk will gradually improve over a period of a few days to weeks. Commonly, most patients are without symptoms by 3 to 4 months. Nonetheless, some patients do experience episodes of pain during their recovery. If you reside in Columbia, Fulton, Centralia, or Mexico, MO, herniated disk treatment is an important part of the healing process for you to look at when deciding on a physician.

Nonsurgical Treatment

Preliminary treatment for a herniated disk is usually nonsurgical in nature. Treatment focuses on giving pain relief.

Nonsurgical treatment may include:

Rest. One to 2 days of bed rest will typically help alleviate back and leg pain. Do not stay off your feet for longer, however. Whenever you return to activity, try to do the following:

Take rest breaks all throughout the day, but avoid sitting for long periods.

Make all your physical activity slow and controlled, especially bending forward and lifting.

Change your daily activities to avoid movements that can cause more pain.

Nonsteroidal anti-inflammatory medications (NSAIDs). Medications such as ibuprofen or naproxen can help ease pain.

Physical therapy. Particular exercises will help strengthen your lower back and abdominal muscles.

Epidural steroid injection. An injection of a cortisone-like drug into the area around the nerve can provide temporary pain relief by lowering inflammation.

There is great evidence that epidural injections can successfully alleviate pain in many patients who have not been assisted by 6 weeks or more of other nonsurgical care.

Surgical Treatment

Just a little percentage of patients with lumbar disk herniation in Central Missouri need surgery. Spine surgery is commonly suggested only after a period of nonsurgical treatment has not relieved painful symptoms, or for patients who are experiencing the following symptoms:

Muscle weakness

Difficulty walking

Loss of bladder or bowel control

Microdiskectomy. The absolute most prevalent procedure used to treat a single herniated disk is microdiskectomy. The procedure is done through a small incision at the level of the disk herniation and commonly involves the use of a microscope. The herniated part of the disk is eliminated in addition to any additional fragments which are taxing the spinal nerve. A larger procedure might be required if there are disk herniations at more than one level.

Rehabilitation. Your doctor or a physical therapist might suggest a simple walking program (like 30 minutes daily), alongside specific exercises to help bring back strength and flexibility to your back and legs.

To reduce the danger of repeat herniation, you might be restrained from bending, lifting, and twisting for the first couple of weeks after surgery.

Considerations

With both surgical and nonsurgical treatment, there is a 5% to 10% chance that the disk may herniate again.

The risk of nonsurgical treatment is that your symptoms might require a long time to deal with. Patients who try nonsurgical treatment for too long before electing to have surgical treatment may experience less improvement of pain and function than those who elect to have surgery sooner. Your physician will talk with you regarding how long you ought to attempt nonsurgical measures before looking into surgical treatment.

Surgical risks. There are small risks related to every surgical procedure. These include bleeding, infection, and reaction to anesthesia.

Specific complications from surgery for a herniated disk include:

Nerve injury

Infection

Tear of the sac covering the nerves (dural tear)

Hematoma causing nerve compression

Recurrent disk herniation

Need for additional surgery

Outcomes

Overall, the results of microdiskectomy surgery are generally very good. Patients tend to see more improvement of leg pain than back pain. Most patients have the capacity to return to their normal activities after a period of recovery following surgery. Typically, the first symptom to improve is pain, followed by overall strength of the leg, and then sensation.

Over the last few years, there has been extensive research on the treatment of disk herniation. Your doctor will be able to talk with you about the advantages and disadvantages of both surgical and nonsurgical treatment. You merely need to ensure you are picking someone who has been keeping in the loop on these recent developments. Dr. Kathleen Weaver in Mexico, Missouri keeps up to date on all the latest advances in orthopedic medicine in the Mid Missouri area. Set up an appointment to see what Dr. Weaver can do for you.

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Herniated Disk in the Lower Back

A herniated disk is a condition that may take place anywhere along the spine, but most often takes place in the lower back. It is sometimes referred to as a bulging, protruding, or ruptured disk. It is among the absolute most common causes of lower back pain, along with leg pain or "sciatica."

Between 60% and 80% of individuals will experience low back pain at some time in their lives. Many of these individuals are going to have low back pain and leg pain triggered by a herniated disk.

Even though a herniated disk may be really painful, many people feel much better with just a few weeks or months of nonsurgical treatment. Having said that, others may need to pursue surgical options to get back to one hundred percent. Whether surgical or nonsurgical treatment is appropriate for you, you can depend on Dr. Kathleen Weaver to partner with you to find the very best treatment plan for your needs. If you might have a herniated disk in Central Missouri, consider contacting Dr. Weaver at Audrain Orthopaedics in Mexico, Missouri.

Anatomy

Your spine is comprised of 24 bones, called vertebrae, that are stacked on top of one another. These bones connect to create a canal which shields the spinal cord.

Five vertebrae comprise the lower back. This area is called your lumbar spine.

Other parts of your spine include:

Spinal cord and nerves. These "electrical cables" travel through the spinal canal carrying messages between your brain and muscles. Nerve roots branch out from the spinal cord through openings within the vertebrae.

Intervertebral disks. In between your vertebrae are flexible intervertebral disks. These disks are flat and rounded, and about a half inch thick.

Intervertebral disks serve as shock absorbers whenever you walk or run. They are comprised of two components:

Annulus fibrosus. This is the tough, flexible outer ring of the disk.

Nucleus pulposus. This is the tender, jelly-like center of the disk.

Description

A disk begins to herniate when its own jelly-like nucleus presses against its outer ring as a result of wear and tear or a sudden trauma. This stress against the outer ring might induce lower back pain.

If the pressure persists, the jelly-like nucleus may push all the way through the disk's outer ring or cause the ring to bulge. This leaves tension on the spinal cord and surrounding nerve roots. In addition, the disk material unleashes chemical irritants that bring about nerve inflammation. Whenever a nerve root is inflamed, there might be pain, numbness, and weakness in one or both of your legs, a problem referred to as "sciatica."

Cause

A herniated disk is usually the end result of natural, age-related wear and tear on the spinal column. This process is referred to as disk degeneration. Within children and young adults, disks have high water content. As people age, the water content in the disks lessens and the disks become less flexible. The disks begin to diminish and the spaces between the vertebrae become narrower. This normal aging process makes the disks more prone to herniation.

A traumatic event, for instance a fall, may also trigger a herniated disk.

Risk Factors

Particular factors might increase your risk of a herniated disk. These include:

Gender. Men between the ages of 20 and 50 are most likely to have a herniated disk.

Improper lifting. Employing your back muscles as opposed to your legs to lift heavy objects can cause a herniated disk. Twisting while you lift can also make your back susceptible. Lifting with your legs, not your back, might defend your spine.

Weight. Being obese places added tension on the disks within your lower back.

Repeating activities that strain your spine. Many jobs are physically demanding. Some require constant lifting, pulling, bending, or twisting. Using safe lifting and movement techniques may help protect your back.

Frequent driving. Remaining seated for long periods, plus the pulsation from the automobile engine, can easily place stress on your spine and disks.

Inactive lifestyle. Regular exercise is very important in preventing many medical conditions, including a herniated disk.

Smoking. It is believed that smoking lowers the oxygen supply to the disk and causes more rapid degeneration.

Symptoms

In most cases of low back pain in Mexico, MO and the surrounding areas, low back pain is the very first symptom of a herniated disk. This pain might last for a couple of days, then improve. Other symptoms may include:

Sciatica. This is a sharp, often acute pain that extends from the buttock down the back of one leg. It is triggered by pressure on the spinal nerve.

Numbness or a tingling feeling in the leg and/or foot.

Weakness within the leg and/or foot.

Loss of bladder or bowel control. This is very rare and might suggest a much more significant trouble called cauda equina syndrome. This condition is triggered by the spinal nerve roots being compressed. It necessitates prompt medical attention.

Doctor Examination

Medical History and Physical Examination

After discussing your symptoms and medical history, your physician will carry out a physical exam. The exam might include the following tests:

Neurological examination. A neurological examination is going to help your doctor determine if you have any muscle weakness or decrease of sensation. Throughout the exam, she or he will:

Check muscle strength in your lower leg by assessing how you walk on both your heels and toes. Muscle strength in other parts of your body might also be tested.

Detect loss of sensation by assessing whether you can feel a slight touch on your leg and foot.

Test your reflexes at the knee and ankle. These may sometimes be absent if there is a compressed nerve root in your spine.

Straight leg raise (SLR) test. This test is a truly authentic predictor of a disk herniation in patients under the age of 35. Throughout the test, you lie on your back and your physician very carefully lifts your affected leg. Your knee keeps straight. If you feel pain down your leg and below the knee, it is a strong indication that you have a herniated disk.

Imaging Studies

Magnetic resonance imaging (MRI) scan. These reports deliver clear pictures of the body's soft tissues, including intervertebral disks. Your doctor may order an MRI scan to help confirm the diagnosis and to find out more about which spinal nerves are impacted.

If you are unable to tolerate an MRI, a computerized tomography (CT) scan, or a CT myelogram can be ordered instead.

If you would like to find out more about Mexico, MO herniated disks and their proper treatment, you can get in touch with Dr. Kathleen Weaver for further guidance by booking an appointment with Audrain Orthopaedics. Do not think that back pain is something you simply have to cope with. There may be a solution closer than you assume.

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Burning Thigh Pain

A hurtful, burning sensation on the outer side of the thigh may mean that just one of the big sensory nerves to your thighs-- the lateral femoral cutaneous nerve (LFCN)-- is actually being squeezed. This condition is called meralgia paresthetica (me-ral'- gee-a par-es-thet'- i-ka). If you believe you might struggle with this orthopedic disorder, Audrain Orthopaedics is here for the people of Mexico, Missouri and all throughout Audrain County.

The nerves within your body bring information to the brain about the environment (sensory nerves) and communications from the brain to stimulate muscles (motor nerves). To do this, nerves must pass on top of, beneath, about, and throughout your joints, bones, and muscles. Normally, there is enough room to permit very easy passage.

For folks in Mexico, Missouri with meralgia paresthetica, swelling, trauma, or pressure can narrow these openings and squash the nerve. When this takes place, pain, paralysis, or other malfunction may well arise.

Symptoms

Pain on the exterior side of the thigh, occasionally extending to the outer side of the knee

A burning sensation, tingling, or numbness within the same area

Occasionally, aching in the groin area or pain dispersing throughout the buttocks

Generally only on one side of the body

Normally more sensitive to light touch than to solid pressure

Doctor Examination

Amid the Central Missouri orthopedic appointment, your physician will ask about recent surgeries, trauma to the hip, or repeated activities that could irritate the nerves.

If your physician suspects meralgia paresthetica, he or she will ask questions to help determine what might be putting stress on the nerve.

Restrictive clothing and weight gain are two of the more typical causes of pressure. Your doctor may ask if you consistently wear tight stockings or a girdle, or whether you wear a large tool belt on the job. Furthermore, meralgia paresthetica may arise from a seatbelt injury during the course of a vehicle crash.

Physical Examination

Your physician will also check for any sensory distinctions between the affected leg and your other leg. To verify the site of the burning pain, he or she will put some stress on the nerve to reproduce the sensation. You might require both an abdominal and a pelvic examination to exclude any issues in those areas.

Tests

X-rays are going to help identify any bone abnormalities that might be taxing the nerve. If your doctor thinks that a growth such as a tumor is the source of the pressure, he or she may well ask for a magnetic resonance image or a computed tomography (CT) scan. In infrequent cases, a nerve conduction study may be advised.

Treatment

Treatments will differ, depending on the source of the strain.

The objective is to remove the root cause of the compression. This may mean resting from an aggravating activity, dropping weight, wearing loose clothing, or utilizing a toolbox rather than putting on a tool belt.

It might take time for the burning pain to stop and, in some cases, numbness will persist in spite of treatment. In much more extreme cases, your physician might give you an injection of a corticosteroid preparation to reduce inflammation. This generally alleviates the symptoms for a long time. In unusual cases, surgical treatment is needed to release the nerve.

No matter what treatment is required, a good Mexico, MO orthopedic doctor like Dr. Kathleen Weaver will be with you each and every step of the way. To get an appointment, simply go to Dr. Weaver's website at www.central-mo-orthopaedics.com.

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Laser Resurfacing

Laser resurfacing is a treatment to lessen facial wrinkles and skin abnormalities, including blemishes or acne scars. The technique guides small, concentrated pulsating beams of light at irregular skin, precisely taking out skin layer by layer. This well-liked procedure is also referred to as lasabrasion, laser peel, or laser vaporization. If you live in Mexico, Missouri, laser resurfacing with Dr. Weaver of Audrain Orthopaedics could be right for you.

Who exactly Is a Good Candidate For Laser Resurfacing?

If you have fine lines or creases around your eyes or mouth or on your forehead, shallow scars from acne breakouts, or non-responsive skin after a facelift, then you might be a really good candidate for laser skin resurfacing.

If you have acne or if you have really dark skin, you might not be a prospect. This technique is also not recommended for stretch marks. You ought to review whether laser resurfacing is right for you by speaking with the physician before having the procedure done.

How Does Laser Skin Resurfacing Work?

Laser vaporizes skin cells damaged at the surface-level.

CO2 Laser Resurfacing

This particular technique has been used for years to treat various skin problems, including wrinkles, scars, warts, enlarged oil glands on the nose, and other conditions.

The newest version of CO2 laser resurfacing (fractionated CO2) utilizes very brief pulsed light energy (known as ultrapulse) or constant light beams that are delivered in a scanning pattern to remove thin layers of skin with marginal heat damage. Recovery takes up to 3 days.

Preparing for Laser Resurfacing

Start by consulting a physician to find out if you're a great candidate. Make sure to choose a doctor who has recorded training and experience in laser skin resurfacing. The doctor will determine which laser treatment is best for you after thinking about your medical history, present health, and desired results.

Tell your Audrian County orthopedic doctor if you get cold sores or fever blisters around your mouth. Laser skin resurfacing may trigger breakouts in people who are at risk.

If you opt to proceed with laser skin resurfacing, your physician will ask you to stay clear of taking any medications or supplements that can impact clotting-- such as aspirin, ibuprofen, or vitamin E-- for 10 days prior to surgery.

If you smoke, you should stop for two weeks just before and right after the procedure. Cigarette smoking can prolong healing.

Your doctor may assign an antibiotic ahead of time to prevent bacterial infections and also an antiviral medicine if you are prone to cold sores or fever blisters.

What to Anticipate

Typically, laser resurfacing is an outpatient procedure, indicating there is no overnight stay. The doctor might treat individual creases around your eyes, mouth, or forehead or treat your entire face.

If the doctor is just treating portions of your face, the procedure is going to take about 30 to 45 minutes. A full-face treatment takes up to one hour. Starting 24 hours following treatment, you will need to clean the treated area four to five times a day.

Then you'll need to put on an ointment, such as petroleum jelly, to prevent scabs from forming. This wound care is intended to stop any scab formation. In general, the areas heal in 2 to 3 days, depending on the condition that was treated.

It's typical to have swelling after laser skin resurfacing. Your doctor may prescribe steroids to manage swelling around your eyes. Sleeping on an extra pillow during the night to elevate your head can help reduce swelling. Placing an ice pack on the treated area also helps to reduce swelling in the first 24 to 48 hours right after laser resurfacing.

You might feel itching or stinging for 12 to 72 hours right after the procedure.

When the skin heals, you can wear oil-free make-up to reduce redness, which usually fades in a couple of months.

You will probably notice that your skin is less heavy for some time after surgery. It is particularly essential that you use a "broad-spectrum" sunscreen, which screens ultraviolet B and ultraviolet A rays, to safeguard your skin during that time. Whenever choosing a sun screen lotion, look for one specifically formulated for usage on the face. It needs to have a physical blocker, like zinc oxide. and a sun protection factor (SPF) of 30 or higher. Also limit your time in the sun, particularly between the hours of 10 a.m. and 2 p.m. Putting on a broad-brimmed hat can help protect your skin from the sun's hazardous rays.

It is likewise important to keep your new skin adequately moisturized. If you utilize Retin A or glycolic acid products, you should be able to begin using them again about 6 weeks after the procedure or when the doctor says you can.

Once the treated areas have healed, you can wear makeup to conceal the pink to reddish color that is generally seen after laser skin resurfacing. Green-based make-ups are particularly appropriate for this camouflage given that they neutralize the red color. Oil-free make-ups are recommended after laser resurfacing. The redness within the laser treated sites typically fades within two to three months But it may take as long as 6 months for the redness to completely disappear. Redness normally lasts longer in folks with fair skin.

People with darker skin tones are more likely to get darker pigmentation. Utilizing a bleaching agent before and after laser skin resurfacing may minimize that - and also strict sun avoidance with use of a day-to-day broad-spectrum sunscreen.

Complications of Laser Skin Resurfacing

Even though skin resurfacing can not produce perfect skin, it can enhance the visual appeal of your skin. Possible risks of the procedure include:

Burns or other injuries from the laser's heat

Scarring

Changes in the skin's pigmentation, including areas of darker or lighter skin

Reactivating herpes cold sores

Bacterial infection

Milia, which are little white bumps, may appear in the laser-treated areas during healing. Your physician can treat those.

If you would like more info regarding laser resurfacing or the host of other Mexico, Missouri orthopedic services offered by Dr. Weaver, please call Audrain Orthopaedics today to arrange your consultation.

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Hormone Therapy May Be Best Defense Against Knee Osteoarthritis

Dr. Kathleen Weaver of Audrain Orthopaedics in Mexico, Missouri is an authority on osteoarthritis and the many other aspects of the orthopedic subfield of medicine. She is dedicated to staying up to date on the very newest research pertaining to her specialty field. Therefore, she would like you to find out about some impressive new discoveries being made within her field that could considerably affect the nature of exactly how we combat knee osteoarthritis.

A large-scale study posted within the journal Menopause reveals that women receiving hormone replacement therapy had a significantly lower prevalence of symptomatic knee osteoarthritis as opposed to women who did not take hormones.

Because oestrogen has an anti-inflammatory effect at high concentrations, it has been hypothesized that hormone changes within women, especially reducing oestrogen levels, may trigger an increase in osteoarthritis right after menopause.

The most common treatments for knee osteoarthritis include surgical treatment or nonsteroidal anti-inflammatory drugs, both of which are associated with risks like surgical complications or gastrointestinal conditions.

A number of small studies have shown that hormone therapy not only decreases histologic changes in the cartilage associated with osteoarthritis, but it likewise decreases the chronic pain. To date, however, no large studies have examined symptomatic knee osteoarthritis and HT.

For the current study, Jae Hyun Jung, MD, Korea University College of Medicine, Seoul, Korea, and associates evaluated data from 4,766 postmenopausal women from the Korea National Health and Nutrition Examination Survey (2009-2012). This Korean study has extremely promising results for those with arthritis within Central Missouri.

In the numerous logistic regression models, the knee osteoarthritis odds ratio was 0.70 for the hormone therapy group as opposed to ladies who did not take hormone therapy. The authors noted that additional research is warranted to adjust for such other variables like age and body mass index.

"Past and current users of hormone therapy had a lesser prevalence of knee joint osteoarthritis, indicating that hormone therapy might be protective against knee osteoarthritis," said JoAnn Pinkerton, North American Menopause Society, Cleveland, Ohio. "This study proposes that oestrogen taken at menopause might inhibit cartilage damage and decrease knee deterioration seen on x-rays."

If you are actually concerned about the probability of knee osteoarthritis or have some other concerns about orthopedic medicine within Mexico, Missouri, schedule an appointment with Dr. Kathleen Weaver of Audrain Orthopaedics. She has the expertise and knowledge you need to get your questions answered and work with you to develop a plan for action.

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Mexico, MO Rotator Cuff Tears: Surgical Treatment Options

Surgery to restore a torn rotator cuff frequently involves re-attaching the tendon to the head of humerus (upper arm bone). A partial tear, however, might require simply a trimming or smoothing treatment called a debridement. A complete tear is fixed by stitching the tendon back to its original site on the humerus.

The rotator cuff tendons cover the head of the humerus (upper arm bone), helping you to raise and rotate your upper arm. That is why a torn rotator cuff in Mexico, MO is a big deal. Do not take chances with this sort of thing. If you have a torn rotator cuff, head to a doctor who has many years of expertise working with patients with this very condition. For those in Central Missouri, Dr. Kathleen Weaver of Audrain Orthopaedics is a wonderful source to go to.

When Rotator Cuff Surgery is Suggested

Your physician might offer surgical treatment as an option for a torn rotator cuff if your discomfort does not greatly improve with nonsurgical methods. Continued pain is the primary indication for surgery. If you are very active and employ your arms for overhead work or sporting activities, your doctor may also propose surgical treatment. Other signs that surgery might be a really good option for you consist of:

Your symptoms have lasted 6 to 12 months

You have a large tear (over 3 cm) and the quality of the surrounding tendon tissue is good

You have notable weakness and loss of function in your shoulder

Your tear was brought on by a recent, acute injury

Surgical Repair Options

There are a couple of choices for fixing rotator cuff tears. Advancements in surgical techniques for rotator cuff repair include much less invasive treatments. While each one of the methods available has its own advantages and disadvantages, all have the very same goal: getting the tendon to heal.

The type of repair performed depends on several factors, including your surgeon's expertise and familiarity with a particular procedure, the size of your tear, your composition, and the quality of the tendon tissue and bone.

Many surgical repair work may be done on an outpatient basis and do not require you to stay overnight in the hospital. Your orthopaedic surgeon will discuss with you the most effective procedure to satisfy your individual health needs.

You might have some other shoulder problems along with a rotator cuff tear, like biceps tendon tears, osteoarthritis, bone spurs, or other soft tissue tears. During the procedure, your surgeon may have the chance to take care of these issues, as well.

The three techniques most commonly used for rotator cuff repair include conventional open repair, arthroscopic repair, and mini-open repair. In the long run, patients rate all three repair techniques the exact same for pain relief, strength improvement, and overall satisfaction.

Open Repair

A traditional open surgical laceration (several centimeters long) is frequently required if the tear is sizeable or complex. The surgeon makes the incision over the shoulder and detaches one of the shoulder muscles (deltoid) to better see and get to the torn tendon.

During an open repair, the doctor usually removes bone spurs from the underside of the acromion (this process is called an acromioplasty). An open repair might be a great option if the tear is large or complex or if supplementary reconstruction, like a tendon transfer, is suggested.

Open repair was the first technique used for torn rotator cuffs. Over the years, new technology and enhanced surgeon experience has led to less invasive procedures.

All-Arthroscopic Repair

During the course of arthroscopy, your surgeon inserts a tiny video camera, called an arthroscope, into your shoulder joint. The video camera shows photos on a tv monitor, and your doctor utilizes these pictures to direct miniature surgical instruments.

During arthroscopy, your surgeon can see the structures of your shoulder in excellent detail on a video monitor.

Because the arthroscope and surgical instruments are thin, your doctor can utilize very small incisions (cuts), instead of the larger incision required for standard, open surgical operation.

All-arthroscopic repair is normally an outpatient procedure and is the least invasive method to mend a torn rotator cuff.

Mini-Open Repair

The mini-open repair uses newer technology and instruments to perform a repair through a small incision. The incision is normally 3 to 5 cm long.

This technique uses arthroscopy to assess and deal with damage to other structures within the joint. Bone spurs, for instance, are frequently removed arthroscopically. This avoids the need to detach the deltoid muscle.

When the arthroscopic portion of the procedure is carried out, the surgeon repairs the rotator cuff through the mini-open incision. During the tendon repair, the surgeon views the shoulder structures directly, rather than through the video monitor.

Recovery

Pain Management

Right after surgical treatment, you are going to experience pain. This is a natural component of the healing process. Your doctor and nurses are going to work to decrease your pain, which may help you recoup from surgery faster.

Medications are often prescribed for short-term pain relief following surgery. Many varieties of medicines are available to help regulate pain, including opioids, non-steroidal anti-inflammatory drugs (NSAIDs), and local anesthetics. Your doctor might use a combination of these medicines to boost pain relief, as well as minimize the necessity for opioids.

Be aware that even though opioids help relieve pain following surgery, they are a narcotic and may be addictive. Opioid dependency and overdose has come to be a vital public health problem. It is very important to use opioids only as directed by your doctor. As soon as your pain begins to improve, stop taking opioids. Talk to your doctor if your pain has not started to improve within a few weeks following your surgery.

Rehabilitation

Rehabilitation plays a crucial role in getting you back to your day-to-day endeavors. A physical therapy program will help you reclaim shoulder strength and motion. When you find yourself pursuing that physical therapy help in Mexico, MO, go to Dr. Kathleen Weaver for the help you need.

Immobilization. Right after surgery, therapy progresses in stages. In the beginning, the repair has to be protected while the tendon heals. To keep your arm from shifting, you will probably make use of a sling and avoid utilizing your arm for the first 4 to 6 weeks. The length of time you require a sling hinges on the seriousness of your injury. Active exercise in the course of rehabilitation might include isometic external rotation exercises.

Passive exercise. Despite the fact that your tear has been fixed, the muscles all around your arm continue to be weak. Once your surgeon decides it is safe for you to move your arm and shoulder, a therapist is going to help you with passive physical exercises to greatly improve range of motion in your shoulder. With passive exercise, your therapist supports your arm and moves it in various positions. In many cases, passive exercise is begun within the very first 4 to 6 weeks after surgery.

Active exercise. After 4 to 6 weeks, you will progress to doing active exercises without the assistance of your therapist. Moving your muscles on your own will progressively increase your strength and boost your arm control. At 8 to 12 weeks, your therapist will start you on a strengthening exercise program.

Anticipate a total recovery to take several months. Many patients have a functional range of motion and adequate strength by 4 to 6 months after surgery. Though it is a slow process, your commitment to rehabilitation is essential to a successful outcome.

Outcome

Many patients report boosted shoulder strength and less pain following surgery for a torn rotator cuff.

Each surgical repair technique (open, mini-open, and arthroscopic) has comparable results in terms of pain relief, improvement in strength and function, and patient satisfaction. Surgeon expertise is more crucial in achieving satisfactory results than the choice of technique.

Factors which can reduce the likelihood of a satisfactory result include:

Poor tendon/tissue quality

Large or huge tears

Poor patient compliance with rehabilitation and limitations following surgery

Patient age (older than 65 years)

Smoking and usage of other nicotine products

Workers' compensation claims

Complications

Shortly after rotator cuff surgery, a small percentage of patients experience complications. In addition to the risks of surgery in general, such as blood loss or complications connected to anesthesia, complications of rotator cuff surgery may include:

Nerve injury. This commonly involves the nerve that activates your shoulder muscle (deltoid).

Infection. Patients are given antibiotics in the course of the procedure to reduce the risk for infection. If an infection develops, an extra surgery or prolonged antibiotic treatment may be needed.

Deltoid detachment. During an open repair, this shoulder muscle is detached to provide better access to the rotator cuff. It is stitched back into area at the end of the treatment. It is extremely important to protect this area following surgery and during the course of rehabilitation to enable it to heal.

Stiffness. Early rehabilitation lessens the likelihood of permanent stiffness or loss of motion. The majority of the time, stiffness will improve with more aggressive therapy and exercise.

Tendon re-tear. There is a chance for re-tear following all types of repairs. The more substantial the tear, the higher the risk of re-tear. Patients who re-tear their tendons generally do not have greater pain or reduced shoulder function. Repeat surgery is needed only if there is severe pain or reduction of function.

As you can see, there are a lot of steps in the process of recuperation from your rotator cuff trauma. If you do not stay with a very carefully-plotted regime, you risk furthering the duration or extent of your injury. Make sure to seek counsel from a qualified orthopedic physician such as Dr. Kathleen Weaver to make certain that you have the aid you need. Audrain Orthopaedics is here to help you with all your orthopedic health needs within Audrain County.

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Shoulder Pain and Common Shoulder Problems

What the majority of people consider the shoulder is actually multiple joints which combine with tendons and muscular tissues to allow a large range of motion within the arm-- from scratching your back to throwing the ideal pitch.

Mobility has its price, however. It might lead to increasing problems with instability or impingement of the soft tissue or bony structures in your shoulder, producing pain. You may feel pain only whenever you move your shoulder, or all of the time. The discomfort may be temporary or it might continue and necessitate medical diagnosis and treatment.

This article brought to you by Audrain Orthopaedics of Mexico, MO explains several of the common sources of shoulder pain, in addition to some general orthopedic treatment options. Your doctor can provide you more in-depth info regarding your shoulder pain.

Anatomy

Your shoulder is comprised of 3 bones: your upper arm bone (humerus), your shoulder blade (scapula), and your collarbone (clavicle). The head of your upper arm bone fits into a rounded socket in your shoulder blade. This specific socket is called the glenoid. A mixture of muscular tissues and tendons helps keep your arm bone centered in your shoulder socket. These kinds of tissues are referred to as the rotator cuff. They cover the head of your upper arm bone and attach it to your shoulder blade.

Cause

The majority of shoulder problems fall under four major categories:

Tendon inflammation (bursitis or tendinitis) or tendon tear

Instability

Arthritis

Fracture (broken bone)

Other much less common causes of shoulder pain are tumors, infection, and nerve-related problems.

Bursitis

Bursae are compact, fluid-filled sacs that are located in joints throughout the body, including the shoulder. They serve as cushions in between bones and the overlying soft tissues, and help reduce friction between the gliding muscle groups and the bone.

In some cases, excessive utilization of the shoulder causes irritation and swelling of the bursa in between the rotator cuff and a component of the shoulder blade referred to as the acromion. The outcome is a condition known as subacromial bursitis.

Bursitis commonly develops in association with rotator cuff tendinitis. The numerous tissues in the shoulder may become inflamed and painful. A lot of daily activities, including combing your hair or getting dressed, might become very difficult.

Tendinitis

A tendon is a cord which connects muscle to bone. Most cases of tendinitis in Central Missouri are an end result of inflammation within the ligament.

Normally, tendinitis belongs to two kinds:

Acute. Too much ball throwing or many other overhead activities during work or sport can result in acute tendinitis.

Chronic. Degenerative conditions like arthritis or repetitive wear and tear thanks to age can result in chronic tendinitis.

The most commonly affected tendons in the shoulder are the 4 rotator cuff tendons and one of the biceps tendons. The rotator cuff is made up of four small muscles and their tendons that cover the head of your upper arm bone and keep it within the shoulder socket. Your rotator cuff helps offer shoulder motion and stability.

Tendon Tears

Splitting and tearing of tendons may result from acute injury or degenerative changes within the tendons due to advancing age, long-term overuse and wear and tear, or a sudden injury. These tears could be partial or may completely separate the tendon from its attachment to bone. In most cases of total tears, the tendon is pulled away from its attachment to the bone. Rotator cuff and biceps tendon injuries are amongst the most common of these traumas.

Impingement

Shoulder impingement occurs whenever the top of the shoulder blade (acromion) puts pressure on the underlying soft tissues when the arm is lifted away from the body. As the arm is hoisted, the acromion rubs, or "impinges" on, the rotator cuff tendons and bursa. This can cause bursitis and tendinitis, causing pain and restricting movement.

Instability

Shoulder instability occurs when the head of the upper arm bone is driven out of the shoulder socket. This could happen because of a sudden injury or from excessive use.

Shoulder dislocations can be partial, with the ball of the upper arm coming just partly out of the socket. This is called a subluxation. A full dislocation means the ball comes all the way out of the socket.

When the ligaments, tendons, and muscles around the shoulder become loose or torn, dislocations can occur repetitively. Repeating dislocations, which might be limited or complete, cause pain and unsteadiness when you raise your arm or move it away from your body. Repeated episodes of subluxations or dislocations result in an increased danger of developing arthritis within the joint.

Arthritis

Shoulder pain may also come from arthritis. There are lots of types of arthritis. The most common type of arthritis within the shoulder is osteoarthritis, also known as "wear and tear" arthritis.

Symptoms like swelling, pain, and stiffness, usually begin during middle age.

Osteoarthritis establishes slowly and the pain it causes worsens in time. Osteoarthritis, could be related to sports or work injuries or persistent wear and tear. Other varieties of arthritis can be related to rotator cuff tears, infection, or an inflammation of the joint lining.

Commonly people will stay clear of shoulder movements in an effort to minimize arthritis pain. This sometimes results in a tightening or stiffening of the soft tissue parts of the joint, causing a painful restriction of motion.

Fracture

Fractures are broken bones. Shoulder fractures typically involve the clavicle (collarbone), humerus (upper arm bone), and scapula (shoulder blade). Shoulder fractures within older patients are often the outcome of a fall from standing height. In more youthful patients, shoulder fractures are commonly triggered by a high energy injury, such as a motor vehicle accident or contact sports injury. Fractures typically cause intense pain, swelling, and bruising around the shoulder.

Doctor's Examination

When it comes to an acute injury causing intense pain, seek medical treatment as soon as possible. If the pain is much less severe, it may be safe to rest a few days to see if time is going to fix the issue. If symptoms persist, see a Mexico, MO orthopedic doctor. Your doctor will conduct a thorough assessment to establish the cause of your shoulder pain and provide you with treatment options.

Medical History

The initial step in the evaluation is a complete medical history. Your physician might ask how and when the discomfort began, whether it has developed before and how it was addressed, and other concerns to help identify both your general health and the possible causes of your shoulder problem.

Since a lot of shoulder conditions are aggravated by specific activities, and relieved by particular activities, a medical history can be a valuable tool in finding the source of your pain.

Physical Examination

A thorough examination will be required to discover the reasons for your shoulder pain. Your doctor will try to find physical irregularities, swelling, deformity or muscle weakness, and check for sensitive areas. She or he will observe your shoulder range of motion and strength.

Tests

Your doctor may order particular tests in order to help identify the cause of your pain and any other problems.

X-rays. These pictures will show any injuries to the bones which make up your shoulder joint.

Magnetic resonance imaging (MRI) and ultrasound. These imaging studies produce better images of soft tissues. MRI may help your physician identify injuries to the ligaments and tendons surrounding your shoulder joint.

Computed tomography (CT) scan. This tool integrates x-rays with computer technology to produce a really thorough view of the bones in the shoulder area.

Electrical studies. Your physician may order a test, like an EMG (electromyogram), to evaluate nerve function.

Arthrogram. In the course of this x-ray study, dye is infused into the shoulder to better show the joint and its surrounding muscles and tendons. It may be combined with an MRI.

Arthroscopy. Within this surgical treatment, your physician looks within the joint with a fiber-optic camera. Arthroscopy may show soft tissue traumas which are not evident from the physical examination, x-rays, and other tests. Along with helping locate the cause of pain, arthroscopy may be used to correct the problem.

Treatment

Activity Changes

Treatment normally involves rest, altering your activities, and physical therapy to help you enhance shoulder strength and flexibility. Common sense solutions like avoiding overexertion or overdoing activities in which you usually do not participate can help to prevent shoulder pain.

Medications

Your physician may prescribe medication to reduce inflammation and pain. If medicine is prescribed to alleviate pain, it should be taken only as directed. Your doctor may also recommend injections of numbing medicines or steroids to relieve pain.

Surgery

Surgery might be required to deal with some shoulder issues. However, the huge majority of patients with shoulder pain will react to straightforward treatment methods including altering activities, rest, exercise, and medication.

Specific varieties of shoulder problems, such as recurring dislocations and certain rotator cuff tears, might not profit from physical exercise. In these cases, surgery might be advised reasonably early. Surgery can involve arthroscopy to remove scar tissue or repair torn tissues, or traditional open procedures for larger reconstructions or shoulder replacement.

No matter what degree of activity or inactivity you have, the reality of the matter is that having shoulder troubles could be a huge issue. Dr. Kathleen Weaver of Audrain Orthopaedics has the experience and training you can trust to help you relieve your Mexico, MO shoulder injury.

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Hip Fracture Prevention

Hip fractures are breaks in the thighbone (femur) just beneath the hip joint. They are considerable injuries that usually take place in people aged 65 and older. Women are particularly prone to hip fractures. Nevertheless, whether you are male or female, Dr. Kathleen Weaver is your go-to orthopedic specialist in Mexico, MO. For people in the Central Missouri area, you can go to Dr. Weaver at Audrain Orthopaedics.

Hip fractures may restrict mobility and self-reliance. A lot of hip fractures need surgery, hospitalization, and extended rehabilitation.

Most people who formerly lived independently before hip fracture need support afterward. This can extend from help from family members and home health professionals, to admittance to a nursing home or some other long-term health and wellness facility.

Cause

Most hip fractures are triggered by factors that weaken bone, combined with the impact from a fall.

Bone Strength

Bone strength lessens as we get older. Bones may get very weak and fragile-- a problem referred to as osteoporosis. Osteoporosis often develops in women after menopause, and in guys in older age. This bone-thinning disorder puts people at greater danger for broken bones, particularly fractures of the hip, wrist, and spine.

Risk Factors

Many of the factors which put you at increased risk for a hip fracture are those that cause bone loss.

Age. The risk for hip fractures increases as we get older. In 2010, more than 80% of the folks laid up for hip fractures were age 65 and older, according to the National Hospital Discharge Survey (NHDS).

Sex. In 2010, 72% of hip fractures within folks aged 65 and older happened in ladies (NHDS).

Heredity. A family history of osteoporosis or perhaps broken bones in later life sets you at increased risk for a hip fracture. Individuals with little, thin frames are also in jeopardy.

Nutrition. Low body weight and substandard nutrition, including a diet low in calcium and Vitamin D, could make you more prone to bone loss and hip fracture.

Lifestyle. Tobacco smoking, extreme alcohol usage, and inadequate of exercise can weaken bone tissues.

Besides factors which affect bone strength, things that put you at higher risk for falling can raise the probability of hip fracture.

Physical and mental impairments. Physical frailty, arthritis, unstable balance, poor eyesight, senility, dementia and/or Alzheimer's disease can raise the chance of falling.

Medications. Many medications can influence balance and strength. Side effects of some medications can also include drowsiness and dizziness.

Preventing Hip Fractures

Home Safety

The majority of hip fractures take place because of a fall, and the majority of falls take place in the home. Many falls could be prevented by simple home safety improvements, such as removing clutter, providing enough lighting, and installing grab bars in restrooms.

Exercise

Modest exercise can slow bone loss and maintain muscle strength. It can also improve balance and coordination. Good exercise options include climbing stairs, jogging, hiking, swimming, dancing, and weight training.

Balance training and tai chi have been demonstrated to minimize falls and reduce the risk of hip fracture. Tai chi is a program of exercises, breathing, and movements based upon early Chinese procedures. These classes can also boost self-confidence and improve body balance.

Be sure to speak with your doctor if you are just starting an exercise program.

Understand Your Health and Medications

Each year, be sure to have an eye examination, as well as a physical that includes an assessment for cardiac and blood pressure problems. Speak with your doctor about the adverse effects of any medications and over-the-counter drugs you take. It is helpful to keep an up-to-date list of all medications you take to ensure that you can provide it to any other physicians with whom you consult.

Maintain Your Bone Health As You Age

As we age, our bones are affected by genetics, nutrition, exercise, and hormone loss. We can not alter our genes, but we can regulate our nourishment and activity level, and if needed, take osteoporosis medications.

There are things you can do to preserve and even improve your bone strength.

Understand your personal risk for fracture. This is based upon any risk factors you have for fracture and your bone density. Ask your doctor if you need to have a bone density test.

Understand your individual risk for bone loss. Genetics plays a role in bone health, and some individuals have genetically determined high rates of bone turnover after menopause or with aging. Speak to your doctor about bone metabolism testing. Bone metabolism testing may offer additional information about your risk for fracture.

Make healthy lifestyle choices. Keep a healthy weight and eat a diet rich in calcium and Vitamin D. Do not smoke and limit your alcohol intake.

Think about bone-boosting medications. In addition to calcium and Vitamin D supplements, there are lots of drug options that slow bone loss and increase bone strength. Speak to your doctor about these methods for safeguarding your bones.

If you do not have an orthopedic specialist, that is something you will certainly want to get dealt with. Do not wait until you have a hip fracture to get that taken care of. Speak to a specialist like Dr. Kathleen Weaver to give you additional information about how to prevent a hip fracture.

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Recurrent and Chronic Elbow Instability

Elbow instability is a looseness in the elbow joint that could cause the joint to catch, pop, or slip out of place during particular arm movements. It most often occurs because of an injury-- normally, an elbow dislocation. This kind of trauma may damage the bone and ligaments which surround the elbow joint and work to keep it stable. Many people within the Central Missouri area with orthopedic problems are beset with elbow instability.

When the elbow is loose and consistently feels as if it might slip out of place, it is called recurrent or chronic elbow instability. Dr. Kathleen Weaver has some vital insights on chronic elbow instability.

Anatomy

Your elbow is comprised of your upper arm bone (humerus) and the 2 bones in your forearm (radius and ulna).

On the inner and outer sides of the elbow, sturdy ligaments (collateral ligaments) hold the elbow joint together and work to prevent dislocation. The two critical ligaments are the lateral (exterior) ligament and ulnar (interior) collateral ligament. The muscular tissues that cross the elbow joint likewise contribute to the stability of the joint.

Description

There are 3 sorts of reoccurring elbow instability:

Posterolateral rotatory instability. The elbow slides in and out of the joint as a result of an injury of the lateral collateral ligament complex, which is a soft tissue structure situated on the outside of the elbow joint.

Valgus instability. The elbow is unstable due to an injury of the ulnar collateral ligament, which is a soft tissue structure positioned on the inside of the elbow.

Varus posteromedial rotatory instability. The elbow slides in and out of the joint because of an injury of the lateral collateral ligament complex, in addition to a fracture (break) of the coronoid portion of the ulna bone on the interior of the elbow.

Cause

There are a wide range of causes for each and every of the different patterns of recurrent elbow instability:

Posterolateral rotatory instability is the most common type of recurrent elbow instability. It is commonly caused by a trauma, like a fall on an outstretched hand. It may likewise develop as a result of a prior surgery, or longstanding elbow deformity.

Valgus instability is usually brought on by recurring stress as seen in overhead athletes (like baseball pitchers). Just like the other forms of recurrent elbow instability, it might also arise from a traumatic event.

Varus posteromedial rotatory instability is generally caused by a traumatic event, like a fall.

Symptoms

Recurrent elbow instability can cause locking, catching, or clicking of the elbow joint. You could also have a sense of the elbow feeling as if it could pop out of place. This feeling typically occurs while pushing off from a chair.

Overhead athletes may have discomfort on the inside of their elbow joint when throwing, or a reduction in throwing velocity (speed).

Doctor Examination

Medical History and Physical Examination

After talking about your symptoms and medical history, your physician at Audrain Orthopaedics or wherever else will examine your elbow joint. He or she will check to see whether or not it hurts in any area or whether there is a deformity. Your physician will have you shift your arm in several different directions to check for instability or a popping or sliding sensation. He or she will also check your arm strength and ensure there are no injuries to your nerves.

Many cases of elbow instability may be diagnosed from the medical history and physical exam results. If you live in Columbia, Fulton, Centralia, or Mexico, MO, Audrain Orthopaedics is the place to go for your examination.

Imaging Tests

X-rays. Even though x-rays can not show soft tissues such as the ligaments, they may be beneficial in identifying fractures, dislocations, or subtle changes in alignment of the elbow.

Magnetic resonance imaging (MRI). This scan creates better images of soft tissues, and might show tears in the ligaments, muscles, or tendons. MRI scans are typically not necessary for a diagnosis of elbow instability.

Treatment

Nonsurgical treatment options are effective at handling symptoms in a lot of patients with valgus instability. However, a very competitive overhead athlete who has a full tearing of the ulnar collateral ligament might demand surgery to go back to full function.

Some cases of posterolateral rotatory instability may also strengthen with nonsurgical treatment, but surgery may be needed in cases where there is chronic stress of the lateral collateral ligament.

Varus posteromedial instability practically always demands surgery to fix the broken bone and the ligament injury. Without surgical treatment, this injury could result in continued instability and early arthritis of the elbow joint.

Nonsurgical Treatment

Nonsurgical management includes:

Physical therapy. Certain exercises to build up the muscles around the elbow joint might improve symptoms.

Activity modification. Symptoms might also be relieved by restricting activities that cause pain or feelings of instability.

Bracing. A brace may really help to restrict painful movements and stabilize the elbow.

Non-steroidal anti-inflammatory medication. Drugs such as aspirin and ibuprofen may be useful with pain during the preliminary injury.

Surgical Treatment

Chronic elbow instability might demand surgical treatment to return to full use of the arm and elbow.

Ligament reconstruction. Most ligament tears can not be sutured (stitched) back together. To operatively repair the injury and bring back elbow strength and stability, the ligament needs to be reconstructed. During the procedure, the doctor switches out the torn ligament with a tissue graft. This graft acts as a new ligament. In most cases, the ligament might be reconstructed using one of the patient's own tendons. Often an allograft (cadaver graft) may be used.

Fracture fixation. People with varus posteromedial rotatory instability require treatment to repair the damaged coronoid bone, along with a repair of the torn ligament. During the operation, the damaged bone fragments are rearranged into normal positioning and then secured together with very special screws and at times a metal plate.

Recovery

During the first week right after surgery, you are going to more than likely wear a splint in order to protect your elbow as it begins healing.

Rehabilitation typically starts in the second week after surgery. The splint will be replaced with a brace which restricts how far you can bend or straighten out your elbow, but makes it possible for you to begin exercises to improve range of motion. With a commitment to rehabilitation, patients may regain total range of motion by 6 weeks following surgery.

Strengthening exercises are frequently prescribed 3 months after the procedure, and the majority of patients return to full activities by 6 months to a year following surgery.

Throwing athletes may require up to a year of rehabilitation before returning to competitive sports.

Future Developments

Recurrent elbow instability is a fairly new idea. Future research will offer a better awareness of the interaction in between the muscles, ligaments, and bones. Newer methods are constantly developing for reconstructing the ligaments. Research is going to lead to much better ways to diagnose, treat, and recover from these complicated injuries.

The fact of the matter is that elbow instability is not something you can sweep aside. You have to get a professional opinion if you ever wish to strengthen your condition. When you are ready to take that critical step, please think about going to Dr. Kathleen Weaver at Audrain Orthopaedics. For the folks of Mexico, MO and the encompassing area, Dr. Weaver is the expert to go to for questions on elbow instability and related orthopedic issues.

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Cervical Radiculopathy (Pinched Nerve)

Cervical radiculopathy, commonly referred to as a "pinched nerve" occurs when a nerve in the neck is compressed or irritated where it branches away from the spinal cord. This might induce pain which radiates into the shoulder, in addition to muscle weakness and numbness which journeys down the arm and into the hand.

Cervical radiculopathy is usually triggered by "wear and tear" changes which occur in the spine as we grow older, such as arthritis. In younger people, it is most often caused by a sudden injury which causes a herniated disk. In most cases, cervical radiculopathy responds well to conservative treatment which includes medication and physical therapy in Mexico, MO. Central Missouri's physical therapy and orthopedic specialists at Audrain Orthopaedics have supplied you with the following information so you can be knowledgeable on the important topic of cervical radiculopathy.

Anatomy

Your spine is composed of 24 bones, called vertebrae, which are stacked atop one another. These bones connect to make a canal which shields the spinal cord. The seven small vertebrae that begin at the base of the skull and form the neck comprise the cervical spine. Cervical radiculopathy takes place in the cervical spine-- the seven small vertebrae that form the neck.

Other parts of your spine consist of:

Spinal cord and nerves. These types of "electrical cables" travel through the spinal canal carrying messages between your brain and muscles. Nerve roots branch out from the spinal cord via openings in the vertebrae (foramen).

Intervertrebral disks. Between your vertebrae are flexible intervertebral disks. They serve as shock absorbers whenever you walk or run. Intervertebral disks are flat and rounded and about a half inch thick. They are composed of two parts:

Annulus fibrosus. This is the tough, flexible outer ring of the disk.

Nucleus pulposus. This is the soft, jelly-like hub of the disk.

Cause

Cervical radiculopathy most typically arises from degenerative changes that take place within the spine as we grow older or from an accident which causes a herniated, or jutting, intervertebral disk.

Degenerative changes. As the disks in the spine grow older, they lose height and start to bulge. They additionally shed water content, begin to dry, and get stiffer. This problem triggers settling, or collapse, of the disk spaces and reduction of disk space height.

As the disks lose height, the vertebrae go closer together. The body reacts to the collapsed disk by forming more bone-- referred to as bone spurs-- around the disk to strengthen it. These bone spurs contribute to the stiffening of the spine. They might also narrow the foramen-- the small openings on each side of the spinal column where the nerve roots exit-- and squeeze the nerve root.

Degenerative changes in the disks are frequently referred to as arthritis or spondylosis. These changes are normal and they occur in everybody. Actually, virtually half of all individuals middle-aged and older have worn disks and pinched nerves that do not induce painful symptoms. It is not known why a number of patients develop symptoms and others do not.

Herniated disk. A disk herniates when its jelly-like core (nucleus) presses against its outer ring (annulus). If the disk is very worn or hurt, the nucleus might squeeze totally through. When the herniated disk bulges out toward the spinal canal, it puts pressure on the sensitive nerve root, causing pain and weakness in the area the nerve supplies. A herniated disk typically occurs with lifting, pulling, bending, or twisting movements.

Symptoms

In many cases, the pain of cervical radiculopathy begins at the neck and journeys down the arm in the area served by the damaged nerve. This pain is typically described as burning or sharp. Specific neck movements-- like extending or straining the neck or turning the head-- might increase the pain. Other symptoms include:

Tingling or the sensation of "pins and needles" in the fingers or hand

Weakness in the muscles of the arm, shoulder, or hand

Reduction of sensation

Certain patients report that pain lessens when they place their hands on top of their head. This movement might briefly relieve pressure on the nerve root.

Doctor Examination

Physical Examination

Right after talking about your medical history and general health, your Mid MO physician will talk to you about your symptoms. He or she will then examine your neck, shoulder, arms and hands-- looking for muscle weakness, loss of sensation, or any change in your reflexes. Your physician might also ask you to carry out certain neck and arm movements to attempt to recreate and/or relieve your symptoms.

Tests

X-rays. These offer pictures of dense structures, like bone tissue. An x-ray will show the alignment of bones along your neck. It could also reveal whether or not there is any narrowing of the foramen and harm to the disks.

Computed tomography (CT) scans. Much more detailed than a simple x-ray, a CT scan can help your doctor determine whether you have developed bone spurs near the foramen within your cervical spine.

Magnetic resonance imaging (MRI) scans. These kinds of research studies create better pictures of the body's soft tissues. An MRI of the neck can reveal if your nerve compression is brought on by damage to soft tissues-- like a bulging or herniated disk. It may also help your physician figure out whether there is any sort of damage to your spinal cord or nerve roots.

Electromyography (EMG). Electromyography measures the electrical impulses of the muscles at rest and throughout contractions. Nerve conduction studies are frequently done along with EMG to determine if a nerve is performing normally. Together, these tests can serve to help your doctor figure out whether your symptoms are triggered by pressure on spinal nerve roots and nerve damage or by a different problem that causes damage to nerves, such as diabetes.

Treatment

It is crucial to note that many patients with cervical radiculopathy improve over time and do not require treatment. For certain patients, the pain goes away fairly promptly-- in days or weeks. For some people, it might take longer.

It is even prevalent for cervical radiculopathy which has improved to come back at some time later on. Even when this occurs, it typically gets better with no particular treatment. In some cases, cervical radiculopathy does not improve, however. These kinds of individuals need assessment and treatment.

Nonsurgical Treatment

Preliminary treatment for cervical radiculopathy is nonsurgical. Nonsurgical treatment selections consist of:

Soft cervical collar. This is a padded ring which twists around the neck and is held in place with Velcro. Your physician may recommend you to wear a soft cervical collar to enable the muscles within your neck to rest and to limit neck motion. This could help diminish the pinching of the nerve roots that go along with movement of the neck. A soft collar ought to only be worn for a short time frame since long-term wear may diminish the strength of the muscles within your neck.

Physical therapy. Particular exercises could help ease discomfort, strengthen neck muscles, and improve range of motion. In certain instances, traction may be utilized to carefully stretch the joints and muscles of the neck.

Medications. In some cases, medications can help greatly improve your symptoms.

Nonsteroidal anti-inflammatory medications (NSAIDs). NSAIDs, including aspirin, ibuprofen, and naproxen, could provide relief if your pain is brought on by nerve irritation or inflammation.

Oral corticosteroids. A brief course of oral corticosteroids might help mitigate soreness by lowering swelling and inflammation around the nerve.

Steroid injection. For this method, steroids are injected near the affected nerve to reduce local irritation. The injection might be positioned in between the laminae (epidural injection), in the foramen (selective nerve injection), or into the facet joint. Even though steroid injections do not alleviate the pressure on the nerve brought on by a narrow foramen or by a bulging or herniated disk, they may lessen the swelling and relieve the pain long enough to allow the nerve to recover.

Narcotics. These medicines are reserved for patients with major pain which is not alleviated by other choices. Narcotics are typically recommended for a limited time only.

Surgical Treatment

If following a period of time nonsurgical treatment does not ease your symptoms, your physician may suggest surgery. There are a number of surgical procedures to manage cervical radiculopathy. The procedure your physician recommends will depend upon numerous factors, including what symptoms you are experiencing and the location of the involved nerve root.

Whenever it boils down to it, the main point to remember with cervical radiculopathy is that it is not something you need to take care of by yourself. Doctor Kathleen Weaver of Audrain Orthopaedics would like to meet with you if you are suffering from a pinched nerve so you can create a pinched nerve treatment plan which is personalized to your needs.

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Ulnar Nerve Entrapment at the Elbow (Cubital Tunnel Syndrome)

Ulnar nerve entrapment takes place whenever the ulnar nerve inside the arm becomes compressed or irritated.

The ulnar nerve is one of the 3 primary nerves within your arm. It travels from your neck downward into your hand, and may be constricted in numerous places along the way, such as below the collarbone or at the wrist. The most common place for compression of the nerve is behind the inside portion of the elbow. Ulnar nerve compression at the elbow joint is referred to as "cubital tunnel syndrome."

Numbness and tingling inside the hand and fingers are common symptoms of cubital tunnel syndrome. In most cases, symptoms can be managed with conventional solutions like changes in activities and bracing. If conservative methods do not improve your symptoms, or if the nerve compression is creating muscle weakness or damage within your hand, your physician may encourage surgery.

Certainly, it is very important to find a wonderful Mexico, MO orthopedic doctor when dealing with a condition such as this. You need somebody who will know what to look for and what treatment is going to be best for your particular case. Please think about Audrain Orthopaedics in Mexico, MO. They have the following info for you regarding ulnar nerve entrapment at the elbow.

Anatomy

At the elbow joint, the ulnar nerve travels through a tunnel of tissue (the cubital tunnel) which runs under a bump of bone at the inside of your elbow. This bony bump is called the medial epicondyle. The place where the nerve runs beneath the medial epicondyle is frequently referred to as the "funny bone." At the funny bone the nerve is close to your skin, and knocking it induces a shock-like feeling.

The ulnar nerve runs behind the medial epicondyle on the interior of the elbow.

Past the elbow joint, the ulnar nerve travels under muscles on the interior of your forearm and into your hand on the side of the palm with the little finger. As the nerve enters the hand, it travels through another tunnel (Guyon's canal).

The ulnar nerve provides feeling to the little finger and fifty percent of the ring finger. It also controls most of the little muscles in the hand that assist with fine movements, and some of the bigger muscles in the forearm that help you make a strong grip.

The ulnar nerve gives sensation (feeling) to the little finger and to half of the ring finger on both the palm and back side of the hand.

Cause

In many cases of cubital tunnel syndrome, the particular cause is not known. The ulnar nerve is particularly vulnerable to compression at the elbow since it must travel through a narrow space with very little soft tissue to protect it.

Common Causes of Compression

There are a number of things which can cause pressure on the nerve at the elbow joint:

When you bend your elbow, the ulnar nerve needs to stretch around the boney ridge of the medial epicondyle. Since this stretching can irritate the nerve, keeping your elbow bent for long periods or repeatedly bending your elbow can cause painful symptoms. For instance, many people sleep with their elbows bent. This can aggravate symptoms of ulnar nerve compression and cause you to wake up at night with your fingers asleep.

In certain folks, the nerve slides out from behind the medial epicondyle when the elbow is bent. Over time, this sliding back and forth might irritate the nerve.

Leaning on your elbow joint for long periods of time can put pressure on the nerve.

Fluid accumulation in the elbow joint can cause swelling that may compress the nerve.

A direct blow to the interior of the elbow joint may cause pain, electric shock sensation, and numbness within the little and ring fingers. This is commonly referred to as "hitting your funny bone."

Risk Factors

Several factors put you more at risk for forming cubital tunnel syndrome. These include:

Prior fracture or dislocations of the elbow

Bone spurs/ arthritis of the elbow

Inflammation of the elbow joint

Cysts near the elbow joint

Repeated or prolonged activities which require the elbow to be bent or flexed

Symptoms

For people in Central Missouri, cubital tunnel syndrome may cause an aching pain on the interior of the elbow. A lot of the symptoms, however, take place in your hand.

Sleeping with your elbow bent can intensify symptoms.

Numbness and tingling within the ring finger and little finger are common symptoms of ulnar nerve entrapment. Often, these symptoms come and go. They happen more often when the elbow is bent, such as when driving or holding the phone. Some people get up at night because their fingers are numb.

The sensation of "falling asleep" in the ring finger and little finger, especially when your elbow is bent can be another symptom you see. In some cases, it might be harder to move your fingers in and out, or to manipulate objects.

Weakening of the grip and frustration with finger coordination (like typing or playing an instrument) might take place. These symptoms are normally seen in more serious cases of nerve compression.

If the nerve is extremely compressed or has been compressed for a very long time, muscle wasting in the hand can occur. When this takes place, muscle wasting can not be turned around. Because of this, it is essential to see your physician if symptoms are severe or if they are less severe but have existed for more than 6 weeks.

Home Remedies

There are several things you may do in your house in order to help ease symptoms. If your symptoms interfere with normal activities or last more than a few weeks, be sure to schedule an appointment with your physician.

Avoid tasks which require you to keep your arm bent for long periods of time.

If you utilize a computer often, make certain that your chair is not too low. Do not rest your elbow on the armrest.

Avoid leaning on your elbow or putting pressure on the inside of your arm. For example, do not drive with your arm resting on the open window.

Keep your elbow straight at night when you are sleeping. This may be done by wrapping a towel around your straight elbow or wearing an elbow pad in reverse.

Doctor Examination

Medical History and Physical Examination

Your physician will go over your health history and general health. He or she may also inquire about your work, your activities, and what medications you are taking.

Right after talking about your symptoms and medical history, your physician will examine your arm and hand to identify which nerve is compressed and where it is compressed. A few of the physical examination tests your doctor may do include:

Tap over the nerve at the funny bone. If the nerve is irritated, this can create a shock inside the little finger and ring finger-- although this may occur whenever the nerve is normal also.

Examine whether or not the ulnar nerve slides out of normal position when you bend your elbow.

Move your neck, shoulder, elbow, and wrist to see if various positions cause symptoms.

Check for feeling and strength within your hand and fingers.

Tests

X-rays. These imaging tests provide detailed pictures of dense structures, like bone. Most causes of compression of the ulnar nerve can not be seen on an x-ray. Nevertheless, your doctor may take x-rays of your elbow or wrist in order to look for bone spurs, arthritis, or some other places that the bone may be compressing the nerve.

Nerve conduction studies assess the signals traveling in the nerves of your arm and hand.

Nerves are like "electrical cables" which travel throughout your body carrying messages in between your brain and muscles. When a nerve is not functioning effectively, it takes too long for it to conduct.

During a nerve conduction test, the nerve is stimulated in one place and the time it takes for there to be a response is measured. Several places along the nerve will be tested and the area where the response takes too long is likely to be the place where the nerve is compressed.

Nerve conduction studies can also identify whether the compression is also causing muscle damage. During the examination, small needles are put into several of the muscles that the ulnar nerve commands. Muscle damage suggests more serious nerve compression.

Treatment

Unless your nerve compression has triggered a lot of muscle wasting, your physician is going to more than likely first highly recommend nonsurgical treatment.

Nonsurgical Treatment

Non-steroidal anti-inflammatory medicines. If your signs and symptoms have barely started, your doctor may advise an anti-inflammatory medicine, like ibuprofen, to help lessen swelling around the nerve.

Even though steroids, like cortisone, are extremely effective anti-inflammatory medications, steroid injections are generally not used because there is a risk of damage to the nerve.

Bracing or splinting. Your physician may prescribe a padded brace or split to wear at night to keep your elbow in a straight position.

Nerve gliding exercises. Certain doctors believe that exercises to help the ulnar nerve slide throughout the cubital tunnel at the elbow joint and the Guyon's canal at the wrist can improve symptoms. These exercises could also help stop stiffness inside the arm and wrist.

Surgical Treatment

Your physician might recommend surgery to take pressure off of the nerve if:

Nonsurgical methods have not improved your condition

The ulnar nerve is very compressed

Nerve compression has resulted in muscle weakness or damage

There are a few surgical procedures which will relieve pressure on the ulnar nerve at the elbow. Your orthopaedic surgeon is going to speak with you about the option that would be most ideal for you.

These procedures are most frequently done on an outpatient basis, but some patients do best with an overnight stay at the hospital.

Cubital tunnel release. Within this operation, the ligament "roof" of the cubital tunnel is cut and divided. This increases the size of the tunnel and reduces pressure on the nerve.

After the procedure, the ligament begins to heal and new tissue develops across the division. The fresh growth mends the ligament, and permits more space for the ulnar nerve to slide through.

Cubital tunnel release tends to work best whenever the nerve compression is mild or moderate and the nerve does not slide out from behind the bony ridge of the medial epicondyle when the elbow is bent.

Ulnar nerve anterior transposition. In a lot of cases, the nerve is moved from its place behind the medial epicondyle to a new place in front of it. Transferring the nerve to the front of the medial epicondyle prevents it from getting caught on the bony ridge and stretching when you bend your elbow. This procedure is called an anterior transposition of the ulnar nerve.

For anterior transposition of the ulnar nerve, an incision is made along the interior of the elbow or along the back side of the elbow.

The nerves may be moved to lie underneath the skin and fat but on top of the muscle (subcutaneous transposition), or within the muscle (intermuscular transposition), or beneath the muscle (submuscular transposition).

Medial epicondylectomy. Another option to release the nerve is to remove part of the medial epicondyle. Like ulnar nerve transposition, this procedure also prevents the nerve from becoming caught on the boney ridge and stretching when your elbow is bent.

Surgical Recovery

Depending upon the type of surgical procedure you have, you may need to wear a splint for a few weeks following the operation. A submuscular transposition generally demands a longer time (3 to 6 weeks) in a splint.

Your surgeon may suggest physical therapy exercises to help you regain strength and motion in your arm. He or she will also speak with you about when it will be safe to return to all of your normal activities.

Surgical Outcome

The results of surgical treatment are normally good. Each method of surgery has a comparable success rate for routine cases of nerve compression. If the nerve is really badly compressed or if there is muscle wasting, the nerve may not be able to return to normal and a few symptoms may remain even after the surgery. Nerves recuperate slowly, and it might take a long period of time to know how well the nerve is going to do following surgery.

When it boils down to it, having a physician who understands what they're doing is among the absolute most essential factors whenever it comes to recovery from Cubital Tunnel Syndrome in Mexico, Moberly, and Columbia, Missouri. Please book an appointment with Audrain Orthopaedics to see what they can do for your orthopaedic health condition.

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BioTE: Frequently Asked Hormone Treatment Questions

Certainly there can be no mistaking the fact that a lot of men and women will have a bunch of questions when it comes to hormone treatments like BioTE. Read on to see some of those inquiries dispelled by the professionals at Audrain Orthopaedics in Mexico, MO. They have years of experience handling all kinds of Central Missouri orthopedic health issues and other health issues as well.

How frequently will I need pellets?

For women: normally every 3-6 months. For men: normally every 5-6 months.

Why are pellets more desirable than patches, shots or pills?

They are pure hormone which is not metabolized into byproducts by passing through the liver, stomach or skin. This delivery system allows your body to use the correct amount of hormone from the pellet as the blood encompassing the pellets picks up what is required.

Where do the pellets go?

Since they are pure hormone without fillers or synthetic ingredients, they completely dissolve.

How long will it take for my body to get back to lean normal?

That is dependent on how much you exercise and work out with weights, as well as your age. Testosterone lowers fat and increases muscle and lean body mass. Testosterone likewise raises your natural growth hormone and consequently will enhance your stamina to work out and increase muscle mass.

Are there any side effects and/or complications?

There are far fewer negative effects than conventional hormone therapy.

How much time will it take for the pellets to get into my system and work?

24-72 hours. Ideal effect occurs three weeks following insertion.

I have no libido - what will this do for that, if anything?

Good hormone balance will substantially improve your libido; the addition of testosterone in pellet form will change everything for the best!

Specifically for Women:

I get terrible headaches - will they help me?

Yes! We have had great success, particularly with women who have menstrual migraines, and new migraines that appear after age 35.

Do I need to take other medication?

If you still have a uterus, you will have to be on natural progesterone also.

Why do I need estrogen?

Estrogen is the absolute most important hormone for a woman. It protects her against heart attack, stroke, osteoporosis, and Alzheimer's. It also keeps us looking youthful and healthy.

Why do I need testosterone?

Testosterone is the third female hormone and is as vital as estrogen and progesterone. We need this hormone to keep our thought process quick and our libido healthy. It strengthens bone density, muscle mass, and strength, as well as protects against some kinds of depression. It is additionally the source of energy and solid sleep!

Will I grow unwanted hair from testosterone?

There is less chance of excess hair growth with natural testosterone than with man-made hormones. Facial hair will grow with testosterone pellets but generally not worse than when you were in your thirties.

Specifically for Men:

Does testosterone lead to prostate cancer?

No. Metabolites of testosterone, Dihydrotestosterone and estrone cause prostate enlargement and bring about prostate cancer. Estrone increases and testosterone decreases as men age and as men gain belly fat. Testosterone pellets are the only replacement which turns around that trend.

How do I take testosterone pellets and not transform them to Dihydrotestosterone and estrone?

Your blood levels of estrone and DHT are examined after treatment to see if they are elevated. Some men still convert to these metabolites even on testosterone pellets. If they are converting, we troubleshoot with natural supplements such as DIM and Saw Palmetto, or an aromatase inhibitor prescription.

What if I have prostate enlargement already?

Testosterone pellets will make things better, if you do not convert it to DHT; we will treat that if it happens.

Will my testicles shrink while I take the testosterone pellets?

Yes, they will. Testicles are suppressed by taking any kind of testosterone and they will certainly not make as much testosterone whenever the pellets are working. This is not permanent and the testicle retains its capability to generate testosterone.

If you have any questions that were not listed here or if you would like to schedule an appointment to see if BioTE is right for you, call Audrain Orthopaedics. Their offices are the ideal place for those in Mexico, MO with osteoarthritis and orthopedic conditions.

[audrainorthopaedics-blog]

Arthritis of the Hand

The hand and wrist have a number of small joints that work together to create motion, including the fine motion needed to thread a needle or tie a shoelace. Whenever the joints are impacted by arthritis, activities of daily living may be tough. Arthritis may occur in many areas of the hand and wrist and can have much more than one cause.

With time, if the arthritis is not handled, the bones that comprise the joint can lose their normal shape. This causes even more pain and further limits motion. These are all big reasons why you should recognize what you are up against if you are facing arthritis in Mexico, Missouri.

Description

Simply defined, arthritis is inflammation of one or more of your joints. One of the most common kinds of arthritis are osteoarthritis and rheumatoid arthritis, but there are more than 100 various types.

Healthy joints move effortlessly because of a sleek, slippery tissue called articular cartilage. Cartilage covers the ends of bones and provides a sleek gliding surface for the joint. This smooth surface is lubricated by a fluid that looks and feels like oil. It is produced by the joint lining called synovium.

Disease

Whenever arthritis occurs because of disease, the beginning of symptoms is progressive and the cartilage decreases slowly. The two most common types of arthritis from disease are osteoarthritis and rheumatoid arthritis.

Osteoarthritis is much more common and typically affects much older people. Also referred to as "wear and tear" arthritis, osteoarthritis causes cartilage to wear away. It appears in a predictable pattern in particular joints.

Rheumatoid arthritis is a chronic disease which can impact numerous parts of your body. It causes the joint lining (synovium) to swell, which causes pain and stiffness in the joint. Rheumatoid arthritis most frequently begins in the little joints of the hands and feet. It usually affects the same joints on each sides of the body.

Trauma

Fractures, especially those which damage the joint surface, and dislocations are amongst the most common injuries that lead to arthritis. Even whenever properly treated, an injured joint is more likely to become arthritic over time.

Symptoms

Pain

Early symptoms of arthritis of the hand include joint pain which may feel "dull," or a "burning" sensation. The pain often occurs after periods of increased joint use, like heavy gripping or grasping. The pain might not be present right away, but may show up hours later or even the following day. Morning pain and stiffness are common.

As the cartilage wears away and there is less material to provide shock absorption, the symptoms occur more often. In advanced disease, the joint pain may wake you up during the night.

Pain might be made worse with usage and relieved by rest. Lots of people in Central Missouri with arthritis complain of increased joint pain with rainy weather. Activities which once were very easy, such as opening a jar or starting the car, become difficult because of pain. To prevent pain at the arthritic joint, you may change the way you utilize your hand.

Swelling

Whenever the affected joint is subject to greater stress than it can bear, it may swell in an attempt to prevent further joint usage.

Changes within Surrounding Joints

In patients with advanced thumb base arthritis, the surrounding joints might become more mobile than normal.

Warmth

The arthritic joint might feel warm to touch. This is due to the body's inflammatory response.

Crepitation and Looseness

There might be a sensation of grating or grinding in the affected joint (crepitation). This is brought on by damaged cartilage surfaces rubbing against each other. If arthritis is due to damaged ligaments, the support structures of the joint might be unstable or "loose." In advanced cases, the joint may appear larger than normal (hypertrophic). This is typically because of a combination of bone changes, loss of cartilage, and joint swelling.

Cysts

When arthritis impacts the end joints of the fingers (DIP joints), little cysts (mucous cysts) may develop. The cysts might then create ridging or dents in the nail plate of the affected finger.

Doctor Examination

A physician may diagnose arthritis of the hand by analyzing the hand and by taking x-rays. Specialized studies, such as magnetic resonance imaging (MRI), are normally not required except in cases where Keinbock's disease (a condition where the blood supply to one of the little bones in the wrist, the lunate, is interrupted) is suspected. Often a bone scan is useful. A bone scan may help the physician identify arthritis when it is in an early stage, even if x-rays appear normal.

Treatment

Arthritis does not need to result in a painful or sedentary life. It is essential to seek help early so treatment can begin and you can return to doing what matters most to you.

Nonsurgical Treatment

Treatment options for arthritis of the hand and wrist consist of medication, splinting, injections, and surgery, and are determined based on:

How far the arthritis has advanced

How many joints are entailed

Your age, activity level and other medical conditions

If the dominant or non-dominant hand is affected

Your individual goals, home support structure, and ability to understand the treatment and observe a therapy program

Medications

Medicines treat symptoms but can not restore joint cartilage or undo joint damage. The most common medicines for arthritis are anti-inflammatories, which stop the body from producing chemicals which cause joint swelling and pain. Examples of anti-inflammatory drugs include medications such as acetaminophen and ibuprofen.

Glucosamine and chondroitin are extensively advertised dietary supplements or "neutraceuticals." Neutraceuticals are not medicines. Instead, they are compounds that are the "building blocks" of cartilage. They were originally used by veterinarians to treat arthritic hips in dogs. However, neutraceuticals have not yet been studied as a treatment of hand and wrist arthritis. (Note: The U.S. Food and Drug Administration does not test dietary supplements. These compounds might cause negative interactions with other medications. Always seek advice from your physician before taking dietary supplements.)

Injections

When first-line treatment with anti-inflammatory medication is not proper, injections may be used. These generally contain a lasting anesthetic and a steroid that can provide pain relief for weeks to months. The injections may be repeated, but only a minimal number of times, due to possible side effects, such as lightening of the skin, weakening of the tendons and ligaments and infection.

Splinting

Injections are usually combined with splinting of the impacted joint. The splint helps support the impacted joint to ease the stress put on it from frequent use and activities. Splints are usually worn during periods when the joints hurt. They should be small enough to allow functional usage of the hand when they are worn. Wearing the splint for too long can result in muscle deterioration (atrophy). Muscles can help in stabilizing injured joints, so atrophy should be prevented.

Surgical Treatment

If nonsurgical treatment fails to give comfort, surgery is usually discussed. There are many surgical choices. The chosen course of surgical treatment should be one that has a practical chance of giving long-term pain relief and return to function. It ought to be tailored to your individual needs.

If there is any way the joint may be preserved or reconstructed, this option is usually chosen. When the damage has progressed to a point that the surfaces will no longer work, a joint replacement or a fusion (arthrodesis) is performed.

Joint fusions offer pain relief but stop joint motion. The fused joint no longer moves; the damaged joint surfaces are gone, so they can not cause pain and other symptoms. The goal of joint replacement is to provide pain relief and bring back functionality. As with hip and knee replacements, there have been considerable improvements in joint replacements in the hand and wrist. The replacement joints are made of materials similar to those utilized in weightbearing joints, such as ceramics or long-wearing metal and plastic parts. The goal is to improve the function and long life of the replaced joint.

Most of the major joints of hand and wrist may be replaced. A surgeon frequently needs additional training to perform the surgery. As with any evolving technology, the long-term results of the hand or wrist joint replacements are not yet understood. Early results have been encouraging. Talk with your physician to learn if these implants are right for you.

After Surgery

After any type of joint reconstruction surgery, there is a period of recovery. Often, you will be confered to a trained hand therapist, who can help you maximize your recovery. You might have to utilize a postoperative splint or cast for some time after surgery. This helps protect the hand while it heals.

During this postoperative period, you might have to modify activities to permit the joint reconstruction to heal correctly. Usually, pain medication you take by mouth is also utilized to decrease discomfort. It is very important to discuss your pain with your physician so it can be adequately treated.

Length of recovery time varies widely and depends upon the extent of the surgery performed and multiple individual factors. However, people usually can return to most if not all of their desired activities in about three months following most major joint reconstructions.

New Developments

More and more, physicians are emphasizing how to preserve the damaged joint. This includes getting an earlier diagnosis and repairing joint components before the whole surface becomes damaged.

Arthroscopy of the little joints of the hand and wrist is now feasible because the equipment has been made much smaller.

There have been encouraging results in cartilage repair and replacement in the bigger joints such as the knee, and some of these techniques have been applied to the smaller joints of the hand and arm.

In addition, stem cell research may be an option to regenerate damaged joint surfaces.

As you can see, arthritis in the hand, wrist, or any other portion of the body is not something to mess around with. If you start to feel its effects, please consider speaking with a specialist like Dr. Kathleen Weaver of Audrain Orthopaedics in Mexico, MO.

[audrainorthopaedics-blog]

What is Hormone Optimization?

Hormones are the regulators of the human body-- they inform your cells the best ways to process nutrients (fuel) and exactly what to do with them. They are like "air traffic controllers", and if they are not balanced and working adequately then your various systems can not manage the needs put on them by an active life. The result is a slowing down, a reduction of energy and interest. And it is frequently accompanied by increased fat and decreased activity. This is undoubtedly a big problem for the people of Central Missouri. Hormone optimization can help with this issue for many.

But that's just" aging ", right? It needn't be!

These hormones specifically: thyroid, testosterone, estrogen (and progesterone for women) are intimately engageded in your general metabolism and energy levels. (We think about estrogen for women and testosterone for guys, but in fact both genders depend on both of these hormonal agents-- simply in various amounts.) The production of these hormones declines as we get older, and result in many of the undesirable effects that are usually credited to getting older: loss of energy, boosted weight, decline of libido, weakness, and mental fogginess.

If you go see your physician about any of these symptoms, they might check your hormone levels (it is a simple blood test). You will probably be told, "everything is normal." Guess what, "normal" amounts for a thirty-year-old are remarkably different from "normal" levels for a fifty-year-old! Do you really want the "normal" physiology of old age, or the "normal" physiology of whenever you were much younger?

By boosting and adjusting your hormone levels, it is feasible to" turn back the clock" for a lot of the effects of aging, including orthopedic health and wellness problems. It won't turn around every aspect of aging, and it won't cure any underlying illness that might be resulting in your symptoms (that is one reason a physician-guided program is important; don't rely on "infomercials" or internet stories to make choices about your health!). The health-enhancing effects of rejuvenating your hormones to the levels you had whenever you were much younger make a substantial difference in how you feel! It also enhances all the other actions that you are taking towards better health-- like weight reduction and more activity.

The health effects of natural hormones have been known for a very long time. But delivering those hormonal agents has not been easy. Testosterone, as an example, is obliterated in the human intestinal tract, so pill forms are not reliable. Transdermal creams are unpleasant and harmful for others in the family. And injections hurt and cause uneven spikes in blood levels. The BioTE ® method gets over these challenges by implanting little pellets of bio-identical hormone beneath the skin (utilizing a small device under local anesthesia in your physician's office). Once in position, the pellets produce consistent and reliable delivery of hormones for months (usually 3-4 months for women and 5-6 months for men). Dr Weaver is a certified Biote ® provider, educated and trained especially to evaluate and treat patients who can profit from hormone optimization.

But don't hormones cause cancer? No! While synthetic hormones (such as Premarin, which is derived from horse urine) have been linked to certain cancers, natural hormones have never been demonstrated to lead to cancer. In truth, they lower the risks of many age-related illnesses, cancers included. The essential point is to use only bio-identical hormones-- the ones that are precisely the same molecules as the ones produced naturally by your own body. (Why haven't the drug companies helped make these available to patients? Easy: they can not be patented, so they won't be profit makers. Do not fall for advertising from huge pharmaceutical companies.).

The assessment of your symptoms is like some other doctor visit: she will take your health history and order suitable tests. If hormone optimization is right for you, she will detail a customized plan of hormone and supplement therapy for you, and explain how every part works to boost your health and wellness. The examinations are paid for under your health insurance. Although insurance does not currently cover the implant procedure, it is affordable for everybody (equal to merely a couple of dollars per day ). Finding a scientifically-based regimen that is tailored to you may get rid of the costly guess-work of off-the-shelf remedies you may be utilizing now. If you get numerous medications for a number of problems (or perhaps medications to treat the side effects of other medications!) then you may be surprised to discover how getting to the root of the underlying concern (insufficient hormone levels) can lower the need for some prescription drugs.

The experts at Audrain Orthopaedics would be delighted to respond to your concerns about the benefits and limitations of hormone optimization. Please give us a call at (573) 582-0444 to set up a visit their clinic, which serves the orthopedic health needs of Mexico, MO and the surrounding communities of Fulton, Columbia, and Vandalia, MO .

[audrainorthopaedics-blog]

Mallet Finger

Mallet finger is an injury to the delicate tendon which straightens the end joint of a finger or thumb. Though it is also referred to as "baseball finger," this injury can happen to anyone when an unrelenting object (such as a ball) hits the tip of a finger or thumb and forces it to bend further than it is intended to go. Consequently, you are unable to straighten the tip of your finger or thumb on your own. With a mallet finger injury, the fingertip droops and can not be actively straightened.

If you might be plagued with mallet finger or any such injury, the best thing you can do is to head to a reputable orthopedic physician in Central Missouri such as Dr. Kathleen Weaver of Audrain Orthopaedics. Nevertheless, before you take that step, please take a look at this information about mallet finger.

Anatomy

Tendons are tissues that connect muscles to bone. The muscles that move the fingers and thumb are located in the forearm. Long tendons extend from these muscular tissues through the wrist and connect to the little bones of the fingers and thumb.

The extensor tendons on the top of the hand straighten the fingers. The flexor tendons on the palm side of the hand bend the fingers.

Description

In a mallet wound, whenever an object hits the tip of the finger or thumb, the force of the impact tears the extensor tendon. Periodically, a small force like tucking in a bed sheet can induce a mallet finger.

The injury may rupture the tendon or pull the tendon away from the place where it attaches to the finger bone (distal phalanx). In some cases, a little portion of bone is pulled away along with the tendon. This is called an avulsion injury.

The long, ring, and little fingers of the dominant hand are most likely to be injured.

Symptoms

The finger is often painful, inflamed, and bruised. The fingertip will sag noticeably and will straighten out only if you push it up with your other hand.

Risk for Infection

It is extremely important to get immediate attention if there is blood beneath the nail or if the nail is unfixed. This might signify a cut within the nail bed, or that the finger bone is broken and the wound penetrates down to the bone (open fracture). These types of accidents put you susceptible for infection.

First Aid

To relieve pain and decrease swelling, apply ice to your finger right away and keep your hand elevated above your heart.

Doctor Examination

A mallet finger accident necessitates medical treatment to guarantee the finger regains as much function as possible. Most Central Missouri physicians suggest seeking treatment within a week of injury. However, there have been instances in which treatment was delayed for as long as a month following injury and total healing was still achieved.

Physical Examination

After discussing your clinical history and symptoms, your physician will take a look at your finger or thumb. During the examination, your doctor will hold the affected finger and ask you to straighten it yourself. This is called the mallet finger test.

X-rays

Your physician will more than likely order x-rays of the injury. If a fragment of the distal phalanx was pulled away whenever the tendon ruptured, or if there is a bigger fracture of the bone, it is going to appear in an x-ray. An x-ray will also show whether the injury pulled the bones of the joint out of alignment.

Treatment

Mallet finger accidents which are not managed usually result in stiffness and deformity of the injured fingertip. The majority of mallet finger injuries can be addressed without surgery.

In little ones, mallet finger injuries could involve the cartilage that controls bone growth. The physician must thoroughly assess and treat this injury in children, to ensure that the finger does not become stunted or deformed.

Nonsurgical Treatment

Most mallet finger accidents are handled with splinting. A splint holds the fingertip straight (in extension) up until it heals.

To bring back function to the finger, the splint must be worn full time for 8 weeks. This means that it needs to be worn while bathing, then meticulously changed after bathing. As the splint dries, you must keep your injured finger straight. If the fingertip droops at all, healing is disrupted and you will have to wear the splint for a lengthier time period.

Since wearing a splint for a long period of time can irritate the skin, your doctor may speak with you regarding how to carefully check your skin for issues. Your physician may also arrange additional visits throughout the 8 weeks to monitor your progress.

For 3 to 4 weeks following the initial splinting period, you will gradually wear the splint less often-- maybe only at night. Splinting treatment typically leads to both acceptable function and appearance, however, many patients might not reclaim full fingertip extension.

For some patients, the splinting regimen is very challenging. In these cases, the doctor might opt to insert a temporary pin across the fingertip joint to keep it straight for 8 weeks.

Surgical Treatment

Your physician may consider surgical repair if there is a big fracture fragment or the joint is out of line (subluxed). In these instances, surgery is performed to repair the fracture using pins to hold the pieces of bone together whilst the injury heals.

It is not usual to manage a mallet finger surgically if bone fragments or fractures are not present. Surgical treatment of the damaged tendon generally demands a tendon graft-- tendon tissue that is taken (harvested) from some other portion of your body-- or even fusing the joint straight.

An orthopedic surgeon should be consulted in making the decision to treat this condition surgically. If you are searching for an orthopedic specialist in Mexico, Centralia, Fulton, or Columbia, MO, consider Audrain Orthopaedics.

[audrainorthopaedics-blog]

Lyme Disease

Lyme disease is an infection caused by a bacteria typically found in deer and transmitted to human beings by deer ticks. The deer tick is located in grassy areas, so men and women who work, play, and hike in these areas are at particular risk. Naturally, we see a lot of those places in and around Mexico and Columbia, Missouri. Orthopedic medicine has not discovered how long the tick needs to be in contact with the skin in order to transmit the disease.

Lyme disease was first described in 1975. It has been pinpointed in almost all the fifty states. Most cases occur in individuals who reside in, or have just recently traveled to, the Northeastern and upper Midwest regions of the country, including Central Missouri. Individuals of any age can get it. Late spring and summer are peak seasons.

Prevention

Mention to your doctor if you travel to places of high risk for Lyme disease, specifically during summer months.

Taking preventative measures is very important to avoid getting this possibly perilous condition.

While hiking, stay on hiking trails and avoid deep grassy areas. Wear pants, long sleeve shirts, and high socks.

Check for ticks on household pets and anybody who may have come in contact with high-risk places.

If a tick bite is suspected, contact your family Mexico, Missouri physician right away.

Symptoms

Symptoms are complex and often confusing.

The infection starts at the site of the tick bite. Most individuals do not remember a tick bite or discovering a tick on their body.

There might be a red spot which looks like a target shape.

A rash grows at the site of the bite and spreads to other parts of the body (Erythema migrans).

In initial stages, Lyme disease induces flu-like symptoms of fever, malaise, rash, neck stiffness, and joint pain. These kinds of symptoms might take days or weeks to appear. Other symptoms include the chills.

Joints may become sensitive with very little swelling and no redness. The knee is the joint most often affected.

In later stages, the disease affects the heart and nervous system and results in Lyme arthritis.

Diagnosis

See your physician to diagnose Lyme disease.

They may utilize imaging studies to help make the diagnosis.

In acute stages, X-rays of affected joints may show soft-tissue swelling.

In the chronic stage, signs of swelling, joint fluid, and arthritis may be seen.

Utilizing just an analysis of the blood to detect Lyme disease might be difficult. The signs of inflammation, like the white blood count, sedimentation rate, and C-reactive protein is going to be higher, but this holds true of other diseases besides Lyme disease.

Particular tests, like serologies, may take up to four weeks to six weeks to become greater than normal (elevated). An elevated serum titer suggests that the body is responding to an exposure to the bacteria. However, the bacterial infection may have been cleared and so an elevated serum titer does not necessarily reflect an active infection.

If joint swelling is present, a culture of the fluid may indicate the presence of an active infection, but is just positive about 60 percent to 70 percent of the time. A more sensitive test called PCR is being developed to detect the presence of the bacteria.

Lyme disease is usually suspected in an individual who has been exposed, has a tick bite, and has joint pain. In instances where it is not clear if the patient has been exposed, the doctor will have to rule out other possible causes for the symptoms. These could include soft-tissue infections, septic arthritis, and rheumatologic diseases, such as juvenile arthritis.

Treatment

Most cases of Lyme disease answer to a one-month course of antibiotics. The proper antibiotic depends on the patient's age, allergies, and special medical conditions (such as pregnancy).

The prognosis is great if the infection is recognized early. Even with treatment, a few of individuals can go on to develop chronic arthritis.

The prophylactic treatment for an individual presenting after locating a tick on their body is controversial. Speak with your doctor. A vaccine has been created, but it is currently not recommended because of potential side effects.

Doctor Kathleen Weaver and her team at Audrain Orthopaedics in Mexico, Missouri would be happy to respond to any additional questions you have on this subject at (573) 582-0444.