Excellence in Care: Types of Pain

How to determine your pain level and when it’s time to begin seeking treatment.

 

Let’s talk about the most common reason most people see a doctor—pain.

Almost everyone experiences some pain in their lives, and most of us have a different way to cope. At times, your pain may begin from the moment you awake, and other times, with changes in the weather.

Of course, there is pain after a fall, sports injuries—new and old, and repetitive movement injuries that produce intermittent nagging pain.

These are just some examples of the types of joint pains we treat daily. We classify various kinds of pains as Acute, Chronic, Inflammatory, Functional, Neuropathic, and Nociceptive.

 

Acute vs. Chronic

Acute pain is temporary is not expected to last. With acute pain, there is a known treatment. The most common examples of acute pain can stem from a simple paper cut to a broken bone. There is an available treatment for both—one may require a bandage and the other a cast or air splint.

Chronic means the pain is lasting and persistent. When the acute injury becomes more persistent in pain and has lasting physical effects, the acute injury or pain then becomes chronic.

Any injury that produces chronic pain requires a treatment plan that is beyond primary care.

Excellence in care for Jaffe Sports Medicine means that we design a treatment plan specifically for you that reaches beyond essential treatment. We have an excellent physical therapist team, technology-applied treatments, and hands-on therapy with our patient’s recovery in mind.

 

Neuropathic vs. Nociceptive

Neuropathic pain, unfortunately, is chronic most of the time because the pain is often associated with a malfunction in your nervous system. The pain is described as burning, shooting pain that is severe at times but can be controlled with medication.

We often hear from our patients with carpal tunnel syndrome, a nerve entrapment, that they experience shooting pains in the wrist, whole hand, and affected arm. This symptom is not unusual. Common reasons for neuropathic pain are herniated disc, arthritis affecting the spinal cord, spinal surgery, diabetes, amputations with phantom limb disorder, chemotherapy, and multiple sclerosis.

Nociceptive pain is the signal that pain is active.

Nociceptive are the receptors that feel pain and occur when damage or injuries to the nerves happen. The impact sends a pain message from the brain to the spinal cord. The message is then sent to the skin and muscles in the body.

Examples of nociceptive pain are arthritis, bruises, sprains, repetitive use damage. This type of pain can be acute or acute, on chronic.

 

Inflammatory Pain

Inflammation is associated with almost any type of injury, arthritis, gout, degenerative diseases, and abdominal diseases. However, inflammatory pain is sometimes associated with healing and is not the same as inflammation.

If you have ever undergone any surgery, have had a sports injury, or any injury affected the spine or joints, you have likely experienced inflammatory pain.

Inflammatory pain is the sensitivity to an affected area with soreness felt after surgery or treatment such as physical therapy. The pain felt is in direct response to the tissue damage.

This type of pain is not chronic and resolves along with healing. For best healing practices, it’s always best to comply with wearing a brace or splint, and any additional regime’s prescribed by your doctor.

 

Functional Pain

Function pain is also pain with no determined origin or apparent reason for the pain. You could consider widespread body pain, such as musculoskeletal pain or fibromyalgia, to be in the category of functional pain. There are additional medical terms associated, such as a pain scale.

Did you know that there are methods to measure your pain?

Your physician may sometimes ask from a scale from 1-10 to measure your pain, with a ten being the worst.

Your answer will help your physician to establish a baseline for your ongoing pain management treatment. This scale is referred to as a functional pain scale.

 

Find Your Pain Relief

Now that you have more information on pain, you may better understand how we treat and evaluate our patients.

If you are suffering from any pain, you can be confident that you will find relief with the help of Jaffe Sports Medicine. Our excellence in care is provided by a highly skilled staff that specializes in a range of pain management techniques. We welcome patients from Naples, Cape Coral, Fort Myers, and the surrounding areas of Florida. Contact us today to schedule your consultation.

TEXT BY M. HIATT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Body in Motion, Part 2

Treating for Better Flexibility and Range of Motion in the Lower Extremities

 

Last month, Jaffe Sports Medicine informed blog readers about optimal range of motion (ROM) of the upper extremities. Part two of this series will discuss the lower extremities and what you can do when optimal motion cannot be achieved.

Anytime you experience pain with motion or loss of movement that worsens over time, these are both signs that there may be something more serious going on within the joint.

Remember, there is always a reasonable concern when our bodies are not moving the way they should. Let us look again at the proper range of motion guides to help in understanding more about where your motion is limited.

Lower Extremities

The lower extremities consist of your hips, knees, and ankles. Decreased motion can occur after an injury, a fall, impact sports, working out, or wear and tear on your joints from repetitive motions over time.

Obesity can also play a part in the decreased motion of the lower extremities—considering that all your weight is resting on your hips, knees, and ankles, which are weight-bearing joints. Excess weight will always affect these weight-bearing joints.

One indicator that ROM is compromised in the lower extremities is an altered gait or the stride you walk. To determine if your gait is altered, your doctor will analyze your gait to look for irregularities. Observation may indicate:

  • A nerve or muscle problem that is causing a limp.
  • An ataxic gait, which is characterized by poor balance, unsteady or weakened stride, or veering.
  • A dropped foot due to weakened muscles in the ankle joint.

Hips

Have you ever noticed that there is a stiffness in your hips after sitting for a long period? The stiffness will typically go away after taking steps forward; however, you may notice a pronounced “waddle” in those first few steps.

For some patients, an affected gait may be one of the first symptoms that hip strength and motion are on the decline.

The hip’s range of motion is produced by the hip joint–the ball and socket that join the pelvis and femur.

This ball and socket fit together to produce the fluid motion that allows the legs and torso to move. Good ROM in the hips is measured in degrees as in the graphic below:

Evaluations look at passive motions, which is how much you can move your ship around the joint with the assistance of a healthcare professional. Active range of motion also evaluates motion but puts the patient in control of the motion.

If ROM is affected, we will take an X-ray, CT, or MRI of the joint to determine deterioration, joint disease, infection, or a fracture. If there appear to be none of these problems affecting motion, we will recommend conservative treatments like at-home stretching, physical therapy, steroid injection, or other pain management options.

Suppose you are looking at just a mild stiffness in the hips rising from a seated position. In that case, we often recommend hip flexors to strengthen the joint and increase the ability to produce better motion in the hip.

Knees

Our knees are the ultimate bearers of all weight. The knees are the most injured joint of all sports-related injuries. Outside of sports, our knees can be injured through a fall, obesity, misstep, or strain while walking on uneven terrain or stairs or overextending while performing daily tasks.

Good ROM in the knees is needed for balancing and support. Good rotation is necessary for stability while the legs are in motion. ROM that is normal looks like this:

 

Again, your doctor will look for passive-active ROM to determine if motion has been compromised. Additional testing may be needed to determine the extent of any cartilage, joint, or patellofemoral damage. There are successful treatments for regaining good motion in the knees that JSM can recommend depending on the extent of your loss of motion.

Ankles

The ligaments, tendons, and bones of the ankles can become injured quite extensively. There are simple sprains and strains, tendonitis, and much more in-depth injuries such as a fracture or torn ligaments. Good ROM in the ankle will appear as in the graphic below:

 

Dorsiflex is raising the foot, and plantar flexion is pointing down with the foot.

Limited ROM can have additional symptoms that include swelling, throbbing, sharp pain, intermittent pain outside or inside of the ankle area, and bruising.

Again, the ankle is a weight-bearing joint and can easily become injured or strained by falling, rolling, or overstepping, balance problems, jumping, and other impact sports.

A good range of motion benefits includes decreased pain, better flexibility, strength, better blood flow, more vigorous movements, and bodily actions, and lower potential for injury.

Treatment Options

If you are experiencing pain that prevents good movement of any joint, we consider you to have a limited range of motion.

Jaffe Sports Medicine understands a good range of motion includes decreased pain, better flexibility, strength, better blood flow, more vital movements and bodily actions, and lower potential for injury. We work individually with each patient to ensure that their health and wellness goals are met. We focus on all aspects of the body, including alignment, movement, and postural habits.

With a blend of physical therapy, interventional pain management, and additional sports medicine strategies, we will help you protect your body and prevent further injury.

At Jaffe Sports Medicine and Rehabilitation, we help our patients recover quickly, regain strength, and improve their range of motion while avoiding painful, expensive surgery. To schedule an appointment at one of our locations, contact Jaffe Sports Medicine today.

TEXT BY M. HIATT

 

 

 

Body in Motion

Treating for Better Flexibility and Range of Motion in the Upper Extremities

Part 1-Upper Extremities- Range of motion is an important topic, so we will focus on the upper extremities this month and move to the lower extremities next month, so look for that article to come soon.

Movement, flexibility, and motion work together so our body can perform at an optimal level. Pain and discomfort will sound the warning alarm to alert you that something is off. Perhaps you notice stiffness in your knee while walking, or you cannot write with a pen or pencil for more than a few minutes due to cramping hand and wrist pain.

Aside from typical aches and pains, you may be experiencing loss of motion and flexibility, which prevent movements that are natural to your body. Maybe your elbow will not bend properly, or you’re not able to fully extend your arm while reaching, causing a sharp pain in your neck or back.

Pain with motion and loss of movement that worsens over time are critical indicators that there may be something more serious going on with the affected area. So, there’s a reasonable concern when our bodies are not moving the way they should.

To better understand your pain, you need to know how your body is designed to perform. For this, we look to the proper range of motion guides to help in understanding more about your limitations.

 

Upper Extremities

The upper extremities consist of both left and right wrists, elbows, shoulders, and hands. Decreased motion can occur after an injury, impact sports, a fall, working out too hard, or wear and tear on your joints over time from repetitive movements.

Repetitive motions can occur in various settings and are commonly referred to as Repetitive Strain Injuries (RSI). Some examples of this include:

  • Work-related movements that cause you to reach throughout the day
  • Assembly line work
  • Grocery store checkout clerk, bagger, or stocking shelves
  • Construction or labor type work
  • Using a computer mouse, typing
  • Exercising and sports training–boxing, weight training, football, basketball, gymnastics, etc.

 

Elbows & Shoulders 

Your shoulders are the least stable and often least moved joint on your body. If you are sitting at a desk all day at work, consider stopping your work for a few minutes each hour to perform flexibility exercises. By improving your passive range of motion, you will find the stiffness and pain in your neck, back, and shoulders will significantly improve.

To test your range of motion in your shoulders, you will first need to stand straight, without arching your back; or you can lie flat on the floor if standing straight produces back pain.

From this position, relax and inhale.

While exhaling, begin to slowly raise your arms, reaching above your head and past your ears.

To test your shoulders, you should be able to raise your arms 180◦ flexion and hyperextend your arms slightly behind the ears, abduction to raise and lower. To test your elbows, follow the diagram of outward and inward rotation and flex inward and outward as you would if you were holding a barbell performing bicep curls. You will also feel this motion in your shoulders.

To increase your motion and obtain maximum motion, remember to work on your flexibility with upper extremity stretches throughout your workday and before and after workouts.

To reduce the risk of injury, use proper techniques while stretching and move slowly.

Wrists & Hands-

The wrist moves along two axes and can move by extension, flexion, adduction, and abduction.

There can be pain in the wrist for a host of reasons, and a diagnosis strongly depends on the symptoms you are experiencing with the loss of motion.

 

Rest your forearm on a table.

With your hand hanging down, follow the graphic to test the range of motion of each wrist.

If you are experiencing loss of motion, tingling, sharp pain, or swelling in the joint, contact Jaffe Sports Medicine for an evaluation.

 

 

Hands-

To test your hands, open and close each hand as you see in the abduction and adduction graphic below.

 

 

You should also periodically perform this exercise and stretch your fingers with opposing thumbs throughout the day. If you cannot touch your thumb to the base of your fifth finger (pinky finger), there may be an underlying cause.

 

If you have a loss of motion in your fingers or thumbs, this information is a helpful start in our determining the cause.

 

Treatment Options

If you cannot complete any of the exercises above or are experiencing pain that prevents the movement of any joint, we consider you to have a limited range of motion.

Jaffe Sports Medicine understands a good range of motion includes decreased pain, better flexibility, strength, better blood flow, more vital movements, and bodily actions, and lower potential for injury.

Jaffe Sports Medicine works individually with each patient to ensure that their health and wellness goals are met. We focus on all aspects of the body, including alignment, movement, and postural habits.

With a blend of physical therapy, interventional pain management, and additional sports medicine strategies, we will help you protect your body and prevent further injury.

At Jaffe Sports Medicine and Rehabilitation, we help our patients recover quickly, regain strength, and improve their range of motion while avoiding painful, expensive surgery.

To schedule an appointment at one of our many locations, contact Jaffe Sports Medicine today.

TEXT BY M. HIATT

4 Common Reasons for Your Back Pain

Understanding your pain, from diagnosis to treatment.

Back pain can happen at any time. The pain can be temporary or chronic in nature and can prevent you from functioning at your normal activity level. There are common back ailments that most doctors see every day, which are discussed here.

Herniated Disc

Spinal discs have a soft center. The soft center is enclosed around a rubber-like, tougher encasing (annulus.) A herniated disc occurs when this soft-like jelly center pushes through a tear in the annulus. These defects will show up on an X-Ray or CT scan of your spine, which we can use to make a correct diagnosis. At times, a herniated disc may be referred to as a slipped disc or a ruptured disc.

Herniations often occur in relation to age. However, a herniated disc can be the result of excess weightlifting, excess body weight, or in those who have jobs that require heavy or repetitive lifting; although, there are many other reasons.

Symptoms of a herniated disc will depend on where the disc is located along your spine. But most herniated discs occur in the lower back.

The most common symptoms include:

  • Numbness or weakness in the arms or legs.
  • A sensation of pins and needles in the arms or legs.
  • Sometimes burning throughout your arms or legs.
  • Problems can also include an unsteady gait.

To treat your herniated disc, we will suggest physical therapy first. If conservative treatments fail, we will consider surgical intervention, which includes removing just the protruding disc.

Sciatica

The sciatic nerve is located in the lower area of your back. The nerve travels through your buttocks and hips, and then down each leg.

Pressure on the sciatic nerve produces radiating pain in the lower extremities, typically in only one side of your body. The cause of sciatica is usually the result of a herniated disc, bone spur or could be from degeneration or narrowing of the spine.

Symptoms are described as a sharp pain along with a burning sensation in one of the legs—starting at the buttocks area and traveling into the leg. You may also experience a tingling sensation followed by burning in pain. The pain can be in one portion of your leg or buttock but could progress to more lasting pain and discomfort. Often, relief comes over time and without surgical intervention.

We see sciatica in our patients who have sedentary lifestyles or jobs that do not require much movement. In these patients, we recommend more activity will provide more relief. However, those who perform repetitive motions throughout the day are not excluded from experiencing sciatica.

Good posture, stretching, and regular movement are all recommended forms of day-to-day conservative treatment. We might suggest physical therapy to learn a few easy stretches you could do while working a sedentary job or after a long day on your feet.

 

disc

 

Degenerative Disc Disease 

Degenerative disc disease occurs when the spinal discs change in ways that are referred to as degeneration. This diagnosis is common and is almost always associated with chronic back pain. A diagnosis is confirmed with an X-ray, CT scan, or MRI.

There are many reasons one may suffer from disc degeneration. Do you remember the soft jelly-like center we discussed with a herniated disc? Not surprisingly, these discs break down over time, causing the fluid to dry out and crack, resulting in less “cushion” on the spinal column. We typically would see this type of degeneration in our older patients.

For those with job requirements that involve repetitive movement and anyone who played contact sports in their youth, these patients are more likely to suffer from degeneration of the spine.

Treatment options begin with controlling chronic pain through over-the-counter medications or prescription medications and physical therapy. For the most severe cases, we may discuss surgical options.

Back Injury

There are several ways to injure your back. The most common we see here at Jaffe Sports Medicine are:

  • Work-related injury
  • Sport-related injury- old or new
  • Repetitive motion- such as twisting back and forth while working.
  • Motor vehicle accidents
  • Working out too hard at the gym

Whether you have been dealing with an older injury or new pain, a diagnosis as to why you are having pain will involve imaging, such as an X-ray, CT scan, or MRI.

Once we understand where the problem on your spine is, we can create a treatment plan for you. Our treatment plans include physical therapy, heat and ice therapy, pain management, and surgical intervention, including kyphoplasty.

The interventional pain management team at Jaffe Sports Medicine will address the site of the pain and determine its cause and treat that area as well. Let our medical professionals diagnose your back pain and find the best course of action to treat your discomfort. Call our offices today to schedule your consultation and start the process of living pain-free today.

TEXT BY M. HIATT

6 Common Foot and Ankle Problems

Ankle and foot pain may result from a variety of things, including fractures, strains, sprains, overuse, and arthritis. Damage done to the ankle and foot can lead to debilitating pain and discomfort and hinder your ability to perform daily activities. Here are six common foot and ankle problems that we treat at Jaffe Sports Medicine daily.

 

Common Foot Problems:

Plantar Fasciitis

If you have problems with pain that forms at the bottom of the heel and travels to the arch, you may have Plantar Fasciitis.

Plantar Fasciitis occurs as the foot rolls inward or pronates more than it should. You may notice the pain is worse after prolonged walking, standing, or exercising. But we also hear our patients notice stiffness and severe foot pain after their first steps out of bed in the morning.

When you visit Jaffe Sports Medicine with this type of pain, we may take X-Rays to rule out any other possible causes for your foot pain and confirm a diagnosis.

Treatment options vary with how severe the pain is and the course of a carefully followed treatment plan that we will create for you. Treatment may include orthotic inserts for your shoes to correct the pronation, as well as physical therapy.

We recommend always wearing a good supportive shoe and stretching the foot before taking your first steps each day. By doing these things, Plantar Fasciitis pain will ease over time.

Hammertoes

If you’re experiencing pain and deformity of your big toes, and possibly even the second or third toe, check your feet. If your toe bends downward at the middle joint, you may have a hammertoe. And your poorly fitted footwear or high-heeled shoes are likely to blame.

Hammertoe occurs when your feet do not have enough room to spread out. The toes become bent into an abnormal position and create a “hammer” head appearance.

A change in footwear to something roomier is recommended, as will the aide of an insert to correct the deformity. If, after time, these standard treatment methods do not fix the problem, the toe or toes will require surgery on the toe to straighten and correct the deformity.

We can also recommend toe exercises to perform that will help strengthen and hopefully correct the problem.

Bunions

Bunions look like a large bump on the side of the large toe. Bunions are painful because they happen when the bones of the big toe become misaligned.

The misalignment occurs over time and is caused by wearing tight, narrow shoes that squeeze the toes together in an unnatural position. Bunions are commonly seen in patient’s feet that roll inward and affect more women than men. Jaffe Sports Medicine will order an X-Ray of the affected foot to confirm a diagnosis. X-rays are typically taken from a standing position, which is the best position, and will reveal how severe the bunion is.

There are non-surgical options available to you for treating a bunion. They include changing the shoe you wear to a wide fit and proper support in the big toe. We can also recommend using a shield to protect the area where the bunion rests in the shoe.

If pain persists and you have no relief from a wider shoe and toe box, we will discuss surgical options. But keep in mind, the recovery can be longer since your foot is a weight-bearing extremity.

 

Common Ankle Problems:

Ankle Sprain

The ankle is a powerhouse joint that keeps us moving. An ankle injury is never a pleasant experience. When an ankle is sprained, the strong ligament is stretched beyond its limit. The same ligament connects the bones and holds the ankle in a stable position to support the movement.

The pain will range with the severity of the sprain. We at Jaffe Sports Medicine see some ankle sprains are minor and can be tended to with ice therapy, elevation, and rest. But we also notice more severe cases of swelling, pain, and those who cannot put any weight on the foot. In those cases, we determine if the care will be more long-term with problems like instability.

There is a grading system associated with sprains that range from mild—meaning a slight stretch; to severe—a complete tear. At-home care includes rest and ice first. Later, we will have patients begin incorporating a light range of motion activities and building strength until the flexibility and strength begin to return.

We will work closely with you to determine the course of your ankle treatment while your healing progresses.

Arthritis

Arthritis of the ankle can be diagnosed as Osteoarthritis, Rheumatoid Arthritis, and Posttraumatic Arthritis. Each type of arthritis is lasting in form, which means you should be mindful that pain and inflammation will always affect your ankle.

With that said, you may have better days with no pain but may also have days with symptoms such as:

  • Pain with movement, including walking
  • Swelling and tenderness after activity or weather changes
  • Warmth and redness
  • increased pain and stiffness in the morning after rising from sleep

Treatment options vary with the severity of your ankle impairment. Still, they can range anywhere from physical therapy exercises you can complete at home to surgery for advanced arthritis of the ankle and ankle joint surfaces

If you experience ankle pain daily, we can help. Call Jaffe Sports Medicine to assess your ankle, and we will create a treatment plan that will help you get back better movement.

Achilles Tendonitis

Achilles tendonitis pain can be severe and will begin at the back of the leg and radiate to the heel. This problem is common in athletes, runners, and even speed walkers, resulting from a breakdown of tissues caused by overuse. The tendon itself is the largest tendon in the human body, but it is also the most frequently ruptured of all tendons.

With severe symptoms such as pain with associated swelling, you should call Jaffe Sports Medicine for immediate treatment. An MRI or ultrasound will determine the extent of your Achilles injury. After diagnosis, we can determine how to proceed with your treatment plan.

To get the best results and heal properly, you will need a suitable bandage or ankle wrap to restrict the range of motion, such as an air cast. We will assign regular stretching and message as your treatment to regain motion and movement in the affected heel/ankle.

With time and rest, you will be able to return to activity once healing progresses. However, you will not be able to return to strenuous activity while recovering, such as running, hill climbing, etc. We will recommend swimming or using a rowing machine to stay fit while resting your injury.

Our doctors and therapists will work one-on-one with each patient to ensure that their treatment goals are met. We have the experience to investigate and treat your specific pain condition. Contact us to schedule an appointment to examine your foot and ankle pain.

TEXT BY M. HIATT

 

Understanding Migraine Headaches

From diagnosis to treatment, how to cope with the chronic nature of migraine headaches

Migraines are unpredictable. They can be triggered by bright and flashing lights, strong odors or scents, heat, extreme cold, poorly ventilated rooms, and noise.

Anyone who suffers from migraine headaches will agree that this type of head pain is not like a typical headache. A migraine can stop ones daily routine for a day or more when the pain strikes, despite medication or natural remedies administered to the patient.

Migraines are one of the most diagnosed illnesses associated with pain. But how do you know you suffer from a migraine and not just an ordinary headache? It would help if you understood the stages of a migraine and the various treatments available for you at Jaffe Sports Medicine.

 

Types of Headaches

Chronic headaches are not always considered migraines. Instead, the type of headache you have is determined by the associated symptoms and where the pain is located. Types of headaches range from a migraine headache, cluster headaches, tension headaches, and common cold or sinus headaches.

If you have widespread head pain, some neck pain, and the pain is considered a 5-6/10 on a rating scale, the headache is likely associated with tension. If you have not experienced visual disturbance, nausea, vomiting, or light sensitivity, the headache is probably a tension headache and will go away in an hour or two.

If your eyes are red and watery, or you’re experiencing facial pain, you could be having a typical sinus headache. The sinus headache symptoms can often mirror a cluster headache; however, with a cluster headache the pain is moderate to severe and lasts longer.

Head pain caused by a sinus headaches tension headache  is annoying and feels dreadful, but often, the pain is quickly relieved with an over-the-counter headache remedy. However, if you experience the stages below, it’s safe to assume you have a migraine headache.

 

Stages of a Migraine

Migraines are often associated with warning symptoms leading up to the attack. With a migraine, the nature of the headache will include stages. These stages may or may not produce pain. The symptoms are varied and can range from mild mood swings to severe and debilitating pain, which almost always lasts from 24 to 72 hours.

Prodrome: Migraine symptoms may begin suddenly or over one or two days leading up to the headache. The symptoms of onset in the prodrome stage will include changes in mood, fatigue, neck pain, and sometimes food cravings.

Aura: The aura stage will include tingling sensations in the arms and legs and sometimes facial areas, as well as the inability to gather thoughts or speak in complete sentences.

You may also notice visual disturbances called “floaters,” which can severely affect the ability to see for a long time. Just know these floaters will subside, and you will have no problems with vision once the migraine has run its course. We understand that there may or may not be head pain associated with the aura stage, depending on how quickly the migraine progresses.

Attack: The attack stage is when the actual pain occurs. Along with pain, you can expect nausea, vomiting, possible fainting, and throbbing head pain. Our patients often describe that they will need to lie down in a dark room with no sounds or light until the pain subsides once the headache begins. The pain/attack phase can last several hours but the duration is often reliant on if you have taken medication to relieve pain.

Recovery: Once the pain subsides, you will likely feel fatigued, despite the numerous hours you may have slept. The recovery stage can last up to 48 hours. After that, you will slowly regain strength, and your functions will feel more restored.

 

Treatment Options

There are many treatment options available for those who suffer from diagnosed chronic migraines.

Medications are available to treat migraines once they occur, and some are even available to prevent migraines from occurring. In addition to these medications, Botox injections have been helpful for patients and some antipsychotic medications.

For those who prefer a more holistic approach, supplements such as magnesium, Butterbur, CoQ10, and Feverfew have been noted to help prevent migraines. In addition to supplements, practicing the methods of stress management, better dietary choices, and yoga are effective treatment options.

Other options include acupuncture and physical therapy that promotes progressive muscle relaxation techniques that Jaffee Sports Medicine can prescribe for you.

At Jaffe Sports Medicine, our physicians will perform an initial evaluation before beginning treatment for your chronic headaches to determine what methods to use for your headache relief. Our multidisciplinary medical center is comprised of experienced and caring doctors that provide the best care in head pain relief. With the most advanced diagnostic and therapeutic tools currently available, our medical professionals can analyze your headache and find the best course of action to improve and relieve your pain and discomfort.

TEXT BY M. HIATT

4 Ways Physical Therapy Can Help Your Recovery

With every strain and sprain is a recovery period, and physical therapy is often the pathway to recovery.

If your strain or sprain is not a persistent problem or a possible reinjured impairment, healing can be achieved with at-home therapy and rest. However, if you are experiencing constant pain, swelling, immobility in the affected area, you will need to be evaluated for a possible deeper problem.

In a situation of injury or post-surgery, physical therapy is the prescribed method for regaining your motion and restoring balance to your body. These are the four most significant benefits of physical therapy.

No Pain No Gain

Did you know that by performing physical motions that you can prevent the need for surgery at times? We know the old saying “no pain no gain” is a cliché, but sometimes surgical intervention can be avoided by going through the painful motion of physical therapy first.

You may hear your doctor mention the term “conservative treatment,” which means your doctor wants to try the first option, physical therapy, to help reduce pain and regain the affected region’s mobility. Perhaps there will be no need for surgery.

Of course, we understand there are circumstances when conservative treatment will not work, and you will need surgery regardless. We will be here for you when you are ready to start the process of physical therapy.

Practicing Stretching Techniques

We know it is not easy stretching the pain away, but we also know that stretching is the best medicine to restore motion to your joints and muscles in small doses. These small doses will ultimately become motions that build strength and endurance.

Consider this—after surgery or an injury, rest is necessary. However, if you continue to rest the injury, scar tissue begins to form like cobwebs and soft tissue contracts.

Stretching regularity will knock down the cobwebs and get you back in action. So, if you want to restore the range of motion or maintain a good range of motion, you must make a regular habit of keeping your muscles and tissues loose.

When you make good habits of stretching, you ensure that scar formations do not hold you back. Practice makes perfect, so be sure to practice the stretching technique at home that one of our PT specialists or doctors has prescribed for you.

Training for Strength

To strengthen your beautiful bones, you must strengthen the muscle and tissues around the bone, which is especially true as you age.

Strength exercises will help improve your muscle’s function and improve strength, endurance, and help you achieve a better range of motion.

We will work together to strengthen your core, which is essential for building strength in the back and pelvis. The core is also the heartbeat of balance.

If you have had surgery or are working with an injury, our doctors work with the physical therapy team to create a physical therapy program for you. Each program assesses your current ability and sets an ultimate end goal for you.

Improve Balance and Prevent Falls

Several injuries can prevent good balance, including leg, hips, pelvis, back, knees, ankles, and feet. Poor balance and fall risk can also occur from muscle weakness, sedentary lifestyle, sitting at a desk working all day, aging, and joint stiffness.

Good posture is paramount in keeping good balance; however, maintaining a stable and upright position when standing, walking, and even sitting can be problematic for older people or people with injuries.

We will assess your posture and teach you exercises to improve your ability to maintain proper posture.

Our physical therapist will prescribe active movement techniques and exercises to help your affected body system. We will also discuss hazards in your home that increase your risk of balance problems are falling, such as a throw rug, poor lighting, or an unrestrained pet, or other possible objects.

By learning the technique and importance of good posture and strengthening the appropriate muscles, we can help you achieve better balance and prevent falls.

Our physical therapists work individually with each patient to ensure that your health and wellness goals are met. At Jaffe Sports Medicine and Rehabilitation, we help our patients recover quickly, regain strength, and improve their range of motion while avoiding painful, expensive surgery.

To schedule an appointment with our physical therapists or sport medicine therapists, contact Jaffe Sports Medicine today.

TEXT BY M. HIATT

Jaffe Sports Medicine Welcomes Doctor Chaturani Ranasinghe

Doctor Chaturani Ranasinghe Jaffe Sports Medicine is pleased to introduce our newest team member, Dr. Chaturani Ranasinghe, a Double Board-Certified Anesthesiologist and Interventional Pain Medicine physician. Dr. Ranasinghe graduated from the University of Miami School of Medicine in 2006 and completed a residency in Anesthesiology at Jackson Memorial Hospital with the University of Miami.

Dr. Ranasinghe will serve our patients at Jaffe Sports Medicine with abackground that includes the completion of one of the country’s highest-rated pain programs,at the prestigious New York University Medical Center, where she was trained by top experts exclusively in the field of pain medicine. Upon completing herfellowship, she practiced as a faculty member at both NYU and the University of Miami, at the Pain Institute, while also serving as the Director of the Wellness Center in the Department of Anesthesiology.

She was appointed as the Director of the Pain Medicine fellowship at the university and was an enthusiastic and inspiring educator, teaching future pain doctors that pain medicine is as much an art as it is a highly trained skill.

Dr. Ranasinghe comes to Jaffe Sports Medicine as not only a highly trained and informed doctor, but also with a passion for treating patient while practicing alternative options for patients with pain specific needs.

Alternative Medicine

Dr. Ranasinghe is educated and experienced in all aspects of pain management, including the entire range of pain management procedures. However, she noticed a trend in her patient’s request for more holistic pain relief options.

Alternative treatment for pain can include acupuncture, herbal remedies, massage, aromatherapy, spinal manipulation, and many other forms of alternative pain therapy. These forms are used when a patient is unable to treat pain with medication for personal or other health related reasons, as well as patient preference.  As with traditional approaches to treating pain, alternative approaches require the best knowledge and safety practices adhered to by the treating physicians.  With an academic focus, she made it a point to gather the available literature and evidence for all treatments.

Dr. Ranasinghe took it upon herself to learn and utilize acupuncture in her treatments and incorporated other alternative healing methods into managing pain. In doing so, shecan now providefor more treatment options during an assessment of each patient.

She is an active member of the Arizona Center for Integrative Medicine, an internationally renowned institution that promotes alternative and Western modalities in a patient-centric model. With her knowledge in advanced medicine, she will be a vital asset to Jaffe Sports Medicine and our patients.

Please request a consultation or make an appointment to see Dr. Ranasinghe today at Jaffe Sports Medicine.

Treating Spinal Fractures with Kyphoplasty

Jaffe Sports Medicine is pleased to offer a minimally invasive procedure for our patients who experience severe back pain or spinal deformities. Pain and deformities can occur due to a number of possible diagnoses, including cancer or osteoporosis. With imaging and further testing, we can begin to evaluate your condition and determine if you are a possible candidate for kyphoplasty.

Diagnosis and Surgical Factors

Before learning more about kyphoplasty, it is important to know what conditions and diagnoses are associated with this type of surgery. Most common are diagnoses such as osteoporosis and spinal tumors associated with certain cancers.

Osteoporosis is the loss of calcium from bones, which results in weakened bone structures throughout the body. In some patients, osteoporosis increases the risk of fractures of the vertebra.

When the vertebral body is fractured, there will be a noticeable collapse occurring at the Thoracic Spine, thus producing a wedge; more familiarly known as a “hunch-back” appearance. What is happening here is the vertebral body is shortened in height and spinal alignment is then shifted.

There are additional serious health problems that are associated with this type of curvature, including chronic and severe pain, reduced mobility, and reduced lung capacity. Osteo fractures such as this make it five times more likely further fractures will occur.

Though osteoporosis is the most common cause in fractured vertebral bodies, cancer with associated spinal tumors can also cause fractures that lead to the need for corrective measures.

As the tumor(s) grow, the fractures occur. The tumor will of course require treatment and/or removal, however, Kyphoplasty is a viable option for treating the fracture and preventing further injury to the vertebral body.

Understanding the Kyphoplasty procedure and the benefits.

Kyphoplasty, also known as vertebral augmentation, is a minimally invasive surgical procedure for treating osteoporosis fractures. As discussed, these fractures may occur because of conditions such as osteoporosis or trauma.

Kyphoplasty is a minimally invasive procedure that includes injecting acrylic bone cement into the spinal fracture through a hole in the skin. The cement-like materials are injected directly into the fractured bone with a needle or thin tube. The cement works to stabilize the fracture, which provides immediate pain relief in many cases.

To be more specific, the needle or thin tube, once inserted into the damaged vertebrae, is tipped with a balloon. The balloon is inflated to create a cavity in which bone cement will be injected.

The balloon is deflated and removed, and the bone cement is then injected into the cavity. The cement mixture hardens in about 10 minutes. The entire procedure will probably take less than an hour, though it may be longer if more vertebrae are treated. Your doctor will use your X-ray as guidance while performing the procedure to ensure accuracy.

You will be under general anesthesia throughout this minimally invasive procedure.

Afterward, you may experience soreness in the area for a few days, but you will likely be symptom-free and will not need to do physical therapy or rehabilitation. You will spend some time in recovery after the surgery, however, you will likely go home the same day, but will need someone to drive you home. The risks of kyphoplasty are exceptionally low.

Who is a candidate for Kyphoplasty?

To be a candidate for kyphoplasty, your pain must be related to the vertebral fracture, and must not be due to any other problems such as disc herniation, arthritis, or stenosis, which is narrowing of the spinal cord.

We feel the best candidates are generally reserved for people with painful, progressive, and increasing back pain caused by osteoporosis, or pathologic vertebral compression fractures. These candidates will also have a reduced ability to move and function because of the fractures. Limitations can include the inability to drive, perform daily tasks such as household chores and cooking, caring for yourself, or your family members.

Like any surgery, there are associated risks, such as infection, bleeding, increased back pain, tingling, numbness or weakness because of nerve damage, allergic reactions to the chemicals used with X Rays to help guide the doctor, cement leaking out of position.

Pre and Post Operative Procedures 

Before the day of your surgery, your physician will perform an exam and will obtain current imaging of the spinal column. You will discuss any recent illnesses and talk about any allergies you may have.

Do not forget to bring with you a list of the medications you are currently taking and discuss with your doctor in the weeks before surgery if you are taking blood thinners or aspirin for a directive, as you will need to stop taking these before the surgery. Do not eat or drink anything up to 8 hours before surgery.

Following the successful kyphoplasty procedure, you can return home to normal activities. Please try to avoid heavy lifting for up to six weeks following the surgery. As previously mentioned, any pain caused by the procedure itself should be gone within two to three days.

Kyphoplasty helps correct bone deformities and relieves pain that comes with spinal compression fractures. kyphoplasty can restore damaged vertebrae and may also relieve pain by injecting a special cement into your vertebrae to provide our patients with relief.

Call us today to make an appointment and let’s begin your evaluation to resolve your back pain.

 

TEXT BY M. HIATT

Promising Treatment for Neuropathy on the Horizon

If you’ve experienced prolonged numbness in your hands, feet, arms, or legs, you may likely have a condition known as neuropathy. Neuropathy is the result of damage to the nerves outside of the brain and spinal cord. Neuropathy is a dysfunction in one or more of the peripheral nerves; peripheral means upper or lower extremities and causes weakness and numbness in the affected area.
While the early stages of neuropathy may feel like a tingling sensation or pins and needles in the affected limb, a pervasive symptom for any stage of neuropathy is typically widespread and chronic nerve pain. But numbness, tingling, and weakness are not the only symptoms. You could also experience the opposite side of the symptom scale with extreme sensitivity to touch or temperature.

Symptoms of Neuropathy Include

  • Numbness
  • Pain when you walk
  • Sharpelectrical-like pain
  • Burning and tingling
  • Muscle weakness
  • Sensitivity to touch
  • Difficulty sleeping from leg or foot discomfort (Such as Restless Leg Syndrome)

Regardless of the severity of the symptom, we understand the unpleasantness. Medications have been used to treat neuropathy and neuropathic pain in the past, however, Jaffe Sports Medicine is now using a combination of FDA-approved treatments. Read on to discover more.

Diagnosis Associates with Neuropathy

Neuropathy can be caused by an accumulation of scenarios or diagnoses. To best assess neuropathy, you must first consider any diagnosed diseases or surgeries that may have contributed to your condition.

Spinal surgeries can cause temporary numbness while healing in some parts of the extremities, such as the toes or a finger. Likewise, a common neurological diagnosis is Carpal Tunnel Syndrome, which is the result of repetitious movement involved with typing or using your hands in a repetitious movement.

For example, if you’re a machine operator or a typist, the motion of your upper extremities each day puts an extraordinary amount of pressure on nerves, which could result in temporary or lasting neuropathy. This is considered a repetitive strain injury and surgery are often performed in this circumstance, with positive results; however, there is occasional neuropathy well after surgery and you may never regain sensation back in the affected extremity. In this circumstance, you would be diagnosed with peripheral neuropathy and may experience pain associated with the numbness.

There are several additional causes and diagnosed impairments associated with neuropathy and neuropathic pain, they are:

  • Diabetes
  • Lasting effect from bodily trauma from sports or motor vehicle accident
  • Autoimmune Disorders, such as—Rheumatoid Arthritis, Fibromyalgia, InflammatoryArthritis, Sjogren’s Syndrome, Lupus, Guillain-Barre Syndrome, Vasculitis
  • Chemotherapy and other cancer treatments, like radiation
  • Certain infections like Lyme’s Disease
  • Inherited diseases, such as Charcot-Marie Tooth Disease
  • Alcoholism
  • Vitamin Deficiencies, B12 and D
  • Spinal surgeries or other neurological surgeries.
  • Carpal Tunnel Syndrome, Tennis Elbow, other repetitive stress injuries from constant upper extremity motion.

Functional Losses and Your Safety

Depending on your symptoms, we always consider how your everyday functioning will be affected.
How can neuropathy affect your function? Consider for a moment the effects on functioning for a patient who has been diagnosed with neuropathy of the left foot. This patient may have a complete loss of function of their left foot. They are unable to bear weight on the left foot, meaning they would have great difficulty in lifting, pushing, or pulling while performing certain tasks.

In this circumstance, the patient may not be able to complete any meaningful movement with their left foot, so the patient:

  • Would be at great risk of falling
  • Could experience a severe wound or have an unknown wound that could result in infection.
  • Need to use a hand-help assistive device, such as a cane, for stability.
  • Have problems walking upstairs.
  • Have problems getting in and out of a vehicle.

These are just examples of the effects that having neuropathy in just one extremity can change the way you function daily. The forefront of treatment will be to focus on recovering the loss of damage, if possible, and your ongoing safety.

Treatment and Recovery

In the past, treatments have been limited to a small assortment of pain medications, which can lead to further issues. These options ignored the problem by masking the systems.

Today, we have better and more successful treatment options available to patients.

Jaffe Sports Medicine is providing hope with FDA-cleared treatment options. We are pleased to announce a new program for treating peripheral neuropathy, which includes a combination of therapies that aid in healing the damaged nerves.

The effects of treatment can be felt in the first few visits. Our goal is to reduce pain and numbness while working to restore, stabilize and rebuild the nerve in your extremities. The patient generally feels relief physically throughout the treatment period and even feel better emotionally after experiencing a reduction in pain.

We are confident you will find healing and relief at Jaffe Sports Medicine. Please call today to begin your treatment plan.

Treatment is covered by most major insurances, including Medicare.

 

TEXT BY M. HIATT