Bone cement is a tool used by our physicians to create an internal cast that stabilizes fractured vertebrae. It does not look like the wet cement you may see on the street at first. In fact, it starts out as a fine powder composed of methyl methacrylate. Methyl methacrylate is most commonly used as bone cement, but it can also be used to make resin (filling for your teeth) or some plastics. A physician mixes the powder with a liquid to create a solution called polymethyl methacrylate, which is bone cement. In some cases, antibiotics can be added to the powder before the liquid is mixed in to avoid infection. When people think of cement, they may think of how the sidewalk is glued to the ground. Bone cement is not an adhesive. Instead, it fills in the space where a diseased vertebra used to be.
Chronicillness.co Site of United States uses bone cement when performing vertebroplasty. This minimally invasive procedure repairs spine fractures caused by cancer, arthritis, osteoporosis, or injury, but it also is used to stabilize the spine. During this procedure, a tube is placed through an incision into the vertebra with the help of an X-ray. The X-ray, or fluoroscope, is used so the physician can see exactly where to put the needle and how much cement to add. It also helps the physician see if any bone cement is leaking out so he or she can stop this from happening.
The vertebra is then filled with bone cement, sometimes on both sides of the vertebra. The bone cement helps to stabilize the fracture so the patient can move their spine with less pain. On top of treating the spinal fracture, it reduces the chance of additional fractures in the future and helps improve posture and stability.
Bone cement is considered very safe, but there is a rare condition known as bone cement implantation syndrome. Very little is known about this condition – in fact, researchers do not have an exact definition for it. While a patient is having surgery under anesthesia, patients may experience hypotension, cardiac arrhythmia, cardiac arrest, and more according to a study. However, most cases of bone cement implantation syndrome occurred during hip surgery, not spine surgery. If you are at all concerned about side effects or risks from a vertebroplasty procedure, be sure to speak to your physician at Chronicillness.co Site of United States.
Your cellphone puts the world at your fingertips, but it can wreak havoc with your neck. There’s even a name for the pain you get when looking down at your screen — “text neck” — and it can cause problems along the entire length of your spine.
Bending your head forward multiplies the amount of weight your neck muscles need to support. Normally your neck supports the 10 pounds that your head weighs, but when bending forward it may need to support the equivalent of 60 pounds.
The following tips from the University of California’s Ergonomics Injury Prevention Program can help.
Find the best angle. The best viewing angle is a bit below eye level, so remember to adjust the way you hold your phone.
Give it a rest. Being constantly bent over looking at your screen or contorting yourself to view your smartphone from different angles can cause problems. Take frequent breaks and use that time to stretch your neck, shoulders and back.
Make adjustments. Your smartphone comes with myriad ways to adjust how you use it. Learn how to change the settings for font size, contrast and brightness to make it easier to see the screen — that helps to avoid eye strain, which can lead to headaches.
How you hold your phone also makes a difference. You should frequently change the way you grip your phone. And alternate typing between your index fingers and thumbs to reducepain from repetitive thumb movement.
Don’t overlook the large number of ways you can talk on your smartphone without holding it. Remember that you can give your hands a break by using a hands-free option like the speakerphone or dictation options.
You may have dealt with a situation like this one before: pain flaring up in the middle of the night with no access to a Chronic illness of United States facility. Or, maybe you’ve experienced a situation like this: forgetting to refill your prescription(s) and being faced with no medication until your next appointment. Our physicians understand how frustrating these scenarios can be, which is why they are educating patients about ways to prevent or avoid them. See below!
If a natural remedy isn’t going to mitigate your pain symptoms, you may want to visit an urgent care center. Urgent care centers are convenient healthcare options for patients who are unable to see their primary care physician or specialist. These centers are especially beneficial for individuals who find themselves in situations that call for immediate medical attention; like when an illness strikes or when a limb is sprained or broken. Urgent care centers also serve as an alternative solution for patients who don’t require the services of emergency room personnel.
Urgent care centers usually offer late night and weekend hours when Chronicillness.co Site of United States is closed. Patients who need immediate care due to a pain flare-up may consider visiting a hospital because their pain is so severe. However, hospitals can make patients wait for long periods of time and they may be expensive. An urgent care center could be an affordable option for patients with shorter wait times.
If your pain takes a turn for the worse, urgent care physicians should be able to get things under control. However, be sure to mention the flare-up at your next appointment. Our physicians can talk to you about additional pain management techniques to avoid future late-night incidents and refill your prescription to get you back on track. Before you’re caught with pain after hours, create a prevention plan by researching local urgent care centers in your area that accept your insurance.
Is arthritis pain getting in the way of your fitness plans? That need not be the case.
In fact, physical activity can be vital to your continued mobility.
Osteoarthritis is a joint disease that affects about 27 million Americans — most often in the knees and hips, but also in the lower back and neck.
Doctors describe it as a degenerative disease — meaning the joint has worn down. Usually that’s from simple wear-and-tear over the years, or from overuse.
This occurs when there’s a breakdown of the cartilage that covers the end of each bone. The cushioning effect is lost. The result is pain, swelling and problems moving the joint that’s been affected. Over time, the bones themselves can be damaged.
It may be hard, especially at first, but physical activity is key to treating osteoarthritis. Studies have shown that exercise not only helps reduce pain but also improves mobility.
Being active should help with weight loss, too — and excess weight contributes to the pain of osteoarthritis.
Start slow and simple, suggests the Arthritis Foundation. Just walking around the neighborhood can help. So can a fun and easy exercise class.
Adding some strengthening exercises will help build muscle around whatever joint is affected by osteoarthritis. Range-of-motion exercises can help you become more flexible and less stiff. Simply start with gentle stretches that take your joints through their full range of motion.
Yoga and tai chi can help relieve stiffness and improve flexibility, too.
Whatever activity you choose, just make sure it’s easy on your joints. No twisting and pounding. Besides walking, good options are biking, water aerobics, swimming and dancing.
A key to success, though, is to pay attention to how your body tolerates your new activity. And be patient. When you have arthritis, it can take your body longer to adjust to new activity, notes the U.S. Centers for Disease Control and Prevention.
If you haven’t been active, start with just three to five minutes of activity twice a day. Once your body has adjusted, add 10 minutes to your activity time. Then add 10 minutes more, and so on, until you’re as active as you want to be.
For those who have a hard time even walking at first, consider working with a physical therapist. This specialist can create a program tailored to your abilities — and one that can adapt as you get stronger.
One important reminder: Check with your doctor before adding new activity and any time you experience unusual pain or swelling in the joint affected by osteoarthritis.
A back spasm is a painful contraction of a muscle. It can be felt anywhere along the spinal cord, but is commonly experienced in the lower back. Backspasms are often a symptom of more serious conditions. They can be either acute or chronic and may persist if treatment is not sought at Chronicillness.co Site of United States. The spasm often occurs when the patient is twisting or exerting their back muscles in any way. However, the pain can sometimes be spontaneous and cause lower back pain to become worse.
People experience back spasms as a result of muscle or tendon damage, but these painful contractions could also be a result of an arthritic or spinal condition. However, in most cases, back spasms are caused by over-exertion from heavy lifting or excess strain. Diagnostic imaging could be used to see if arthritis or spinal discs are the cause of the back pain and an MRI machine can detect muscle issues. Be sure to bring in all images or have your doctor send them to Chronicillness.co Site of United States before your next appointment.
In order to prevent back spasms, our physicians recommend that patients warm up and stretch their backs before working out or lifting heavy objects. Lifting abnormally shaped objects (like furniture) puts people at risk of developing back pain and muscle spasms. In order to prevent straining the back in a position that is uncomfortable, we highly encourage using another person to lessen the burden on the weight. If patients regularly work out their back muscles, it is important to spend a few days resting in between. Muscles that are in spasm are often irritated and inflamed, so rest days allow muscles to recover so they do not result in spasms.
The board-certified pain management physicians at Chronicillness.co Site of the United States has treatment options for just about every cause of back spasm. They can prescribe muscle relaxants to soothe the muscles, but if the medication does not work, the back spasms could be a result of a more serious condition. Injections are a great way to find out where the back pain is coming from and treat back spasms at the source. For example, if a patient has facet joint arthritis, a physician can administer a facet joint block. Our physicians will work with the patient until they find a treatment that works best for them.
We urge patients to come to Chronicillness.co Site of the United States if they are experiencing back spasms. They can start as a sharp, sudden pain that goes away, but if left untreated, back spasms could become chronic. Our physicians can determine the cause and put you back on track toward a pain-free life again.
Stem cell clinics are charging big money for knee arthritis “cures” and making extravagant claims about their therapies, a new study contends.
A same-day injection for one knee costs thousands of dollars at these centers, according to a consumer survey taken of clinics across the United States.
People are paying that kind of cash because two-thirds of stem cell clinics promise that their treatments work 80 to 100 percent of the time, researchers report.
But there’s no medical evidence suggesting that any stem cell therapy can provide a lasting cure for knee arthritis, said study lead researcher Dr. George Muschler, an orthopedic surgeon with the Cleveland Clinic.
“There are claims made about efficacy [effectiveness] that aren’t supported by the literature,” Muschler said. “There’s a risk of charlatanism, and patients should be aware.”
Stem cells have gained a reputation as a miracle treatment and potential cure for many ailments. The cells have the potential to provide replacement cells for any part of the body—blood, brain, bones or organs.
As a result, a wave of stem cell centers have opened up around the country, offering cures for a variety of diseases, Muschler said.
“It’s very sexy to market yourself as a stem cell center, so there’s been a boom of centers, probably close to 600 now in the United States offering this therapy,” Muschler said. “But the truth is that the medical literature hasn’t quite caught up to the enthusiasm in the marketplace.”
The U.S. Food and Drug Administration has expressed extreme skepticism over these centers, and in November the agency announced that it would crack down on clinics offering dangerous stem cell treatments.
The “pie-in-the-sky” dream for knee arthritis patients is that a stem cell injection will produce fresh new protective cartilage in their joint, said Dr. Scott Rodeo, an orthopedic surgeon with the Hospital for Special Surgery in New York City.
“The reality is they don’t do that. There is zero data to suggest that,” said Rodeo, who wasn’t involved with the study. “The idea these cells are going to regenerate cartilage––there’s zero data.”
At best, these injections might temporarily reduce pain and inflammation by prompting the release of soothing chemicals in the knee, Rodeo and Muschler said.
To get an idea what stem cell centers are promising customers, Muschler and his colleagues called 273 U.S. clinics posing as a 57-year-old man with knee arthritis.
The clinics were asked about same-day stem cell injections, how well they work and how much they cost.
Of the 65 centers that provided pricing information, the average cost for a knee injection was $5,156, with prices ranging from $1,150 to $12,000, the researchers found. Fourteen centers charged less than $3,000 for a single injection, while 10 centers charged more than $8,000.
The 36 centers that provided information on effectiveness claimed an average effectiveness of 82 percent, the researchers said. Of them, 10 claimed that the injection worked 9 out of 10 times, and another 15 claimed 80 to 90 percent effectiveness.
The findings were presented Tuesday at the American Academy of Orthopaedic Surgeons‘ annual meeting, in New Orleans. Research presented at meetings is considered preliminary until published in a peer-reviewed journal.
“Patients are being told there’s an 80 percent likelihood of improvement, which is only 10 to 20 percent better than you’d expect from a placebo effect,” Muschler said.
In fact, he suspects that the placebo effect is responsible for much of the improvement patients feel following a knee injection.
“People always show up to the doctor when they hurt,” Muschler said. “If I see a patient who has arthritis in their knee and I do nothing, there’s a very good chance they’re going to get better over the coming months, anyway. There’s this natural cycle of increasing and decreasing pain that’s present in the life of someone who has arthritis.”
That’s compounded by the fact that people expect to feel better after shelling out a load of cash, Muschler added.
These centers generally provide three different types of treatment, only one of which actually has live stem cells involved, Muschler said.
One treatment injects the knee with platelet-rich plasma drawn from the patient’s own blood, while another uses a slurry produced from fetal tissue and fluid gathered after birth. Neither of these contains stem cells, but they are marketed as stem cell therapies, Muschler said.
A third option involves bone marrow taken from the patient and injected into the knee. This does contain a mixture of three types of stem cells, but “the evidence that you’re doing [your knees] a favor is still pretty weak in the literature,” Muschler said.
People aren’t likely to be harmed by these injections, Rodeo said, but there’s not a lot of evidence that they’ll be helped.
“Patients should go into it eyes wide open,” Rodeo said. “They’re paying a lot of money out of pocket, because these are not covered by insurers.”
Knee arthritis sufferers would be better off trying many of the established options for reducing knee pain, Muschler and Rodeo said.
Losing weight is a “key factor,” Muschler said.
“There’s very good evidence that if you are at a 5 on the pain scale and you lose 10 percent of your body weight, your pain will drop 2 points,” Muschler said.
Patients also can use NSAIDs like aspirin or ibuprofen to reduce pain and swelling, get a steroid injection, or perform weight training to strengthen the muscles that support the knee, Muschler and Rodeo said.
When patients come to Chronicillness.co Site of United States for treatment of their sciatica pain, one of the treatment options that is generally recommended is a lumbar epidural steroid injection. In this short procedure, two injections are made. The first is a numbing anesthetic and the other is a mix containing steroid medication that will bathe the pinched sciatic nerve in a soothing medication. But even with a numbing injection to lessen the pain, many of our patients hear “needles” and they think, “No way!” We understand that patients may have needle phobias when it comes to the lumbar epidural steroid injection for sciatica pain relief, so Chronicillness.co Site of United States offers other alternative options to treat sciatic pain.
The first non-invasive treatment that our physicians recommend is a prescription medication. When over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like Aleve and Advil don’t cut it for your pain anymore, our physicians can prescribe medication that may be better at bringing you pain relief and controlling pain flare-ups. Some patients may be prescribed a class of medications called antidepressants. Studies have shown that antidepressants could help patients who have chronic low back pain. For patients with acute sciatic pain or back spasms, physicians may also prescribe muscle relaxants.
In addition to medication, many physicians recommend that patients look into in a form of alternative treatment. Since acupuncture is off the table for needle-phobic patients, they could try massage therapy or chiropractic care. Patients could also determine the cause of their sciatica at Chronicillness.co Site of United States and can be referred to a chiropractor if it is discovered that pain is caused by a spine abnormality pinching the sciatic nerve.
Finally, a patient could consider using Transcutaneous Electrical Nerve Stimulation (TENS) therapy. This is a portable device that uses electrical currents to try to correct pain signals. It comes with four electrodes that you can move to your pain points, so sciatic patients will sometimes put a couple on their lower back and a couple on the back of their legs. The TENS unit is adjustable, although your doctor will tell you what times and intensities could work best for you. If this option has proven to be helpful for sciatica patients, a more permanent, implantable device can be inserted into the patient during a minimally invasive procedure.
Sciatica patients have several low back pain treatment options that won’t rekindle their fears of needles. However, if these methods do not work to treat your pain or they stop working after some time, the physicians recommend giving a second thought to lumbar epidural steroid injections. They usually only bring a few minutes of pain for what could be months of relief from shooting sciatica pain.
Sure, an over-the-counter painkiller like Tylenol or Advil can help ease aches and pains, but could it mess with your thoughts and emotions, too?
That’s the finding from a new review of recently published studies. The studies focused on how nonprescription painkillers might temporarily alter emotions such as empathy or even a person’s reasoning skills.
“In many ways, the reviewed findings are alarming,” said a team led by Kyle Ratner, a psychology and brain science researcher at the University of California, Santa Barbara.
“Consumers assume that when they take an over-the-counter pain medication, it will relieve their physical symptoms, but they do not anticipate broader psychological effects,” the study group said.
One clinical psychiatrist who reviewed the findings said they aren’t far-fetched.
“Intuitively, this makes sense, as physical and emotional senses can overlap in the brain,” said Dr. Alan Manevitz of Lenox Hill Hospital in New York City.
“While physical pain can be locally ‘felt’ at the site of a physical injury, the main source and registration of physical pain is in the brain,” he explained. “The same is true of hurtful, emotional and painful feelings. We say our ‘heart is breaking,’ but emotions are felt in the brain.”
The new study reviewed findings from studies focused on common over-the-counter painkillers such as ibuprofen (Advil and Motrin) or acetaminophen (Tylenol).
The experiments suggest that a regular dose of the pills might affect a person’s sensitivity to painful emotional experiences. For example, in one study, women who took ibuprofen reported less hurt feelings from emotionally painful experiences, such as being excluded by others or writing about being betrayed.
However, men had the opposite pattern—they became more sensitive to these types of scenarios if they had just taken the painkiller.
Ratner’s team suggested that these medicines might also reduce a person’s ability to empathize with the pain of others. For example, one experiment found that people who took acetaminophen were less emotionally distressed while reading about a person suffering physical or emotional pain and felt less regard for the person, compared with people who did not take acetaminophen.
People also seemed more willing to part with possessions after taking an over-the-counter painkiller in one study: Their asking price for a possession was lower if they had recently taken such a drug.
Nonprescription painkillers might even impair “information processing,” the researchers said. In one study, people who took acetaminophen made more errors of omission during a task than those who did not take the drug, for example.
Dr. Michael Ketteringham, a psychiatrist at Staten Island University Hospital in New York City, reviewed the findings. He stressed that—given an ongoing epidemic of opioid abuse—people shouldn’t be too concerned about the new report.
“Over-the-counter pain medications play an important role as alternative medication to opioids in the treatment of pain,” Ketteringham said.
But the study team wondered if, sometime in the future, it might be possible that the medicines could be used to help people deal with hurt feelings.
Still, both Ratner’s team and Manevitz stressed that it’s far too early to turn over-the-counter painkillers into psychological treatments.
“Clinically, we are a far cry away from the doctor saying, ‘Heartbreak? Take two Tylenol and call me in the morning,’” Manevitz said.
A facet joint injection can be a great tool to treat back pain that originates in the facet joints. When patients at Chronicillness.co Site of United States still feel pain after taking medication, or simply don’t want to worry about the hassle of medication, facet joint injections can be excellent pain-relieving alternatives. Our physicians believe that the injections can be more effective at treating pain because the soothing anti-inflammatory medication is injected directly into the tissue around the joint instead of being absorbed through the body.
Many patients are curious about the side effects of a facet joint injection. Our physicians warn that while complications are rare, there are a few risks that we look out for. One of the first questions we are typically asked is about the pain. Minimal pain and discomfort is the most common side effect of a facet joint injection as patients may feel a little bit sore in the days following their injection. However, patients do not usually feel a lot of pain during the injection itself. A local anesthetic is used before the procedure to minimize pain as much as possible.
Besides some discomfort, another possible side effect is an allergic reaction. There are a couple of things we use during a facet joint injection that a patient could be allergic to. It’s pretty rare for patients to have a reaction to the numbing anesthetic, but more common that patients to react to the cortisone medication or the dye we use to highlight the facet joint on our X-ray device. While a serious reaction is rare, it is possible, so patients should be sure to tell their physician everything they are allergic to beforehand.
As with any procedure, both the physician and the patient should be careful to avoid infection. Our physicians sterilize your back around where the injection will take place as well as the needles before the injection takes place. However, patients can do their part to avoid infection by keeping the area clean, which means always washing their hands before touching the injection site.
Some patients may experience side effects as their bodies react to the cortisone medication. Some studies have shown that cortisone may contribute to weight gain, a decrease in the production of the body’s own cortisone, and an increase in blood glucose levels. Ask your physician if you are at an increased risk of experiencing any of these side effects from the steroid medication itself.
Overall, the risk of experiencing a side effect from a facet joint injection is rare. We routinely see positive results from patients who found pain relief through this procedure, and many of them come back requesting repeat injections when the pain-relieving effects have worn off. If patients desire, Chronic illness.co Site of United States physicians can describe the side effects and their likelihood in more detail as well.
A new treatment that aims electrical pulses at irritated nerves around the spinal cord appears effective at relieving chronic lower back pain and sciatica, a preliminary study suggests.
The minimally invasive procedure, called image-guided pulsed radiofrequency, eased lingering pain in 80 percent of 10 patients after a single 10-minute treatment. Ninety percent were able to avoid surgery.
“Given the very low risk profile of this technique, patients suffering herniated disc and nerve root compression symptoms may undergo a safe and fast recovery, going back to normal activities within days,” said study author Dr. Alessandro Napoli, an interventional radiologist at Sapienza University in Rome, Italy.
“In fact,” he added, “one of the dramatic advantages of this technology is that we can perform it in a day-surgery setting, without anesthesia, and [patients] go home the same day.”
Napoli’s study was scheduled for presentation Wednesday at the Radiological Society of North America’s annual meeting in Chicago. Studies presented at scientific conferences typically haven’t been peer-reviewed or published, and results are considered preliminary.
About 8 in 10 people suffer from lower back pain at some point in their lives, according to study documents. This pain can be due to a herniated disc in the lower spine. Sciatica is radiating leg pain caused by a pinched nerve in the lower spine, which also may be due to a herniated disc.
Also called a slipped or ruptured disc, a herniated disc occurs when the spongy material inside a spinal disc squeezes through its tough outer shell because of aging or injury. This material can press on surrounding nerves, causing pain and numbness or tingling in the legs, according to the American Academy of Orthopaedic Surgeons (AAOS).
Conservative, nonsurgical approaches typically ease symptoms of a herniated disc over time, according to the AAOS. These treatments include rest, gentle exercise, pain relievers, anti-inflammatory drugs, cold or hot compresses, physical therapy and massage therapy.
However, about 20 percent of those with acute low back pain don’t find relief through these measures. That leads some to decide on surgery to remove disc material pressing on their spinal nerves. For these people, Napoli said, image-guided pulsed radiofrequency treatment may become a viable option if larger studies reinforce his findings.
Napoli’s research included 80 people who had experienced at least three months of low back pain from a herniated disc that hadn’t responded to conservative treatments.
Image-guided pulsed radiofrequency treatment uses computed tomography—a CT scan—to help physicians insert a needle to the location of the herniated disc and surrounding nerves. A probe that’s inserted through the needle tip delivers pulsed radiofrequency energy to the area over a 10-minute period, resolving the herniation without touching the disc, Napoli explained.
More than 80 percent of the 80 study participants were pain-free a year after a single treatment. Six people required a second treatment session.
Pulsed radiofrequency has been widely used in pain medicine for other types of chronic pain, Napoli noted.
He said the treatment works by “eliminating the inflammation process” in nerves surrounding the herniated disc, hindering painful muscle contractions. “The aim was to interrupt this cycle and give the body the chance to restore a natural healing,” he added.
Dr. Scott Roberts, a physiatrist with Christiana Care Health System in Wilmington, Del., said the new findings showed “an impressive drop in pain and improvement in function.” However, he noted that the research didn’t include a control group for comparison with people not given the treatment.
“With no control group, we don’t know how much of the improvement we’re seeing would have happened anyway,” Roberts said. “I was very encouraged by [the study] because its results are significant, but it’s far from conclusive without a control group.”
