Patient Information

ANKLE SPRAINS: Ankle sprains are very common injuries that result from twisting or rolling the ankle excessively. Typical symptoms include pain, swelling, and bruising. The patient may or may not be able to walk on the ankle. Ankle injuries should be examined by a physician and x-rayed to make sure that there are no fractures. If no bones are broken, simple ankle sprains are typically treated by R-I-C-E (Rest, Ice, Compression, Elevation). Anti-inflammatory medications may also be prescribed by your physician. Rarely an ankle sprain may be so severe that it requires a walking cast for a short period of time. For patients who have recurrent ankle sprains, a short course of physical therapy is often helpful in strengthening the ankle and preventing further instability. Back to index BUNION / HAMMERTOE: Over 90% of deformities in the forefoot are caused by poorly-fitting shoes. A bunion is a deformity of the great toe which angles towards the second toe leaving a large, painful prominence on the inner border of the foot. A hammertoe is a deformity of the lesser toes which develop a contracture of one of the knuckles leaving a painful prominence on the top of the toe that can rub on the inside of a shoe. Both problems can often be treated with better fitting shoes and accommodative padding. Only painful deformities that do not respond to conservative measures require surgery. Back to index CARPAL TUNNEL SYNDROME: Carpal tunnel syndrome occurs because of abnormal compression of the median nerve at the wrist. Typical symptoms include numbness over the thumb, index, middle, and ring fingers. Pain and clumsiness can also be associated with carpal tunnel syndrome. It may often be associated with activities which require repetitive wrist movements such as typing or jackhammering. Initial treatment includes bracing and occasionally a cortisone injection. If these fail, a simple test can be done to confirm the diagnosis and the nerve can subsequently be released with outpatient surgery. Back to index FRACTURES AND DISLOCATIONS: All fractures and dislocations should be seen immediately by either an orthopedist or emergency room physician for definitive treatment. Back to index HEEL PAIN: Plantar fasciitis is one of the most common causes of heel pain. Typically the pain is the worst when taking the first step out of bed in the morning, but then can be gradually walked off. After a full day of activity, the pain is usually worse. Initial treatment for plantar fasciitis is stretching exercises and heel pads. If these fail, night splints and sometimes cortisone injections are necessary to relieve the pain. Back to index HIP ARTHRITIS: Hip arthritis is a degenerative condition of the hip joint which usually causes groin pain, stiffness and difficulty walking. The most common causes of hip arthritis are osteoarthritis and rheumatoid arthritis. Other conditions that can lead to hip arthritis include hip trauma, childhood hip diseases, and avascular necrosis among others. Initial treatment of hip arthritis includes activity modification such as weight loss, using a cane or walker, and therapy. Arthritis medications can be added under the supervision of your family physician to help alleviate the symptoms further. Cortisone shots are not commonly used in the hip joint because it is difficult to locate without special x-ray techniques. Finally, if all conservative measures fail and the arthritis is severely affecting the patients lifestyle, total hip replacement is an excellent operation for relieving pain and restoring function and is successful in over 95% of patients. Back to index KNEE ARTHRITIS: Knee arthritis is a degenerative condition of the knee joint which typically causes knee pain, stiffness, and difficulty walking. The most common causes are osteoarthritis, rheumatoid arthritis, and previous injuries to the knee. Initial treatment includes activity modification such as weight loss, walking with a cane or walker, and therapy. Anti-inflammatory medications can also be used to help alleviate the symptoms of arthritis under the close supervision of your family physician. Cortisone shots are often very effective in relieving the pain of arthritis for variable periods of time. Cortisone shots should not be given more frequently that four times per year. If all conservative measures should fail, then total knee replacement is a very effective way of relieving pain and restoring function and is successful in over 95% of patients. Back to index KNEE INJURIES: Knee injuries are very common in sports as well as daily activities. Patients typically complain of a twisting or buckling injury or a fall or blow to the knee. The injured knee is often swollen and tender and the patient may or may not be able to put weight on the leg. Knee injuries should be examined by a physician as soon as possible. X-rays can rule out a fracture that may need casting or surgery. If there is no sign of fracture, initial treatment for knee injuries includes icing, rest, and anti-inflammatory medications if medically indicated. Occasionally a cortisone injection may quickly relieve the acute inflammation and pain. If there is no significant improvement within a few days to weeks, a short course of therapy may be all that is needed to get the patient back into shape. If all conservative measures fail, then an special imaging study called an MRI is often ordered by the physician which will help him identify problems such as a meniscal tear, ACL tear, or other ligament injuries. Surgery, such as arthroscopic surgery, may be required to bring the knee back to health. Back to index PATELLOFEMORAL PAIN: Patellofemoral pain is a common condition occurring most frequently in young women. It typically causes pain and "cracking or popping" in the front of the knee. Patients often complain of pain around the knee cap when going up or down steps or with squatting. Patellofemoral pain can usually be treated with ice, physical therapy to strengthen the quadriceps muscles, and anti-inflammatory medications if medically indicated. Occasionally for resistant cases that do not respond to conservative measures, surgery may be required. Back to index ROTATOR CUFF TENDINITIS / ROTATOR CUFF TEARS: Rotator cuff tendinitis and rotator cuff tears are caused by inflammation and degeneration of the tendons which surround the shoulder joint. These are frequently the result of repetitive overuse of the shoulder. The most common symptoms are pain over the outside of the arm and sometimes can radiate down to the hand. The pain is aggravated by overhead activities as well as lifting away from the body. Often times patients cannot sleep on the affected shoulder. Initial treatment includes ice, physical therapy, and anti-inflammatory medications if medically indicated. Cortisone shots are often effective at relieving the acute inflammation and pain. If conservative measures fail, your physician may order a test called an MRI which can help determine whether or not a tear is present. If the pain persists and is severely affecting the patient's lifestyle, surgery may be necessary to bring the shoulder back to health. Back to index TENNIS ELBOW: Tennis elbow is a common degenerative condition of the extensor tendons of the forearm which originate from the outside of the elbow. The most common complaints are pain and weakness on the outside of the elbow with lifting or holding objects. Patients who have tennis elbow often times have never played tennis. Early treatment includes use of a tennis elbow strap on the forearm as well as ice and therapy exercises. Cortisone shots into the origin of the tendons at the elbow is very effective at reducing the pain of tennis elbow. If the brace, therapy, and shots are not effective at eliminating the pain, then surgery can often times relieve the symptoms. Back to index TRIGGER FINGER: Trigger finger is caused by swelling and inflammation of the flexor tendons in the palm of the hand. Symptoms include pain and "triggering or locking" of the finger when flexing and straightening it. Occasionally trigger fingers may become locked in a flexed position. Initial treatment includes a cortisone injection around the inflamed tendon to reduce swelling. If the problem persists after a few injections, then surgery may be indicated to release the trigger finger. Back to index