Healthcare Library

<div class=media-desc><strong>What is tennis elbow?</strong><p>Dr. Alan Greene explains causes of tennis elbow and how to treat it.</p></div><div class=media-desc><strong>Foot pain</strong><p>Healthy feet often travel miles each day. You use them to get up and down supermarket aisles, climb stairs, and walk on the treadmill, among other things. Any pain or discomfort in your feet can really slow you down and impact your life. Let's talk about foot pain, and what to do if you have it.

A lot of different things can cause foot pain, including those stiletto heels you couldn't resist passing by the shoe store window at the mall. Wearing poorly fitting or high-heeled shoes day after day can squeeze and pinch your feet until they start to hurt.

For example, shoes that are too narrow can cause bunions, swollen bumps at the base of your big toe. Wearing shoes that are too tight can curl your toes until they look like a claw. That's called a hammer toe. When your feet rub against your shoes, you can get areas of thickened skin called calluses or corns. And too much pressure from your shoes on the soles of your feet can create an opening for a viral infection called plantar warts.

If your shoes aren't a problem, you may have one of several conditions that cause foot pain. Arthritis, a fractured or broken bone, gout, tendinitis, plantar fasciitis can all make your feet hurt. You're more likely to have foot problems as you get older and your joints wear down. Being overweight puts extra pressure on your feet, which can also lead to pain.

So, what do you do if your feet hurt?
That depends on what's causing your pain. Sometimes you can treat foot pain at home. For example, you can hold ice to your foot to bring down swelling, and take an over-the-counter pain reliever such as ibuprofen or acetaminophen. Try to keep off the painful foot as much as you can. Sit with your feet raised until they start to feel at least a bit better. Wearing foot pads and other shoe inserts may also help your feet heal and prevent future pain. 

Sometimes you'll need to see a doctor, especially if the pain is due to an injury, or it's severe, or it hasn't improved after a couple of weeks of treatment at home. Your podiatrist can examine your feet, diagnose the problem, and remove any growths like warts, corns, or calluses. A foot doctor can also treat a broken or fractured bone. Depending on how serious the problem is, you may even need surgery to treat it.

There are ways to prevent foot pain before it can start-like being careful when you exercise. Working out is great, but you never want to run or jump hard enough to damage your feet. Losing weight can also help take some of the pressure off of your feet. 

Probably the kindest thing you can do for your feet is to wear comfortable shoes. Your shoes should fit properly, supporting and cushioning your feet while leaving plenty of room for your toes to wiggle around. So, when you're shoe shopping, leave the stilettos on the shelf, and reach for a comfortable, attractive option instead. Your feet will thank you by not causing you pain.</p></div><div class=media-desc><strong>Heel pain</strong><p>Heel pain can be a common problem. Though the cause is rarely serious, the pain can be severe and sometimes disabling. 

Heel pain is often the result of overusing your foot. Causes may include, running, especially on hard surfaces like concrete, tightness in your calf, or from Achilles tendonitis (inflammation of that large tendon that connects your calf muscle to your heel), shoes with poor support, sudden inward or outward turning of your heel, or landing hard or awkwardly on your heel after a jump or fall.

Problems related to heel pain include bursitis (inflammation of the bursa at the back of the heel), bone spurs in the heel, and plantar fasciitis (swelling of the thick band of tissue on the bottom of your foot).

Heel pain is something you can usually treat at home. If you can, try resting as much as possible for at least a week. Apply ice to the painful area twice a day or so, for 10 to 15 minutes. Take acetaminophen or ibuprofen for pain and inflammation. If you need to, you can buy a heel cup, felts pads, or shoe inserts to comfort your heel.

You should call your doctor if your heel pain does not get better after two or three weeks of home treatment. But also call your doctor if your pain is getting worse, or your pain is sudden and severe, your feet are red or swollen, or you can't put weight on your foot.

If you visit the doctor, you may have a foot x-ray. Your treatment will depend on the cause of your heel pain. You may need to see a physical therapist to learn exercises to stretch and strengthen your foot.

To prevent future heel pain, we recommend you exercise. Maintaining flexible, strong muscles in your calves, ankles, and feet can help ward off some types of heel pain. And do yourself a favor, trade those sleek high heels in for a comfortable, properly fitting pair of shoes.</p></div><div class=media-desc><strong>Neck pain</strong><p>Your neck is sore. It hurts to move your head. Are you sleeping wrong, is it stress, or a result of climbing that ladder to clean your gutters? Let's get to the bottom of those real pains in your neck.

When your neck is sore, you may have trouble moving it, especially to one side. Many people describe this as having a stiff neck. If neck pain involves nerves, such as a muscle spasm pinching on a nerve or a slipped disk pressing on a nerve, you may feel numbness, tingling, or weakness in your arm, hand, or elsewhere.

A common cause of neck pain is muscle strain or tension. Usually, everyday activities are to blame. Such activities include bending over a desk for hours hunching in place, having poor posture while watching TV or reading, placing your computer monitor too high or too low, sleeping in an uncomfortable position, or twisting and turning your neck in a jarring manner while exercising.

Usually, you can treat minor neck pain at home. Simple posture improvements are a great place to start, sitting straight with shoulders held back, driving with arms on armrests, and avoiding carrying shoulder bags. Take breaks when sitting in front of video displays or holding a telephone.

For pain, you might try over-the-counter pain relievers such as Advil or Tylenol. And low level laser therapy can be very effective. Physical therapy can be great for treating or preventing the recurrence of neck pain. Slow range of motion exercises, moving your head up and down, side to side from ear to ear, can gently stretch your neck muscles. Applying heat beforehand may help. Good sleep position is especially important with the head aligned with the body. You can try sleeping with a special neck pillow for that. 

You may want to see a doctor if your symptoms linger for longer than a week of self care, or if you have numbness, tingling, or weakness in your arm or hand, or if your pain was caused by a fall, blow, or injury.

If the pain is due to a muscle spasm or a pinched nerve, your doctor may prescribe a muscle relaxant or a tricyclic antidepressant, and possibly a more powerful pain reliever than you were taking at home. You may be referred to a neurologist if he suspects any nerve damage in your neck.

You can help prevent neck pain or keep it from coming back in many ways. Use relaxation techniques and regular exercise to prevent unwanted stress and tension to your neck muscles. Learn stretching exercises for your neck and upper body, stretch every day, before and especially after exercise. Use good posture, especially if you sit at a desk all day, keep your back supported, adjust your computer monitor to eye level, so you don't have to continually look up or down. Talk to your doctor if pain persists, you do not want to go through life with a real pain in the neck.</p></div><div class=media-desc><strong>Hip joint replacement</strong><p>Your hip is hurting so bad, you can't sleep. It's hard to bathe, to clean, make it to the mailbox or shop at the mall. You may have severe arthritis in your hip, and there's a good chance you need a hip replacement.

Hip replacements are usually done in people age 60 and older. If you need one, you probably have severe arthritis that limits your daily life, or perhaps have a hip fracture.

Your hip joint is made up of two parts, the hip socket and the upper end of the thigh bone. One or both parts may be replaced during surgery. Your new hip will probably have a socket made of strong metal, a liner that fits inside the socket, usually plastic, a metal or ceramic ball to replace the round head of your thigh bone, and a metal stem attached to the thigh bone to make your joint more stable.

So, how is the hip replacement procedure done?
Well you won't not feel any pain during surgery because you will have medicine to make you fall asleep. The surgeon will cut and remove the head of your thigh bone and clean out your hip socket, removing cartilage and damaged or arthritic bone. The surgeon will put the new hip socket in place, insert the metal stem into your thigh bone, and place the ball for a new joint. Cement will probably hold the new joint in place. The surgery can take several hours. 

After the surgery, you will probably stay in the hospital for three to five days. As soon as the first day after surgery, you will be asked to start moving and walking around with a walker, crutches, or a cane. You will need physical therapy to strengthen your new joint for up to several weeks after your operation. Some people need a short stay in a rehabilitation center after they leave the hospital. At the rehab center, you will learn how to safely do your daily activities on your own.

Your new hip should allow you to resume your daily activities once you've learned to move around on your own. In the long run, over 20 years or so, the joint may need to be placed again. But, in the short run, most or all of your pain should go away. The stiffness should go away. Your doctor should be able to monitor any problems and you should enjoy your new joint.</p></div><div class=media-desc><strong>Rotator cuff problems</strong><p>Feeling pain in your shoulder when you lift your arm over your head may mean you have a have a problem with your rotator cuff. 

So, what causes rotator cuff problems?
The rotator cuff is a group of muscles and tendons that attach to the bones of your shoulder joint. The group allows your shoulder to move and keeps it stable. Pain in your rotator cuff area usually means you have rotator cuff tendinitis, or inflammation of these tendons and inflammation of the bursa, smooth slippery sacs the tendons glide across; or a rotator cuff tear, when one the tendons is torn from overuse or injury.

Rotator cuff tendinitis may be due to keeping your arm in the same position for long periods of time, such as doing computer work or hairstyling. Sleeping on the same arm each night can also cause this problem. You can also get tendinitis playing sports that require you to move your arm over your head repeatedly, such as in tennis, baseball especially pitching, swimming, and weight-lifting.

Rotator cuff tears may happen if you fall on your arm while it is stretched out, or after a sudden, jerking motion when trying to lift something heavy. Chronic tears occur slowly over time, particularly in people who have chronic tendinitis. At some point, the tendon wears down and starts to tear.

If you have tendinitis, you'll have pain when you lift your arm over your head, such as when you brush your hair and reach for objects on shelves. The pain may be mild at first, but over time you may have pain at rest or at night, especially when you lie on your shoulder.

The pain of a sudden rotator cuff tear can be intense. Your shoulder may be weak, and you may hear a snapping sound when you move your shoulder. Chronic symptoms include a gradual worsening of pain, weakness, stiffness or loss of motion. Most people with rotator cuff tears have worse pain at night and when they wake up.

To treat your rotator cuff problem, your doctor will check your shoulder for tenderness and lift your arm to see in which position you have pain. X-rays may show a bone spur, a bony projection. If your doctor thinks you have a tear, you may have an ultrasound or MRI. 

Treatment for rotator cuff tendinitis involves resting your shoulder and avoiding the activities that cause you pain. You can also try applying ice packs 20 minutes at a time, 3 or 4 times a day. Medicines like ibuprofen may help reduce swelling and inflammation. Eventually, you should start physical therapy to learn to stretch and strengthen the muscles of your shoulder. Surgery can remove inflamed tissue and part of the bone that lies over the rotator cuff, which may help relieve the pressure on your tendons.

Someone with a partial rotator cuff tear can try rest and exercise, if they don't normally put a lot of demand on their shoulder. But if there's a complete tear, or if the symptoms don't improve with therapy, you may need surgery to repair the tendon.

But with rest or exercise, symptoms of most shoulder problems often improve or go away, though it may take months.</p></div><div class=media-desc><strong>Herniated disk</strong><p>You might have heard a friend say that they have slipped a disk. Or, you may have slipped a disk yourself during an overly strenuous workout, or by straining while lifting something heavy. A slipped disk can be painful, so painful, in fact, that you can barely move. But what exactly is a slipped disk? And what can you do about it if you have one?

This is your spine. In between the bones, which are called vertebrae, are little cushioning disks. These disks not only allow you to bend and move but also prevent your bones from rubbing against each other. 

Sometimes an injury can push a disk out of place, producing a bulge. This bulge is called a herniated disk. Or, a disk may break open. When a disk moves, it puts pressure on nearby nerves, and that's when you start to feel pain. Most slipped disks are found in the lower back or lumbar region, although you can also have one in your neck, or cervical region.

When you have a slipped disk, you'll hurt, but often just on one side of your body. If the disk is in your lower back, you may feel a sharp pain in one part of your leg, hip, or buttocks. Your leg may also feel weaker than usual. If the disk is in your neck, the pain and numbness can stretch all the way from your neck down to your shoulder and arm. You may notice that it hurts even more when you stand for a long period of time, or if you sneeze, cough, or laugh.

So, how do you treat a slipped disk?
First your doctor will want to make sure that you actually have a slipped disk. To find out, the doctor will check your muscle strength, feeling, and reflexes, and have you move in different ways, for example, by bending, standing, and walking. You may also have a scan to find the exact location of the slipped disk.

While bed rest was once the standard therapy for low back pain, studies show that for most people it does not help and may even make the situation worse. Rapid return to healthy normal activity is usually best, being careful not to put too much stress on the back. While you're doing that, you can take medicines like ibuprofen or aspirin to relieve the pain. Muscle relaxants may also help. Acupuncture, massage, and yoga have also been shown to be affective in some studies. Physical therapy may be helpful after the first two or three weeks. It can help strengthen the muscles of your spine, and teach you how to move properly so you don't injure yourself again.

If these measures don't help, your doctor may suggest getting steroid injections into the area where you slipped the disk, to reduce pain and relieve swelling. As a last resort when all other treatments have failed, you may have a surgery called a diskectomy to remove the damaged disk.

You may be in pain now, but don't despair, with treatment it should ease. Realize that it may take a few months before you're back to your old self. Don't try to overdo it by bending or doing any heavy lifting. You'll just wind up back on your couch, hurting again.</p></div><div class=media-desc><strong>Carpal tunnel syndrome</strong><p>Typing all day on a computer keyboard can be tough on your wrists. If you type for hours at a time, day after day, eventually you may really start to feel some discomfort. The numbness, pain, and tingling you feel in your hands and wrists may be carpal tunnel syndrome, and it can have such a big effect on your life that you may eventually need surgery to treat it.

Doing any repetitive motion with your hands, whether it's typing, sewing, driving, or writing, can cause carpal tunnel syndrome. The condition gets its name from an area in your wrist called the carpal tunnel. Running through this tunnel is the median nerve, which sends feeling to your palm and most of your fingers. When you do the same task over and over again, especially flexing and extending the wrist, you put pressure on the median nerve. Over time, it swells up inside the carpal tunnel until it's so tight in there that the nerve gets pinched. 

The classic symptoms of carpal tunnel syndrome are numbness and tingling in your hand, including the thumb, index, middle, and half of the ring finger. The discomfort is usually worse at night. And anytime you may not be able to grip things as tightly in the affected hand, and you can feel pain that may stretch all the way from the wrist to your elbow. Your doctor can run tests on your hand to confirm that your numbness, weakness, and pain are due to carpal tunnel. You may also have nerve conduction studies, or tests of the muscles.

If you're feeling a lot of discomfort from carpal tunnel wearing a wrist splint especially at night could help. In addition, short term oral or injected glucocorticoid medications can help by reducing swelling. Studies have also shown some benefit from physical or occupational therapy techniques, and joga. About half of the people with carpal tunnel though will eventually need a procedure called carpal tunnel release to lift pressure off the pinched nerve. Surgery is a more permanent solution, but whether it works depends on how severe the nerve damage is, and how long you've had it. 

You may not be able to completely avoid the repetitive flexing or extending the wrist that gave you carpal tunnel in the first place, especially if it's part of your job. But, you can make some adjustments, for example, by using special devices like a cushioned mouse pad, wrist braces, or a raised keyboard, to relieve the pressure on your wrists. Take occasional breaks whenever you're going to be typing or doing any other repetitive task for long periods of time. And if you are having any numbness, tingling, or pain in your hands or wrists, see your doctor sooner rather than later. Letting carpal tunnel syndrome go untreated could leave you with a permanently damaged nerve.</p></div><div class=media-desc><strong>Knee joint replacement</strong><p>Your knee has been hurting for a while, and it hurts bad. You've  had trouble sleeping. It may be hard to bathe, to do normal chores like wash the car, or even be comfortable on the job. You may have severe arthritis in your knee, and if so there's a good chance you need a knee replacement.

So, what is a knee replacement?
Knee replacements are usually done in people age 60 and older. If you need one, you probably have severe arthritis that limits your daily life. 

During knee joint replacement, your surgeon will remove damaged cartilage and bone from the knee joint. The surgeon then puts man-made pieces, called prostheses, in their place. The lower end of the thigh bone, also called the femur, is usually replaced with a metal part. The part that replaces the upper end of the shin bone, the tibia, is usually made from metal and a strong plastic. The piece that replaces the back side of your kneecap, or patella, is usually made from a strong plastic.

You shouldn't feel any pain during surgery because you will have medicine to make you fall asleep. The surgeon will make a cut over your knee to open it up. The cut is usually eight to ten inches long. Your surgeon will move your kneecap out of the way, then cut the ends of your thigh bone and shin bone to fit the replacement part. The surgeon will then cut the underside of your kneecap and prepare it for the new pieces that will attach there. The surgeon then fastens the two parts of the prosthesis to your bones, the upper end of the shin bone and the lower end of the thigh bone. Then the parts are attached to the underside of your kneecap using a special cement. The surgery usually takes a couple hours.

After surgery, you will probably stay in the hospital for three to five days. As soon as the first day after surgery, you will be asked to start moving and walking around with a walker, crutches, or a cane. You will likely need physical therapy to strengthen your new joint after your operation. Some people need a short stay in a rehabilitation center after they leave the hospital. At the rehab center, you will learn how to safely do your daily activities on your own. Full recovery can take three months to a year.

Your new knee should last for 15 years or maybe even 20. And in the mean time, your new knee should allow you to resume your daily activities once you have learned to move around. Most or all of your pain and stiffness should go away.</p></div><div class=media-desc><strong>Shoulder pain</strong><p>Swelling, damage, or bone changes around the rotator cuff in your shoulder can cause pain that puts a kink in the activities of your life. Let's talk about shoulder pain.

The rotator cuff is a group of muscles and tendons that attach to the bones of your shoulder joint. The group allows your shoulder to move and keep it stable. The most common cause of shoulder pain is when rotator cuff tendons become inflamed or trapped in your shoulder. This is called rotator cuff tendinitis, or irritation of these tendons and inflammation of the bursa, small slippery fluid filled sacs that the tendons glide over. A rotator cuff tear, when one of the tendons is torn from overuse or injury, can also cause intense shoulder pain. 

Other causes of shoulder pain can include arthritis, bone spurs - bony projections, a broken shoulder bone, frozen shoulder, when the muscles, tendons, and ligaments in your shoulder become stiff, and shoulder dislocation.

Most of the time, you can take care of your shoulder pain at home. Try putting ice on your shoulder for 15 minutes, then leave it off for 15 minutes, three or four times a day for a few days. Make sure you wrap the ice in cloth, so it doesn't give you frostbite. Take ibuprofen to reduce pain and swelling. Slowly return to your regular activities once you start feeling less pain. 

Sudden shoulder pain can be a sign of a heart attack. Call Emergency Services if you have sudden pressure or crushing pain in your shoulder, especially if the pain starts in your chest, jaw, or neck.

If you fall on your shoulder and feel sudden intense pain, you should see a doctor because you may have torn rotator cuff or dislocated your shoulder.

If you have had shoulder pain before, try using ice and ibuprofen after exercising. Learn proper exercises to stretch and strengthen your rotator cuff tendons and shoulder muscles. Also, physical therapy can help. Make an appointment and talk about your options.</p></div><div class=media-desc><strong>Knee arthroscopy</strong><p>Knee arthroscopy is surgery that is done to check for problems, using a tiny camera to see inside your knee. Other medical instruments may also be inserted to repair your knee. </p></div><div class=media-desc><strong>Fracture types (1)</strong><p>There are several types of bone fracture, including oblique -- a fracture which goes at an angle to the axis, comminuted -- a fracture of many relatively small fragments, spiral -- a fracture which runs around the axis of the bone, and compound -- a fracture (also called open) which breaks the skin.</p></div><div class=media-desc><strong>Osteoarthritis</strong><p>Osteoarthritis is a chronic disease of the joint cartilage and bone, often thought to result from "wear and tear" on a joint, although there are other causes such as congenital defects, trauma and metabolic disorders. Joints appear larger, are stiff and painful and usually feel worse the more they are used throughout the day.</p></div><div class=media-desc><strong>Rheumatoid arthritis</strong><p>Rheumatoid arthritis is a systemic autoimmune disease which initially attacks the synovium, a connective tissue membrane that lines the cavity between joints and secretes a lubricating fluid.</p></div><div class=media-desc><strong>ACL injury</strong><p>Anterior cruciate ligament (ACL) injuries may occur from coming to a quick stop with a directional change while running, pivoting, landing, or overextending the joint in either direction.</p></div><div class=media-desc><strong>Internal fixation devices</strong><p>An internal fixation device may be used to keep fractured bones stabilized and in alignment. The device is inserted surgically to ensure the bones remain in an optimal position during and after the healing process.</p></div><div class=media-desc><strong>Calcium source</strong><p>Getting enough calcium to keep bones from thinning throughout a person's life may be made more difficult if that person has lactose intolerance or another reason, such as a tendency toward kidney stones, for avoiding calcium-rich food sources. Calcium deficiency also effects the heart and circulatory system, as well as the secretion of essential hormones. There are many ways to supplement calcium, including a growing number of fortified foods.</p></div><div class=media-desc><strong>Bone-building exercise</strong><p>Exercise plays an important role in the retention of bone density in the aging person. Studies show that exercises requiring muscles to pull on bones cause the bones to retain and possibly gain density.</p></div><div class=media-desc><strong>Early treatment of injury</strong><p>Minor injuries like sprains may be treated at home if broken bones are not suspected. The acronym RICE is helpful in remembering how to treat minor injuries: "R" stands for rest, "I" is for ice, "C" is for compression, and "E" is for elevation. Pain and swelling should decrease within 48 hours, and gentle movement may be beneficial, but pressure should not be put on a sprained joint until pain is completely gone (one to several weeks).</p></div><div class=media-desc><strong>Fracture types (2)</strong><p>There are several types of bone fracture, including greenstick -- an incomplete fracture in which the bone bends, transverse -- a fracture that goes across the bones axis, and simple -- a fracture which does not break the skin.</p></div>
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