Injury and degeneration of the spine are the most common cause of back pain and most people will experience it at some time during their life. Fortunately for most, limiting activity, physical therapy and rest and medication are all that is required for relief. In cases that call for treatment, we provide the highest level of care for problems of the spine. Diagnosis and individual treatment plans are provided for each patient.
In the low back, nerves join to form the sciatic nerve, which runs down into the leg and controls the leg muscles. Sciatica is a condition that may cause radiating pain, numbness, tingling, and/or muscle weakness in the leg but originates from nerve root impingement in the lower back. Nerve impingement is most often caused by a herniated disk or spinal stenosis.
Stenosis refers to a narrowing of the spinal canal, usually in the lower back (lumbar) region. This narrowing is often a result of the normal degenerative aging process. It occurs as the disks of cartilage that separate the spine's vertebrae lose water and the space between the vertebrae become smaller, causing friction between the bones. The loss of water in the disks makes them less flexible and unable to act as shock absorbers in the spine. Daily wear and tear on the spine becomes more significant without these shock absorbers.
As the disks degenerate, vertebrae may shift, causing the spinal canal to narrow. In some cases, the nerves that travel through the spinal column to the legs become squeezed. This can cause back and leg pain, and even leg weakness. Arthritis and falls also contribute to the narrowing of the spinal canal, compressing the nerves and nerve roots and causing pain and discomfort.
Degenerative disk disease is a general term applied to back pain that has lasted for more than three months. It is caused by degenerative changes in the intervertebral disks in the spine and can occur anywhere in the spine: low back (lumbar), mid-back (thoracic), or neck (cervical).
Under the age of 30, these disks are normally soft, and they act as cushions for the vertebrae. With age, the material in these lumbar disks becomes less flexible and the disks begin to erode, losing some of their height. As their thickness decreases, their ability to act as a cushion lessens. The less dense cushion now alters the position of the vertebrae and the ligaments that connect them. In some cases, the loss of density can even cause the vertebra to shift their positions. As the vertebrae shift and affect the other bones, the nerves can get caught or pinched and muscle spasms can occur.
Degenerative disk disease is primarily a result of the normal aging process, but it may also occur as a result of trauma, infection, or direct injury to the disk. Heredity and physical fitness may also play a part in the process.
The spinal vertebrae are separated by flexible disks of shock absorbing cartilage. These disks are made of a supple outer layer with a soft jelly-like core (nucleus). If a disk is compressed, so that part of it intrudes into the spinal canal but the outer layer has not been ruptured, it may be referred to as a "bulging" disk. This condition may or may not be painful and is extremely common.
Herniated disks are often referred to as "slipped" or "ruptured" disks. When a disk herniates, the tissue located in the center (nucleus) of the disk is forced outward. Although the disk does not actually "slip," strong pressure on the disk may force a fragment of the nucleus to rupture the outer layer of the disk.
If the disk fragment does not interfere with the spinal nerves, the injury is usually not painful. If the disk fragment moves into the spinal canal and presses against one or more of the spinal nerves, it can cause nerve impingement and pain.
If the injured disk is in the low back, it may produce pain, numbness, or weakness in the lower back, leg, or foot. If the injured disk is in the neck, it may produce pain, numbness, or weakness in the shoulder, arm, or hand.
Radiculopathy refers to a condition in which the spinal nerve roots are irritated or compressed. Many people refer to it as having a "pinched nerve." Lumbar nerve impingement indicates that the nerve roots in the lower spine are involved, while cervical radiculopathy is associated with nerve roots in the neck. Nerve impingement is most often caused by a herniated disk or spinal stenosis.
An epidural is a potent steroid injection that helps decrease the inflammation of compressed spinal nerves to relieve pain in the back, neck, arms or legs. Cortisone is injected directly into the spinal canal for pain relief from conditions such as herniated disks, spinal stenosis, or radiculopathy. Some patients may need only one injection, but it usually takes two or three injections, given two weeks apart, to provide significant pain relief.
Amazing flexibility makes our shoulders so versatile and yet so unstable. The elbow is a complex joint that coordinates the movement of the three large bones of the upper extremity. When these vulnerable joints are injured, our lifestyle suffers. From the repair of rotator cuff injuries, to total shoulder replacement surgery, to elbow reconstruction, our upper extremity specialists offer thorough knowledge and experience to restore your shoulder and elbow function.
When the hand is affected by injury or disease, a person’s quality of life can be significantly compromised. Given that our hands are in constant motion – reaching, grasping, carrying and releasing – they are regularly exposed to a number of dangers. They are also susceptible to over-use injuries, such as tendonitis and carpel tunnel syndrome. Whether your hand problem results from trauma associated with new injuries, complications of old injuries, arthritic conditions, nerve compression disorders or abnormal growths, you can depend on our hand and wrist specialists to treat your condition with expertise and care.
Shoulder problems can affect us at any stage of our lives. Conditions range from instability such as dislocations, rotator cuff pathology including impingement and rotator cuff tears and degenerative problems such as shoulder arthritis. Treatment options include non-operative with therapy and injections as well as many surgical options such as arthroscopic and open stabilizations, rotator cuff repairs and total shoulder arthroplasty or shoulder replacement.
The hip joint is one of the largest joints in the human body and connects our trunk to our lower limb. Without it, we cannot walk, run, or perform any number of sporting activities. Anyone with hip pain knows that it’s almost impossible to escape the pain because it hurts in almost every position from standing to sitting.
Most hip problems stem from an issue with one of the structures of the hip either due to a trauma, a developmental or congenital abnormality, or chronic overuse. Arthritis is the loss of cartilage in the joint which can be either global or focal. The labrum can tear and produce pain and mechanical symptoms such as popping and clicking. The hip can become frankly unstable from a significant trauma or more subtly from a combination of a developmental or congenital issue which could be exacerbated by overuse. Finally, the bones, like all bones in the body, can break, or fracture.
The knee is the largest joint in the human body and somewhat disproportionately results in orthopedic conditions. Common knee conditions include anterior cruciate ligament (ACL) injuries, cartilage and meniscus injuries, patella (knee cap) dislocations and arthritis. Treatment for these problems can be non-operative with bracing, physical therapy and injections or surgical with ACL reconstruction, knee arthroscopy (scopes), cartilage restoration, patella stabilizations and full and partial knee replacement (unicompartmental arthroplasty and total knee arthroplasty).
From the moment you learn to walk, you expect your feet and ankles to support your weight and keep you mobile. In essence, the foot and ankle are the body’s foundation. Whether you incur a common sprain, complex fracture, or the effects of wear and tear, these important bones deserve expert care. When pain or injury strikes your foundation, let our dedicated, skillful foot and ankle specialists get you back on your feet.
Injury and degeneration of the spine are the most common cause of back pain and most people will experience it at some time during their life. Fortunately for most, limiting activity, physical therapy and rest and medication are all that is required for relief. In cases that call for treatment, we provide the highest level of care for problems of the spine. Diagnosis and individual treatment plans are provided for each patient which may include spine surgery.
If you are facing total joint replacement, the care you will receive from our surgical team will be unsurpassed. Hip and knee replacements are miracles of modern medicine, and often are the best solution for pain, stiffness or lack of mobility caused by arthritis or injury. Our skilled surgeons, using the latest techniques and technology, assure you the least invasive procedure and the most positive outcome possible.
Orthopedic trauma is a branch of orthopedic surgery specializing in the care of broken bones following trauma. It covers the spectrum of simple isolated fractures to severe injuries with multiple broken bones. The primary goal of this branch of orthopedics is the healing of fractured bones and restoration of anatomic joint surface alignment to allow for maximal recovery and return to function. While many fractures do not require the care of a fracture specialist, some injuries with multiple broken bones, open fractures, fractures involving a joint, and fractures of the pelvis or acetabulum (hip socket) may benefit from specialized care. Additionally problems such as nonunions (failure of a bone to heal), malunions (bones which have healed in poor alignment), and infections (osteomyelitis) are often treated by orthopedic traumatologists.
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