Centura is Colorado's Leading Provider of Orthopedic Care

FAQ’s about Bones and Joints

We know figuring out what hurts and what the best course of treatment is can be confusing. Here’s a few of the most commonly asked questions to help you through the process.

QUESTION:

My Doctor recommended I undergo Arthoscopy for my bad knee. What exactly is this procedure? Is it common?

Arthroscopy is a test used to examine joints and surrounding tissues, and to repair joint problems (including complications related to arthritis or sports injuries). A surgeon inserts a tube called an arthroscope into the joint through small incisions in the skin. A small camera on the tube as well as a light allow the surgeon to display images of the joint on a video screen. Later, the surgeon may insert other tools through the arthroscope to repair the joint.

The test takes place in a hospital or clinic. Orthopedic surgeons often perform this test. The use of either general or local anesthesia depends on which joint is being tested.

How often should this test be performed?

Your doctor will decide when and how frequently this test is required.

Why is this test performed?

An arthroscopy is performed to diagnose joint problems. These joints include shoulder, knees, ankles, elbows, or hips. It is also performed to surgically repair a joint problem.

If you require arthroscopy, it is likely because you have:

• symptoms related to certain bone conditions (e.g., arthritis, osteoporosis, rheumatoid arthritis, bone spurs)
• an inflammation of a joint
• damaged ligaments or tendons
• an infections of a joint
• pain in joints or bones that has not been diagnosed

Are there any risks and precautions I should know about?

Arthroscopy is a relatively safe procedure and complications are rare, occurring in less than 1% of people. These complications may include bleeding, infection, blood clots, damage to surrounding muscles and ligaments, nerve or blood vessel damage, or a reaction to the general anesthesia.

If you experience fever, bleeding, or drainage from the incision, this may indicate infection - call your doctor. Additionally, call your doctor if you feel numbness, tingling, or pain at the site.

QUESTION: 

I think I may have arthritis in my fingers since they ache after I garden. How do I treat this and will it ever just stop on its own?

Arthritis is usually a chronic condition that needs long term treatment. Some people do go into remission - meaning they'll be pain-free for a while - but when they're having pain, it needs to be addressed. Fortunately, there are medications that can help.

For rheumatoid arthritis, doctors often recommend medications such as:

• non-steroidal anti-inflammatories (NSAIDs), for example, aspirin, ibuprofen and naproxen
• disease-modifying anti-rheumatic drugs (DMARDs), such as biologics (adalimumab, anarinka, etanercept, and infliximab) and traditional DMARDs (such as hydroxychloroquine, oral and injectable gold, sulfasalazine, d-penicillamine or methotrexate)
• corticosteroids such as prednisone

Some of these medications can be hard on the stomach with effects that range from mild nausea and heartburn up to an ulcer. It is important to check with your doctor or pharmacist about what warning signs (such as persistent heartburn or dark, tarry stools) to watch for. People who are at a high risk of developing an ulcer may be prescribed a preventative medication. As for any medication, ask your doctor or pharmacist about possible side effects and what you can do to prevent or minimize them.

Besides medications, physical therapy might be recommended to keep your joints as flexible and strong as possible.

To treat osteoarthritis, doctors take a slightly different approach because the pain doesn't have the same cause as in rheumatoid arthritis. Medications with anti-inflammatory effects, such as NSAIDs and steroids, are used, but in many cases the pain can be managed with acetaminophen, which isn't an anti-inflammatory. As well, steroid injections directly into the painful joints might be helpful. Other non-medication approaches include physical therapy, wearing braces that stabilize the joint, preventing movement. Also, losing weight can help relieve stress on weight-bearing joints such as the hips and knees. In more severe cases, surgery might be necessary.

QUESTION:

My children are very active in sports. When they have a minor injury, what is the best way to treat it at home?

Treatment of sports injuries is based on the RICE principle:

• Rest
• Ice
• Compression
• Elevation

Ice should be crushed to better conform to your shape. It should be placed in a bag that is wrapped around the injury. First, put a towel between the bag and the skin. Then, wrap a bandage around the icebag, not so tight as to cut off blood flow. Ice only constricts blood vessels for about 10 minutes, after which they "rebound." For very new or traumatic injuries you should leave the ice in place for only 10 minutes at a time, removing it for the same period. Alternate like this for an hour or two, keeping the injury elevated all the time.

You should carry out this procedure several times during the first day or so after injury. Following this, ice can be used for longer periods to better reduce swelling and pain. You can apply ice for up to 30 minutes several times a day. Packages of frozen peas or corn are excellent ready-made ice packs. If the injury is in the leg or ankle, don't try to stand up the first day, and do your best to keep it elevated as much as possible.

If there's some other exercise you can perform that doesn't stress your injured part, you can do that to remain fit, but don't try to use the injured part until healing is well along. Then you can start light exercises to get it back in shape. In the long run, you may want to exercise it more to make it stronger, in order to prevent repeat occurrences. A doctor or physiotherapist might recommend specific exercises to strengthen particular muscles and tendons.

Other treatments include surgery and steroid injections. Surgery is an extreme measure and one you're unlikely to need if you treat injuries with respect. Steroid injections can relieve pain but may delay healing. They can be safely used once or twice, but should never be used as a cure-all or a first resort.

QUESTION:

How can I prevent sports injuries?

There are two ways you can prevent sports injuries. One is by using the right equipment. This means properly-fitting, sport-specific shoes and may mean orthotics (shoe inserts) to control excessive movement of the foot. Orthotics may reduce the width of your footwear, so you may need new shoes. Helmets, face masks, and protective padding made to regulation and worn as instructed prevent many serious sport injuries.

Correct technique is important to prevent injury. For example, tennis players should avoid rackets with excessively narrow shafts and try to perform backhand and forehand shots with their whole arm and shoulder rather than just the wrist. racket strings shouldn't be too tight. Wet, heavy balls are more likely to cause problems, as is hitting the ball off-center.

The second way of preventing injury is by warming up and cooling down with adequate stretching. The best medical evidence suggests that warming up definitely makes the muscles stronger and more injury resistant. Stretching improves muscle performance but not injury resistance, so it is most effective after exercise. Don't stretch so far that it becomes painful. Cooling down may help prevent dizziness from blood pooling in dilated (widened) leg veins, but it doesn't help muscle soreness the next day, which is caused by injury to the fibers.

All strenuous exercise involves microscopic damage to individual muscle fibers. Exercise works because they tend to heal stronger than before. You must give them 48 hours to heal. You shouldn't vigorously exercise the same muscle in two successive days, as you'll be damaging it faster than it can heal. If you want to exercise every day, you should either work on different muscle groups on alternate days or do "strength-training" exercises one day and cardiovascular exercises the next. Following these recommendations should allow you to enjoy regular and injury-free exercise.

QUESTION:

 I have been struggling with my weight for years and recently my heels feel very painful. Is this what they call "heel spurs?"

Physical examination is the best way to determine if you have plantar fasciitis. Your doctor examines the affected area to determine if plantar fasciitis is the cause of your pain.

It is important to discuss your daily routine with your doctor. An occupation in which you stand for long periods of time may cause plantar fasciitis.

An X-ray may reveal a heel spur. The actual heel spur is not painful. The presence of a heel spur suggests that the plantar fascia has been pulled and stretched excessively for a long period of time, sometimes months or years. If you have plantar fasciitis, you may or may not have a heel spur. Even if your plantar fasciitis becomes less bothersome, the heel spur will remain.

QUESTION: 

My husband was just told he has gout in his big toe. I thought this was something people got 300 years ago. Could this really be gout?

Gout is a type of arthritis, characterized by sudden, severe attacks of joint pain with redness, warmth, and swelling in the affected area. It usually attacks only one joint at a time. It most often strikes the joint of the big toe, where it's also known as podagra, but other toes can also be involved. Gout is typically a condition of middle age, ten times more common in men than in women, unusual in people under the age of 30, and rarely seen in women before menopause. A first gout attack most commonly occurs around age 47. It's most common in countries with high standards of living, mainly because diet plays a big part in this condition. It affects about 1% of the population.

QUESTION:

I've recently experienced severe pain shooting down one of my legs and my back is very stiff. Is this sciatica and if so, what do I do with the pain?

Sciatica can be relieved by treating symptoms and any specific cause that exists, such as a slipped disc. Your doctor may prescribe muscle relaxants, nonsteroidal anti-inflammatory drugs (NSAIDs), painkillers, or corticosteroids to reduce inflammation. Moderate exercise is recommended if pain is minimal. When the symptoms have lessened, therapy to strengthen abdominal muscles and back muscles is important to prevent a return of symptoms.

Here are some other things that may help. Many of them are similar to ways of dealing with other common lower back problems:

• Sleep on a firm mattress on your side or back with knees bent.
• During bad attacks, sleep with a pillow under or between your knees.
• Try not to sleep on your stomach.
• Adjust the height of chairs so your feet are flat on the floor and the knees are a little higher than the hips.
• Keep your feet flat on the floor and do not cross your legs when sitting.
• Sit in chairs that have firm back support and sit up straight against the back of the chair.