Author Archive: aenriquez

For Patients with Lymphoedema – Decongestive Lymphatic Therapy Could be Key

What is Lymphoedema?

Lymphoedema is a chronic disorder characterized by swelling tissue (usually a lump) with fluid rich in proteins. It can either be a developmental problem (meaning there is no cause per se) or secondary and associated with some sort of precipitating event. These secondary causes include:

● Surgical causes:
○ Sometimes removal of lymph nodes – such as in breast cancer surgery – can result in lymphoma
● Radiation treatment for certain cancers can scar the nodes and vessels.
● Cancer. Certain types of cancer can invade the lymphatic vessels and this can result in lymphoedema
● Infection often invades the lymph nodes and causes them to swell.

If you have lymphoedema you might suffer from a number of symptoms including:

● Swelling of a limb. This can occur in part of the leg or arm or the entire limb.
● The affected limb will typically cause heaviness and tightness
● The limb will have restricted movement
● There may be aching or discomfort
● There may be recurrent infections of the surrounding skin (cellulitis)
● There might be a hardening of the skin.

What is decongestive lymphatic therapy?

A decongestive lymphatic drainage is a specialized form of physical therapy offered at a number of specialist centers across the country. The decongestive lymphatic therapy consists of four distinct components:

● Compression bandages are applied to complement the exercises in the therapy to move fluid out of the limb.
● Skincare is undertaken to reduce the chances of skin breakdown (which is a big infection risk in these patients)
● Exercises will be undertaken with a physiotherapist to improve the lymph drainage in the affected limb
● The therapist will also undertake specialist massage techniques known as manual lymphatic drainage that stimulated the flow of fluid through the system and reduces the swelling.

The treatment is intensive and can be every day for a number of weeks. After this initial phase patients typically move to the maintenance phase whereby they maintain good lymph flow with exercise and home self-massage techniques.

Does decongestive lymphatic therapy work?

There is a growing body of literature that suggests decongestive lymphatic therapy is a safe and effective treatment for patients with lymphedema that resulted following breast cancer surgery (eg a mastectomy with axillary clearance). A study conducted at the University of Texas looked to see whether the therapy worked on this patient group even if they had had the therapy before. They found that in both patients who had had the therapy before and naive patients, there was a statistically significant reduction in the mean size of the limb. This is great news for sufferers!

If you our somebody you know is suffering from lymphoedema, either following a surgical procedure or for development reasons – contact a specialist physiotherapy center who and provide one to one support and a personalized treatment plan to help reduce the swelling and get you back on your feet.

Dizziness Found to be Significantly Reduced in Patients Undergoing Vestibular Rehabilitation Therapy

Dizziness is one of the most common complaints a family practitioner will deal with day to day and some estimates suggest that 1 in 3 of us will have vestibular dysfunction (causing dizziness) at some point over a 3 year period.

Patients who have dizziness because of a peripheral cause (aka the balance system outside of the brain) report symptoms that include:

● Dizziness
● Imbalance
● Some visual disturbance

There are a number of causes of unilateral peripheral vestibular dysfunction, some rarer than others. These include:

● Meniere’s disease
● Vestibular neuritis (often caused by a viral infection)
● Benign paroxysmal positional vertigo (known as BPPV)

What is vestibular rehabilitation therapy?

For patients that are having trouble with balance, there are a number of medication available. However, these can be used to more effect in combination with physiotherapy from specialist centers across the united states. Vestibular rehabilitation therapy is done a trained and specialized physiotherapist who will assess your needs and recommend a personalized blend of different exercises and retraining regimes to help your particular balance problems.

These can involve a whole host of different techniques but a few are listed below:

● The Epley maneuver: This is highly effective for those patients suffering from benign paroxysmal positional vertigo (BPPV).
● Gait drills: these can help you with walking
● Balance retraining guidance: these exercises help hone your balance so that dizziness and vertigo don’t take you off guard.
● Strength training: training groups of muscles can help the body respond to imbalance. Don’t worry – this isn’t bodybuilding! It just gets your core muscles to a point where they can react appropriately to instability.
● There are also other therapies that include symptom management (accepting you have balance issues and psychologically getting over this) and relaxation therapies

Does vestibular rehabilitation therapy?

Evidence-based medicine counts for a lot in this 21st century. Treatments that don’t have a good evidence base quickly fall by the wayside. Thankfully vestibular rehabilitation therapy has a large and growing body of research suggesting how beneficial it is. Many doctors consider a Cochrane review to be the highest form of evidence. Vestibular rehabilitation had a Cochrane review undertaken in 2015. A Cochrane review is a systematic review that looks at all the previous research published across the world and amalgamates it see if overall the treatment is working. The researchers pooled 39 scientific studies including more than 2440 patients and conclude

“ There is moderate to strong evidence that vestibular rehabilitation is a safe, effective management for unilateral peripheral vestibular dysfunction, based on a number of high-quality randomized controlled trials. There is moderate evidence that vestibular rehabilitation resolves symptoms and improves functioning in the medium term”

This is great news for anybody struggling with balance problems. If you or somebody you know has problems with dizziness and vertigo and thinks they might benefit from vestibular rehabilitation therapy – get in contact with a specialist physiotherapy clinic today.

Stories of Trigeminal Neuralgia

Trigeminal Neuralgia“When an attack actually happens, it feels like you’ve been placed into an electric chair for about five minutes. It feels like your face is being scraped off, acid being thrown on it, and it’s a burning, searing sensation that will travel on my whole right side,”

These are the words of Tim Haynes – who recently talked to Daily-Journal.com about his struggles with the severe facial pain disease Trigeminal Neuralgia.

“You can’t see it. You can’t tell it’s there until you live with it,” Haynes said. “It’s a life-changing, debilitating disease, and you wouldn’t want your worst of the worst enemies to have it. … And I don’t have it nearly as bad as a lot of people that have it.”

Amy Cook is another young sufferer of the disease. At just 21 she is also plagued by the sharp stabbing pains. She talked to the Daily Mail saying

“It has almost taken over my life in a sense because when it’s really bad I cannot function.”

From Johannesburg in South Africa, Amy said

“I have decided to raise awareness of it. It made me happy to know that I was not alone in this rare condition.”

What is Trigeminal neuralgia?

Trigeminal neuralgia is a disease whereby the trigeminal nerve that supplies the sensation to the face comes into contact with blood vessels in the brain. When this happens, the nerve is stimulated and it shoots signals off to the brain that tell the central nervous system there is severe injury happening to the face. As such patients feel a shooting electric intense pain for just a few seconds. This happens periodically as the blood vessel touches up against the nerve.

How can trigeminal Neuralgia be treated

Is there any hope for Amy, Tim and the others afflicted with this rare disease? In fact, there is. Treatments are currently available and recent reports suggest new drugs are on the horizon. However, people need specialist help to get the treatment they desperately need. Treatments can include:

● Avoiding triggers. This seems simple but specialists can often provide invaluable tips and tricks to avoid the shooting pains. Knowing what triggers the pain, like a scarf touching your chin or the blowing of the wind can help patients avoid these situations
● Epilepsy drugs are the major treatment options. Anticonvulsants, as they are often called, were not originally intended to treat pain but they calm activity in the nerves and as such work well in conditions like trigeminal neuralgia. The most commonly used is Carbamazepine – which is effective in lots of patients. Others, however, are available such as pregabalin and baclofen.

If you or somebody you know are suffering from sharpshooting facial pains then consider getting in contact with a specialist clinic to help relieve their condition. Often family doctors are ill-equipped to deal with this rare and debilitating disorder and specialist help can often make all the difference.

When Athletes Suffer from Hip Labral Tears

Is it game over when an athlete suffers from a labral tear in the hip? Many athletes have found themselves in the unenviable position of having to consider surgery when a labral tear has occurred. Although there are treatments to consider, professional athletes are very aware of the significance of such an injury. As a prime example, British tennis star Andy Murray had to make the decision recently to have surgery on his hip and even with a favorable result, it is unlikely that he will be able to compete at the top level for a while.

Approximately one-fifth of all athletes who suffer from groin pain have hip labral tears and require treatment to help heal the injuries to the acetabular labrum surrounding the hip socket. There’s no doubt that treatment including arthroscopic techniques have certainly improved surgical options and there are regenerative curative treatments available too, so, it is a far more favorable outlook these days. When an athlete, professional or not, has tried various treatments including rest and physical therapy but, is still unable to compete after six months, the diagnosis is likely to be a labral tear and articular cartilage damage.

This is a painful injury and it causes great discomfort also restricting movement. The labrum serves to seal the joint of the hip and to provide stability and cushioning. Hip labral tears occur when partial or complete damage has occurred although compression or traction injuries will happen.

Hip Labral TearSymptoms of a hip labral tear include:

  • Groin pain
  • Pain in the front of the hip
  • Stiffness in the hip joint
  • Grating or locking feeling within the hip
  • Restricted movement
  • Reduced stability of the hip
  • Radiating pain to the buttocks

Frustratingly, it can be difficult to determine the actual cause but could include:

  • Stress, pressure or excessive force to the area
  • Dislocated hip
  • Degeneration of the hip
  • Microtrauma affecting the capsular tissue
  • Hypermobility
  • Structural abnormalities
  • Direct trauma – falling and landing on the hip, etc.

Anyone who participates actively in sporting events could find themselves suffering from this type of hip injury.

Medical advice is essential.

For any athlete, this is the type of diagnosis that is most unwelcome. There’s no doubt that following this type of surgery, athletes will make an incredible recovery, but delays are unavoidable. It takes time for fitness, strength, and mobility to be regained.

A diagnosis is made through movement of the hip joint and placing the leg in different postures. Where there is a limited range of motion, this is often indicative of a labrum hip tear, but, x-rays or MRI scans can help to confirm whether injury to the soft tissues has occurred.

Medication can help to ease the inflammation, and this is a good starting point. Often, cortisone injections are used which provide pain relief and then, physical therapy can increase strength and stability while reducing stress on the joint. Treatment is likely to include strengthening workouts with massage therapy.

Stem cell surgery has also been found to be highly effective when it comes to treating these types of injury and should certainly be considered when physical therapy and anti-inflammatory treatments does not ensure full recovery.  Treatment will depend on the exact diagnosis and on the patient’s needs, but recovery potential is typically good.

Could Texting Cause Carpal Tunnel Syndrome?

Have you ever felt a numbness, tingling or shooting pain in your hands? If so you might be one of millions of people worldwide who suffer with Carpal Tunnel syndrome. The causes of Carpal Tunnel have long been contested, and previously doctors argues that it might be caused by “overuse” of the wrist – ie people sat still at a desk typing all day. New research points the finger at our smartphone addiction, with a possible link between smartphone use and Carpal tunnel recently being reported by the DailyMail and CNN after research in Hong Kong found a link.

 

Carpal Tunnel Syndrome Due to textingWhat is Carpal Tunnel Syndrome?

 

The carpal tunnel is a small passageway in your wrist that the median nerve travels through. It is thought that this passageway can become compressed and in turn compress the median nerve. This results in a number of symptoms such as:

 

  • Pins and needles in your hand (known to medical professionals as paresthesia)
  • Thumb Weakness (the median nerve controls your thumb)
  • A dull ache in your hand

 

Could Carpal Tunnel Be Linked with texting?

 

The study, published in the Journal Muscle and Nerve asked a small number of patients (48_ to fill out questionnaires on their wrist pain before taking tests to see whether they has numbness and tingling – the classic symptoms of carpal tunnel. They found that patients who used their devices for 4-5 hours a day or more often had enlarged median nerves (seen in carpal tunnel) and had more pain in their wrists.

 

The director of Arthritis Research UK talked to the DailyMail, and said of the results

 

‘Previously we only saw this type of repetitive strain injury in people using a mouse and keyboard at work.

‘Now we have these new repetitive movements, swiping and tapping, in our leisure time, as people are barely ever without their smartphones and tablets.

‘This is a real new challenge for the 21st century and I would encourage anyone suffering symptoms of burning and tingling to contact their GP promptly.”

 

He also noted that the sample size of the study was small – and more research is needed.

 

What Can Be Done About Carpal Tunnel?

 

A number of specialist clinics across the united states can provide excellent care if you think you are suffering from carpal tunnel syndrome. The treatments usually include the following:

 

  • Self Care: Take it easy – rest up! If you are over using a keyboard then stop!
  • Medication: Drugs like Ibuprofen can reduce swelling and inflammation in the nerve and reduce pain
  • A splint or brace: These can be bought cheaply online and keep the wrist in a position that doesn’t hurt.
  • Steroid injection: Corticosteroids can be injected right into the wrist – these are much more powerful than simple painkillers.
  • Surgery: Some clinics will offer a surgery that opens up the roof of the passageway (the carpal tunnel) and reduces pressure on the median nerve.

 

If you or someone you know are suffering from carpal tunnel, contact a specialist clinic today.

What is Tendonitis and How can it Be Managed?

TendonitisThe tendons are thick, fibrous cords that attach muscles to bones and they can become inflamed and cause pain similar to that experienced by muscle injury and inflammation. This is them referred to as tendinitis and the causes of this condition may be due to:

  • Sudden injury sustained to the affected limb or joint.
  • Repetitive movements over a period of time that results in increased stress being placed on the affected tendons.
  • Occupations that involve the individual being placed into awkward positions to perform duties in, frequent overhead reaching, forceful exertion, and being exposed to repetitive vibrations.
  • Using improper techniques to perform certain jobs or sport-related movements.

Types of tendinitis

Some common names of tendonitis pathologies include:

  • Golfer’s elbow – involvement of the medial (inside) tendon of the elbow.
  • Tennis elbow – involvement of the lateral (outside) tendon of the elbow.
  • Swimmer’s shoulder – impingement of the rotator cuff tendon between the acromion of the shoulder blade and the greater tuberosity of the humerus (bone of the upper arm). This is seen in swimmers who specialize in freestyle and front crawling swimming strokes.
  • Pitcher’s shoulder – inflammation of the long head of the biceps muscle that attaches to the shoulder which is called bicep tendonitis and may occur in baseball and softball pitchers. This condition may also occur in swimmers where the bicep muscle is involved as well as in any other sports where throwing activities are performed such as javelin and cricket, and where contact occurs such as in wrestling, gridiron football, and martial arts.
  • Jumper’s knee – inflammation of the tendon of the patella (knee-cap) or even the quadriceps tendons caused by repetitive straining from too much running and/or jumping.

Signs and symptoms

Patients may present with the following clinical signs and symptoms when dealing with tendinitis:

  • Pain that is often described as a dull pain that is felt over the affected area.
  • Increased pain when moving the affected limb or joint.
  • Tenderness and swelling over the affected area.
  • Decreased range of motion of the affected limb which is restricted due to pain.

Management

Tendonitis is managed conservatively with the following therapies:

  • Resting the affected limb and not performing movements that cause pain.
  • Using pain medication such as acetaminophen and anti-inflammatory medications such as ibuprofen or naproxen.
  • Applying ice packs or cold compresses over the affected areas to help reduce swelling and inflammation.
  • Physical therapy to help incorporate exercises and to learn correct techniques that will help prevent inflammation of the tendons.
  • Steroid and local anesthetic medications can be injected into an affected joint or around an involved tendon to also help reduce inflammation and pain.
  • Regenerative medicine in the form of platelet-rich plasma (PRP) can be administered where the platelet cells help to repair damage to a tendon caused by chronic inflammation.

If these therapies are ineffective, then surgical intervention may be warranted. Procedures may include:

  • Focused aspiration of scar tissue (FAST) which is performed to remove scar tissue on tendons caused by chronic inflammation of the tissue.
  • Arthroscopic tendon repair using small instruments if the inflamed tendon has torn or ruptured.

Conditions That Affect Hand Function

The hands are vital parts of the human body and without them, very little essential and social activities can be performed such as feeding, being productive to be able to make a living and support dependents, and interactions with others. Losing the ability to use one’s hand can be a very emotional and debilitating problem that can lead to increased stress and anxiety that may result in the development of mental health issues such as depression. Therefore, the proper diagnosis and management of conditions affecting hands is extremely important.

The following are conditions that can result in the hands becoming unable to function properly and how they are managed.

Dupuytren’s contracture Hand SurgeryDupuytren’s contracture

  • Progressive thickening of the tissue in the palm of the hand results in shortening of this tissue and causes flexing contractures of the fingers (makes the fingers close).
  • The most commonly affected fingers are the fourth and fifth digits and this can be quite a disabling condition.
  • Management includes physical and occupational therapy and surgical intervention in severe cases.

Trigger finger

  • Referred to in medicine as stenosing tenosynovitis.
  • Trigger finger causes a similar issue to Dupuytren’s contracture. The difference though is that where the latter involves pathology of the tissue covering the palm of the hand, trigger finger is caused by thickening of the tissue that covers the tendons which allow the fingers to close.
  • The condition is characterized by the affected finger seeming like it is stuck in a trigger-pulling position. Since it is difficult for the finger to be straightened, when it becomes unlocked it resembles the pulling of a trigger.
  • Management includes trigger finger surgery and when the thumb is involved is referred to as trigger thumb surgery.
  • These surgeries may be performed through minimally invasive access or open procedures if the cases are severe.

Carpal tunnel syndrome

  • This condition is associated with compression of the median nerve through the carpal bones in the wrist.
  • Compression of the median nerve results in the decreased sensation of the thumb and first two fingers which can complicate and lead to decreased power in the hand with an inability to use the limb.
  • Management of this condition involves initial conservative therapy with pain relieving measure and the use of splints to help take pressure off the median nerve.
  • If these therapies are ineffective, or the case is severe, then carpal release surgery is performed.

Rheumatoid arthritis

  • An autoimmune condition where antibodies are produced by the immune system that attacks and damages the synovial tissue around joints, especially of the wrists and fingers.
  • This process results in damage to the joints leading to deformities of the fingers making them stiff and difficult to use.
  • Management of this condition includes using medications such as steroids and non-steroidal anti-inflammatories such as ibuprofen or naproxen. Early therapy may also include medications such as disease-modifying anti-rheumatic drugs (DMARDs) like azathioprine, sulfasalazine, and methotrexate to help reduce disease progression as well as induce more remissions.
  • Surgical interventions may be warranted in cases where the medications are not working and the patient’s use of their hands has becomes severely debilitating.

Quick Recovery with New Carpal Tunnel Treatment Option

Carpal tunnel syndrome is a condition which causes numbness, weakness, and pain in wrist and hands. It is caused due to the raised pressure on the median nerve. This nerve sends sensations to the index, middle fingers and thumb. The median nerve is responsible for providing strength to the base muscles of the thumb.

Individuals who are most at risk of suffering from the carpal tunnel syndrome are people with activities or jobs involving a repetitive movement of fingers, or high force motion of wrist and hand.

Carpal tunnel syndrome is a condition which causes numbnessOther possible causes can include:

  • Wrist fracture
  • Deformity of hand or wrist
  • Thyroid imbalance
  • Diabetes
  • Tumor
  • Arthritis or gout disease
  • Pregnancy

Treatment options:

  • Non-surgical

The non-surgical treatment involves the use of anti-inflammatory drugs to relieve pain. Cortisone injections may be used to provide temporal relief, however, is not a permanent cure. Physiotherapy and a change in hand motion are recommended to alter the movement of the wrist.

  • Surgical treatments

In case non-surgical treatments do not show the result, surgery is recommended to increase the tunnel size to relieve pressure on the tendons and nerves. Carpal tunnel surgery recovery may range from six months to over a year. Patients who undergo surgical methods will have to restrict movement. The stitches are removed after 2-4 weeks (depending on the size of the incision). The skin may take more than 8 weeks to recover fully.

New innovations in treatment

A new innovation in the treatment for carpal tunnel surgery is the SX-One Microknife. It is an innovative surgical device that allows a 4-5mm long single incision and is used with the help of ultrasound-based imagery.

Dr.Cobb, a board-certified orthopedic surgeon explains in simple terms how the TCL blade is activated after positioning to release pressure from the ligament, enabling a pain-free smooth movement. The procedure involves the following steps:

  • The blade remains closed till required with the help of Stealth Microgaurds.
  • These Microgaurds prevent tissue damage and safe positioning of the scalpel around the damaged area.
  • As the procedure ends, the blade closes back up and is released from the same incision.
  • The use of SX-One technology requires no stitches, an adhesive bandage proves sufficient to heal the incision.

Benefits vs traditional surgery

  • Compared to the traditional carpal tunnel surgery which employs more than a half an inch of the incision and requires a longer time to heal, the SX-One Microknife is less invasive.

 

  • Traditional surgical methods put patients at a higher risk of tendon and blood vessel damage. In respect to that specialists believe that this new innovation in technology may be more effective.

 

  • It is cost effective and faster in both the procedure and healing.

 

In conclusion

 

An ultra-low profile device for surgery, SX-One Microknife allows surgeons to release carpal tunnel through a single 4-5mm incision. This new advancement in technology is most definitely more effective than the traditional surgical methods. Not only does it saves cost but also minimizes the period of healing. It is believed that the carpal tunnel syndrome can be effectively catered to millions of people using this less invasive tool.

MACI – A New Regenerative Technique for Knee Problems

MACI for Knee ProblemsCartilage regeneration has been a long debated issue for orthopedic surgeons. In the case of runner’s knee, this problem can cause a lot of irritation where the kneecap rests on the thighbone.

Together the kneecap and the thighbone form a third joint known as the patellofemoral joint. It is at this junction that cartilage denegation or damage happens resulting in a sharp and sudden pain or one that is dull and chronic. The pain may affect one or both knees with symptoms including the following:

• Tenderness behind or around the kneecap.
• Pain located at the back of knee.
• Sense of cracking that the knee is giving out.
• More discomfort when treading on uneven terrain or climbing stairs.

In addition to cartilage getting damaged in this area from sports injuries, the same can also happen due to auto accidents as well as arthritis.

New Re-Generating Techniques

As the regenerative technology constantly evolves, it makes available a range of orthopedic surgery treatments for the prevention of bone, joint and muscle ailments.

A latest advancement is in the surgical methods is Matrix-Induced Autologous Chondrocyte Implantation. This invention was approved for use by FDA in 2017. It is a new cartilage regeneration procedure which allows the growth of chondrocyte cells on a biologic scaffold.
The new technology uses cells from the patient’s own cartilage to generate the scaffold and as opposed to earlier treatments, can be affixed to the cartilage.

The treatment has only recently surfaced in the US but has been operational in Europe for at least a decade with very promising results.
Basics of MACI include the following:
• In the first step of the MACI procedure, healthy chondrocytes are harvested on a sponge-like area of the bone.
• These cells are sent to the laboratory for 4-6 weeks to be cultivated over a sterile collagen membrane.
• The enriched scaffold is comparatively easier to implant and requires a minimal incision.
• The procedure is less painful with fast recovery.
• More than 6 weeks are required for the growth of the new cartilage cells.
• After the surgery, the cells grow to cover the defected area of the knee.
• The recovery period, as is true with most knee surgery procedures, is long and demands minimum movement to prevent damage to the new cartilages.
MACI appears to be an effective alternative for cartilage regeneration, compared to microfracture. If the quality of the cartilage used is good, MACI may be able to give surgeons a new technique at hand to prevent osteoarthritis.

Conclusion:

Cartilage damage can severely paralyze knee movement. The holes caused as a result of damaged cartilages can lead up to osteoarthritis. Compared to the old surgical techniques, new innovations in technology like MACI may prove effective as a procedure that requires a minimum invasion.
MACI, with the use of high-quality cartilages and minimal incision, places an implant on the knee to enable growth of new cells. FDA approval makes the effectiveness of this treatment promising for many suffering from runner’s knee and other knee issues.

Is Spinal Stenosis a Serious Condition?

Is Spinal Stenosis a Serious ConditionSpinal stenosis is a condition where the bony vertebral canal that the spinal cord runs through narrows leading to compression of this structure. The result is pain and neurological issues such as numbness reduced reflexes and decreased muscle power at the level of spinal cord compression. Paralysis may occur if the stenosis is severe enough which makes this a very serious condition that needs to be managed adequately and appropriately. Spinal stenosis causes include the following pathologies and scenarios:

Congenital defects

  • The spinal canal develops a narrow structure.
  • There may be deformities of the vertebrae leading to canal stenosis.

Aging

  • The spinal ligaments can become thicker.
  • Intervertebral discs may bulge or herniate into the canal.
  • Bone spurs may form taking up space in the spinal canal.
  • Breakdown of facet joints leading to spinal column collapse.
  • Degenerative disc disease resulting in narrowing of the spaces in the spinal column.
  • Cyst formations on the facet joints resulting in compression of the thecal sac which is the spinal sac of nerves.
  • Osteoporosis (brittle bones) complicating into compression fractures of the vertebral bones.

Trauma

  • Patients with spinal stenosis caused by cervical spine myelopathy are at a higher risk of acute cord injury if they are involved in any accidents.
  • Injuries and accidents may result in dislocation of the spine or spinal canal or lead to burst fractures where fragments of bone may end up in the canal.

Arthritis

  • Osteoarthritis and less commonly rheumatoid arthritis results in narrowing of the canal due to persistent inflammation in or around the bony structure resulting in the formation of space-occupying canal lesions.

Management

Spinal stenosis treatment protocols involve conservative (non-surgical) and surgical therapies.

Conservative treatments may include:

  • Oral medications such as acetaminophen, non-steroidal anti-inflammatories, and narcotics.
  • Aerobic exercising to help to achieve or maintain overall satisfactory health.
  • Physical therapy to help perform and learn stretching and to strengthen exercises to build-up muscle mass to help support the back.
  • Weight loss in order to reduce pressure on the back and slow down the progression of the spinal stenosis.
  • Epidural steroid and/or anesthetic injections to help with pain relief.

Surgical interventions may include:

  • Lumbar decompressive laminectomy where the roof of bone overlying the narrowed spinal canal and surrounding thickened ligaments are removed to allow more space for the nerves and spinal cord to displace in. Around 70 to 90 percent of patients have good results after this procedure reporting decreased pain and neurological deficits.1
  • An interlaminar implant is placed in the area where the decompression was done to offer stability to the spine and to allow the nerves to freely run through the device without any compression of the tissue.
  • Patients with cervical myelopathy may have a discectomy and fusion performed where the intervertebral disc where spinal cord compression is located is removed from the cervical spine. The procedure can be done via access to the front or back of the neck.

JOIN OUR E-MAIL LIST!