Month: September 2016

When To Use Cortisone For Joint Pain

Cortisone is a miraculous medication, one which can diminish chronic pain and restore a freer range of motion within minutes. But as chronic elbow pain sufferers will tell you, that relief may be short-lived, and can exact its own price over time.

Cortisone is a steroid, which means it can activate some of the body’s most powerful signaling mechanisms for healing. These can be especially effective for joint pain, including elbow pain, shoulder pain, knee pain, and wrist pain, as well as specific diagnoses including bursitis and arthritis.

But cortisone’s power cuts both ways, and may eventually deteriorate the treated joint, by diminishing bone density and thinning soft tissues. Consequently many orthopedic surgeons such as myself use the shots sparingly, and always in concert with a more holistic rehabilitation effort which includes exercise, stretching, and restful recovery.

Bottom line: cortisone is a perfect example of short-term benefit, long-term harm. If you’re looking for a lasting solution to joint pain which won’t hamper your chances for a more lasting recovery, it’s wise to consider lifestyle changes and orthopedic surgery instead.

Is Golfer’s Elbow Serious?

Golfer’s elbow, like so many other ailments of the elbow, can start out mild but quickly escalate into debilitating pain. Most people begin with rest, ice, and possibly analgesics, but when the pain lingers past the point where self-care is no longer working, then it’s time to see an elbow pain doctor here in San Diego.

Golfer’s elbow is technically known as medial epicondylitis. It arises from overuse – too much swinging, pulling, lifting, and otherwise stressing the muscles and tendons in your elbow. When that overuse becomes longstanding or chronic, the pain may be proportionally persistent.

Visiting an elbow pain specialist in San Diego for golfer’s elbow will typically leave you fitted with a brace. You may also receive some stronger pain management medications, and possibly platelet rich plasma injections, which involve spinning out your own blood and re-injecting it at the site to promote faster healing.

If all else fails, there’s elbow surgery. This is typically a last resort, but it can also be effective. When swelling or damage gets too great to clear on its own, a San Diego elbow surgeon can help to create more room in the joint, and possibly replace damaged tissue.

For more information how to treat golfer’s elbow, call us anytime.

What To Do About Chronic Elbow Pain in San Diego

Part of my job as a San Diego elbow pain doctor requires constantly reviewing the latest literature on how and when to escalate cases of elbow pain into surgery. So I read this recent article with interest, as it describes a medical case presentation of the type we typically get on rounds as attending physicians:

A 42-year-old man with a history of metastatic lung cancer on chemotherapy and daily steroid therapy presented to the ED with right elbow pain. The pain had begun the day before, and the patient denied history of trauma, overuse, or increased time or pressure on his elbows. His review of systems was otherwise unrevealing.

In this case a deeper diagnostic look yielded a definitive cause: Septic Olecranon Bursitis, which is an infection of the fluid-filled sac that rests just behind the joint of the elbow. The “septic” part is the infection – brown liquid suggesting that bacteria had found their way into the fluid, causing swelling, pain and discomfort. This is not unexpected for a patient on chemotherapy, which can wallop the immune system and result in unusual sites of infection.

The article recommends antibiotics and drainage as first measures, but eventually discusses when elbow surgery may be a good idea:

Surgery or repeated drainage may be considered if the patient does not respond to conservative management. Surgical management as a first-line therapy is less likely to be successful and more likely to be associated with complications such as the creation of a chronic sinus tract when compared with aspiration.

For conservative elbow pain management and treatment, and the best elbow surgery in San Diego, contact AOSM for an appointment today.

The Best Treatment for Knee Pain? Avoid It

When doctors talk about how to prevent knee pain, most of the advice follows predictable ideas about rest and good warm-ups. But you can also reduce the incidence of knee pain by limiting the loads you place on the joint, and by applying better mechanics to your lifting and squatting motions.

This video from the Huffington post includes a few more exercises that should help your knee stay loose and healthy.

One of the most useful things about these exercises is that they aren’t just designed to help you prevent knee pain in your daily life or in the sports you play; these exercises can reduce strain during your workouts as well.

For more good advice on the best treatment for knee pain in San Diego, please contact the American Orthopedic Sports Medicine Center today.

Treating Shoulder Pain in Swimmers

Shoulder pain is a common complaint throughout the developed world, but especially for swimmers of every age bracket who rely on the propulsive force of their shoulders to achieve top speeds in the water.

From impingement to scapular dyskinesis to GIRD, or glenohumeral internal rotation deficit, shoulder pain can arise because of a variety of causes, and present with a dizzying array of symptoms.

There is no single best treatment for all cases of shoulder pain. Often the most effective treatment is a hybrid involving any number of modalities, including corticosteroid injections, physical therapy, rest, and exercise.

Each swimmer is different, and each stroke places its particular burden on the joint. Even as children age, they may graduate from one source of shoulder pain to another, requiring an attentive pediatric orthopedist to track the source of the pain as it occurs.

If you or your child is experiencing shoulder pain in San Diego, we’ve got you covered. Contact my offices for a complete workup today.