New Ways To Treat Carpal Tunnel Syndrome

Acupuncture works. This is hardly a controversial statement anymore, as a wide array of rigorous medical testing have supported the efficacy of this ancient treatment.

But until recently, a controversy continued to rage over whether acupuncture worked as a placebo, or as a true therapy. Many people believed that acupuncture worked because people want it to, rather than because it provides any meaningful medical benefit.

Now a new study seems to put this objection to bed. It includes a randomized set of patients with three options – two tiers of acupuncture, and a control that received “sham” acupuncture, i.e. a simulacrum of the real thing. The results:

All three groups found relief from pain, but both of the true acupuncture groups showed measurable physiological improvements in pain centers in the brain and nerves, while sham acupuncture did not produce such changes. Improvement in brain measures predicted greater pain relief three months after the tests, a long-term effect that placebo did not provide.

Consider this one more arrow in the quiver of orthopedic professionals for treating carpal tunnel syndrome. As a San Diego orthopedic surgeon, I am always scouring the literature for new or old ways to offer my patients lasting relief from the pain of a repetitive stress injury. Studies such as this one help me provide better care.

Want to learn more? Contact the carpal tunnel experts at AOSM here today.

When Steroids and Orthopedic Knee Surgery Don’t Mix

When it comes to knee pain, steroid injections can be a godsend. These powerful hormones trigger the body’s own healing mechanisms and dramatically reduce pain, giving many patients the sensation of a new lease on life.

But all that relief isn’t free: steroids can also suppress immune response, which can create problems if surgery is on the horizon. That’s the conclusion of a couple of new studies, which found that the incidence of infection among knee and hip replacement surgery patients is markedly higher if they have taken a course of steroids in the month before the procedure:

The infection rate one year after surgery for patients who did not have an injection was 2.06 percent, but for patients who had an injection it jumped to 2.8 percent — a 40 percent increase. The strongest period for increased risk was the 12 weeks before surgery, with injections given more than three months before surgery having a significantly lower infection rate of 0.87 percent.

It is one more data point in our ongoing effort to mediate pain without usurping the body’s natural healing response. If nothing else, these studies should stand as a reminder that pain management requires a sophisticated understanding of the risks and benefits involved, and that orthopedic surgery can levy its own demands on the treatment of chronic pain.

Is More Motion Better for Shoulder Injuries?

Orthopedic surgeons have long debated how much is too much when it comes to pitching in baseball. Although some voices have called for limiting pitches for younger players, some specialists insist that proper form and care can prevent injuries at any age.

Now new data has come to light in support of the “proper form” argument: researchers found that increased rotation in the shoulder during a pitching motion can actually help to prevent injury:

“What we found was … [that] external rotation was actually protective to the shoulder and we were surprised that we did not find association with the loss of internal rotation or the loss of cross-body motion,” Wilk said.

Tightening up and aiming for a more compact form may actually be stressing the ligaments of the shoulder, creating greater tension that leads to an increase in injuries.

Research such as this is unlikely to stop the debate, of course, but it’s an interesting that may open the door toward greater insight into form and technique among baseball players of every age nationwide.

If you have experienced shoulder pain from pitching or any other athletic activity, contact the expert orthopedic surgery staff at my office today.

Unseen Risks for Knee Surgery?

Some of our patients have expressed concern in recent days over this study, which found a correlation between orthopedic knee surgery and in increased risk of heart attack down the line.

Although the scare headlines may sound alarming, the truth is more mundane: the study is an observational one, meaning that it was completed without controls or placebos. Although scientists may yield some valuable insights from studies like these, in general they tend to be considerably less reliable than randomized studies.

In this case the observed correlation between knee surgery and later health issues could be due to factors that simply lie beyond the study’s scope, including that many people who require knee replacements already exhibit a higher risk for health issues across the board.

Of course we cannot ignore correlations even if they aren’t directly causal, and this one rightly points toward the value of asiduous follow up care and rehabilitation. Knee surgery is no trivial thing, and the risk of clots and venous thromboemboli are typically higher after any kind of surgery.

To learn more about knee surgery and how we can help you restore a more normal life, contact the San Diego knee surgery professionals at AOSM.

The Link Between Student Athletics and Orthopedic Surgery

Competitive athletes tend to suffer more injuries than their sedentary peers. As someone who specializes in orthopedic surgery for athletes in San Diego, I have witnessed firsthand just how often an active lifestyle can land patients in my office.

But until recently, no one had bothered to examine how often college athletes require orthopedic surgery, and whether there is any correlation with earlier injuries.

One study attempted to do just that, using multiple regression analysis to try and tease out the relationship between prior and future injuries within a population of NCAA athletes. Their conclusion?

Results from the multiple Cox regression model showed lower extremity surgery before college and type of sport were independent predictors for shoulder and knee surgery.

The strongest indicators for orthopedic surgery were participation in gymnastics, basketball and volleyball, whereas volleyball, gymnastics and baseball/softball were strongest indicators for shoulder surgery. The strongest indicators of knee surgery were basketball, football and volleyball, according to the researchers.

The takeaway is that we should be doing more to protect high school athletes as their bodies develop, and ought to consider systematizing a more rigorous approach to healing and rehab from injuries in young people.

If you’re any athlete in search of expert orthopedic care, please contact the San Diego sports medicine specialists at my practice today.