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The meniscus is a piece of cartilage that provides a cushion between your femur (thighbone) and tibia (shinbone). There are two menisci in each knee joint. They can be damaged or torn during activities that put pressure on or rotate the knee joint. Taking a hard tackle on the football field or a sudden pivot on the basketball court can result in a meniscus tear. However, you don’t have to be an athlete to get a meniscus tear. Simply getting up too quickly from a squatting position, a sudden pivot or turn, deep squatting, or heavy lifting can lead to a meniscus injury. The meniscus weakens with age and tears become more common in people over the age of 30.
Many athletes are at risk for a meniscus tear. The meniscus can be torn during activities that cause direct contact or pressure from a forced twist or rotation. Sports that require sudden turns and stops may put you at higher risk for meniscus tears. Some of these sports include:
If someone has osteoarthritis, they are at higher risk of injuring their knee or tearing their meniscus. Osteoarthritis is a common joint disorder involving pain and stiffness in joints caused by aging and wear and tear. When an older person experiences a meniscus tear, it’s more likely to be related to degeneration. This is when the cartilage in the knee becomes weaker and thinner.
When a meniscus tear occurs, you may hear a popping sound around the knee joint. Afterward, you may experience:
- Pain, especially when the area is touched
- Difficulty moving your knee or inability to move it in a full range of motion
- The feeling of your knee locking or catching
- The feeling that your knee is giving way or unable to support you
You may also experience a slipping or popping sensation, which is usually an indication that a piece of cartilage has become loose and is blocking the knee joint.
Contact your doctor if you experience any of these symptoms and they persist for more than a few days or occur after your knee has been injured. Call your doctor immediately if your knee locks and you’re unable to bend your knee after straightening it.
After you discuss your symptoms with your doctor, they will examine your knee, test your range of motion, and look closely at the spot where the meniscus is along the joint. Initially, they may treat the knee injury with conservative techniques that include rest, ice, compression, and elevation. If this approach does not provide relief and surgery is not an option, a new procedure utilizing MOS Regenerative Medicine Solutions and Platelet Rich Plasma may be the optimal way to treat the injury.
PRP (Platelet Rich Plasma) is a concentration of platelets and growth factors created from a small amount of the patients own blood. It focuses on concentrating the healing factors to increase the speed of recovery.
The platelets are concentrated down to a cellular level. Outside of the bloodstream these platelets become activated and release important proteins to help increase growth levels and improve the signaling of recruitment / regenerative cells to the injured area.
A similar treatment can be executed for reoccurring sprains as well.
Do not live in pain; schedule a consultation with an orthopedic specialist at Miller Orthopedic today to receive a customized treatment plan.
Total knee replacement involves replacing a diseased or damaged joint with an artificial joint implant. A Mako Robot assisted total knee replacement is when a Mako Robot assists the surgeon in making pre-determine cuts to perform the total knee replacement surgery.
The first step in the process is to have doctor consultation to determine how much damage there has been to the knee joint. Then a CT scan is perform and creates a 3D image to model to the patient’s unique anatomy. The doctor consults the robot to ensure that model displays the most accurate placement of the implant. This process spares the muscles, limits tissue damage and quickens the recovery time.
The robotic knee replacement does not do all the work for the surgeon but rather guides the surgeon and has the option for the surgeon to make adjustments if needed during surgery. Most insurances cover the robot assisted surgery because it is treated like any other regular equipment in the operating room.
If you suffer from knee pain schedule an appointment for an examination and consultation with an orthopedic specialist. Knee pain does not have to be a deterrent to living life to its fullest.
You can learn more about this procedure and other advancements in hip and knee pain/surgeries on February 21st, 11:30am at our Omaha location.
by: Hassan Khan
Image source: https://www.everydayhealth.com
Individuals suffering from arthritis are frequently disheartened by how much the disease takes from their lives. If you are suffering from arthritis, chronic pains, and stress can narrow your world and may interrupt living a normal life. You may have tried all kinds of medications, performed meditations, and breathing exercises, and maybe even followed a series of different dietary schedules to make you feel better, but somehow, the disease seems to be winning.
With arthritis, energy is expended simply attempting to achieve normal errands and normal everyday activities. Your concentration may be restricted to simply “getting through the day.” Arthritis begins to take control of your life, rather than taking control of the disease. How can you deal with your illness in a better way? What alterations and changes can you make to your lifestyle to make living with arthritis a lot easier? What actions can you do to get and keep control over the restrictions enforced by arthritis?
- Get more exercise
There are more advantages to working out than simply weight reduction. Frequent and constant movement aids to uphold flexibility in your joints. Weight-bearing working out techniques such as running and walking can be harmful. In its place, attempt low-impact workouts for example water aerobics or swimming to flex your joints without putting additional stress.
- Reduce weight
Your weight can make a huge impact on the amount of pain you go through from arthritis. Additional weight adds more strain on your joints — particularly your knees, hips, and feet.
Lessening the strain on your joints by reducing your weight will augment your movement, reduce pain, and prevent future harm to your joints.
- Protect Your Joints
Joint protection can decrease strain on arthritic joints and lessens pain. There are a number of joint protection ideologies which, if performed, will aid in preserving energy and conserving joint function.
- Manage Your Medications
When your physician gives you a new prescription, it turns out to be your duty to know what the medication is for, how to take it, and what probable side effects might take place. Medication blunders have a lot of reasons, but typically, have one thing in common — they could have been avoided.
- Keep Active
The advantages of exercise, as part of a management program for treating arthritis, are well-recognized and recorded. Besides the identified advantages, a lot of individuals with arthritis do not exercise on a daily basis.
- Seek Support
Arthritis not only has an impact on individuals who have the disease, but it also has an impact on the folks around them, particularly family and friends. Individuals living with arthritis and those who have dear ones with the disease can attain understanding and draw motivation from others going through same kinds of challenges and difficulties
- Try acupuncture
Acupuncture is an olden Chinese medical management that consists of introducing thin needles into precise points on your body. This is thought to redirect energies and reinstate balance in your body. Acupuncture is the most investigated corresponding therapy and is acclaimed by the World Health Organization for treatment of over 100 different illnesses.
It is believed that acupuncture has the ability to lessen the pain of arthritis. If you wish to learn more about this treatment method, be sure to locate a licensed and certified acupuncturist in your area.
- Use meditation to deal with the pain
Meditation and relaxation methods may be able to aid you in lessening pain from arthritis by decreasing stress and letting you deal with it in a better way. As stated by the National Institutes of Health (NIH), researchers have discovered that the art of mindfulness meditation is beneficial for a few individuals with painful joints. Researchers also discovered that those with depression and arthritis profited the most from meditation. When anxiety is lessened, inflammation and therefore, swelling and pain also decrease.
- Add the right fatty acids in your diet
Omega-3 fatty acids are essential nutrients, that are important in maintaining a healthy body. These fats also assist in your arthritis. Fish oil supplements, which are rich in omega-3s, have been revealed to lessen joint stiffness and pain.
Another fatty acid that can assist is gamma-linolenic acid or GLA. It is present in the seeds of particular plants such as evening primrose, borage, hemp, and black currants. You can purchase the oils of the seeds as a supplement as well. However, be certain to consult with your physician before taking them.
- Think about herbal supplements
There are a lot of different kinds of herbal supplements on the market that claims to be able to lessen the joint pain. A few of the herbs hyped for arthritis pain consist of:
- devil’s claw
- stinging nettle
- thunder god vine
Always have a talk with your physician before trying a new supplement to not be victim side effects and hazardous drug interactions. Herbs are not regulated and evaluated by the U.S. Food and Drug Administration for quality, purity, or safety. Be certain to purchase from a reputable and quality source.
- Improve Sleep
Bad sleeping habits can exacerbate arthritis pain and exhaustion, but there are things you can do to help you fall asleep and remain asleep. Make your bedroom dark, cool and silent, do not consume caffeine or perform strenuous exercise in the evening, and wind down with a warm bath or perform relaxation methods before bedtime. Still, have a problem in sleeping? Have a talk with your physician about an alteration in or timing of your medication or other methods that may help in your sleep.
If you pay attention to yourself and be familiar with your responsibility – and ability – to take good care of yourself, you can live well and healthily with arthritis. You will need to make modifications, but make certain your aims are realistic and practical, even if they consist of only little steps in the present.
No one can take care of you better than you can.
Regenerative Medicine Solutions is a game-changing area of medicine that can provide hope and healing to many who thought their only option was surgery. This starts the healing from within, using stem cells to treat orthopedic conditions with minimal side effects.
Regenerative medicine itself is not new — the first bone marrow and solid-organ transplants were done decades ago. However, through advances in developmental and cell biology, immunology, and other fields: new opportunities to refine existing regenerative therapies and develop novel new ones have been unlocked.
Chronic pain or acute injuries can keep a patient from work and enjoying life. For people living with ongoing pain and injury, this non-surgical option can provide great promise. Regenerative Medicine Solutions is an approach to help patients suffering primarily from joint pain, arthritis and tendon conditions.
MOS Regenerative Medicine Solutions utilizes a patient’s own blood and cells to start a customized healing process at a cellular level to quicken and concentrate the healing and lessen the chance of the body rejecting the process.
Orthopedic conditions potentially treated through Regenerative Medicine Solutions include:
- Joint Pain and Arthritis
- Muscle Strains and Tears
- Sprains and Ligament Tears
- Soft Tissue Injuries
- Meniscus Tears
- Rotator Cuff Tears
- Carpal Tunnel Syndrome
- Tennis Elbow
There are different types of MOS Regenerative Medicine Solutions treatment options that can be implemented depending upon the injury or condition being treated. Most of the treatment plans can be completed in the doctor’s office in less than an hour. They are extremely customizable and patients can choose one or a combination of the various procedures available through MOS Regenerative Medicine Solutions.
- Platelet-Rich Plasma (PRP) is a rapid, efficient concentration of platelets and growth factors from the patient’s own blood. In ACP, the white blood cells are separated from the red blood cells and reconfigured to improve the patient’s healing process. This treatment procedure can provide good results for conditions in the soft tissue like elbow extensors or hip adductors.
- Autologous Condition Plasma (ACP) is a concentration of platelets and growth factors created from a small amount of the patient’s blood. The blood goes through a rapid spinning process that separates the concentrates the platelets like in the PRP. The blood is spun down twice using a special machine.
- Amniotic Fluid (AF) is a protein-rich fluid with proven regenerative potential. The Amnion contains growth factors and proteins essential to healing that reduce scar formation, inflammation and support soft tissue regeneration.
- Bone Marrow Concentration (BMC) is a concentration of stem cells, platelets and growth factors created from the patient’s own bone marrow. A local anesthetic is applied and the bone marrow is removed from the patient and concentrated to focus on the location of the joint pain, starting the healing from the inside
Stem Cells are cells that do not start out with a specific purpose. They can change shape and grow based on the need. These cells help heal damaged tissue, tendons, ligaments, cartilage and bone. This therapy often diminishes the amount of time needed for rehabilitation. Stem Cell Therapy starts healing from within at a cellular level to get patients back to a healthy life faster.
The carpal tunnel is a narrow passage in the wrist that protects the main nerve of the hand and the tendons that move and flex the first three fingers. The actual tunnel is made up of bone, tendons, tissue and nerves that run up the arm travel into the hand, palm, fingers, and wrist to allow for free movement. If the tunnel swells, this pressure and inflammation will affect the inner nerves causing severe pain, and tingling or numbing sensations known as carpal tunnel syndrome.
Common symptoms of carpal tunnel syndrome include burning, tingling or numbness in the palm of the hand and along the fingers, especially the thumb, index and middle finger. These feelings may intensify to the point where it becomes difficult to hold small objects or to make a fist. The pain associated with this condition can range from mild-to-severe. As the syndrome progresses, symptoms may be felt during the day when using the hand. People may also experience weakness in the hands, clumsiness, decreased grip strength and difficulty in doing tasks where manual dexterity is required. If left untreated it can lead to muscle damage. Carpal tunnel syndrome may increase gradually with symptoms usually first noticed at night. If left untreated it can lead to muscle damage.
There are many causes and risk factors that increase the chances of getting carpal tunnel syndrome. A wrist dislocation or fracture may create a change in pressure in the carpal tunnel, increasing the chances for median nerve damage. Women are more likely to have this condition because of the smaller carpal tunnel. Obesity is also a common risk factor. Fluid retention, specifically during pregnancy or menopause, can increase the pressure on the median nerve as well. If you have certain medical conditions such as diabetes, rheumatoid arthritis, osteoarthritis, kidney failure, or thyroid disorders, there is an increased risk for carpal tunnel syndrome.
In order to diagnose carpal tunnel syndrome, a physician will start with a physical examination and run a few different tests. These can include an X-ray that can rule out any other wrist pain such as a fracture or arthritis, an electromyogram that evaluates the muscles of the arm and hand, and a nerve conduction study that shocks the median nerve.
There are many ways to treat carpal tunnel syndrome depending on the severity of the condition. Those who have mild symptoms can treat their wrist discomfort and pain by frequently resting their arms, avoiding any strenuous physical activity and movements of the arms, and applying ice packs if there is swelling. If these do not provide relief in weeks, your doctor can provide other options. Wrist splinting can relieve the tingling and numbness, especially at night. Nonsteroidal anti-inflammatory drugs such as ibuprofen provides temporary pain relief. Corticosteroid injections can decrease the swelling and inflammation of the median nerve and have been found to be effective.
Surgery is an option if the carpal tunnel symptoms are severe, extremely painful, and if there is no progress after nonsurgical treatment. Carpal tunnel surgery relieves the pressure on the median nerve by severing the ligament producing the pressure that is irritating the nerve. This can be done by either endoscopic surgery or open surgery.
The risk of carpal tunnel syndrome can be reduced by maintaining a healthy body weight and managing conditions such as diabetes and rheumatoid arthritis that contribute to nerve damage and inflammation. Avoid sleeping on the wrists and maintain good posture, positioning, and grip in everyday tasks to reduce wrist strain. If you perform repetitive tasks at work or at home, take frequent breaks and change your hand positions. When working at a computer, ensure you are using good posture and your wrists are not in a flexed position when you type. You can also do wrist stretching exercises.
If the first few steps you take in the morning are painful, you might be experiencing plantar fasciitis. It’s one of the most common causes of foot pain, with over two-million people seeking medical treatment each year. Many people typically seek treatment after having months or years of heel pain.
The stabbing pain that is felt is caused by inflammation of a band of tissue known as the plantar fascia that connects the heel bone to the toes. The pain is normally localized near the heel but can be felt anywhere along the plantar fascia ligament. The pain tends to be worse first thing in the morning and after long periods of sitting or standing. When there is no weight put on the foot, the ligament shortens and tightens,
There are many reasons why one might develop plantar fasciitis. Some of these factors include being overweight, being on your feet for extended periods and wearing shoes with inadequate support and high impact sporting activities. In addition, flat feet or high arches, excessive pronation (when the foot rolls severely inward when walking) or wearing high heels on a regular basis can be aggravating factors.
To diagnose plantar fasciitis, a physician will examine the foot, including looking for areas of tenderness, the height of the arch and ankle mobility. Imaging tests such as X-rays or MRIs may also be used to rule out other potential causes of foot pain, such as fractures or arthritis.
There are three main ways to treat plantar fasciitis:
- Stretching the plantar fascia and the muscle group in the back of the leg,
- Wearing good quality and supportive shoes or orthotics,
- Reducing inflammation.
If plantar fasciitis remains untreated, chronic heel pain can develop with irreversible consequences including: scarring and thickening of the plantar fascia at its origin in the heel. The ligament could also become partially or completely ruptured if a person with plantar fasciitis continues their high-impact activities.
Stretching is the single most important thing to do to eliminate and prevent pain. Physicians also recommend taking a break from high-impact exercises like running and switching to low-impact exercises like swimming or yoga. Over-the-counter anti-inflammatory medications such as ibuprofen and the use of ice and massage can be used to reduce inflammation and pain. If pain continues it is important to see your physician for a more extensive treatment plan that could include steroid injections and sometimes surgery. More than 90 percent of people with plantar fasciitis experience a significant reduction in pain after less than a year of treatment
The feet are relatively small body parts that experience significant pressure and stress on a daily basis. For that reason, it’s important to make sure your feet stay healthy and be aware of the symptoms of foot conditions such as plantar fasciitis.
If you are experiencing pain in your feet please call Miller Orthopedic Specialists at 712-323-5333 (Council Bluffs Office) or 402-991-9958 (Omaha Office) to schedule an appointment to evaluate, diagnose and develop treatment plan that is both beneficial and appropriate for you.
by: Jacqueline Taylor
Osteoporosis affects 200 million people worldwide, according to the International Osteoporosis Foundation. However, in women, it most commonly strikes following the menopause, which typically occurs between 48 and 55 years of age. Due to the decreased production of estrogen, females may suddenly experience an ankle fracture or broken hip out of the blue. Thankfully, an orthopedic surgeon can administer physical therapy to treat postmenopausal osteoporosis and prevent further fractures from presenting.
Once a woman has gone through the menopause, bone resorption happens at a much faster rate than new bone building. As a result, bone mass is lost and this puts the woman at risk of osteoporosis, breaks, and fractures. An even bigger risk is prevalent in females who experience early menopause as their bones experience a longer period of low estrogen levels and more stress. Should the menopause occur before the age of 45, it is referred to as ‘early menopause’. These women should be particularly cautious about the activities they participate in and seek assistance from a physical therapist as early as is practically possible.
Strengthening the bones
Despite females acquiring 85-90% of their bone mass by the age of 18, it is possible for women to build and maintain their bone mass during and after the menopause. A physical therapist will provide patients with a tailor-made exercise plan, which is based on their age, current fitness and risk. This plan should, in most cases, be followed two to three times a week in order to improve the condition of the bones. Typically, both resistance and weight-bearing exercises will need to be performed. Examples of suitable resistance exercises for postmenopausal women include using exercise bands and lifting light weights. Meanwhile, dancing and low-impact aerobic classes for the over 50’s can be enjoyed as weight-bearing exercises.
During physical therapy treatment, a therapist will show his or her patient how to make changes in their day to day life to reduce the impact that their osteoporosis has on them. In most cases, these changes will be minimal but they can make the difference between an injury transpiring or not. Typical changes will include:
- Learning how to lift and pick up objects without using the back
- Discovering how to maneuver out of bed or from a chair without twisting the spine
- Identifying when to ask for assistance
- Using aids to carry shopping and similar objects from one destination to another
Improved quality of life
Research has shown that patients with osteoporosis have a better quality of life when they undertake physical therapy. Bergland et al’s study of women with osteoporosis aged between 60 and 84 years of age, concluded that circuit training had a positive impact on both mobility and quality of life. This can only be a good thing seeing as Whiteley et al’s study on menopause described it as a ‘humanistic and economic burden’ for women due to the 34 possible symptoms it can cause.
Physical therapy is an effective treatment for postmenopausal women dealing with osteoporosis. A qualified therapist will use this therapy to prevent future problems and aid the recovery of existing ones. As a result, postmenopausal women can enjoy life to the full without worry.
International Osteoporosis Foundation – Facts & Statistics https://www.iofbonehealth.org/facts-statistics
National Osteoporosis Foundation – Osteoporosis Fast Facts https://cdn.nof.org/wp-content/uploads/2015/12/Osteoporosis-Fast-Facts.pdf
The Whoot – 34 Menopause Symptoms To Know https://thewhoot.com/newsletter/hot-flash-remedies
Allcareptc – Osteoporosis and Physical Therapy https://allcareptc.com/publications/fighting-osteoporosis-through-physical-therapy/
National Center for Biotechnology Information – Effects Of Physical Therapy On Quality Of Life In Osteoporosis Patients – A Randomized Clinical Trial https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3511275/National Center for Biotechnology Information – The Impact Of Menopausal Symptoms On Quality Of Life, Productivity, And Economic Outcomes https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3820128/
Most patients have heard the phrase “slipped disc”, “ruptured disc” or “disc popped out”. While these are certainly descriptive terms, they can be somewhat misleading. What these terms are referring to is a disc herniation. Disc herniation is common, especially in the low back (i.e. lumbar spine), and is one of the most common causes for low back and leg pain.
Discs, which act as shock absorbers for the spine, are located in between each of the vertebrae in the spine. Each disc contains a tire-like outer band (called the annulus fibrosis) that surrounds a gel-like substance (called the nucleus pulposus).
A herniation occurs when the outer band of the disc breaks or cracks and the gel-like substance from the inside of the disc leaks out, placing pressure on the spinal canal or nerve roots. In addition, the nucleus releases chemicals that can irritate the surrounding nerves causing inflammation and pain.
Most lumbar disc herniation occur as a result of sudden stress, such as from an accident. Sometimes they occur gradually, over weeks or even months.
The risk factors that can contribute to the chances of a disc herniation, include:
- Aging, as we get older, discs gradually dry out, losing their strength and resiliency.
- Lifestyle choices such as: lack of regular exercise, not eating a well-balanced diet, being over-weight, and tobacco use substantially contribute to poor disc health.
- Poor posture, incorrect and/or repetitive lifting or twisting can place additional stress on the lumbar 3
Symptoms of a lumbar disc herniation may include the following:
- Dull or sharp pain in the lower back, intensified by movements or activities such as bending, coughing, or sneezing
- Muscle spasms or cramping
- Sciatica (pain, burning, tingling, and numbness that extends from the buttock into the leg or foot)
- Leg weakness or loss of leg function
The good news is that most cases of lumbar disc herniation do not require surgery! Long-standing evidence suggests that pain associated with a herniated disc often diminishes without surgical treatment within 4-6 months. Unfortunately, it is not possible to predict which cases will have natural resolution, and which will not. Thus, patients are usually prescribed non-surgical treatments initially to help relieve symptoms.
A combination of the following treatments will be used with most herniated disc patients:
- Pain medications such as anti-inflammatories to reduce swelling and pain, muscle relaxants to calm spasms, and occasionally narcotic painkillers to alleviate acute pain
- Heat/cold therapy, especially during the first 24-48 hours
- Physical therapy exercises such as: gentle massage, stretching, and strengthening exercises to decrease pain and increase flexibility
- An epidural injection of anti-inflammatory medication. This is for patients who have severe pain or significant leg pain
If you continue to experience low back pain and/or leg pain please call Miller Orthopedic Specialists at 712-323-5333 to schedule an appointment with an Orthopedic Spine Specialist to evaluate, diagnose and develop treatment plan that is both beneficial and appropriate for you.
Miller Orthopedic Specialists proudly introduces Dr. Clayton Thor, Orthopedic Total Joint Surgeon.
His specialties are:
- Total Joint Reconstruction
- Total Hip Replacement
- Minimally Invasive Direct Superior Approach Hip Replacement
- Total Knee Replacement
- Robot Assisted Total Knee Replacement
- Robot Assisted Partial Knee Replacement
- Muscle Sparing Total Knee Replacement
Dr. Thor has clinics in Council Bluffs, Omaha, Clarinda and Manning.
Book your appointment today.
Miller Orthopedic Specialists FREE * Sports Injury Clinic will begin Saturday hours just in time for fall sports. The sports injury clinic is very beneficial to athletes, coaches, and recreational sports enthusiasts. Parents of young, injured athletes will appreciate the peace of mind it gives them in having their child promptly diagnosed and treated.
The FREE* Sports Injury Clinic is open Monday through Friday from 10:00 am-11:00 am. Saturday appointments will be available August 18 thru October 27, 2018 (closed holidays and holiday weekends) from 8:00 am-9:00 am at Miller Orthopedic Specialists Council Bluffs Clinic:
1 Edmundson Place Suite 500
Council Bluffs, IA 51503
In addition to the Council Bluffs clinic location Miller Orthopedic Specialists is also offering a FREE* Sports Injury Clinic at the Omaha Clinic – Monday through Friday by appointment only.
16221 Evans Plaza
Omaha, NE 68116
Doctors Larose, Atteberry and Huston provide a FREE* initial assessment of the sports injury. Then based on the patient’s goals and expectations, the Sports Medicine Team will recommend a comprehensive treatment plan designed to get the athlete back to the playing field as quickly and safely as possible.
Miller Orthopedic Specialists is proud to be Team Physicians for Iowa Western Reivers and UNO Mavericks! The Sports Medicine Team evaluates hundreds of athletes every year.
*Initial evaluation is FREE. Additional charges may apply for x-rays, supplies and follow-up visits.
Whether we realize it or not, our wrists are always getting a workout. From typing on a computer to carrying groceries or playing sports, we depend on our wrists to be in good shape all of the time. Though it is a common complaint, wrist pain especially affects older individuals that strain their wrists during work or play.
The wrist is a complicated structure made up of many different bones, ligaments tendons. Injury to any of these different parts can cause wrist pain. It’s important to determine if your pain in brand new (also called acute) or if you’ve had it for some time (called sub-acute or chronic). Acute wrist pain is most often caused by injury or sprain, while longer lasting pain is usually due to wear and tear. In rare cases, wrist pain symptoms can be a sign of infection or systemic illness that may deserve further investigation.
Some common wrist pain causes include:
- Repetitive Motions/Stress– Activities range from hammering, painting to typing – all done repetitively can cause stress. This stress causes the tissues around the joint to become inflamed, causing stress fractures and much pain.
- Sudden Impact– A fall in which you catch yourself on the palm of your hand can sprain, strain, or fracture the wrist.
- Arthritis– Both osteoarthritis and rheumatoid arthritis cause pain to the joints, which includes the wrist.
- Carpal Tunnel Syndrome– Carpal tunnel syndrome occurs when the carpal tunnel passageway is compressed, causing pain and even numbness to the wrist.
- Cysts/ Nerve Compression– Cysts can cause a lot of pain to the wrists, even if they are small.
Since it’s a common problem, treatment options for wrist pain can seem overwhelming. The good news is there are easy, tried-and-true remedies that can be done in the comfort of your own home, and if those fail, a visit to the doctor can usually help.
At-home wrist pain remedies:
- Painkillers: Over-the-counter drugs like ibuprofen or naproxen help treat inflammation that causes joint pain, especially from wear-and-tear or overuse. Tylenol is a reasonable alternative.
- Brace: Using a wrist brace can help stabilize the joint and prevent painful movements.
- Take a break: Sometimes fixing pain may require giving the joint a break from repetitive or strenuous tasks.
- Optimize ergonomics: At the office, ensure your wrists are well supported and kept in a neutral position. Avoid typing with bent wrists or gripping the mouse too tightly.
- Heat or ice packs: Some people find gentle heat helpful in relieving pain, while others prefer ice. Try both and see what works for you.
- Pain creams: Topical medications contain ingredients like menthol or capsaicin that can make joint pain less noticeable.
Sometimes the pain may persist despite these steps and may require further evaluation and treatment by your doctor.
Other wrist pain treatment options:
- Steroid injections: This is a way of directly injecting anti-inflammatory medication into an area of pain.
- Casting: Fractures are often treated by application of a cast.
- Aspiration: If a cyst is the cause of your pain, the doctor can use a needle to remove the fluid inside.
- Antibiotics: Only pain caused by bacterial joint infection or Lyme disease requires antibiotic treatment.
- Rheumatologic medications: A rheumatologist can prescribe a wide range of medications if your joint pain is caused by autoimmune or crystal diseases.
- Surgery: While a more invasive option, a surgeon can help relieve pain caused by nerve compression, fractures, cysts, or ligament tears.
You should see a doctor right away if:
- Your joint is very warm, red, or swollen
- You have sudden onset of weakness, especially if it affects an entire arm or leg or if you also have slurred speech or a droopy face
- The pain is very severe
- Your wrist is deformed, looks pale or is very cold, especially after trauma or a fall
If you are experiencing constant wrist pain and none of the home remedies are working for you, please call us at Miller Orthopedic Specialists. Our orthopedic specialists can get you the care you need.
What is an ACL Tear?
An anterior cruciate ligament (ACL) tear is an injury to the knee that commonly affects athletes that participate in high –demand sports such as soccer, football or basketball. Approximately 70% of ACL tears in sports are the result of non-contact injuries caused from a rapid change of direction, stopping suddenly or landing from a jump incorrectly. ACL tears are very common and women are four-to-six times more likely than men to experience this type of injury.
The ACL is one of the major bands of tissue (ligaments) connecting the thigh bone (femur) to the shin bone (tibia) at the knee joint. When the ACL is torn, you may feel a sharp, intense pain or hear a loud “pop” or snap. You might not be able to walk on the injured leg because you can’t support your weight through your knee joint. Usually, the knee will swell immediately (within minutes to a few hours), and you might feel that your knee “gives way” when you walk or put weight on it.
Immediately following an injury, you should be examined by an orthopedic doctor for a thorough examination and evaluation to assess the damage to the ACL and also to assess potential damage to other parts of the knee.
Most people who sustain an ACL tear will undergo surgery to repair the injury; however, there are a few instances where surgery may not be required. It is best to see an orthopedic specialist for proper diagnosis and treatment plan.
With proper treatment and physical therapy, people who have experienced a torn ACL can often be back in the game within 6 to 12 months.
If you are looking for help with an ACL tear or another orthopedic injury, contact Miller Orthopedic Specialists today.
Vertebral compression fractures (VCFs) are the most common fracture in patients with osteoporosis, affecting about 750,000 people annually.
VCFs occur when the bony block or vertebral body in the spine collapses, which can lead to severe pain, deformity and loss of height. While osteoporosis is the most common cause, these fractures may also be caused by trauma or metastatic tumors.
The main clinical symptoms of VCFs may include any of the following, alone or in combination:
- Sudden onset of back pain
- An increase of pain intensity while standing or walking
- A decrease in pain intensity while lying on the back
- Limited spinal mobility
- Eventual height loss
- Eventual deformity and disability
While a diagnosis can usually be made through history and a physical examination, plain x-rays, computed tomography (CT) or magnetic resonance imaging (MRI) can help in confirming diagnosis, predicting prognosis and determining the best treatment options.
Traditionally, people with severe pain from VCFs have been treated with bed rest, over the counter medications, bracing, use of heat or ice and a slow return to mobility. Surgery may also be advisable depending upon the servility of the pain and injury. After sustaining a vertebrae fracture, a patient is at risk for more fractures, so treatment of the underlying osteoporosis is an important part of the treatment plan.
An ankle sprain can happen to anyone at any age. Walking on an uneven surface or even wearing inappropriate foot wear can cause this type of injury. Many times a sprain occurs when the foot suddenly twists or rolls, forcing the ankle joint out of its normal position. This movement can stretch or tear the ligaments that hold the ankle bones and joints together.
If you have recently injured your ankle and are noticing the following symptoms you may have a sprained ankle:
- inability to put weight on the affected ankle
- skin discoloration
The ankle can sustain many different types of injuries. It’s important to see your doctor when you’re experiencing problems with your ankle as they can determine whether the injury is a sprain or something more severe. Your physician will perform a physical exam to determine if ligaments have been torn. During the exam, your doctor may move your ankle joint in various ways to check your range of motion.
Imaging tests, such as X-rays, may also be ordered to rule out a bone fracture. An MRI may be done if your doctor suspects a fracture, a serious injury to the ligaments, or damage to the surface of the ankle joint allowing your physician to make the proper diagnosis.
Your doctor may tell you to stay off of your injured ankle until the pain subsides. For mild sprains, this may take a week to 10 days, while more severe sprains may take up to several weeks to heal
Treating a sprained ankle promotes recovery and prevents further discomfort. You may be able to treat mild sprains at home.
Recommended home care treatments include:
- using elastic bandages (such as an ACE bandage) to wrap your ankle, but not too tightly
- wearing a brace to support your ankle
- using crutches, if needed
- elevating your foot with pillows as necessary to reduce swelling
- taking ibuprofen (such as Advil) or acetaminophen (such as Tylenol) to manage pain
- getting plenty of rest and not putting weight on your ankle
It’s also helpful to apply ice to the injured area as soon as you can to reduce swelling. On the first day, you should apply ice every 20 to 30 minutes, three to four times per day. Afterward, apply ice every three to four hours for the next two days.
Surgery for a sprained ankle is rare. It may be performed when the damage to the ligaments is severe and there is evidence of instability, or when the injury doesn’t improve with nonsurgical treatment.
In most cases, an ankle sprain isn’t very serious and will completely heal with proper treatment. The amount of time required for a full recovery will depend on the severity of the sprain. Most ankle sprains take a few weeks to fully heal. A more severe sprain may take months.
Although pain and swelling will eventually go away, your injured ankle may not be as stable as your unaffected ankle. Your doctor may suggest certain exercises to help strengthen the muscle about the ankle. However, you shouldn’t proceed with exercises until your doctor has told you to do so.
If you have recently sustained an injury to your ankle, contact Miller Orthopedic Specialists for more information or to set up an appointment.
The rotator cuff is a group of muscles and tendons that surround the shoulder joint, keeping the head of the upper arm bone firmly within the shallow socket of the shoulder. A rotator cuff injury can cause a dull ache in the shoulder, which often worsens when you try to sleep on the involved side. A torn rotator cuff is a very common shoulder injury that can be caused from repeated movements while playing sports, performing a job function or doing common household chores such as yard work. Other common causes of a torn rotator cuff include falling, lifting or pulling a heavy object, or in some cases bone spurs in the shoulder.
With repeated motion, the muscles and tendons that surround the shoulder socket can become torn. A torn rotator cuff can be both painful and inconvenient, which is why it is so important to get a diagnosis early if you think you may have this injury.
4 Common Symptoms of a Torn Rotator Cuff
Some of the symptoms of a torn rotator cuff include:
- Pain– Many people feel a dull ache in their shoulder joint in association with a torn rotator cuff. The pain is typically felt deep in the joint and can increase with movement of the shoulder.
- Limited range of motion– If you have a torn rotator cuff you may find it difficult to reach behind your back, lift your arm over your head, or lift your arm laterally.
- Disturbed sleep– Because of the pain in the shoulder, many people find it difficult to sleep, particularly on the side of the injured arm.
- Weakness– Muscle weakness in the arm on the injured side of the body is a common symptom of a torn rotator cuff.
- Crackling sensation – when moving the shoulder in certain directions.
An orthopedic doctor will diagnose a rotator cuff injury by palpating the area and doing a series of range of motion tests. In some cases scanning equipment is used to identify damage to the soft tissue in the shoulder joint.
Common treatments for a torn rotator cuff include rest, joint immobilization and physical therapy. Many people recover from rotator cuff injury with physical therapy exercises that improve flexibility and strength of the muscles surrounding the shoulder joint; however, in extreme cases, surgery may be recommended.
Shoulder injuries such as a torn rotator cuff should be treated immediately to prevent further damage and start the healing process as soon as possible. See a physician right away if you have a sudden loss of motion after an injury — you could have a substantial rotator cuff tear.
If you have pain lasting longer than a few weeks or you’ve been formally diagnosed with a rotator cuff tear, you need to be seen by a shoulder specialist, because some of the surgical procedures are time sensitive. Please contact Miller Orthopedic Specialists today if you think you may have torn your rotator cuff!
Podiatry for Bunions!
Even though bunions are a common foot deformity, there are numerous misconceptions about them. A bunion (also referred to as hallux valgus) is a bony bump that forms on the joint at the base of your big toe. The classic bunion bump forms when your big toe pushes against your next toe, forcing the joint of your big toe to get bigger and stick out. Bunions are a progressive disorder that can become very painful and are most often caused by:
- Heredity – some people have certain foot types that make a person prone to developing a bunion.
- Medical condition – inflammatory condition, such as rheumatoid arthritis, or a neuromuscular condition, such as polio.
- Wearing poorly fitting shoes – in particular, shoes with narrow, pointed toe box that forces the toes into an unnatural position.
Bunions can also form at the base of the little toe – this is referred to as a “tailor’s bunion” or bunionette.
Symptoms of bunions may include:
- Pain and soreness
- A burning sensation
- Swelling at the joint of the affected toe
- Skin thickness at the base of the affected toe
- The presence of corns or calluses
- Movement restrictions within the affected toe
The presence of bunions can lead to other conditions developing such as pain and swelling (bursitis), arthritis, difficulty walking, hammertoe and much more.
Bunions are readily apparent—the prominence is visible at the base of the big toe or side of the foot. However, it is recommended that someone that suffers from the condition see a podiatrist to fully evaluate the degree of the deformity and asses the changes that have occurred. Once the doctor has made an evaluation, a treatment plan can be developed that is suited to the patient’s needs.
Contact Miller Orthopedic today if you are experiencing bunions so we can develop a treatment plan!
Johnny Rodgers visits Miller Orthopedic Specialists in Omaha for Knee Replacement Surgery
Nicknamed “The Jet” for his rapid speed on the field, Johnny Rodgers won the Heisman Trophy in 1972 then played in the Canadian Football league. He later joined the NFL until a knee injury ended his career. Only after several years of operation and rehabilitation did his knee return to normal.
Now at 64, Rodgers experienced years of knee pain, but he did not want to undergo major surgery. He says, “I found out I needed a total knee replacement, but I didn’t want the surgery because I had to stay in the hospital.” He continues, “Hospitals are full of sick people and I didn’t want to stay in the hospital for two to three days with risks of getting an infection or getting sick.”
Rodgers then found Dr. Kent Boese, orthopedic surgeon with Miller Orthopedic Specialists, who performs total knee replacements on an outpatient basis, allowing patients same-day discharge. Miller Orthopedic Specialists is the only orthopedic group in the Omaha, Council Bluffs and Southwest Iowa community conducting outpatient total knee replacements. Dr. Boese explains, “This is made possible with recent advances, such as improved anesthesia, less invasive techniques, comprehensive pre-operative programs and protocols for post-surgery home-health and rehabilitation.”
Rodgers spent eight hours at the Advanced Surgery Center in Omaha. He received a spinal block instead of general anesthesia and nurse visits that provided similar clinical care at home as he would have in a hospital.
“I was surprised when I was done with surgery that I didn’t have a lot of pain. I even went to my office that afternoon and walked the halls to show everyone I just had surgery and was feeling great,” Rodgers said.
It has been one month since his surgery and he has been undergoing physical therapy to return to activities he could not do before surgery. Both Rodgers and Dr. Boese agree that he is doing better than expected. “I had a great experience and would recommend it to anybody,” claims Rodgers.
Outpatient total knee replacement is not a new procedure and has been conducted in larger cities for years. “Not every patient who is interested will qualify. We look for patients who are very motivated to return to activity better than pre-surgery and who can follow post-surgical requirements. Someone who is reasonably in good physical condition and has a strong support system in their home for an extra set of eyes and hands to help after surgery is important too,” says Dr. Boese.
A research study published in the Journal of Arthroplasty in 2014 showed costs for outpatient total knee replacement are significantly less than an inpatient total knee replacement. Another study indicated no differences in long-term complication rates between patients undergoing outpatient total knee replacement versus inpatient total knee replacement.
For more information, visit our outpatient total knee replacements page. The phone number to the main clinic in Council Bluffs is 712-323-5333 and the Omaha office is 402-991-9958. Several physicians within Miller Orthopedic Specialists, Drs. Boese, Abraham, Trinh and Atteberry, perform this procedure. Convenient locations are available with twelve outreach clinics throughout Omaha, Council Bluffs and Southwest Iowa. Miller Orthopedic Specialists has served the Council Bluffs/Omaha area for over 40 years. The goal is to restore patients to optimum health quickly and safely.
Click here to see our ad about outpatient total knee replacement.
Contact us for more information about how we can help with your knee replacement.
“Trigger finger,” or stenosing tenosynovitis, is a condition that causes pain, locking, popping or clicking of the fingers or thumb when the hand is opened or closed.
In its early stages, trigger finger can cause pain. Usually, it is tender on your palm where the finger or thumb joins the hand. Sometimes, you feel the pain further along or even on the back of the finger. You might feel like your hands or fingers are stiff or swollen. As it progresses, the tightness can cause the tendon to catch as it tries to glide, leading to a painful snapping sensation when making a fist or opening the hand. Eventually, the finger can get stuck where it is, making it really hard either to straighten or to bend it.
The symptoms are often worst in the mornings immediately after waking up and can occur in any of the fingers or thumbs. People whose work or hobby require repetitive gripping actions are at a higher risk of
developing trigger finger. The condition is also more common for those with diabetes or other inflammatory conditions.
If caught in the early stages, a splint or anti-inflammatory medicines may be able to calm down the symptoms. After this, the first line of treatment is usually a steroid injection into the sheath of the tendon. This helps to decrease the swelling and allow the tendon to glide smoothly again.
If you have had injections that did not work in the past, your symptoms have been happening
for a long time, or your finger is stuck in place, your physician might discuss surgery with you.
If you are experiencing any of these symptoms please call Miller Orthopedic Specialists at our Council Bluffs clinic at 712-323- 5333 or our Omaha clinic at at 402-991- 9958 for an appointment.
Your Back Pain May Be From Sciatica
Sciatica is a condition you’ve probably heard about, it’s a painful, annoying condition where you experience pain that radiates down from your lower back, hips, buttocks and down your leg, but only on one side of your body. Sometimes your feet and toes feel tingly and numb. You may even feel shooting, electrical pains going up and down the back or the outside of your thighs and calves.
Sciatica is a term used to describe the symptoms you experience if you have a pinched or compressed sciatic nerve on one side of your body. The two sciatic nerves, one on each side of the body, run down the lengths of your legs. The sciatic nerves are the human body’s largest and longest nerves. These two sciatica nerves connect the spinal cord to the leg muscles of the thigh and lower leg, including the outside of the thigh and the hamstrings (where sciatica pain symptoms are often felt). Each sciatica branches out to the entire leg and foot, and is responsible for controlling the motor and sensory function of each leg.
The most likely cause of your sciatica pain is the pinching of a highly sensitive sciatic nerve root by a nearby herniated or slipped disc in your lower back. When one spinal vertebra slips over another, the protruding segment of bone can impinge one of the sciatica nerve roots in the area. This pinching creates inflammation and irritation, which is responsible for a set of symptoms you’ll recognize as prickling, numbness, pain, and possibly weakness of the leg and foot.
More often than not, if your sciatica symptoms are caused by a slipped disc they will resolve on their own with minimal treatment. If your pain doesn’t improve, your doctor might suggest some conservative treatment like anti-inflammatories, muscle relaxants, physical therapy or even steroid injections. Surgery is an option if the compressed nerve causes significant weakness or when pain progressively worsens or doesn’t improve with other therapies. Since sciatica is a symptom, not a disease, it can be a sign of another underlying spinal condition that may need specific treatment: for example, sciatica can be caused by degenerative disc disease, spinal stenosis, or spondylolisthesis.
The bottom line: if you have sciatica pain, weakness, or numbness, don’t assume it’s a minor annoyance that will go away on its own; a visit to a doctor is needed to diagnose your symptoms and to gauge whether a more serious problem may be the cause of your nerve impairment.
Have back pain that radiates from your lower back and creeps down your leg? Miller Orthopedic in Omaha and Council Bluffs has orthopedic doctors that can help. Contact us today to find your specialist.
High Frequency Sports Injuries Can Happen, We Can Help
Sports are a healthy, fun pastime that not only enables people to aspire to greater fitness level but also provides a form of entertainment for many. However, since many sports often require rigorous training, intense exercise, heightened flexibility, and bodily strain, athletic activities carry the risk of sports injury.
Overexerting yourself to throw the football further, kick the soccer ball into a goal, or slam a tennis ball into your opponent’s court could harm or even seriously impair your body. Orthopedists, doctors who diagnose and treat musculoskeletal conditions, often specialize in sports medicine because athletes regularly harm their muscles, bones, ligaments, tendons, or suffer from other sports-related injuries.
Since sports activities often require repeated movements and putting pressure on the same joints and bones over and over, certain conditions are common for athletic people. Some of the most frequently reported sports-related injuries orthopedic surgeons see include:
- Shoulder injury: Any sport that involves throwing, such as baseball or football, can cause shoulder injuries including inflamed joints or torn ligaments. The rotator cuff tendons in the shoulder are particularly prone to sports-related damage.
- Torn ACL (knee): The anterior cruciate ligament, or “ACL,” helps your knee move properly. Overuse or rapid twists can damage or tear the ACL, limiting your leg movement.
- Ankle sprain: Stretching or rupturing your ankle ligaments can be uncomfortable and impair your mobility. This injury can occur during any sport that requires repetitive foot movements.
- Fractures: A fracture occurs when a bone becomes cracked or broken. Stress fractures are very common in contact sports, such as football, or sports which involve repetitive movements like long distance running.
- Epicondylitis: Also called “tennis elbow” for the sport that most frequently causes it, this is a swollen outer elbow joint.
- Hip bursitis: The hip’s “bursa” are fluid-filled membranes that pad the joints. Biking, running, or standing for long periods can cause them to swell.
- Lower back pain: Running, bending over, and twisting can put undue pressure on your lower back vertebrae, muscles, and ligaments, harming them and causing pain.
- Shin splints: These are sharp pains that result from running. They can be caused by an improper foot arch, swollen shin muscles, or even stress fractures, small cracks in the leg bones.
- Hamstring pull: Repetitive jumping or running can overextend the muscles along the back of your thigh.
- Groin pull: Jumping, sprinting, and sudden movements can injure the muscles that connect your pelvis to your upper thighs, causing a groin pull. You may hear a crackling sound as you strain these muscles and then feel a prolonged aching when you attempt to use your thighs, especially when lifting or closing them.
- Achilles tendinitis: The “Achilles” muscles adjoining your calf with your heel can become swollen and uncomfortable.
- Plantar fasciitis: The tissue that runs from your heel to your toes is called “fascia”. If it becomes damaged or stretched, the bottom of your foot may experience sharp pains and swelling.
Athletes experiencing pain and discomfort for time should consult with sports medicine physician to evaluate their symptoms and devise a treatment plan to reduce pain, reduce the chances of further injury or damage to the affected area and get you back in the game. For help with any of the conditions listed above, please visit our free sports injury clinic or schedule an appointment.
Council Bluffs, IA: Miller Orthopedic Specialists FREE * Sports Injury Clinic will begin Saturday hours just in time for fall sports. The sports injury clinic is very beneficial to athletes, coaches, and recreational sports enthusiasts. Parents of young injured athletes will appreciate the peace of mind it gives them in having their child promptly diagnosed and treated.
The FREE* Sports Injury Clinic is open Monday through Friday from 10:00 am-11:00 am. Saturday appointments will be available August 12th thru December 9th (closed holidays and holiday weekends) from 8:30 am-10:00 am at Miller Orthopedic Specialists Council Bluffs Clinic:
1 Edmundson Place Suite 500
Council Bluffs, IA 51503
In addition to the Council Bluffs clinic location Miller Orthopedic Specialists is also offering a FREE* Sports Injury Clinic at the Omaha Clinic – Monday through Friday by appointment.
16221 Evans Plaza
Omaha, NE 68116
Doctors Larose, Atteberry, and Huston provide a FREE* initial assessment of the sports injury. Then based on the patient’s goals and expectations, the Sports Medicine Team will recommend a comprehensive treatment plan designed to get the athlete back to the playing field as quickly and safely as possible.
Miller Orthopedic Specialists is proud to be Team Physicians for Iowa Western Reivers and UNO Mavericks! The Sports Medicine Team evaluates hundreds of athletes every year.
*Initial evaluation is FREE. Additional charges may apply for x-rays, supplies and follow-up visits.
Dry needling involves the insertion of a fine filament needle into neuromuscular junctions /motor points, stimulating the muscles, and bringing unbelievable pain relief and significantly improved function to athletes and patients who have been suffering for years.
There is no injectable solution and the needle which is used is very thin. Most patients will not even feel the needle penetrate the skin, but once advanced into the muscle, the patient may have a sensation like a muscle cramp – which is often referred to as a “twitch response”. The twitch response results in deactivating the trigger point, thereby reducing pain and restoring normal length and function to the involved muscle.
Typically positive results are apparent within 2-4 treatment sessions but may vary depending on cause and duration of the symptoms and overall health of the patient. Dry needling is an effective treatment for acute and chronic pain, rehabilitation from injury, and even pain and injury prevention, with very few side effects. This technique is unequaled in finding and eliminating neuromuscular dysfunction that leads to pain and functional deficits.
Dry needling may also be used for many acute, chronic and sports related injuries such as:
- Muscular hematomas
- Muscle strains/tears
- Compartment syndrome
- Medial tibial stress syndrome (shin splints)
- Rotator cuff injuries
- Impingement syndrome
- Tennis/golfer’s elbow
- Piriformis syndrome
- Cervicogenic headaches
- Hamstring issues
- IT band syndrome
- Patellar Femoral Syndrome
- Patellar tendonitis
- Achilles tendonopathies
- Plantar fasciitis
- Thoracic Outlet Syndrome
- Carpal Tunnel Syndrome
- Back pain: A common cause of nerve irritation and neuropathic pain is underlying spinal degeneration (i.e. spondylosis of the spine), which can be a result of trauma and/or normal wear and tear. Spondylosis irritates the nerve root and leads to neuropathy which can result in muscle shortening. This process leads to pain and dysfunction in many common acute and chronic conditions that practitioners see in their everyday patient population. The introduction of a dry needle into the active trigger sites of these muscles can provide enormous relief of symptoms.
Miller Orthopedic Specialists own physical therapist, Joshua Blintz, PT, DPT, is now providing Dry Needling Therapy as a treatment option. Call 712-323-5333 to schedule an appointment for a consultation.
The ACL is the anterior cruciate ligament located in the knee. This ligament helps to prevent the tibia (shin bone) from sliding in front of the femur (thigh bone). It also provides rotational stability to the knee.
An ACL strain or tear is a common sports injury. This kind of injury most commonly happens during a sudden stop, jumping or changing directions. It can also occur during a direct contact collision. Many people hear a “popping” noise and feel their knee give out when injuring their ACL. Other symptoms can include swelling, loss of full range of motion or discomfort while walking.
To help with swelling rest, ice, compression and elevation should be done to the injured knee. Several weeks of physical therapy can be prescribed to help further reduce swelling and work on range of motion. For many cases, ACL surgery will need to be performed to regain full range of motion in the knee, primarily if you’re an athlete wanting to return to your sports. After knee surgery, more physical therapy will be done to restore stability and function of the knee. Click here to download a PDF about the ACL Reconstruction procedure.
Carpal tunnel syndrome is a common condition that causes pain, numbness, and tingling in the hand and arm. Another symptom includes an electrical shock-like feeling mostly in the thumb, index and long fingers. The condition occurs when one of the major nerves to the hand — the median nerve — is squeezed or compressed as it travels through the wrist.
Most cases of carpal tunnel syndrome are caused by a combination of factors. Studies show that women and older people are more likely to develop the condition.
Although it is a gradual process, for most people carpal tunnel syndrome will worsen over time without some form of treatment. For this reason, it is important to be evaluated and diagnosed by your doctor early on. In the early stages, it may be possible to slow or stop the progression of the disease.
If diagnosed and treated early, the symptoms of carpal tunnel syndrome can often be relieved without surgery. If your diagnosis is uncertain or if your symptoms are mild, your doctor will recommend nonsurgical treatment first.
Nonsurgical treatments may include:
- Bracing or splinting. Wearing a brace or splint at night will keep you from bending your wrist while you sleep. It may also help to wear a splint during the day when doing activities that aggravate your symptoms.
- Nonsteroidal anti-inflammatory drugs (NSAIDs). Medications such as ibuprofen and naproxen can help relieve pain and inflammation.
- Activity changes. Symptoms often occur when your hand and wrist are in the same position for too long—particularly when your wrist is flexed or extended.
- Nerve gliding exercises. Some patients may benefit from exercises that help the median nerve move more freely within the confines of the carpal tunnel. Specific exercises may be recommended by your doctor or therapist.
- Steroid injections. Although these injections often relieve painful symptoms or help to calm a flare up of symptoms, their effect is sometimes only temporary. A cortisone injection may also be used by your doctor.
If pressure on the median nerve continues, however, it can lead to nerve damage and worsening symptoms. To prevent permanent damage, surgery to take pressure off the median nerve may be recommended for some patients.
Endoscopic Carpal Tunnel Release is a minimally invasive procedure performed to relieve pressure on the median nerve, alleviating the pain of carpal tunnel syndrome and restoring normal sensation to the hand and fingers. The endoscopic technique is performed on an outpatient basis, creates less pain and scarring than traditional open surgery and allows for quicker recovery.
People experiencing pain and discomfort for an extended period of time should consult with one of our orthopedic specialists to evaluate their symptoms and devise a treatment plan to reduce pain and improve the quality of health. Contact us today!
Miller Orthopedic Specialists is the only orthopedic group in the Omaha, Council Bluffs and Southwest Iowa community conducting outpatient total hip and total knee replacement. Outpatient total hip and total knee replacement are not a new procedure and have been conducted in larger cities for years. This is made possible with recent advancements such as improved anesthesia, less invasive techniques, comprehensive pro-operative programs and protocols for post-surgery home health and rehabilitation. The benefits of outpatient total hip or total knee replacement versus a traditional total hip or total knee replacement are lower cost, less risk of infection, quicker recovery and being able to recover in your own home.
A research study published in the Journal of Arthroplasty in 2015 showed costs for outpatient hip replacement are significantly less an inpatient total hip replacement. Another study indicated no difference in long-term complication rates between patients undergoing outpatient total hip replacement versus inpatient total hip replacement.
Home health care and physical therapy are arranged prior to surgery. A professional arrives at the patient’s home to help access if adjustments need to be made around the house for a comfortable recovery. At home exercises as well as physical therapy sessions continue after the surgery to help retain full range of motion.
Patients who are very motivated to return to activity better than pre-surgery, who can follow post-surgery requirements are in reasonably in good physical condition and have a support system at home are the best candidates for the outpatient surgery option.
To learn if you are an eligible candidate for an outpatient total hip or total knee replacement make an appointment for a consultation with one of our physicians at Miller Orthopedic Specialists.
Arthritis is the inflammation of a joint often characterized by pain, stiffness and structural changes. Unfortunately, there are no known cures for arthritis but there are ways to manage the symptoms.
There are two types of arthritis: Osteoarthritis and Rheumatoid Arthritis. Osteoarthritis is caused by damage in the cartilage between the bones in a joint creating a surface that is inflamed and painful. This damage occurs mostly in weight bearing joints and as a result of degeneration, but can also occur as a result of overuse or traumatic injury. Patients with osteoarthritis are treated by orthopedic specialists.
Rheumatoid Arthritis is an inflammation of the joints, but it is caused by a chronic progressive autoimmune disease. This type of arthritis can affect multiple joints in the body. Patients with rheumatoid arthritis experience pain, stiffness and swelling in the joints and may feel tired and unwell. Patients with rheumatoid arthritis are treated by Rheumatologists.
What can an orthopedic specialist do for osteoarthritis?
An orthopedic specialist will do a thorough examination of the patient. If the diagnosis is indeed osteoarthritis, the x-ray will show the loss of cartilage in the joint. The treatment plan will then be tailored according to the extent of the damage in order to relieve the patient’s discomfort and allow them to return to their normal daily activities.
What types of treatment plans are available for osteoarthritis?
Diet and exercise is one of the first recommendations. A well balanced diet promotes overall good health and exercise improves joint mobility and strength. The specialist may order physical therapy to help the patient begin getting range of motion back into the joint.
Over-the-Counter medication may be suggested to control pain and inflammation. Drugs like acetaminophen aspirin, ibuprofen or naproxen may be recommended as they can be effective.
Steroid injections such as cortisone, are very strong anti-inflammatories that provide relief after being injected directly into the joint. A patient can receive up to three steroid injections a year.
Artificial Joint Replacement may be part of the treatment plan when the patient has exhausted all other non-invasive and conservative measure to treat their symptoms. A patient will be offered this option when their pain hinders their ability to perform activities of daily living or their deformity worsens. The goal of the artificial joint replacement is to reduce pain, increase range of motion, increase activity level and improve the patient’s quality of life.
People experiencing arthritic joint pain for an extended period of time should consult with an orthopedic specialist to evaluate their symptoms and devise a treatment plan to reduce pain and improve quality of health.
Diabetes is a growing epidemic in the United States. According to the American Diabetes Association there are 26 million adults and children living with disease and an additional 7 million who have prediabetes. Diabetes complications in the feet can be dangerous and is the leading cause of non-traumatic lower limb amputation. These complications and amputations can be prevented with proper foot care from a podiatrist.
The connection between a podiatrist and diabetes is an important one as proper foot care can help avoid serious limb injury or loss. Podiatrists specialize in caring for feet so they can offer the best possible treatment and recommendations to their patients. This care improves patients’ outcomes by catching problems at an early stage and providing access to appropriate treatment. A podiatrist will complete a full examination looking for signs and symptoms representative of potential diabetic foot problems. Some examples to look for on your feet and ankles include:
- ulcers or non-healing wounds
If you have diabetes you are more vulnerable to foot problems because of possible nerve damage and poor circulation to your leg and foot. This can lead to loss of sensation in the feet, meaning that the damage is more likely to go unnoticed. In addition, high blood glucose leads to dry skin, making your feet more prone to cuts and tears. You are also more susceptible to foot infections, toenail fungus and athlete’s foot.
It’s important to educate yourself and your family on your condition. They can play a vital role in helping you control your diabetes. If your family has a history of diabetes, the chance of you developing diabetes also increases.
Your podiatrist will instruct you on proper self-exam and care for your feet. This could include how to properly wash and dry your feet, why it is important to keep your feet moisturized, what to look for when examining your feet, taking care of your toenails and exercising tips. They may also recommend special footwear, such as socks that pull moisture away from your feet or shoes specifically designed for people with diabetes. Educated patients with the right tools can prevent foot and lower extremity problems by controlling their diabetes effectively and taking some simple steps to care for their feet.
A podiatrist can perform vascular, neurological and functional tests which will tell you your foot health status. It is important to have your feet checked regularly, and you should be checking your own feet daily if you are diabetic. A podiatrist’s education, training, and experience qualify them to diagnose and treat conditions of the foot, ankle and related structures of the leg as well as perform surgery if needed.
If you have diabetes and would like to start a relationship with a podiatrist to ensure the health of your feet, make an appointment to see one of our physicians today.
Miller Orthopedic Specialists were honored on Friday October 14th to be inducted into the Iowa Western Reivers Athletics Hall of Fame. Miller has been offering sports medicine to injured athletes in the Omaha/Council Bluffs area since 1988, including all types of injuries to the shoulder, elbow, hand, wrist, knee, foot and ankle. Miller Orthopedic Specialists’ focus is to return the player to their chosen sport or an individual to their healthy and active lifestyle. Miller Orthopedic Specialists have been the official Reivers team physicians for over two decades.
For over 44 years Miller Orthopedic Specialists have served the Omaha/Council Bluffs area. Their goal is to get patients back to optimum health as quickly and safely as possible treating patients with pain and conditions related to bones, joints, muscles and tendons. Whether a patient has a shoulder, elbow, hand, wrist, spine, hip, knee, ankle or foot problem, Miller Orthopedic Specialists has the physician who will help each patient return to an active and healthy lifestyle. Miller Orthopedic Specialists offers patients same/next day appointments for all orthopedic needs.
For more information or to schedule an appointment, please call Council Bluffs at 712-323-5333 or Omaha at 402-991-9958.
Council Bluffs, IA 11/1/16 – Miller Orthopedic Specialists were honored on Friday October 14th to be inducted into the Iowa Western Reivers Athletics Hall of Fame. Miller has been offering sports medicine to injured athletes in the Omaha/Council Bluffs area since 1988, including all types of injuries to the shoulder, elbow, hand, wrist, knee, foot and ankle. Miller Orthopedic Specialists’ focus is to return the player to their chosen sport or an individual to their healthy and active lifestyle. Miller Orthopedic Specialists have been the official Reivers team physicians for over two decades.
For over 44 years Miller Orthopedic Specialists have served the Omaha/Council Bluffs area. Their goal is to get patients back to optimum health as quickly and safely as possible treating patients with pain and conditions related to bones, joints, muscles and tendons. Whether a patient has a shoulder, elbow, hand, wrist, spine, hip, knee, ankle or foot problem, Miller Orthopedic Specialists has the physician who will help each patient return to an active and healthy lifestyle. Miller Orthopedic Specialists offers patients same/next day appointments for all orthopedic needs. For more information or to schedule an appointment, please call Council Bluffs at 712-323-5333, Omaha at 402-991-9958, or Clarinda at 712-542-2176 or visit their website at millerortho.com.
Council Bluffs, IA 8/3/16 – Miller Orthopedic Specialists is proud to announce their newest hand surgeon Gavin D. O’Mahony, MD. He specializes in hand trauma; adult, pediatric and congenital hand conditions; carpal and cubital tunnel release; treatment for arthritis of the hand and wrist as well as treatment of injuries to the tendons, nerves and arteries.
Dr. O’Mahony received his Medical Degree in May of 2006 from Vanderbilt University School of Medicine in Nashville, Tennessee. Dr. O’Mahony completed his General Surgery Residency at Lenox Hill Hospital in New York, New York, in June 2011. He completed his Hand Surgery Fellowship at the University of New Mexico School of Medicine in Albuquerque, New Mexico, in July 2012. Dr. O’Mahony practiced as a Hand Surgeon at Oklahoma University Medical Center for four years where he was also an Assistant Professor.
For over 44 years Miller Orthopedic Specialists has served the Omaha/Council Bluffs area. Their goal is to get patients back to optimum health as quickly and safely as possible treating patients with pain and conditions related to bones, joints, muscles and tendons. Whether a patient has a shoulder, elbow, hand, wrist, spine, hip, knee, ankle or foot problem, Miller Orthopedic Specialists has the physician who will help each patient return to an active and healthy lifestyle. Miller Orthopedic Specialists offers patients same/next day appointments for all orthopedic needs. Dr. O’Mahony will be accepting new patients at the Council Bluffs, Omaha, and Clarinda clinics. For more information or to schedule an appointment, please call Council Bluffs at 712-323-5333, Omaha at 402-991-9958, or Clarinda at 712-542-2176 or visit their website at millerortho.com.
Don’t forget to take care of your feet during those summertime runs! Read the graphic below to learn how to prevent common running injuries. If you experience any heel pain, achilles tendon pain, ball of the foot pain or stress fracture/broken bones, make an appointment with one of our physicians or visit our free sports injury clinic.
Click here to learn more about the foot and ankle injuries we treat.
March 3, 2016 (Omaha, NE) – At Nan Colwell’s first yoga class she couldn’t wait for the hour to be over. Laying flat on the floor hurt her hip tremendously. But now, she loves it.
“Recently I just started going to a yoga class again; I have no pain at all,” said Colwell of Missouri Valley, IA. “My flexibility is getting better and better all the time.”
After having pain in her hip for over a year Colwell, 57, wasn’t shocked when Dr. C. Kent Boese, orthopedic surgeon at Miller Orthopedic Specialists, said she needed a hip replacement. For her, a traditional total hip replacement wasn’t the only option. Dr. Boese told Colwell she was an eligible candidate for an outpatient total hip replacement.
“I was a little afraid of (the procedure) but the longer I thought about it and (Dr. Boese) explained the lesser risk of infection and faster recovery, it made a lot of sense,” she said.
Outpatient total hip replacement is different than a traditional total hip replacement because the patient has surgery that morning and is in the comfort of their home that afternoon to continue recovery. With a traditional total hip replacement patients stay at the hospital for an average of 3 – 4 days after surgery. Colwell’s surgery took place at the Advanced Surgery Center in Omaha.
“My family couldn’t believe when they came back from lunch that I was all dressed and ready to go,” Colwell said.
Miller Orthopedic Specialists is the only orthopedic group in the Omaha, Council Bluffs and Southwest Iowa community conducting outpatient total hip and knee replacements. Outpatient total hip and knee replacement are not a new procedure and has been conducted in larger cities for years.
“This is made possible with recent advances, such as improved anesthesia, less invasive techniques, comprehensive pre-operative programs and protocols for post-surgery home-health and rehabilitation,” Dr. Boese said.
The benefits of an outpatient total hip replacement versus a traditional total hip replacement are lower cost, less risk of infection, quicker recovery and being able to recover in the comfort of your own home.
A research study published in the Journal of Arthroplasty in 2015 showed costs for outpatient total hip replacement are significantly less than an inpatient total hip replacement. Another study indicated no differences in long-term complication rates between patients undergoing outpatient total hip replacement versus inpatient total hip replacement.
Home health care and physical therapy are arranged prior to surgery. A professional arrives at the patient’s home to help assess if adjustments need to be made around the house for a comfortable recovery. At home exercises as well as physical therapy sessions continue after surgery to help retain full range of motion.
“It wasn’t easy-peasy,” Colwell said. “Every day it just got better and better.”
Eleven days after surgery Colwell arrived at Miller Orthopedic Specialists’ Council Bluff Clinic for her hospital follow up with Dr. Boese. She was able to walk down the hallway of the doctor’s office without a walker or a cane. After the appointment Colwell continued to use a cane throughout her day and used a walker while walking around her home at night.
A couple months after surgery, Colwell said she feels no pain and was able to mow her lawn and walk on the treadmill again, as well as give yoga a second chance.
“I try to walk 10,000 steps a day,” Colwell said. “Every day I could see improvement. I was really pleased with how recovery went.”
To learn if you are an eligible candidate for an outpatient total hip or total knee replacement, make an appointment for a consultation with one of our physicians at Miller Orthopedic Specialists.
“We look for patients who are very motivated to return to activity better than presurgery and who can follow post-surgical requirements,” Dr. Boese said. “Someone who is reasonably in good physical condition and has a strong support system in their home for an extra set of eyes and hands to help after surgery is important too.”
Colwell said she would definitely recommend Miller Orthopedic Specialists to family and friends.
“Dr. Boese and his staff were just wonderful to work with and sought to any need that I had,” Colwell said. “The overall experience was wonderful. I would do it again in a heartbeat if I had to. I just wouldn’t wait as long.
For more information about outpatient total hip or knee replacements with Miller Orthopedic Specialists, visit millerortho.com. The phone number to the main clinic in Council Bluffs is 712-323-5333 and the Omaha office is 402-991-9958. Several Physicians within Miller Orthopedic Specialists, Drs. Boese, Abraham, Trinh and Atteberry, perform this procedure. Convenient locations are available with 12 outreach clinics throughout Omaha, Council Bluffs and Southwest Iowa. Miller Orthopedic Specialists has served the Council Bluffs/Omaha area for over 40 years. The goal is to restore patients to optimum health quickly and safely.
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Council Bluffs, IA 08/26/2015 – Pauline Kapoun, 60, had put off hip replacement surgery for years until the pain made walking and daily activities difficult. That was when she decided to see Dr. C. Kent Boese, an orthopedic surgeon with Miller Orthopedic Specialists, who performs a less invasive surgical technique for hip replacement called the Anterior Approach. This procedure helped Pauline, and other patients, recover sooner with less pain and fewer restrictions than traditional hip replacement surgery.
The Anterior Approach allows the surgeon to work between the patient’s muscles and tissues without detaching them from either the hip or thighbones, sparing the tissue from trauma. In traditional approaches to hip replacement, surgeons make the incision on the back or side, which requires them to cut and detach muscles to get to the hip.
“Many candidates for hip replacement surgery come in expecting a long and sometimes painful recovery and they are quite relieved to learn that we have a way that can get them back on their feet and to their normal activities much sooner than they think,” explained Dr. Boese.
“I could not believe that, when I came to, I felt great,” Pauline said. She was walking several days after the surgery, sometimes without a walker or cane. She continues, “My experience has been wonderful and to me, this surgery was life changing. Two months after surgery, I am back to activities I love without dealing with the pain.”
For more information about the Anterior Approach or to schedule a consultation for this procedure, please call the main office at 712-323-5333 or visit millerortho.com. Dr. Boese has several clinics throughout Southwest Iowa and Nebraska including Council Bluffs, Clarinda, Denison, Manning and Omaha. Miller Orthopedic Specialists has served the Council Bluffs/Omaha area for over 40 years. The goal is restore patients to optimum health as quickly and safely as possible.
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Total knee replacement is traditionally considered an inpatient surgical procedure where you are in the hospital for an average of 3-4 days. Outpatient total knee replacement is an alternative to traditional total knee replacement as it allows patients to go home the same day of surgery. This is possible with recent advances in techniques, improved anesthesia and expedited rehabilitation protocols.
For a consultation with Dr. Boese, Dr. Abraham, Dr. Trinh and Dr. Atteberry, please schedule an appointment at one of his clinic locations to see if you are a candidate for the outpatient total knee replacement.
Miller Orthopedic Specialists is in-network with Blue Cross Blue Shield. We are welcoming new patients at our Omaha and Council Bluffs clinics. For all of your injuries or conditions of your bones, joints and muscles, call Miller Orthopedic Specialists and get back to your healthy and active lifestyle.
Back then, if you were under 60-years-old and experienced hip pain, your orthopedic physician advised you to hit the “magic number” before undergoing a hip replacement. Many orthopedic physicians have since changed their stance. It is increasingly more common for younger individuals to undergo a hip replacement due to osteoarthritis, avascular necrosis and traumatic arthritis. Orthopedic physicians now recommend a total hip replacement when patients have tried non-surgical alternatives to no avail.
Newer prosthetic devices are estimated to last over 20 years. Modern devices have a replaceable liner between the ball and socket that can be replaced solely due to wear, rather than replacing the entire hip prostheses. To extend the durability of the prostheses, it is recommended to switch from high impact to more moderate impact activities.
Despite your age, if hip pain has affected your lifestyle, it is time to see an orthopedic physician and learn your treatment options in getting back into an active lifestyle.
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