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Understanding Ankle SprainEsguinces de tobillo

Understanding Ankle Sprain

Side view of bones of lower leg and foot showing ligaments.The ankle is the joint where the leg and foot meet. Bones are held in place by connective tissue called ligaments. When ankle ligaments are stretched to the point of pain and injury, it is called an ankle sprain. A sprain can tear the ligaments. These tears can be very small but still cause pain. Ankle sprains can be mild or severe.

What causes an ankle sprain?

A sprain may occur when you twist your ankle or bend it too far. This can happen when you stumble or fall. Things that can make an ankle sprain more likely include:

  • Having had an ankle sprain before

  • Playing sports that involve running and jumping. Or playing contact sports such as football or hockey.

  • Wearing shoes that don’t support your feet and ankles well

  • Having ankles with poor strength and flexibility

Symptoms of an ankle sprain

Symptoms may include:

  • Pain or soreness in the ankle

  • Swelling

  • Redness or bruising

  • Not being able to walk or put weight on the affected foot

  • Reduced range of motion in the ankle

  • A popping or tearing feeling at the time the sprain occurs

  • An abnormal or dislocated look to the ankle

  • Instability or too much range of motion in the ankle

Treatment for an ankle sprain

Treatment focuses on reducing pain and swelling, and avoiding further injury. Treatments may include:

  • Resting the ankle. Avoid putting weight on it. This may mean using crutches until the sprain heals.

  • Prescription or over-the-counter pain medicines. These help reduce swelling and pain.

  • Cold packs. These help reduce pain and swelling.

  • Raising your ankle above your heart. This helps reduce swelling.

  • Wrapping the ankle with an elastic bandage or ankle brace. This helps reduce swelling and gives some support to the ankle. In rare cases, you may need a cast or boot.

  • Stretching and other exercises. These improve flexibility and strength.

  • Heat packs. These may be recommended before doing ankle exercises.

Possible complications of an ankle sprain

An ankle that has been weakened by a sprain can be more likely to have repeated sprains afterward. Doing exercises to strengthen your ankle and improve balance can reduce your risk for repeated sprains. Other possible complications are long-term (chronic) pain or an ankle that remains unstable.

When to call your healthcare provider

Call your healthcare provider right away if you have any of these:

  • Fever of 100.4°F (38°C) or higher, or as directed

  • Pain, numbness, discoloration, or coldness in the foot or toes

  • Pain that gets worse

  • Symptoms that don’t get better, or get worse

  • New symptoms

Ankle Pain

Ankle pain is often due to an ankle sprain but can also be caused by other issues.

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ArthritisArtritis

Arthritis

What is arthritis?

Arthritis and other rheumatic diseases are common conditions that cause pain, swelling, and limited movement. They affect joints and connective tissues around the body. Millions of people in the U.S. have some form of arthritis.

Arthritis means inflammation of a joint. A joint is where two or more bones meet. There are more than 100 different arthritis diseases. Rheumatic diseases include any condition that causes pain, stiffness, and swelling in joints, muscles, tendons, ligaments, or bones. Arthritis is usually chronic, which means that it is ongoing.

Arthritis and other rheumatic diseases are more common in women than men.  They are also often associated with old age. This is because the most common form of arthritis, osteoarthritis, occurs more often in older adults. However, arthritis and other rheumatic diseases affect people of all ages.

The three most common forms of arthritis are:

  • Osteoarthritis. This is the most common type of arthritis. It is a chronic disease of the joints, especially the weight-bearing joints of the knee, hip, and spine. Osteoarthritis destroys cartilage and narrows the joint space. It can also cause bone overgrowth, bone spurs, and reduced function. It occurs in most people as they age. It may also occur in young people as a result of injury or overuse.
  • Fibromyalgia. This is a disease that causes chronic, widespread pain in muscles and soft tissues around the body.
  • Rheumatoid arthritis. This is an inflammatory disease of the lining of the joint (synovium). The inflammation may affect all of the joints.

Other forms of arthritis or related disorders include:

  • Gout. This condition causes urate crystals to build up in small joints, such as the big toe. It causes pain and inflammation.
  • Systemic lupus erythematosus (lupus). Lupus is a chronic autoimmune disorder that causes episodes of inflammation and damage in joints, tendons, and organs.
  • Scleroderma. This is an autoimmune disease that causes thickening and hardening of the skin and other connective tissue in the body.
  • Ankylosing spondylitis. This disease causes the bones of the spine to grow together.
  • Juvenile idiopathic arthritis (JIA) or juvenile rheumatoid arthritis (JRA). This is a form of arthritis in children that causes inflammation and stiffness of joints. Children often outgrow JRA. But it can affect bone development in a growing child.

What causes arthritis?

The cause of arthritis depends on the type of arthritis. Osteoarthritis is caused by the wear and tear of the joint over time or because of overuse. Rheumatoid arthritis, lupus, and scleroderma are caused by the body’s immune system attacking the body’s own tissues. Gout is caused by the buildup of crystals in the joints. Arthritis can be linked to genes. People with genetic marker HLA-B27 have a higher risk of ankylosing spondylitis. Many other forms of arthritis are idiopathic. This means that the cause is not known.

Who is at risk for arthritis?

Some risk factors for arthritis that can’t be avoided or changed include:

  • Age. The older you are, the more likely you are to develop arthritis.
  • Gender. Women are more likely to have arthritis than men.
  • Heredity. Some types of arthritis are associated with specific genes.

Risk factors that may be avoided or changed include:

  • Weight. Being overweight or obese can damage the knee joints. This can make them more likely to develop osteoarthritis.
  • Injury. A joint that has been damaged by an injury is more likely to develop arthritis at some point.
  • Infection. Reactive arthritis can affect joints after an infection.
  • Occupation. Work that involves repetitive bending or squatting can lead to knee arthritis.

What are the symptoms of arthritis?

Symptoms can occur a bit differently in each person. The most common symptoms include:

  • Pain in one or more joints that doesn’t go away, or comes back
  • Warmth and redness in one or more joints
  • Swelling in one or more joints
  • Stiffness in one or more joints
  • Trouble moving one or more joints in a normal way

The symptoms of arthritis can be like other health conditions. Make sure to see your health care provider for a diagnosis.

How is arthritis diagnosed?

The process starts with a medical history and a physical exam. Tests may also be done. These include blood tests such as:

  • Antinuclear antibody (ANA) test, to check the levels of antibodies in the blood
  • Complete blood count, to see if white blood cell, red blood cell, and platelet levels are normal
  • Creatinine, to check for kidney disease
  • Sedimentation rate, to detect inflammation
  • Hematocrit, to measure the number of red blood cells
  • Rheumatoid factor test, to see if rheumatoid factor is present in the blood
  • White blood cell count, to determine the level of white blood cells in the blood
  • Uric acid, to help diagnosis gout

Other tests may be done, such as:

  • Joint aspiration (arthrocentesis). A small sample of the synovial fluid is taken from a joint. It's tested to see if crystals, bacteria, or viruses are present.
  • X-rays or other imaging tests. These are done look at the extent of damage to a joint.
  • Urine test. This is done to check for protein and various kinds of blood cells.
  • HLA tissue typing. This is done to look for genetic markers of ankylosing spondylitis.
  • Skin biopsy. Tiny pieces of tissue are taken to check under a microscope. This helps to diagnose a type of arthritis that involves the skin, such as lupus or psoriatic arthritis.
  • Muscle biopsy. Tiny pieces of tissue are taken to check under a microscope. This helps to diagnose conditions that affect muscles. These include polymyositis or vasculitis.

How is arthritis treated?

Treatment will depend on your symptoms, your age, and your general health. It will also depend on how what type of arthritis you have, and how severe the condition is. A treatment plan is tailored to each person with his or her health care provider.

There is no cure for arthritis. The goal of treatment is often to limit pain and inflammation, and help ensure joint function. Treatment plans often use both short-term and long-term methods.

Short-term treatments include:

  • Medications. Short-term relief for pain and inflammation may include pain relievers such as acetaminophen, aspirin, ibuprofen, or other nonsteroidal anti-inflammatory medications.
  • Heat and cold. Pain may be eased by using moist heat (warm bath or shower) or dry heat (heating pad) on the joint. Pain and swelling may be eased with cold (ice pack wrapped in a towel) on the joint.
  • Joint immobilization. The use of a splint or brace can help a joint rest and protect it from further injury.
  • Massage. The light massage of painful muscles may increase blood flow and bring warmth to the muscle.
  • Transcutaneous electrical nerve stimulation (TENS). Pain may be reduced with the use of a TENS device. The device sends mild, electrical pulses to nerve endings in the painful area. This blocks pain signals to the brain and changes pain perception.
  • Acupuncture. This is the use of thin needles that are inserted at specific points in the body. It may stimulate the release of natural, pain-relieving chemicals made by the nervous system. The procedure is done by a licensed health care provider.

Long-term treatments include:

  • Disease-modifying antirheumatic drugs (DMARDs). These prescription medications may slow down the disease and treat any immune system problems linked to the disease. Examples of these medications include methotrexate, hydroxychloroquine, sulfasalazine, and chlorambucil.
  • Corticosteroids. Corticosteroids reduce inflammation and swelling. These medications, such as prednisone, can be taken orally or as an injection.
  • Hyaluronic acid therapy. This is a joint fluid that appears to break down in people with osteoarthritis. It can be injected into a joint, such as the knee, to help relieve symptoms.
  • Surgery. There are many types of surgery, depending on which joints are affected. Surgery options may include arthroscopy, fusion, or joint replacement. Full recovery after surgery takes up to 6 months. A rehabilitation program after surgery is an important part of the treatment.

Arthritis treatment can include a team of health care providers, such as:

  • Orthopedist/orthopedic surgeon
  • Rheumatologist
  • Physiatrist
  • Primary care doctor (family medicine or internal medicine)
  • Rehabilitation nurse
  • Dietitian
  • Physical therapist
  • Occupational therapist
  • Social worker
  • Psychologist/psychiatrist
  • Recreational therapist
  • Vocational therapist

What are the complications of arthritis?

Because arthritis causes joints to degenerate over time, it can cause disability. It can cause pain and movement problems that cause a person to be less able to carry out normal daily activities and tasks.

Living with arthritis

Although there is no cure for arthritis, it is important to help keep joints functioning by reducing pain and inflammation. Work on a treatment plan with your health care provider that includes medication and therapy. Work on lifestyle changes that can improve your quality of life. Lifestyle changes include:

  • Weight loss. Extra weight puts more stress on weight-bearing joints, such as the hips and knees.
  • Exercise. Some exercises may help reduce joint pain and stiffness. These include swimming, walking, low-impact aerobic exercise, and range-of-motion exercises. Stretching exercises may also help keep the joints flexible.
  • Activity and rest. To reduce stress on your joints, alternate between activity and rest. This can help protect your joints and lessen your symptoms.
  • Use of assistive devices. Canes, crutches, and walkers can help to keep stress off certain joints and to improve balance.
  • Use of adaptive equipment. Reachers and grabbers allow people to extend their reach and reduce straining. Dressing aids help people get dressed more easily.
  • Managing use of medications. Long-term use of some anti-inflammatory medications can lead to stomach bleeding. Work with your health care provider to develop a plan to reduce this risk.

When should I call my health care provider?

If your symptoms get worse or you have new symptoms, let your health care provider know.

Key points about arthritis

  • Arthritis and other rheumatic diseases cause pain, swelling, and limited movement in joints and connective tissues in the body.
  • Arthritis and other rheumatic diseases affect people of all ages. They are more common in women than men.
  • Symptoms may include pain, stiffness, swelling, warmth, or redness in one or more joints.
  • There is no cure for arthritis. The goal of treatment is to limit pain and inflammation and preserve joint function.
  • Treatment options include medications, weight reduction, exercise, and surgery.

Next steps

Tips to help you get the most from a visit to your health care provider:

  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

Arthritis

Arthritis is inflammation of one or more joints. There are over 100 types of arthritis.

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Ligament Injuries to the KneeLesiones de los Ligamentos de la Rodilla

Ligament Injuries to the Knee

What are knee ligaments?

There are 4 major ligaments in the knee. Ligaments are elastic bands of tissue that connect bones to each other and provide stability and strength to the joint. The 4 main ligaments in the knee connect the femur (thighbone) to the tibia (shin bone), and include:

Anatomy of the knee
Click image to enlarge

  • Anterior cruciate ligament (ACL). The ligament, located in the center of the knee, that controls rotation and forward movement of the tibia (shin bone).

  • Posterior cruciate ligament (PCL). The ligament, located in the back of the knee, that controls backward movement of the tibia (shin bone).

  • Medial collateral ligament (MCL). The ligament that gives stability to the inner knee.

  • Lateral collateral ligament (LCL). The ligament that gives stability to the outer knee.

How are cruciate ligaments injured?

The anterior cruciate ligament (ACL) is one of the most common ligaments to be injured. The ACL is often stretched and/or torn during a sudden twisting motion (when the feet stay planted one way, but the knees turn the other way). Skiing, basketball, and football are sports that have a higher risk of ACL injuries.

The posterior cruciate ligament (PCL) is also a common ligament to become injured in the knee. However, the PCL injury usually occurs with sudden, direct impact, such as in a car accident or during a football tackle.

What are the symptoms of a cruciate ligament injury?

Often, a cruciate ligament injury does not cause pain. Instead, the person may hear a popping sound as the injury occurs, followed by the leg buckling when trying to stand on it, and swelling. However, each individual may experience symptoms differently.

The symptoms of a cruciate ligament injury may look like other conditions or medical problems. Always see your doctor for a diagnosis.

How are collateral ligaments injured?

The medial collateral ligament is injured more often than the lateral collateral ligament. Stretch and tear injuries to the collateral ligaments are usually caused by a blow to the outer side of the knee, such as when playing hockey or football.

What are the symptoms of a collateral ligament injury?

Similar to cruciate ligament injuries, an injury to the collateral ligament causes the knee to pop and buckle, causing pain and swelling.

The symptoms of a collateral ligament injury may look like other conditions or medical problems. Always see your doctor for a diagnosis.

How is a knee ligament injury diagnosed?

In addition to a complete medical history and physical exam, diagnostic procedures for a knee ligament injury may include:

  • X-ray. A diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film to rule out an injury to bone instead of, or in addition to, a ligament injury.

  • Magnetic resonance imaging (MRI). A diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body; can often determine damage or disease in bones and a surrounding ligament or muscle.

  • Arthroscopy. A minimally-invasive diagnostic and treatment procedure used for conditions of a joint. This procedure uses a small, lighted, optic tube (arthroscope) that is inserted into the joint through a small incision in the joint. Images of the inside of the joint are projected onto a screen; used to evaluate any degenerative and/or arthritic changes in the joint; to detect bone diseases and tumors; to determine the cause of bone pain and inflammation.

Treatment for knee ligament injuries

Treatment may include:

  • Medicaine such as ibuprofen

  • Muscle-strengthening exercises

  • Protective knee brace (for use during exercise)

  • Ice pack application (to reduce swelling)

  • Surgery

Knee Ligament Injuries

Ligament injuries to the knee can include damage to the ACL (most common), MCL, LCL or the PCL.

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FracturesFracturas

Fractures

What is a fracture?

A fracture is a partial or complete break in the bone. When a fracture occurs, it’s classified as either open or closed:

  • Open fracture (also called compound fracture): The bone pokes through the skin and can be seen, or a deep wound exposes the bone through the skin.
  • Closed fracture (also called simple fracture). The bone is broken, but the skin is intact.

Fractures have a variety of names. Here is a listing of the common types that may occur:

  • Greenstick. This is an incomplete fracture. A portion of the bone is broken, causing the other side to bend.
  • Transverse. The break is in a straight line across the bone.
  • Spiral. The break spirals around the bone; common in a twisting injury.
  • Oblique. The break is diagonal across the bone
  • Compression. The bone is crushed, causing the broken bone to be wider or flatter in appearance.
  • Comminuted. The bone has broken into three or more pieces and fragments are present at the fracture site.
  • Segmental. The same bone is fractured in two places, so there is a "floating" piece of bone.

What causes fractures?

Fractures most often happen when more force is applied to the bone than the bone can take. Bones are weakest when they are twisted.

Bone fractures can be caused by falls, trauma, or as a result of a direct blow or kick to the body.

Overuse or repetitive motions can tire muscles and put more pressure on the bone, causing a stress fractures. This is more common in athletes.

Fractures can also be caused by diseases that weaken the bone, such as osteoporosis or cancer in the bones.

What are the symptoms of a fracture?

The following are the most common symptoms of a fracture. However, each person may experience symptoms differently. Symptoms of a broken or fractured bone may include:

  • Sudden pain
  • Trouble using or moving the injured area or nearby joints
  • Swelling
  • Obvious deformity
  • Warmth, bruising, or redness

The symptoms of a broken bone may resemble other medical conditions or problems. Always see a doctor for a diagnosis.

How is a fracture diagnosed?

In addition to a complete medical history (including asking how the injury occurred) and physical exam, tests used for a fracture may include the following:

  • X-ray. A diagnostic test which uses invisible electromagnetic energy beams to make pictures of internal tissues, bones, and organs on film.
  • Magnetic resonance imaging (MRI). An imaging test that uses large magnets, radiofrequencies, and a computer to produce detailed pictures of structures within the body.
  • Computed tomography scan (also called a CT or CAT scan). An imaging test that uses X-rays and computer technology to produce horizontal images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs.

CT scan
CT scan

How is a fracture treated?

The goal of treatment is to put the pieces of bone back in place, control the pain, give the bone time to heal, prevent complications, and restore normal use of the fractured area.

Treatment may include:

  • Splint or cast. This immobilizes the injured area to keep the bone in alignment. It protects the injured area from motion or use while the bone heals.
  • Medication. This may be needed to control pain.
  • Traction. Traction is the use of a steady pulling action to stretch certain parts of the body in a certain direction. Traction often uses pulleys, strings, weights, and a metal frame attached over or on the bed. The purpose of traction is to stretch the muscles and tendons around the broken bone to help the bone ends to align and heal.
  • Surgery. Surgery may be needed to put certain types of broken bones back into place. Occasionally, internal fixation (metal rods or pins located inside the bone) or external fixation devices (metal rods or pins located outside of the body) are used to hold the bone fragments in place while they heal.

Fractures can take many months to heal as broken bones “knit” back together when new bone is formed between the broken parts.

What can I do to prevent fractures?

Most fractures are caused by accidents, such as falls, or other injuries. But there are some things you may be able to do to decrease your risk of bone fractures, for instance:

  • Follow a healthy diet that includes vitamin D and calcium to keep bones strong.
  • Do weight-bearing exercises help to keep bones strong.
  • Do not use any form of tobacco. Tobacco and nicotine increase the risk of bone fractures and interfere with the healing process.
  • Osteoporosis is a common cause of fractures in older people. Talk to your doctor about your risk of osteoporosis and get treatment if you have it.

When should I call my health care provider?

You should see a health care provider any time you think you may have a broken bone.

An open fracture (one in which the bone comes through the skin so you can see it or a deep wound that exposes the bone through the skin) is considered an emergency. Get medical attention right away for this type of fracture.

Any injury to the bones of the spine is also a medical emergency. These cause severe back pain and may cause nerve problems, such as numbness, tingling, weakness, or bowel/bladder problems. Call 911 if you suspect a person has a break in the bones of their spine.

Key points

  • A fracture is a partial or complete break in the bone. There are many different types of fractures.
  • Bone fractures are often caused by falls, trauma, or as a result of a direct blow or kick to the body. Overuse or repetitive motions can cause stress fractures. Fractures can also be caused by diseases that weaken the bone, such as osteoporosis or cancer in the bones.
  • The main goal of treatment is to put the pieces of bone back in place so the bone can heal. This can be done with a splint, cast, surgery, or traction.
  • You should see a health care provider any time you think you may have a broken bone.

Next steps

Tips to help you get the most from a visit to your health care provider:

  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

Fracture

A fracture occurs when a bone is cracked or broken. There are several types of fracture.

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Understanding Joint Pain

Understanding Joint Pain

Sprained ankles and wrists, arthritic knees and hips, and torn rotator cuffs all have one thing in common: they result in joint pain.

The usual causes of joint pain are over use, sprains, fractures, and arthritis. Becoming familiar with the usual causes and symptoms of joint pain can help you seek appropriate treatment and ongoing care, if necessary.

Here are several medical conditions that can cause joint pain.

Arthritis

Persistent joint pain, swelling, and limited range of motion are typical symptoms of arthritis. Inflammatory types of arthritis, such as rheumatoid or gouty arthritis, may also make the joint red, hot, and tender to the touch.

Mild arthritis can often be self-managed with pain relievers, ice, and gentle range of motion exercise. Pain that is getting worse or is severe warrants a trip to the doctor to verify the diagnosis and get stronger medications or other therapies. 

Osteoarthritis

This is a chronic disease of the joints and the most common joint disorder. The cartilage between a joint's bones gradually wears away with time and use. The lack of cartilage results in pain and stiffness in the joint.

Tendonitis

Tendonitis is inflammation of a tendon, a thick fibrous cord that attaches muscle to bone. Some common names for tendonitis are tennis or golfer’s elbow and repetitive stress injury. Symptoms include pain, tenderness, and mild swelling near a joint.

Self-care that includes ice and resting the joint are often effective. A doctor should evaluate ongoing pain.

Sprains

A sprain is an injury to a ligament. The severity of the injury depends on how badly a ligament is torn or strained and the number of ligaments involved. A sprain can result from a fall, sudden twist, or blow to the body that forces a joint out of its normal position.

The usual signs and symptoms include pain, swelling, bruising, and loss of the ability to use the joint.

Bursitis

The bursae are fluid-filled sacs around the joints that allow muscles and tendons to slip easily over the ends of bones. If these bursae become inflamed, the joint will be painful.

See a doctor

Although mild joint pain can often be treated with RICE (Rest, Ice, Compression, and Elevation) and over-the-counter pain and inflammation relievers, you should see a doctor if you have severe pain, can’t put any weight on the joint, it looks crooked, or you can’t move it.

Do not resume full activity before you are fully recovered or you are at greater risk for reinjury.

Joint Pain

Joint pain can be caused by injury affecting any of the ligaments, bursae, or tendons surrounding the joint.

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Psoriatic ArthritisArtritis Psoriásica

Psoriatic Arthritis

What is psoriatic arthritis?

Psoriatic arthritis is a form of arthritis associated with psoriasis. Psoriasis is a chronic skin and nail disease. It causes red, scaly rashes and thick, pitted fingernails. Psoriatic arthritis is similar to rheumatoid arthritis (RA) in symptoms and joint inflammation. But it tends to affect fewer joints than RA. And it does not produce the typical RA antibodies. The arthritis of psoriatic arthritis comes in 5 forms:

  • Arthritis that affects the small joints in the fingers and/or toes
  • Asymmetrical arthritis of the joints in the hands and feet
  • Symmetrical polyarthritis, a type of arthritis similar to rheumatoid arthritis
  • Arthritis mutilans, a rare type of arthritis that destroys and deforms joints
  • Psoriatic spondylitis, arthritis of the lower back (sacroiliac sac) and the spine

What causes psoriatic arthritis?

The cause of psoriatic arthritis is unknown. But factors such as immunity, genes, and the environment may play a role.

What are the symptoms of psoriatic arthritis?

The skin condition psoriasis may start before or after the arthritis. Symptoms can occur a bit differently in each person. Psoriasis causes red, scaly rashes and thick, pitted fingernails. Symptoms of psoriatic arthritis may include:

  • Inflamed, swollen, and painful joints, often in the fingers and toes
  • Deformed joints from chronic inflammation
  • The symptoms of psoriatic arthritis can be like other health conditions. Make sure to see your health care provider for a diagnosis.

How is psoriatic arthritis diagnosed?

Psoriatic arthritis is easier to confirm if you already have psoriasis. If the skin symptoms have not yet occurred, diagnosis is more difficult. The process starts with a medical history and a physical exam. Your health care provider will ask about your symptoms. You may have blood tests to check:

  • Erythrocyte sedimentation rate (ESR or sed rate). This test looks at how quickly red blood cells fall to the bottom of a test tube. When swelling and inflammation are present, the blood's proteins clump together and become heavier than normal. They fall and settle faster at the bottom of the test tube. The faster the blood cells fall, the more severe the inflammation.
  • Uric acid. High blood uric acid levels are linked with psoriatic arthritis.

How is psoriatic arthritis treated?

Treatment will depend on your symptoms, your age, and your general health. It will also depend on how severe the condition is.

Treatment is done for both the skin condition and the joint inflammation. Some medications used to treat psoriatic arthritis include:

  • Nonsteroidal anti-inflammatory medications to relieve symptoms
  • Vitamins and minerals, such as calcium and vitamin D, to slow bone deformation
  • Immunosuppressive medications, such as methotrexate, to suppress inflammation if NSAIDs are not effective
  • Biologic medications, such as the drugs etanercept and adalimumab
  • Corticosteroids for inflammation

Other treatment may include:

  • Ultraviolet light treatment (UVB or PUVA)
  • Heat and cold
  • Splints
  • Exercise
  • Physical therapy to improve and maintain muscle and joint function
  • Occupational therapy to improve ability to perform activities of daily living
  • Management of psoriasis skin rash
  • Surgery to repair or replace a damaged joint (usually not needed until years after diagnosis)

What are the complications of psoriatic arthritis?

The condition may damage joints enough to change a person’s activity level. Lack of activity can lead to stiff joints and muscle weakness. Psoriatic arthritis can also cause fatigue and low red blood cell count (anemia). People with psoriatic arthritis are more likely to develop:

  • High blood pressure
  • High cholesterol
  • Obesity
  • Diabetes

Living with psoriatic arthritis

There is no cure for psoriatic arthritis. However, you can reduce your symptoms. This includes sticking to your treatment plan. Manage pain with medication, acupuncture, and meditation. Get enough exercise. Good exercises include yoga, swimming, walking, and bicycling. Work with a physical or occupational therapist. He or she can suggest devices to help you in your daily tasks.

When should I call my health care provider?

If your symptoms get worse or you have new symptoms, let your health care provider know.

Key points about psoriatic arthritis

  • Psoriatic arthritis is a form of arthritis with a skin rash.
  • Psoriasis is a chronic skin and nail disease. It causes red, scaly rashes and thick, pitted fingernails. The rash may come before or after the arthritis symptoms.
  • Psoriatic arthritis causes inflamed, swollen, and painful joints. It happens most often in the fingers and toes. It can lead to deformed joints.
  • Treatment may include medications, heat and cold, splints, exercise, physical therapy, and surgery.

Next steps

Tips to help you get the most from a visit to your health care provider:

  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

Psoriatic Arthritis

Psoriatic arthritis is a chronic disease characterized by inflammation of the skin and joints.

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KyphosisCifosis

Kyphosis

What is kyphosis?

A normal spine, when viewed from behind appears straight. However, a spine affected by kyphosis has a forward curvature of the back bones (vertebrae) in the upper back area, giving an abnormally rounded or "humpback" appearance.

Kyphosis is defined as a curvature of the spine measuring 50 degrees or greater on an X-ray. The normal spine can bend from 20 to 45 degrees of curvature in the upper back area. Kyphosis is a type of spinal deformity.

What causes kyphosis?

Kyphosis can be congenital (present at birth), or due to acquired conditions that may include the following:

  • Metabolic problems
  • Neuromuscular conditions
  • Osteogenesis imperfecta (also called "brittle bone disease"). A condition that causes bones to fracture with minimal force.
  • Spina bifida. A neural tube defect.
  • Scheuermann's disease. A condition that causes the vertebrae to curve forward in the upper back area. The cause of Scheuermann's disease is unknown and is commonly seen in males.
  • Postural kyphosis. The most common type of kyphosis. It generally becomes noticeable in adolescence and can be associated with slouching versus a spinal abnormality. Exercise is used to help correct posture.

Kyphosis is more common in females than males.

What are the symptoms of kyphosis?

The following are the most common symptoms of kyphosis. However, each person may experience symptoms differently. Symptoms may include:

  • Difference in shoulder height
  • The head bends forward compared to the rest of the body
  • Difference in shoulder blade height or position
  • When bending forward, the height of the upper back appears higher than normal
  • Tight hamstrings (back thigh) muscles

Back pain, pain down the legs, and changes in bowel and bladder habits are not commonly associated with kyphosis. A person experiencing these types of symptoms requires further medical evaluation by a doctor.

The symptoms of kyphosis may resemble other spinal conditions or deformities, or may be a result of an injury or infection. Always consult your doctor for a diagnosis.

How is kyphosis diagnosed?

The health care provider makes the diagnosis of kyphosis with a complete medical history, physical exam, and diagnostic tests. For a child, the health care provider will want to have a prenatal and birth history of the child and ask if other family members are known to have kyphosis. The health care provider also will ask about developmental milestones since some types of kyphosis can be associated with other neuromuscular disorders. Developmental delays may require further medical evaluation.

Diagnostic procedures may include the following:

  • Blood tests
  • X-rays. A diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film. This test is used to measure and evaluate the curve. With the use of a full-spine X-ray, the doctor measures the angle of the spinal curve. A treatment plan can often be made based on this measurement.
  • Radionuclide bone scan. A nuclear imaging technique that uses a very small amount of radioactive material, which is injected into the bloodstream to be detected by a scanner. This test shows blood flow to the bone and cell activity within the bone.
  • Magnetic resonance imaging (MRI). A diagnostic procedure that uses a combination of large magnets and a computer to produce detailed images of organs and structures within the body. This test is done to rule out any associated abnormalities of the spinal cord and nerves.
  • Computed tomography scan (also called a CT or CAT scan). A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.

Early detection of kyphosis is important for successful treatment. Doctors, and even some school programs, routinely look for signs that kyphosis may be present.

How is kyphosis treated?

Specific treatment for kyphosis will be determined by your health care provider based on:

  • Your age, overall health, and medical history
  • Extent of the condition
  • Your tolerance for specific medications, procedures, and therapies
  • Expectation for the course of the disease
  • Your opinion or preference

The goal of treatment is to stop the progression of the curve and minimize deformity. Treatment may include:

  • Observation and repeated exams. The child will need observation and repeated exams. Progression of the curve depends on the amount of skeletal growth, or how skeletally mature, the child is. Curve progression slows down or stops after the child reaches puberty.
  • Bracing. If the child is still growing, the doctor may prescribe a brace. The type of brace and the amount of time spent in the brace will be determined by your doctor.
  • Surgery. In rare instances, surgery is recommended when the curve measures 75 degrees or more on X-ray and bracing is not successful in slowing down the progression of the curve.

What are the complications of kyphosis?

Possible complications of kyphosis depend on the type of kyphosis your child has. With Scheuermann’s kyphosis, there may be pain with activity or with long periods of sitting or standing.

Key points

Kyphosis is a type of spinal deformity. Kyphosis is defined as a curvature of the spine measuring 50 degrees or greater on an X-ray.

  • It can be congenital (present at birth), or due to acquired conditions
  • It is more common in females.           
  • The most common symptoms may include:
    • Difference in shoulder height
    • The head bends forward compared to the rest of the body
    • Difference in shoulder blade height or position
    • When bending forward, the height of the upper back appears higher than normal
    • Tight hamstrings (back thigh) muscles
  • The goal of treatment is to stop the progression of the curve and minimize deformity

Next steps

Tips to help you get the most from a visit to your health care provider:

  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

Kyphosis

A condition in which the normal roundback in the upper spine is increased.

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Common Injuries of the Shoulder

Common Injuries of the Shoulder

Whether throwing a ball, paddling a canoe, lifting boxes, or pushing a lawn mower, we rely heavily on our shoulders to perform a number of activities.

Normally, the shoulder has a wide range of motion, making it the most mobile joint in the body. Because of this flexibility, however, it is not very stable and is easily injured.

Front view of shoulder anatomy showing bones, muscles, tendons, and ligaments. Acromion is top part of shoulder blade. Rotator cuff is group of muscles and tendons that attach arm bone to shoulder blade and help shoulder move.  Humerus is arm bone. Humeral head is top part of arm bone shaped like ball and resting against shoulder socket. Scapula is shoulder blade. Glenoid is shallow socket that forms cradle for head of arm bone. Cartilage is smooth covering on ends of bones, cushioning them and allowing them to move without pain. Capsule is sheet of fibers that surround joint. Capsule is tough enough to keep joint stable yet flexible enough to allow it to move freely.

The shoulder is made up of two main bones: the end of upper arm bone (humerus) and the shoulder blade (scapula). The end of the humerus is round and fits into a socket in the scapula. Surrounding the shoulder is a bag of muscles and ligaments. Ligaments connect the bones of the shoulders, and tendons connect the bones to surrounding muscle.

To keep shoulders healthy and pain-free, it's important to know how to spot and avoid common injuries.

Shoulder instability

Shoulder instability happens most often in young people and athletes. When muscles and ligaments that hold it together are stretched beyond their normal limits, the shoulder becomes unstable. For younger people, this condition may be a normal part of growth and development. Shoulders often stiffen or tighten with age.

In athletes, shoulder instability is caused by certain motions used in tackling or pitching, for example. These motions put great force on the shoulder, stretching the shoulder ligaments over time. It can cause pain that comes on either quickly or over time, a feeling that the shoulder is loose, or a weakness in the arm. Treatment includes rest, physical therapy or surgery.

A shoulder separation, or sprain, happens when the ligaments that hold the clavicle to the roof of the shoulder tear. If this happens, the clavicle is pushed out of place and forms a bump at the top of the shoulder. Sprains often happen during a fall, when your hand or arm is outstretched to stop the fall, or when you fall on a hard surface. When the sprain happens, it causes severe pain, a misshapen shoulder, and decreased shoulder movement. Treatment depends on the severity of the sprain. To help decrease pain and swelling, apply ice right after the injury. Keeping the arm in a sling to limit the movement of the shoulder lets ligaments to heal. This is followed by physical therapy exercises. Sometimes, surgery is needed.

If the ligaments holding the shoulder muscles to bones tear and can't hold the joint together, the shoulder is dislocated. Falling onto an outstretched hand, arm or the shoulder itself, or a violent twisting, can cause a shoulder dislocation. The main symptom is pain in the shoulder that becomes worse with movement. To treat a dislocation, apply ice right after the injury to decrease pain, swelling and bleeding around the joint. Within 15 to 30 minutes of the injury, the joint will be painful and swollen. A dislocated shoulder needs urgent medical care. Healthcare providers treat dislocations by using gentle traction to pull the shoulder back into place. When the shoulder pops out of the socket repeatedly, it’s called recurrent instability. Recurrent instability can be treated with surgery to repair the torn ligaments.

Rotator cuff tear

The rotator cuff is a group of four muscles of the upper arm. They allow you to raise and rotate the arm. The muscles are attached to the bones by tendons. The tendons of the rotator cuff allow the muscles to move the arm. If the tendons tear, the humerus can't move as easily in the socket. This makes it hard to move the arm up or away from the body.

As people age and are less active, tendons start to degenerate and lose strength. This weakening can lead to a rotator cuff tear. Most rotator cuff injuries happen to middle-aged or older adults who already have shoulder problems. They can happen in younger people too. The shoulder has a poor blood supply. This makes it harder for the tendons to repair and maintain themselves. Using your arm overhead puts pressure on the rotator cuff tendons. Repetitive movement or stress to these tendons can lead to impingement. This is when the tissue or bone in that area becomes misaligned and rubs or chafes.

The rotator cuff tendons can be injured or torn by trying to lift a very heavy object with an extended arm. It can also happen from falling, or by trying to catch a heavy falling object.

Symptoms of a torn rotator cuff include tenderness and soreness in the shoulder when using the shoulder. If the tendon has ruptured, you may not be able to raise the arm at all. It may be hard to sleep lying on that side. You may feel pain when pressure is put on the shoulder.

Treatment depends on the severity of the injury. If the tear is not complete, your healthcare provider may suggest RICE, for Rest, Ice, Compression, and Elevation. Resting the shoulder is probably the most important part of treatment. But, after the pain has eased, you will need to start physical therapy to regain shoulder movement. Your healthcare provider may prescribe a nonsteroidal anti-inflammatory drug (NSAID) for pain.

Frozen shoulder

This extreme stiffness in the shoulder can happen at any age. It affects about 2% of Americans, most often between 40 and 60 years of age. But the causes are not fully understood. Frozen shoulder can affect people with diabetes, thyroid disease, heart disease, or Parkinson disease. It can also happen if the shoulder has been immobile for a period of time. It happens when a minor shoulder injury heals with scar tissue that affects how the joint moves. This scar tissue reduces flexibility in the shoulder and makes it more prone to injury. The main symptom is the not being able to move the shoulder in any direction without pain. Treatment can be NSAIDs, cortisone shots, or physical therapy. You can reduce further injury and stiffness by stretching before starting activities.

Overuse/strains

A sudden increase in activity can place great stress on the shoulders and lead to a loss of flexibility. This is a common problem in middle age, especially among people who don't exercise regularly, but go out every now and then for an intense sport.

Although painful and inconvenient, overuse problems can often be treated with rest, NSAIDs and stretching exercises.

Arthritis

Starting as early as age 50, some people get osteoarthritis, which causes painful movement. This happens as the smooth surfaces of the cartilage that line the bones of the shoulder joint are worn away, and joints start to wear out and become larger. The most common cause of osteoarthritis is overuse. Treatments for arthritis in the shoulder depend on the severity of pain. The usual treatments are rest, NSAIDs, and cortisone shots. In some cases, a replacement of the shoulder joint is needed.

 

Shoulder & Elbow Pain

Pain in the shoulder or elbow is extremely common with many possible causes.

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Tendonitis and TenosynovitisTendinitis

Tendonitis and Tenosynovitis

What are tendonitis and tenosynovitis?

Tendons are strong cords of tissue that connect muscles to bones. Tendonitis is when a tendon is inflamed. It can happen to any tendon in the body. When a tendon is inflamed, it can cause swelling, pain, and discomfort. Another problem called tenosynovitis is linked to tendonitis. This is the inflammation of the lining of the tendon sheath around a tendon. Usually the sheath itself is inflamed, but both the sheath and the tendon can be inflamed at the same time.

What causes tendonitis and tenosynovitis?

The cause of tendonitis and tenosynovitis is often not known. They may be caused by strain, overuse, injury, or too much exercise. Tendonitis may also be related to a disease such as diabetes, rheumatoid arthritis, or infection.

Types of tendonitis and tenosynovitis

Common types of these tendon problems include:

  • Lateral epicondylitis. This is most often known as tennis elbow. It causes pain in the back side of the elbow and forearm, along the thumb side when the arm is alongside the body with the thumb turned away. The pain is caused by damage to the tendons that bend the wrist back and away from the palm.

  • Medial epicondylitis. This is most often known as golfer's or baseball elbow. It causes pain from the elbow to the wrist on the palm side of the forearm. The pain is caused by damage to the tendons that bend the wrist toward the palm.

  • Rotator cuff tendonitis. This is also known as biceps tendonitis. It’s a shoulder disorder. It causes inflammation of the shoulder capsule and related tendons.

  • DeQuervain's tenosynovitis. This is the most common type of tenosynovitis disorder. It causes swelling in the tendon sheath of the tendons of the thumb.

  • Trigger finger or trigger thumb. This is a type of tenosynovitis. The tendon sheath becomes inflamed and thickened. This makes it hard to extend or flex the finger or thumb. The finger or thumb may lock or "trigger" suddenly.

Symptoms of tendonitis and tenosynovitis

Symptoms may include:

  • Pain in the tendon when moved

  • Swelling from fluid and inflammation

  • A grating feeling when moving the joint

The symptoms of tendonitis can be like other health problems. Make sure to talk with a healthcare provider for a diagnosis.

Diagnosing tendonitis and tenosynovitis

Your healthcare provider will ask about your health history and give you a physical exam. You may have tests to check for other problems that may be causing your symptoms. The tests may include:

  • Joint aspiration. The healthcare provider uses a needle to take a small amount of fluid from the joint. The fluid is tested to check for gout or signs of an infection.

  • X-ray. A small amount of radiation is used to make an image. Tendons can’t be seen on an X-ray, but they can show bone. This test can check for arthritis.

Treatment for tendonitis and tenosynovitis

Treatment may include:

  • Changing your activities

  • Icing the area to reduce inflammation and pain

  • Putting a splint on the area to limit movement

  • Steroid injections to reduce inflammation and pain

  • Nonsteroidal anti-inflammatory medicine to reduce inflammation and pain

  • Antibiotics if due to infection

  • Surgery

Tendonitis

Tendonitis is the inflammation of the tendons, occurs for a variety of reasons.

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Ankylosing SpondylitisEspondilitis Anquilosante

Ankylosing Spondylitis

What is ankylosing spondylitis?

Ankylosing spondylitis (AS) is a type of arthritis that affects the spine. Ankylosing means stiff or rigid, spondyl means spine, and itis refers to inflammation. The disease causes inflammation of the spine and large joints, resulting in stiffness and pain. The disease may result in erosion at the joint between the spine and the hip bone. This is called the sacroiliac joint. It may also cause bony bridges to form between vertebrae in the spine, fusing those bones. Bones in the chest may also fuse.

What causes ankylosing spondylitis?

The cause of AS is not known, but researchers think that genes play a role. A gene called HLA-B27 occurs in over 95 percent of Caucasian-Americans who have AS, but only 50% of African-Americans who have the disease. However, some people with the HLA-B27 gene do not have AS.

Who is at risk for ankylosing spondylitis?

AS is more common among people ages 17 to 35. It can occur in children and older adults as well. The disease affects more young men than women. It tends to run in families.

What are the symptoms of ankylosing spondylitis?

Symptoms of AS tend to go away and come back over periods of time. Symptoms can occur a bit differently in each person. The symptoms may include:

  • Back pain, usually most severe at night during rest
  • Early morning stiffness
  • Stooped posture in response to back pain (bending forward tends to relieve the pain)
  • Straight and stiff spine
  • Inability to take a deep breath, if the joints between the ribs and spine are affected
  • Appetite loss
  • Weight loss
  • Fatigue
  • Fever
  • Anemia
  • Joint pain
  • Mild eye inflammation
  • Organ damage, such as to the heart, lungs, and eyes
  • Skin rashes
  • Gastrointestinal illness (such as Crohn's or ulcerative colitis)

The symptoms of ankylosing spondylitis can be like other health conditions. Make sure to see your health care provider for a diagnosis.

How is ankylosing spondylitis diagnosed?

The process starts with a medical history and a physical exam. Tests may also be done, such as:

  • X-ray. This test uses a small amount of radiation to create images of internal tissues, bones, and organs onto film.
  • Erythrocyte sedimentation rate (ESR or sed rate). This test looks at how quickly red blood cells fall to the bottom of a test tube. When swelling and inflammation are present, the blood's proteins clump together and become heavier than normal. They fall and settle faster at the bottom of the test tube. The faster the blood cells fall, the more severe the inflammation. Up to 70 percent of people with AS have a high ESR.
  • Genetic testing. Genetic testing is done to find if a person carries a copy of an altered gene for a disease. The gene HLA-B27 is found in over 95 percent of people with AS.

How is ankylosing spondylitis treated?

Treatment will depend on your symptoms, your age, and your general health. It will also depend on how severe the condition is. The goal of treatment is to reduce pain and stiffness, prevent deformities, and maintain as normal a lifestyle as possible. Treatment may include:

  • Nonsteroidal anti-inflammatory medications , to reduce pain and inflammation
  • Tumor-necrosis-factor blockers (biologic medications), to reduce inflammation and swelling
  • Disease-modifying antirheumatic drugs (DMARDs), such as sulfasalazine, to decrease inflammation and control AS
  • Short-term use of corticosteroids, to reduce inflammation
  • Short-term use of muscle relaxants and pain relievers, to relieve severe pain and muscle spasms
  • Surgery to replace a joint, place rods in the spine, or remove parts of the thickened and hardened bone
  • Maintaining of proper posture
  • Regular exercise, including exercises that strengthen back muscles

Talk with your health care providers about the risks, benefits, and possible side effects of all medications.

What are the complications of ankylosing spondylitis?

Over time, a forward curve of the spine can develop with AS. Patients with AS are at great risk of thinning of the bones (osteoporosis). This can result in spinal fractures. AS can also lead to psoriasis, and inflammation of the eye, aortic valve, and intestinal tract.

Living with ankylosing spondylitis

There is no cure for AS, so it is important to work on a treatment plan with your health care provider. Work on lifestyle changes that can improve your quality of life. Stay active and keep up with exercise to reduce pain. A physical therapist can help you design an exercise plan and assist you in keeping good posture.

When should I call my health care provider?

If your symptoms get worse or you have new symptoms, let your health care provider know.

Key points about ankylosing spondylitis

  • Ankylosing spondylitis is a type of arthritis that affects the spine.
  • A gene may be part of the cause of AS.
  • Symptoms of AS include back pain, early morning stiffness, and a stooped posture.
  • AS can cause other symptoms such as appetite loss, weight loss, fatigue, fever, anemia, eye inflammation, and GI illness.
  • The goal of treatment for AS is to reduce pain and stiffness, prevent deformities, and maintain as normal a lifestyle as possible.
  • Staying active is important in the management of AS.

Next steps

Tips to help you get the most from a visit to your health care provider:

  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

Ankylosing Spondylitis

Is a form of chronic, often painful, arthritis. It affects joints in the spine and the pelvis.

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Lumbar Disk Disease (Herniated Disk)Enfermedad del Disco Lumbar [Hernia de Disco]

Lumbar Disk Disease (Herniated Disk)

What is lumbar disk disease?

The vertebral column, or backbone, is made up of 33 vertebrae that are separated by spongy disks. The spine is divided into 4 areas:

  • Cervical spine: The first 7 vertebrae, located in the neck
  • Thoracic spine: The next 12 vertebrae, located in the chest area
  • Lumbar spine: The next 5 vertebrae, located in the lower back
  • Sacral spine: The lowest 5 vertebrae, located below the waist, also includes the 4 vertebrae that make up the tailbone (coccyx)

The lumbar spine consists of 5 bony segments in the lower back area, which is where lumbar disk disease occurs.

  • Bulging disk. With age, the intervertebral disk may lose fluid and become dried out. As this happens, the spongy disk (which is located between the bony parts of the spine and acts as a “shock absorber”) becomes compressed. This may lead to the breakdown of the tough outer ring. This lets the nucleus, or the inside of the ring, to bulge out. This is called a bulging disk.
  • Ruptured or herniated disk. As the disk continues to break down, or with continued stress on the spine, the inner nucleus pulposus may actually rupture out from the annulus. This is a ruptured, or herniated, disk. The fragments of disc material can then press on the nerve roots located just behind the disk space. This can cause pain, weakness, numbness, or changes in sensation.

Most disk herniations happen in the lower lumbar spine, especially between the fourth and fifth lumbar vertebrae and between the fifth lumbar vertebra and the first sacral vertebra (the L4-5 and L5-S1 levels).

What causes lumbar disk disease?

Lumbar disk disease is caused by a change in the structure of the normal disk. Most of the time, disk disease happens as a result of aging and the normal break down that occurs within the disk. Sometimes, severe injury can cause a normal disk to herniate. Injury may also cause an already herniated disk to worsen.

What are the risks for lumbar disk disease?

Although age is the most common risk, physical inactivity can cause weak back and abdominal muscles, which may not support the spine properly. Back injuries also increase when people who are normally not physically active participate in overly strenuous activities. Jobs that require heavy lifting and twisting of the spine can also cause back injuries.

What are the symptoms of lumbar disk disease?

The symptoms of lumbar disk disease vary depending on where the disk has herniated, and what nerve root it is pushing on. These are the most common symptoms of lumbar disk disease:

  • Intermittent or continuous back pain. This may be made worse by movement, coughing, sneezing, or standing for long periods of time
  • Spasm of the back muscles
  • Sciatica – pain that starts near the back or buttock and travels down the leg to the calf or into the foot
  • Muscle weakness in the legs
  • Numbness in the leg or foot
  • Decreased reflexes at the knee or ankle
  • Changes in bladder or bowel function

The symptoms of lumbar disc disease may look like other conditions or medical problems. Always see your healthcare provider for a diagnosis.

How is lumbar disk disease diagnosed?

In addition to a complete medical history and physical exam, you may have one or more of the following tests:

  • X-ray. A test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
  • Magnetic resonance imaging (MRI). A procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.
  • Myelogram. A procedure that uses dye injected into the spinal canal to make the structure clearly visible on X-rays.
  • Computed tomography scan (also called a CT or CAT scan). An imaging procedure that uses X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
  • Electromyography (EMG). A test that measures muscle response or electrical activity in response to a nerve’s stimulation of the muscle.

How is lumbar disk disease treated?

Typically, conservative therapy is the first line of treatment to manage lumbar disk disease. This may include a mix of the following:
  • Bed rest
  • Education on proper body mechanics (to help decrease the chance of worsening pain or damage to the disk)
  • Physical therapy, which may include ultrasound, massage, conditioning, and exercise programs
  • Weight control
  • Use of a lumbosacral back support
  • Medicine to control pain and relax muscles

If these measures fail, you may need surgery to  remove the herniated disc. Surgery is done under general anesthesia. Your surgeon will make an incision in your lower back over the area where the disc is herniated. Some bone from the back of the spine may be removed to gain access to the disc. Your surgeon will remove the herniated part of the disc and any extra loose pieces from the disc space.

After surgery, you may be restricted from activity for several weeks while you heal to prevent another disc herniation. Your surgeon will discuss any restrictions with you.

What are the complications of lumbar disk disease?

Lumbar disk disease can cause back and leg pain that interferes with daily activities. It can lead to leg weakness or numbness and trouble with bowel and bladder control.

Can lumbar disk disease be prevented?

Maintaining a healthy weight, participating in regular exercise, and using good posture can lessen your risk for lumbar disk disease.

Living with lumbar disk disease

Conservative therapy requires patience; but sticking with your treatment plan can reduce back pain and minimize the chance of worsening pain or damage to the disk. Conservative measures and surgery can both take time to be effective.

When should I call my healthcare provider?

Call your healthcare provider if your pain increases or if you start having trouble with bowel or bladder control.

Key points about lumbar disk disease

  • Lumbar disk disease may occur when a disc in the low back area of the spine bulges or herniates from between the bony area of the spine.
  • Lumbar disk disease causes lower back pain and leg pain and weakness that is made worse by movement and activity.
  • The first step in treatment is to reduce pain and reduce the risk of further injury to the spine.
  • Surgery may be considered if the more conservative therapy fails.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

Herniated Disk

This condition occurs when a disk has slipped along the spinal cord. Also referred to as cervical radiculopathy.

Learn More

Neck PainDolores y Problemas del Cuello

Neck Pain

What is neck pain?

Because of its location and range-of-motion, your neck is often left unprotected and subject to injury. Neck pain can range from mild discomfort to disabling, chronic pain.

What causes neck pain?

Neck pain can result from many different causes--from injury, to age-related disorders, or inflammatory disease. Causes of neck pain and problems may include the following:

  • Injury (damage to the muscles, tendons, and/or ligaments)
  • Herniated disk in the neck
  • Arthritis (such as osteoarthritis, rheumatoid arthritis)
  • Cervical (neck) disk degeneration
  • Congenital (present at birth) abnormalities of the vertebrae and bones
  • Tumors

Symptoms

How is neck pain diagnosed?

Along with a complete medical history and physical exam, diagnostic procedures for neck pain may include the following:

  • Blood tests. These tests can help determine the diagnosis of inflammatory disease.
  • Electromyogram (EMG). A test to evaluate nerve function.
  • X-ray. A diagnostic test which uses invisible electromagnetic energy beams to produce images of bones onto film.
  • Magnetic resonance imaging (MRI). A diagnostic procedure that uses a combination of large magnets and a computer to produce detailed images of organs and structures within the body; can often determine damage or disease of internal structures within our joints, or in a surrounding ligament or muscle.
  • Computed tomography scan (also called a CT or CAT scan). A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce  images of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.

How is neck pain treated?

Specific treatment for neck pain will be determined by your doctor based on:

  • Your age, overall health, and medical history
  • Your diagnosis
  • Extent of the condition
  • Your tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the condition
  • Your opinion or preference

Treatment may include:

  • Medication (to reduce inflammation and control pain)
  • Rest
  • Physical therapy
  • Neck brace or immobilization
  • Exercise
  • Surgery

When should I call my health care provider?

Treatment for neck pain is recommended when the pain starts to prevent any future injury or damage. 

Living with neck pain

Living with neck pain can be difficult. But the following treatments , often in combination, prove effective both immediately and over time.

To manage your neck pain, you may try medications, rest physical therapy and exercise. 

Key points

  • Neck pain can range from mild discomfort to disabling, chronic pain.
  • Neck pain can result from many different causes--from injury, to age-related disorders, or inflammatory disease.
  • Seeking medical advice as soon as possible after the injury will minimize future damage and inflammation.
  • Once you have been treated for the initial injury, a program of physical rehabilitation may be necessary. It is important to follow through with your program and exercises to both strengthen and build muscles to support your activities.
  • Using good body mechanics may prevent future injury.

Next steps

Tips to help you get the most from a visit to your health care provider:

  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

Neck Pain & Injuries

Age-related wear and tear affecting the neck joints. This may also be referred to as cervical spondylosis.

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Dislocations (Shoulder, Jaw, Elbow, Finger)Dislocaciones (hombro, mandíbula, codo, dedo)

Dislocations (Shoulder, Knee Cap, Elbow, Finger)

A joint is the place where your bones come together. Normally, bones glide smoothly within your joints, allowing a wide range of motion. But a bone can be pushed or pulled out of position. This is known as a dislocation. Dislocation prevents normal joint movement and can be very painful. Prompt treatment is crucial.

X-ray of dislocated shoulder with bones highlighted in white.
An X-ray of a dislocated shoulder joint.

Causes of dislocations

Dislocations can happen to almost any joint. But they're most common in the shoulder, knee cap, elbow, and finger. Dislocated elbows happen most often in children. Many dislocations result from trauma, such as a blow or fall. But some can happen during normal activities. A shoulder can dislocate during the act of throwing a ball.

When to go to the Emergency Room (ER)

A dislocation needs emergency care. Injuries that aren`t treated promptly take longer to heal and may result in lasting damage to the joint. Seek medical help right away if you:

  • Have severe pain in a joint.

  • Can't move the joint normally.

  • Can see the misplaced bone.

  • Have numbness or tingling.

  • Have a break in the skin over the painful joint.

What to expect in the ER

  • You will be given pain medicine to make you more comfortable.

  • The joint will be examined and an X-ray may be taken to check for fractures or other injuries.

  • The joint is put back into place.

  • A dislocated finger or elbow may be splinted to keep it from moving while it heals. An injured shoulder may be placed in a sling.

  • A second X-ray may be done before you leave the hospital.

  • In some cases, you may be referred to a bone specialist (orthopaedist) or a primary care sports medicine healthcare provider. He or she will make sure you heal properly.

Reduce swelling and pain due to a dislocation

Tips to reduce swelling and pain: 

  • Apply ice to the joint (keep a thin cloth between the ice and your skin).

  • Raise the injured area above heart level if you can.

Dislocation

A dislocation is a separation of bones at the joint. A dislocation may cause nerve damage.

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Hip Problems Problemas de la Cadera

Hip Problems

What is the hip?

Anatomy of the hip joint
Click Image to Enlarge

The hip is defined as the region on each side of the pelvis. The pelvis bone is made up of 3 sections, including:

  • Ilium. The broad, flaring portion of the pelvis.

  • Pubis. The lower, posterior part of the pelvis.

  • Ischium. One of the bones that helps form the hip.

The hip joint is a ball-and-socket joint that allows motion and provides stability needed to bear body weight.

The socket area, which is inside the pelvis, is called the acetabulum. The ball part of this joint is the top of the leg bone. It joins with the acetabulum to form the hip joint.

The hip is one of the most stable joints in the body. But, its function, bearing the body's weight, makes it susceptible to arthritis due to excessive pressure. Pain in the hip may involve injury to muscles, tendons, or bursae (small fluid-filled sacs that cushion and lubricate joints).

What are common hip problems?

The following are some of the most common hip problems:

  • Arthritis. The most common cause of the breakdown of hip tissue. There are 3 kinds of arthritis that commonly affect the hip, including:

    • Osteoarthritis. Also referred to as "wear and tear" arthritis. This type of arthritis involves the cartilage that cushions the bones of the hip wearing away, letting the bones then rub together, causing hip pain and stiffness.

    • Rheumatoid arthritis. A disease in which, for unknown reasons, the synovial membrane becomes irritated and produces too much fluid. It damages the cartilage, leading to pain and stiffness.

    • Traumatic arthritis. Often the result of an injury or fracture, there are more than 300,000 hospitalizations for hip fractures in the U.S. every year.

  • Avascular necrosis. Involves the loss of bone caused by insufficient blood supply, injury, and bone tumors and may lead to breakdown of the hip joint.

  • Bursitis. In this condition, the bursa, a closed fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body, becomes inflamed. There are 2 major bursae of the hip, both of which can be associated with stiffness and pain around the hip joint, including the following:

    • Trochanteric bursa. The bursa located on the side of the hip and separated significantly from the actual hip joint by tissue and bone.

    • Ischial bursa. The bursa located in the upper buttock area.

  • Hip pointer. A bruise or tear in the muscle that connects to the top of the ilium (the crest of the pelvis, just below the waist). Causes of a hip pointer may include a blow, a fall, or a quick twist or turn of the body.

Hip Pain

This condition can range from mild to severe pain. This may be caused by a number of medical disorders.

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Torn MeniscusDesgarro del Menisco

Torn Meniscus

What is a torn meniscus?

There are 3 bones in the knee, the femur, tibia and patella. The ends of those bones are covered with cartilage (a smooth material that cushions the bone and allows the joint to move easily without pain). The cartilage acts as a shock absorber. Between the bones of the knees are two crescent-shaped discs of connective tissue, called menisci, which also act as shock absorbers to cushion the lower part of the leg from the weight of the rest of the body.

What causes a torn meniscus?

Meniscus tears can occur during a rotating movement while bearing weight, such as when twisting the upper leg while the foot stays in one place during sports and other activities. Tears can be minor, with the meniscus staying connected to the knee, or major, with the meniscus barely attached to the knee by a cartilage thread.

What are the symptoms of a torn meniscus?

The following are the most common symptoms of a torn meniscus. However, each individual may experience symptoms differently. Symptoms may include:

  • Pain, especially when holding the knee straight
  • Swelling and stiffness
  • Knee may click or lock
  • Knee may feel weak

The symptoms of a torn meniscus may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.

How is a torn meniscus diagnosed?

In addition to a complete medical history and physical exam, diagnostic procedures for a torn meniscus may include the following:

  • X-ray. A diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
  • Magnetic resonance imaging (MRI). A diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body; can often determine damage or disease in a surrounding ligament or muscle.
  • Arthroscopy. A minimally-invasive diagnostic and treatment procedure used for conditions of a joint. This procedure uses a small, lighted, optic tube (arthroscope) which is inserted into the joint through a small incision in the joint. Images of the inside of the joint are projected onto a screen. They are used to evaluate any degenerative and/or arthritic changes in the joint. The procedure also may detect bone diseases and tumors as well as determine the cause of bone pain and inflammation.

How is a torn meniscus treated?

Specific treatment for a torn meniscus will be determined by your doctor based on:

  • Your age, overall health, and medical history
  • Extent of the injury
  • Your tolerance for specific medications, procedures, and therapies
  • Expectation for the course of the injury
  • Your opinion or preference

Treatment may include:

  • Icing
  • Medication to relieve pain and reduce inflammation, such as ibuprofen
  • Muscle-strengthening exercises
  • Arthroscopic surgery

What are the complications of a torn meniscus?

An untreated torn meniscus can result in instability of the knee, persistent pain, and increased your risk of osteoarthritis.

When should I call my health care provider?

Call your health care provider if your knee:

  • Locks or catches or makes a clicking, popping, or grinding sound
  • Is painful and swollen
  • Feels week or buckles

Key points

  • Torn meniscus is caused by a twisting movement of the knee while bearing weight.
  • A torn meniscus causes pain, locking or clicking, and weakness of the knee.
  • Exercises, medication and arthroscopy may be used to treat a torn meniscus.

Next steps

Tips to help you get the most from a visit to your health care provider:

  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

Meniscus Tears

One of the most commonly injured parts of the knee, the meniscus, is located where the major bones of the leg connect.

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Rheumatoid ArthritisArtritis Reumatoide

Rheumatoid Arthritis

What is rheumatoid arthritis?

Rheumatoid arthritis (RA) is a chronic disease that causes inflammation of the joints. The inflammation can be so severe that the function and appearance of the hands and other parts of the body can be affected. In the hand, RA may cause deformities in the joints of the fingers. This makes moving the hands difficult. Lumps, known as rheumatoid nodules, may form over small joints in the hands and the wrist. Juvenile rheumatoid arthritis (JRA) is a form of arthritis in children ages 16 or younger that causes inflammation and stiffness of joints for more than six weeks. Unlike adult RA, which is chronic and lasts a lifetime, children often outgrow JRA. However, the disease can affect bone development in the growing child.

What causes rheumatoid arthritis?

The exact cause of RA is not known. RA is an autoimmune disorder. This means the body's immune system attacks its own healthy cells and tissues. This causes inflammation in and around the joints. It then may lead to a damage of the skeletal system. RA can also cause damage to other organs, such as the heart and lungs. Researchers think certain factors, including heredity, may contribute to the onset of the disease.

RA most often occurs in people from ages of 30 to 50. It happens more in women than in men.

What are the symptoms of rheumatoid arthritis?

The joints most often affected by RA are in the hands, wrists, feet, ankles, knees, shoulders, and elbows. The disease often causes inflammation in the same areas on both sides of the body. Symptoms of RA may begin suddenly or slowly over time. Symptoms can occur a bit differently in each person, and may include:

  • Pain
  • Stiffness, especially in the morning
  • Swelling over the joints
  • Decreased movement
  • Pain that is worse with movement of the joints
  • Bumps over the small joints
  • Trouble performing activities of daily living (ADLs), such as tying shoes, opening jars, or buttoning shirts
  • Decreased ability to grasp or pinch
  • Fatigue
  • Occasional fever

The symptoms of RA can be like other health conditions. Make sure to see your health care provider for a diagnosis.

How is rheumatoid arthritis diagnosed?

Diagnosing RA may be difficult in the early stages. This is because symptoms may be very mild, and signs of the disease may not be seen on X-rays or in blood tests. Diagnosis starts with a medical history and a physical exam. Tests may also be done, such as:
  • X-ray. This is a test that uses a small amount of radiation to create images of internal tissues, bones, and organs onto film.
  • Joint aspiration. For this test, a small amount of fluid is taken from a swollen joint. It is done to look for signs of infection or gout.
  • Nodule biopsy. Tiny pieces of tissue are taken to look at under a microscope. This helps to check for cancer or other abnormal cells.   
  • Blood tests. These tests are done to detect certain antibodies, called rheumatoid factor, and other indicators for RA.

How is rheumatoid arthritis treated?

Treatment will depend on your symptoms, your age, and your general health. It will also depend on how severe the condition is. A treatment plan is tailored to you with your health care provider.

There is no cure for RA. The goal of treatment is often to limit pain and inflammation, and help ensure function. You may have one or more types of treatments. Treatment may include:

  • Medications. Some medications may be used for pain relief. Some are used to treat inflammation. Others can help to slow the disease from getting worse. Medications are often managed by a rheumatologist. This is a doctor who is a specialist in arthritis and rheumatic diseases. You may need regular blood tests to check how the medications affect your blood cells, liver, and kidneys.
  • Splints. Splints may be used to help protect the joints and strengthen the weak joints.
  • Physical therapy. Physical therapy may be used to help increase the strength and movement of the affected areas.

In some cases, surgery may be an option if other treatments do not work. Surgery does not cure RA. It helps correct the deformities caused by the disease. After surgery, RA can continue to cause problems in the hand, and may even require more surgery. Repair or reconstruction of the hand and wrist can be done in a variety of ways, including:

  • Surgical cleaning. This surgery removes inflamed and diseased tissues in the hands to help increase function.
  • Joint replacement. This type of surgery, also called arthroplasty, may be used in cases of severe arthritis of the hand. This surgery may be done on older adults with a lower activity level. Joint replacement may lessen pain and help increase function of the hands and fingers. During the surgery, a joint that has been destroyed by the disease is replaced with an artificial joint. The new joint may be made out of metal, plastic, silicone rubber. Or, if may be made from your own tissue, such as a tendon from another part of your body.
  • Joint fusion. For this surgery, a joint is removed, and the two ends of bones are fused together. This makes one large bone without a joint. This is usually done on patients with advanced RA. After the fusion of the bone, there is no movement in the fused joint.

Complications of rheumatoid arthritis

Because RA damages joints over time, it causes some disability. It can cause pain and movement problems that cause a person to be less able to carry out normal daily activities and tasks. This can also lead to problems such as depression and anxiety.

Living with rheumatoid arthritis

Although there is no cure for RA, it is important to help keep joints functioning by reducing pain and inflammation. Work on a treatment plan with your health care provider that includes medication and physical therapy. Work on lifestyle changes that can improve your quality of life. Lifestyle changes include:

  • Activity and rest. To reduce stress on your joints, alternate between activity and rest. This can help protect your joints and lessen your symptoms.
  • Use of assistive devices. Canes, crutches, and walkers can help to keep stress off certain joints and to improve balance.
  • Use of adaptive equipment. Reachers and grabbers allow people to extend their reach and reduce straining. Dressing aids help people get dressed more easily.
  • Managing use of medications. Long-term use of some anti-inflammatory medications can lead to stomach bleeding. Work with your health care provider to develop a plan to reduce this risk.
  • Seek support. Find a support group can help you deal with the effects of RA.

When should I call my health care provider?

If your symptoms get worse or you have new symptoms, let your healthcare provider know.

Key points about rheumatoid arthritis

  • RA is a chronic disease that causes inflammation of the joints.
  • RA may cause deformities in the joints of the fingers, making movement difficult.
  • The joints most often affected by RA are in the hands, wrists, feet, ankles, knees, shoulders, and elbows.
  • Symptoms may include joint pain, stiffness, and swelling, decreased and painful movement, bumps over small joints, fatigue, or fever.
  • Treatment includes medications, splints, physical therapy, and surgery.

Next steps

Tips to help you get the most from a visit to your health care provider:

  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

Rheumatoid Arthritis

Rheumatoid arthritis is a chronic disease, mainly characterized by inflammation of the lining of the joints.

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OsteoarthritisArtrosis

Osteoarthritis

What is osteoarthritis?

Osteoarthritis is the most common form of arthritis. It is a chronic degenerative joint disease that affects mostly middle-aged and older adults. Osteoarthritis causes the breakdown of joint cartilage. It can occur in any joint, but it most often affects the hands, knees, hips, or spine.

What causes osteoarthritis?

Osteoarthritis can be classified as primary or secondary. Primary osteoarthritis has no known cause. Secondary osteoarthritis is caused by another disease, infection, injury, or deformity. Osteoarthritis starts with the breakdown of cartilage in the joint. As the cartilage wears down, the bone ends may thicken and form bony growths (spurs). Bone spurs interfere with joint movement. Bits of bone and cartilage may float in the joint space. Fluid-filled cysts may form in the bone and limit joint movement.

Who is at risk for osteoarthritis?

The risk factors of osteoarthritis include:

  • Heredity. Slight joint defects or double-jointedness (laxity) and genetic defects may contribute to osteoarthritis.
  • Excess weight. Being overweight or obese can put stress on such joints as the knees over time.
  • Injury or overuse. Severe injury to a joint, such as the knee, can lead to osteoarthritis. Injury may also result from overuse or misuse over time.

What are the symptoms of osteoarthritis?

The most common symptom of osteoarthritis is pain after overuse or inactivity of a joint. Symptoms usually develop slowly over years. Symptoms can occur a bit differently in each person, and may include:

  • Joint pain
  • Joint stiffness, especially after sleep or inactivity
  • Less movement in the joint over time
  • A grinding feeling of the joint when moved, as the cartilage wears away (in more advanced stages)

The symptoms of osteoarthritis can be like other health conditions. Make sure to see your health care provider for a diagnosis.

How is osteoarthritis diagnosed?

The process starts with a medical history and a physical exam. You may also have x-rays. This test uses a small amount of radiation to create images of bone and other body tissues.

How is osteoarthritis treated?

Treatment will depend on your symptoms, your age, and your general health. It will also depend on how severe the condition is. The goal of treatment is to reduce joint pain and stiffness, and improve joint movement. Treatment may include:

  • Exercise. Regular exercise, including stretching and strengthening, may help reduce pain and other symptoms.
  • Heat treatment. Treating the affected joint with heat may help reduce pain.
  • Physical and occupational therapy. These types of therapy may help to reduce joint pain, improve joint flexibility, and reduce joint strain. Splints and other assistive devices may also be used.  
  • Weight maintenance. Keeping a healthy weight or losing weight if needed may help to prevent or reduce symptoms.
  • Medications. These may include pain relievers and anti-inflammatory medications. Either may be taken by mouth as a pill, or rubbed on the skin as a cream.
  • Injections of thick liquids into the joints. These liquids mimic normal joint fluid.
  • Joint surgery. Surgery may be needed to repair or replace a severely damaged joint.

Talk with your health care providers about the risks, benefits, and possible side effects of all medications.

What are the complications of osteoarthritis?

Because osteoarthritis causes joints to degenerate over time, it can cause disability. It can cause pain and movement problems that cause a person to be less able to carry out normal daily activities and tasks.

Living with osteoarthritis

Although there is no cure for osteoarthritis, it is important to help keep joints functioning by reducing pain and inflammation. Work on a treatment plan with your health care provider that includes medication and therapy. Work on lifestyle changes that can improve your quality of life. Lifestyle changes include:

  • Weight loss. Extra weight puts more stress on weight-bearing joints, such as the hips and knees.
  • Exercise. Some exercises may help reduce joint pain and stiffness. These include swimming, walking, low-impact aerobic exercise, and range-of-motion exercises. Stretching exercises may also help keep the joints flexible.
  • Activity and rest. To reduce stress on your joints, alternate between activity and rest. This can help protect your joints and lessen your symptoms.
  • Use of assistive devices. Canes, crutches, and walkers can help to keep stress off certain joints and to improve balance.
  • Use of adaptive equipment. Reachers and grabbers allow people to extend their reach and reduce straining. Dressing aids help people get dressed more easily.
  • Managing use of medications. Long-term use of some anti-inflammatory medications can lead to stomach bleeding. Work with your health care provider to develop a plan to reduce this risk.

When should I call my health care provider?

If your symptoms get worse or you have new symptoms, let your health care provider know.

Key points about osteoarthritis

  • Osteoarthritis is a chronic joint disease. It affects mostly middle-aged and older adults.
  • It starts with the breakdown of joint cartilage.
  • Risk factors include heredity, obesity, injury, and overuse.
  • Common symptoms include pain, stiffness, and limited movement of joints.
  • The goals of treatment are to reduce joint pain and stiffness, and improve joint movement.
  • Treatment may include medications, exercise, heat, and joint injections.
  • Surgery may be needed to repair or replace a severely damaged joint.

Next steps

Tips to help you get the most from a visit to your health care provider:

  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

Osteoarthritis

Osteoarthritis is a type of arthritis that is caused by the breakdown and eventual loss of the cartilage of one or more joints.

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Trauma Services at Baylor

Surgeons on the medical staff at Baylor specialize in the critical care needs of our patients.

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