Cortisone-injection frequency up for debate

November 6, 2010 By

DEAR DR. GOTT: Could you tell me how often someone can have cortisone injections? My mother had some in her shoulders. They worked great, but now the pain and stiffness are back with a vengeance.

DEAR READER: Cortisone can be injected into joints such as the ankle, knee, shoulder and other areas to relieve pain and inflammation. They have been known to help osteoarthritis, gout, carpal-tunnel syndrome, bursitis, plantar fasciitis and a host of other conditions. About 30 years ago, corticosteroids were given with great regularity. Today, however, a different approach is taken. Some physicians restrict a person to three injections a year, others to three in a lifetime. [Read more...]

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Weightlifting can be a pain

November 5, 2010 By

DEAR DR. GOTT: I have osteoarthritis, bursitis and tendinitis in both shoulders and upper arms. I hurt both shoulders while lifting weights. What is the best treatment to reduce the inflammation? Is it ice or ultrasound? Would it help to immobilize my shoulder joints with arm slings? Lifting my arms away from my body and above my head causes the most pain.

Would it hurt to try and do light exercise? Is it better to wait until the inflammation and pain go away? With proper treatment, how long do you think it will take to heal?

Would an MRI test on both shoulders help to determine how much inflammation is present and whether there are any muscle tears in the shoulder joints? I would appreciate any insight and information you can provide.
[Read more...]

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Avoiding whiplash and how to treat it

October 26, 2010 By

Last week I almost hit three deer on two different occasions while driving to work. I have also driven through torrential rain and witnessed a van hitting and cracking a telephone pole.

Accidents happen all the time and while modern cars can often withstand quite a bit of “injury”, the human body often can not.

Your head weighs 8 to 10 pounds; if your seat belt is fastened, the force of a collision can cause your head to whip forward and back or side to side. Accidents are at times unavoidable, but there are things you can do to decrease the chance of sustaining a whiplash injury.

  • Always fasten your seat belt.
  • Position your head rest to “catch” your head, which means it should be right in the center of your head. Positioning it too high or too low can actually cause or worsen a whiplash injury.
  • Position your seat properly. You should be sitting up straight and the seat should be as close to your head as possible to lessen the distance between your head and the seat upon impact.
  • Be aware of your surroundings — which means no calling, texting, eating, putting on makeup, etc.

If you do sustain a whiplash injury, get checked out by a medical professional. Some of the symptoms of whiplash: blurred vision, dizziness, jaw, shoulder or neck pain, headaches, vertigo, memory loss, irritability, sleeplessness, fatigue.

Most pain associated with whiplash is caused by tense muscles. When the neck is forced back and forth in a jarring motion, such as the type caused by a car accident, muscles and ligaments in the area are stretched beyond their normal limits. In severe instances, the supportive muscles of the spine are torn. Muscles in the surrounding area then tighten to try and support the injured tissues. This limits range of motion and causes strain on those muscles which are not being used to bearing the extra load. This causes more pain.

Muscle pain is your chiropractor’s specialty, so get checked out. And be careful out there.

Monica S. Nowak, DC
The Chiropractic Center of Canaan
176 Ashley Falls Road
Canaan, CT 06018
860-824-0748

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Is PRP right for shoulder injury?

June 3, 2010 By

DEAR DR. GOTT: I would like your opinion about platelet-rich plasma (PRP). I have an impingement in my shoulder and was told I need surgery. Do you think the PRP is an option?

DEAR READER: There is an increasing demand, and rightly so, for the use of autologous (self-donated) blood products that aid the healing process. Blood contains red and white blood cells, platelets and plasma. The platelets are responsible for the production and revitalization of new connective tissue. Let me briefly discuss PRP, and then I will try to answer your question.
[Read more...]

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Rice bodies plague patient

May 28, 2010 By

DEAR DR. GOTT: My healing wasn’t complete a year following rotator-cuff surgery. My shoulder became red and swollen. My doctor opened it up to see what was going on and found “rice bodies” — thousands of them. I understand this is a rare thing and that little is known about the cause or the treatment. I am specifically interested in knowing what antibiotics should be used. I am now on infusion therapy. Also, could these be elsewhere in my body?

DEAR READER: Identified and documented as far back as 1895, rice bodies were originally thought related to tuberculous arthritis. The name originated because of a similarity in appearance to grains of polished white rice.
[Read more...]

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Is surgery appropriate for sports injury?

May 27, 2010 By

DEAR DR. GOTT: I am an active 50-year-old man with chronic shoulder pain. My doctor, a sports-medicine surgeon, wants to remove the bursa sac and maintains that the sac is not necessary. Because I would like to remain active — especially in the gym — I am skeptical.

DEAR READER: A bursa is defined as a small, fluid-filled sac whose purpose is to reduce friction between bodily tissues. There are 160 bursae throughout the body, all of which are located in areas of large joints, such as the knees, elbows, hips and shoulders. The main symptom of bursitis of the shoulder is severe pain, primarily on movement. Causes include arthritis, infection, injury to the site or, most likely in your case, overuse.
[Read more...]

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Is surgery the answer for rotator cuff?

April 15, 2010 By

DEAR DR. GOTT: I have not seen anything in your column about a torn rotator cuff. I have one in my right shoulder. I am a 79-year-old male and wonder if an operation would help me in any way. I had a triple bypass in 1977 and implants placed in my prostate. Other than that, I’m in good health.

DEAR READER: The muscles and tendons that connect the upper arm bone to the shoulder blade and hold the ball of the bone firmly into the shoulder socket are known as the rotator cuff. Injuries result primarily from a fall with impact to the arm, the aging process, poor posture and from repetitive activity — specifically, that which is done overhead. Symptoms include loss of motion because of pain and shoulder weakness.
[Read more...]

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Daily Column

April 3, 2009 By

DEAR DR. GOTT:
I am an 85-year-old female in excellent health. I don’t take any medications, walk a lot and swim every day.

A few years ago, I suddenly got severe muscle pains in my shoulders and arms. My doctor could only advise cortisone shots which I declined. Shortly after, I went to visit a relative who lives in Germany who has suffered from terrible rheumatism all his life. I had visited because he was about to be released from the hospital after a heart problem. While helping him get ready to leave, I noticed his discharge instructions at the foot of his bed. His doctor had written that he needed to avoid peas, beans and lentils.

I remembered that, in months before, I had really indulged in these legumes which I love and are supposed to be very healthful. After that I stayed away from them and within a few weeks all the pain in my arms and shoulders disappeared. [Read more...]

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Swimming may aggravate rotator cuff

January 21, 2008 By

DEAR DR. GOTT: I am 82 years old. I walk, hike and swim every day. I’ve been having a lot of discomfort with my right shoulder, arm and hand. When I swim, I can hear and feel my shoulder grinding. A friend says it is my rotator cuff and that I just have to live with the pain. Did swimming cause the condition? Is exercise good for it?

DEAR READER: The rotator cuff helps stabilize the shoulder. Consequently, it can be easily strained, irritated or torn in people who are physically active. Therefore, in answer to your question, swimming and other forms of exercise can aggravate your shoulder and may be the cause of the rotator cuff problem, if that is what is causing your discomfort. If you gain pleasure from remaining fit, and it appears you certainly do, I highly endorse the exercise. If, however, you feel you are damaging your shoulder every day, you might consider taking a few days or a couple of weeks off to determine if the pain subsides. Settle for a brisk walk to get your daily exercise. If you remain pain free, gradually introduce a modified hiking schedule that shouldn’t require much shoulder involvement. You can ultimately add a modified swim program once or twice a week, stepping the program up to your current daily regimen if you remain pain free.

Treatment depends on the amount of damage. A strained cuff usually responds to rest and heat. An irritated cuff usually improves with rest, over-the-counter anti-inflammatory drugs such as Advil, Aleve and others, coupled with physical therapy. A torn cuff can be a real problem that may require surgery.

You may need further testing, such as a CT scan or MRI, to determine the extent of damage. Ask your primary care physician for his recommendation of a referral because more than anything, you need a consultation with an orthopedic surgeon who is familiar with sports injuries. He may determine your pain isn’t related to your rotator cuff at all. The CT or MRI can provide vital information on this annoying problem.

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