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Plantar Fasciitis and Bone Spurs

Plantar fasciitis (fashee-EYE-tiss) is the most common cause of pain on the bottom of the heel. Approximately 2 million patients are treated for this condition every year.

Plantar fasciitis occurs when the strong band of tissue that supports the arch of your foot becomes irritated and inflamed.

Anatomy

The plantar fascia is a long, thin ligament that lies directly beneath the skin on the bottom of your foot. It connects the heel to the front of your foot, and supports the arch of your foot.

Plantar fascia

The plantar fascia is a ligament that lies beneath the skin on the bottom of your foot.

Cause

The plantar fascia is designed to absorb the high stresses and strains we place on our feet. But, sometimes, too much pressure damages or tears the tissues. The body's natural response to injury is inflammation, which results in the heel pain and stiffness of plantar fasciitis.

Damage to plantar fascia

Too much pressure on the plantar fascia can damage or tear the tissues, causing heel pain. 

Risk Factors

In most cases, plantar fasciitis develops without a specific, identifiable reason. There are, however, many factors that can make you more prone to the condition:

  • Tighter calf muscles that make it difficult to flex your foot and bring your toes up toward your shin
  • Obesity
  • Very high arch
  • Repetitive impact activity (running/sports)
  • New or increased activity

Heel Spurs

Although many people with plantar fasciitis have heel spurs, spurs are not the cause of plantar fasciitis pain. One out of 10 people has heel spurs, but only 1 out of 20 people (5%) with heel spurs has foot pain. Because the spur is not the cause of plantar fasciitis, the pain can be treated without removing the spur.

X-ray of heel spur

Heel spurs do not cause plantar fasciitis pain.

Symptoms

The most common symptoms of plantar fasciitis include:

  • Pain on the bottom of the foot near the heel
  • Pain with the first few steps after getting out of bed in the morning, or after a long period of rest, such as after a long car ride. The pain subsides after a few minutes of walking
  • Greater pain after (not during) exercise or activity

Doctor Examination

After you describe your symptoms and discuss your concerns, your doctor will examine your foot. Your doctor will look for these signs:

  • A high arch
  • An area of maximum tenderness on the bottom of your foot, just in front of your heel bone
  • Pain that gets worse when you flex your foot and the doctor pushes on the plantar fascia. The pain improves when you point your toes down
  • Limited "up" motion of your ankle

Tests

Your doctor may order imaging tests to help make sure your heel pain is caused by plantar fasciitis and not another problem.

X-rays

X-rays provide clear images of bones. They are useful in ruling out other causes of heel pain, such as fractures or arthritis. Heel spurs can be seen on an x-ray.

Other Imaging Tests

Other imaging tests, such as magnetic resonance imaging (MRI) and ultrasound, are not routinely used to diagnose plantar fasciitis. They are rarely ordered. An MRI scan may be used if the heel pain is not relieved by initial treatment methods.

Treatment

Nonsurgical Treatment

More than 90% of patients with plantar fasciitis will improve within 10 months of starting simple treatment methods.

Rest. Decreasing or even stopping the activities that make the pain worse is the first step in reducing the pain. You may need to stop athletic activities where your feet pound on hard surfaces (for example, running or step aerobics).

Ice. Rolling your foot over a cold water bottle or ice for 20 minutes is effective. This can be done 3 to 4 times a day.

Nonsteroidal anti-inflammatory medication. Drugs such as ibuprofen or naproxen reduce pain and inflammation. Using the medication for more than 1 month should be reviewed with your primary care doctor.

Exercise. Plantar fasciitis is aggravated by tight muscles in your feet and calves. Stretching your calves and plantar fascia is the most effective way to relieve the pain that comes with this condition.

Calf stretch

Calf stretch

  • Calf stretch
    Lean forward against a wall with one knee straight and the heel on the ground. Place the other leg in front, with the knee bent. To stretch the calf muscles and the heel cord, push your hips toward the wall in a controlled fashion. Hold the position for 10 seconds and relax. Repeat this exercise 20 times for each foot. A strong pull in the calf should be felt during the stretch.
  • Plantar fascia stretch
    This stretch is performed in the seated position. Cross your affected foot over the knee of your other leg. Grasp the toes of your painful foot and slowly pull them toward you in a controlled fashion. If it is difficult to reach your foot, wrap a towel around your big toe to help pull your toes toward you. Place your other hand along the plantar fascia. The fascia should feel like a tight band along the bottom of your foot when stretched. Hold the stretch for 10 seconds. Repeat it 20 times for each foot. This exercise is best done in the morning before standing or walking.

Cortisone injections. Cortisone, a type of steroid, is a powerful anti-inflammatory medication. It can be injected into the plantar fascia to reduce inflammation and pain. Your doctor may limit your injections. Multiple steroid injections can cause the plantar fascia to rupture (tear), which can lead to a flat foot and chronic pain.

Supportive shoes and orthotics. Shoes with thick soles and extra cushioning can reduce pain with standing and walking. As you step and your heel strikes the ground, a significant amount of tension is placed on the fascia, which causes microtrauma (tiny tears in the tissue). A cushioned shoe or insert reduces this tension and the microtrauma that occurs with every step. Soft silicone heel pads are inexpensive and work by elevating and cushioning your heel. Pre-made or custom orthotics (shoe inserts) are also helpful.

Heel pad

Soft heel pads can provide extra support.

Night splints. Most people sleep with their feet pointed down. This relaxes the plantar fascia and is one of the reasons for morning heel pain. A night splint stretches the plantar fascia while you sleep. Although it can be difficult to sleep with, a night splint is very effective and does not have to be used once the pain is gone.

Physical therapy. Your doctor may suggest that you work with a physical therapist on an exercise program that focuses on stretching your calf muscles and plantar fascia. In addition to exercises like the ones mentioned above, a physical therapy program may involve specialized ice treatments, massage, and medication to decrease inflammation around the plantar fascia.

Extracorporeal shockwave therapy (ESWT). During this procedure, high-energy shockwave impulses stimulate the healing process in damaged plantar fascia tissue. ESWT has not shown consistent results and, therefore, is not commonly performed.

ESWT is noninvasive—it does not require a surgical incision. Because of the minimal risk involved, ESWT is sometimes tried before surgery is considered.

Surgical Treatment

Surgery is considered only after 12 months of aggressive nonsurgical treatment.

Gastrocnemius recession. This is a surgical lengthening of the calf (gastrocnemius) muscles. Because tight calf muscles place increased stress on the plantar fascia, this procedure is useful for patients who still have difficulty flexing their feet, despite a year of calf stretches.

In gastrocnemius recession, one of the two muscles that make up the calf is lengthened to increase the motion of the ankle. The procedure can be performed with a traditional, open incision or with a smaller incision and an endoscope, an instrument that contains a small camera. Your doctor will discuss the procedure that best meets your needs.

Complication rates for gastrocnemius recession are low, but can include nerve damage.

Plantar fascia release. If you have a normal range of ankle motion and continued heel pain, your doctor may recommend a partial release procedure. During surgery, the plantar fascia ligament is partially cut to relieve tension in the tissue. If you have a large bone spur, it will be removed, as well. Although the surgery can be performed endoscopically, it is more difficult than with an open incision. In addition, endoscopy has a higher risk of nerve damage.

Complications. The most common complications of release surgery include incomplete relief of pain and nerve damage.

Recovery. Most patients have good results from surgery. However, because surgery can result in chronic pain and dissatisfaction, it is recommended only after all nonsurgical measures have been exhausted.

Download this PDF handout to learn more about plantar fasciitis

Dr. Robert Howard
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Robert Howard, DO

Dr. Howard is primarily focused on diagnosing and treating foot and ankle conditions with the latest techniques. Dr. Howard is one of the few orthopedic surgeons specifically trained in conditions of the foot and ankle. 

Published in Patient Education
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NECK AND ARM PAIN

Neck and Arm Pain can be from muscles, bones and nerves.  Read more about causes of Neck and Arm pain

LEARN MORE

BACK AND LEG PAIN

Back pain is a common reason for patients to seek medical care.  Read more about the causes and treatment of back pain

LEARN MORE

PHYSICAL THERAPY

Physical therapy is important for prevention and treatment of spinal disorders. Read more about physical therapy for neck and back problems

LEARN MORE

SPINE INJECTIONS

Injections can be the first line of treatment for many spinal problems.  Read more about the differnet types of spine injections

LEARN MORE

SPINE SURGERY

There are many spinal surgical procedures available with excellent results. Read more about the differnet types of spine surgeries

Learn more about Dr. Schroeder

Nicholas Schroeder, MD

Dr. Nicholas Schroeder is a orthopedic surgeon who is specially trained in the diagnosis and treatment of spine conditions. Call today for an appointment with Dr. Schroeder.

Published in Patient Education

Neck and Arm Pain

Neck and Arm Pain can be from muscles, bones and nerves.

Read more about causes of Neck and Arm pain below.

Muscle Strain

“Whiplash” injuries are common causes of neck pain.

They are muscular in nature and most often resolve with time.

A brief period of brace wear is a reasonable.

Physical therapy to stretch and strengthen the neck muscles is the main treatment.

When a ligament injury is present causing instability, surgery may be necessary.

Arthritis

The joints and discs of the neck wear out as we age.

Everyone develops neck arthritis to some degree, but not everyone experiences pain.

People will often have neck stiffness in the morning, and neck pain with bending activities.

Physical therapy to strengthen the neck muscles is the mainstay of treatment.

When arthritis leads to painful pinched nerves, sugery may be an option.

Herniated Disc

Intervertebral discs are located between the bones of your neck.

Discs are the shock absorbers of your spine.

Pressure on the disc, often from bending, twisting or heavy lifting, can cause part of the disc to bulge out.

The bulged disc pushes against a nerve and causes nerve irritation

This can cause neck, shoulder, and shooting arm pain.

Treatment includes observation, anti-inflammatory medications, injections or surgery.

Fusion or disc replacement are surgical options.

Spinal Stenosis

Spinal arthritis can sometimes lead to compression of the nerves in the spine, called stenosis.

Spinal stenosis can cause both back and leg pain.

Pain is worse with walking and improves when you sit down. You may find yourself bending forward more than usual.

Injections are the first step in treatment of spinal stenosis.

To permanently treat spinal stenosis, a surgery called decompression may be necessary.

Treatment Options for Neck and Arm Pain

Multiple non-surgical and surgical options are available for neck and arm pain. Click below to learn more about treatment options for Neck and Arm Pain.

Physical therapy is important for prevention and treatment of many spinal disorders including acute back pain and chronic back pain.

Injections are the first line of treatment for many spinal pathologies.

Injections are useful for both diagnosing and treating spinal conditions.

There are many spinal surgical procedures available for the treatment of spine problems.

Learn More about Dr. Schroeder

Nicholas Schroeder, MD


Dr. Nicholas Schroeder is a orthopedic surgeon who is specially trained in the diagnosis and treatment of spine conditions. Call today for an appointment with Dr. Schroeder.

Published in Patient Education

Physical Therapy for the Back and Neck

Physical therapy is important for prevention and treatment of many spinal disorders including acute back pain and chronic back pain.

Abdominal and Core Strengthening

Strong “core” muscles are essential to treating and preventing back pain.

Core muscles include abdominals, pelvic floor, and deep muscles of the back.

A strong core will take pressure off the discs and joints of the back, helping relieve back pain.

Core muscles also stabilize the sacroiliac joint, which treats sacroiliac joint pain.

Postural Training

Unbalanced trunk and limb position can lead to tissue damage and pain.

Optimal posturing can counteract environmental loads and stresses.

Postural training is essential in treatment and prevention of neck pain and back pain.

Stretching

It is important to stay mobile and active.

Stretching helps to reduce unwanted tension in the neck and back muscles.

“Nerve glides” are a type of stretch to help relieve pinched nerves.

Modalities

“Modalities” involve the use of energy to cause physiologic changes. These include:

  • Electrical Stimulation

  • Traction

  • Ultrasound

  • Heat and Ice

  • and more…

Learn More about Dr. Schroeder

Nicholas Schroeder, MD


Dr. Nicholas Schroeder is a orthopedic surgeon who is specially trained in the diagnosis and treatment of spine conditions. Call today for an appointment with Dr. Schroeder.

Published in Patient Education

Spine Surgical Procedures

There are many spinal surgical procedures available.

Below are some basic categories.

Cervical (Neck) Decompression and Fusion

When there is compression of the spinal cord or nerves in the neck, fusion is usually necessary.

This is because removal of the compression usually causes instability, which requires a fusion.

Fusion can be performed from the front or the back

The disc is removed and a spacer is inserted in its place. A plate used for added stability.

Lumbar (Back) Decompression

Decompression, also known as laminectomy, involves removal of bone and ligament.

When the nerves of the spine are compressed, removal of this tissue relieves the compression.

Decompression does not involve fusing bones together.

A decompression is a smaller procedure than a fusion.

Lumbar (Back) Microdiscectomy

A microdiscectomy involves removal of a herniated disc that is pressing on a nerve.

This is a type of decompression, but is a smaller procedure.

Microdiscectomy reliably relieves pain that shoots down the leg.

This is usually an outpatient surgery.

Lumbar (Back) Fusion

When spinal instability exists, a fusion procedure is necessary.

Fusions are sometimes necessary when nerve compression is severe.

Fusions can be performed through the abdomen, from the side, or from the back.

The disc is removed and a spacer is inserted in its place.

Screws and rods are inserted from the back.

Once the bones fuse, you can return to full activities.

Kyphoplasty

Vertebral compression fractures can be very painful.

A kyphoplasty is a procedure that involves injecting cement into the collapsed bone.

The cement hardens and stabilizes the fracture, leading to pain relief.

Sacroiliac Joint (SI Joint) Fusion

When SI joint pain is not treated by physical therapy and injections, fusion is a final option.

This is a surgery that involves placement of metal implants across the sacroiliac joint.

Fusion eliminates motion at the joint, which in turn relieves pain.

Learn More about Dr. Schroeder

Nicholas Schroeder, MD


Dr. Nicholas Schroeder is a orthopedic surgeon who is specially trained in the diagnosis and treatment of spine conditions. Call today for an appointment with Dr. Schroeder.

Published in Patient Education

Spinal Injections

Injections are the first line of treatment for many spinal pathologies.

Injections are useful for both diagnosing and treating spinal conditions.

Epidural Injections

Medication is injected into the epidural space, which is the space around the spinal nerves.

Both a numbing medication and a steroid (cortisone) are injected.

Epidural injections are used to diagnose and treat pain caused by pressure on the nerves.

Injections may fix the problem, or they may only work temporarily

Sacroiliac Joint Injections

Medication is injected into the sacroiliac joint, which is where the pelvis meets the spine.

Both a numbing medication and a steroid (cortisone) are injected.

Sacroiliac joint injections are used to diagnose and treat pain caused from joint irritation.

Learn More about Dr. Schroeder

Nicholas Schroeder, MD


Dr. Nicholas Schroeder is a orthopedic surgeon who is specially trained in the diagnosis and treatment of spine conditions. Call today for an appointment with Dr. Schroeder.

Published in Patient Education

Chronic Back and Leg Pain

Chronic Back and Leg Pain occurs daily for months to years.

Read more about causes of Chronic Back and Leg Pain below.

Spinal Arthritis

The joints and discs of the spine wear out as we age.

Everyone develops spinal arthritis to some degree, but not everyone experiences pain.

Common symptoms are stiffness in the morning and pain with bending motions.

Physical therapy to strengthen the back and core muscles is the mainstay of treatment.

When arthritis leads to painful nerve compression, surgery may be an option.

Spondylolisthesis

Spondylolisthesis occurs when a spinal bone slips forward on the bone below.

  • This can occur due to arthritis, trauma, or stress fractures.

  • Spondylolisthesis can cause pain when there is spinal instability or nerve compression.

  • Types of spondylolisthesis can be treated with physical therapy and activity modification.

When the instability is causing back or leg pain from nerve compression, surgical fusion may be necessary.

Spinal Stenosis

Spinal arthritis can sometimes lead to compression of the nerves in the spine, called stenosis.

Spinal stenosis can cause both back and leg pain.

Pain is worse with walking and improves when you sit down. You may find yourself bending forward more than usual.

Injections are the first step in treatment of spinal stenosis.

To permanently treat spinal stenosis, a surgery called decompression may be necessary.

Sacroiliac Joint Pain

The sacroiliac joint, or SI joint, is where the spine meets the pelvis.

Abnormal movement or inflammation of this joint can cause pain.

SI joint pain can be acute or chronic.

Pain is in the lower back and buttocks region, and sometimes shoots down the leg.

Treatment includes physical therapy, injections, and SI joint fusion.

Stress and Depression

Psychological factors can cause back pain as well.

Stress and depression can cause back pain, or make existing back pain worse.

Increased pain can lead to worsening mood, which leads to a vicious cycle.

Cognitive behavioral therapy is a type of counseling and an effective treatment for back pain due to psychological factors.

Learn More about Dr. Schroeder

Nicholas Schroeder, MD


Dr. Nicholas Schroeder is a orthopedic surgeon who is specially trained in the diagnosis and treatment of spine conditions. Call today for an appointment with Dr. Schroeder.

Published in Patient Education

Acute Back and Leg Pain

Acute Back and Leg Pain has been going on for a short period of time.

Read more about causes of Acute Back and Leg Pain below.

Muscle Strain

Have you ever "thrown your back out?" This is most likely a muscle strain.

Up to 80% of people will experience an episode of back pain in their lifetimes.

A brief period of rest and gradual return to activities is recommended.

Physical therapy can help prevent injuries in the future.

Fracture

Spinal Fractures most commonly occur from falls.

A Vertebral Compression Fracture means one of your spinal bones collapses.

These fractures are associated with weakened bone, called osteoporosis.

Most can be treated effectively in a back brace, or with a procedure called kyphoplasty.

Herniated Disc

Intervertebral Discs are located between the bones of your spine.

Discs are the shock absorbers of the spine.

Pressure on the disc, often from bending, twisting or heavy lifting, can cause part of the disc to bulge out

The bulged, or herniated, disc pushes against a nerve and causes pain.

Pain often shoots down the leg, called "sciatica."

Treatment includes observation, anti-inflammatory medications, injections or surgical removal.

Sacroiliac Joint Pain

The sacroiliac joint, or SI joint, is where the spine meets the pelvis.

Abnormal movement or inflammation of this joint can cause pain.

SI joint pain can be acute or chronic.

Pain is in the lower back and buttocks region, and sometimes shoots down the leg.

Treatment includes physical therapy, injections, and SI joint fusion.

Infection

An infection in the spine is a rare but very serious problem.

Infection often spreads from other locations in the body.

Patients with weakened immune systems are at higher risk.

If you experience back pain, unintentional weight loss, fevers and chills, seek medical attention.

Learn More about Dr. Schroeder

Nicholas Schroeder, MD


Dr. Nicholas Schroeder is a orthopedic surgeon who is specially trained in the diagnosis and treatment of spine conditions. Call today for an appointment with Dr. Schroeder.

Published in Patient Education

Back and Leg Pain

Back pain is a common reason for patients to seek medical care. Most people experience back pain in one form or another, and there are many potential causes. Back pain can be divided into 2 broad categories:

Acute back pain is severe and has been going on for a short period of time.

  • Have you ever “thrown your back out,” or woken up with a back ache? Many of us have, and this is most commonly due to a muscle strain or overuse.

  • Physical therapy to strengthen the muscles of the core and back can protect you from another back injury.

  • For more information, and to learn about other causes and treatments of Acute back pain, click here.

Chronic back pain usually occurs every day over months or years.

  • Pain can be severe, but is often described as stiffness, achy, burning, and/or fatigue. Chronic back pain has multiple causes, including degenerative arthritis, muscle fatigue, and nerve compression.

  • Physical therapy to strengthen the muscles of the core and back can be an effective treatment. When nerve compression is involved, other treatments are often necessary.

  • For more information, and to learn about other causes of Chronic back pain, click here.

Learn More about Dr. Schroeder

Nicholas Schroeder, MD


Dr. Nicholas Schroeder is a orthopedic surgeon who is specially trained in the diagnosis and treatment of spine conditions. Call today for an appointment with Dr. Schroeder.

Published in Patient Education

Many people think a bunion is a simple bone prominence by the big toe. Actually, a bunion can be a progressive deformity of bones and joints. These mal-aligned structures can cause a painful “bump,” but can also cause functional problems, leading to other regions of foot pain. 

Bunions develop slowly. Pressure on the big toe joint causes the big toe to lean toward the second toe. Over time, the normal structure of the bone changes, resulting in the bunion bump. This deformity will gradually increase and may make it painful to wear shoes or walk.

Anyone can get a bunion, but they are more common in women. Many women wear tight, narrow shoes that squeeze the toes together—which makes it more likely for a bunion to develop, worsen and cause painful symptoms.

In most cases, bunion pain is relieved by wearing wider shoes with adequate toe room and using other simple treatments to reduce pressure on the big toe.

Cause and Symptoms

Bunions may be caused by:
  • Wearing poorly fitting shoes—in particular, shoes with a narrow, pointed toe box that forces the toes into an unnatural position
  • Heredity—some people inherit feet that are more likely to develop bunions due to their shape and structure
  • Having an inflammatory condition, such as rheumatoid arthritis, or a neuromuscular condition, such as polio
In addition to the visible bump on the inside of the foot, symptoms of a bunion may include:
  • Pain and tenderness
  • Redness and inflammation
  • Hardened skin on the bottom of the foot
  • A callus or corn on the bump
  • Stiffness and restricted motion in the big toe, which may lead to difficulty in walking
bunion

Treatment

Treating a “simple” bunion may not be so simple! An orthopedic surgeon, especially a foot and ankle specialist, would be best trained to correct a bunion, achieving lasting improvements in pain relief and function. 

In most cases, bunions are treated without surgery. Although nonsurgical treatment cannot actually "reverse" a bunion, it can help reduce pain and keep the bunion from worsening.

Changes in Footwear

In the vast majority of cases, bunion pain can be managed successfully by switching to shoes that fit properly and do not compress the toes. Some shoes can be modified by using a stretcher to stretch out the areas that put pressure on your toes. Your doctor can give you information about proper shoe fit and the type of shoes that would be best for you. 

Padding

Protective "bunion-shield" pads can help cushion the painful area over the bunion. Pads can be purchased at a drugstore or pharmacy. Be sure to test the pads for a short time period first; the size of the pad may increase the pressure on the bump. This could worsen your pain rather than reduce it.

Orthotics and Other Devices

To take pressure off your bunion, your doctor may recommend that you wear over-the-counter or custom-made shoe inserts (orthotics). Toe spacers can be placed between your toes. In some cases, a splint worn at night that places your big toe in a straighter position may help relieve pain.

Icing

Applying ice several times a day for 20 minutes at a time can help reduce swelling. Do not apply ice directly on your skin.

Medications

Nonsteroidal anti-inflammatory medications such as ibuprofen and naproxen can help relieve pain and reduce swelling. Other medications can be prescribed to help pain and swelling in patients whose bunions are caused by arthritis.

Surgery for Bunions

Your doctor may recommend surgery for a bunion or bunionette if, after a period of time, you have pain and difficulty walking despite changes in footwear and other nonsurgical treatments. Bunion surgery realigns bone, ligaments, tendons, and nerves so that the big toe can be brought back to its correct position.

There are several surgical procedures to correct bunions. Although many are done on a same-day basis with no hospital stay, a long recovery is common after bunion surgery.

Learn More

Robert Howard, DO

Dr. Howard is primarily focused on diagnosing and treating foot and ankle conditions with the latest techniques. Dr. Howard is one of the few orthopedic surgeons specifically trained in conditions of the foot and ankle. 

Published in Patient Education

Arthritis

Arthritis literally means inflammation of a joint. It is more commonly known as wearing out of our joints. When arthritis occurs, cartilage (which is the material that covers the ends of the bones) begins to wear leading to inflammation and pain.

When enough cartilage wears off then bone will be exposed and lead to persistent pain and disability. There are many different types of arthritis.

These can include Osteoarthritis and inflammatory types such as gout and rheumatoid arthritis. In these types the joints are inflamed because of crystals or the body attacking its own tissues. Osteoarthritis is the “wear and tear” arthritis and is the most common type. This is the arthritis that usually affects older individuals and is most commonly seen in the hands, knees and hips.

X-ray showing arthritis of the right knee with loss of cartilage and bone on bone contact.

Arthritis Signs and Symptoms

Most people with arthritis have one or more of the signs and symptoms listed below. When these symptoms are severe enough patients will find themselves limiting their activities and changing their lifestyles.

 

  • Pain in and around the joints

  • Pain in the back of the knee (Baker’s Cyst)

  • Swelling in and around the joints

  • Stiffness after prolonged sitting and in the morning

  • Pain with weather changes

  • Limp

It is usually at this point when patients seek medical attention for their condition. There are many effective treatments available. Patients who suffer with this disease should seek medical treatment to discuss their options.

Arthritis Treatment

Once arthritis sets in there is no way to reverse the damage that is done. Treatment can range from things as simple as exercise to as involved as injections and medications.

Most patients are given an overall program that includes a variety of treatment options. The goals of treatment are therefore to decrease the patient's discomfort, increase the patient's function, and to hopefully protect the joints from further damage. Our doctors believe that a crucial part of the treatment plan is to educate the patient regarding their condition so that they may be an integral part of the treatment plan.

exercise Activity

> Weight loss

Most patients don’t understand that we can apply 6-8 times our body weight across our hips and knees with most every day activities. Therefore weight reduction is a crucial part of treating the pain and disability associated with arthritis.


> Activity modifications

Avoiding high impact activities such as running, jumping and excessive climbing can significantly decrease the symptoms of arthritis.

> Assistive devices such as cane or walker

Using a cane in the opposite hand can help decrease the load across the opposite hip by as much as 50 %.

pillMedications

There are many medications available for the treatment of arthritis. Some of these are effective and others are nothing more than a gimmick. Unfortunately there are no medications which have been proven to reverse the disease.

> Anti-Inflammatory Medications

These include Ibuprofen, Naproxen, Celebrex, and others.

These medications work by decreasing the inflammation associated with arthritis. If effective, these medications can significantly decrease the pain associated with this disease. Unfortunately these medications have some serious side effects and patients should consult with their doctor before taking them.

> Health Foods

These are “foods” that are available over the counter and without prescription.

BEWARE:

Because these substances are classified as foods they are not regulated by the FDA and usually make unfounded claims of curing arthritis. To date there are no medications which have been proven to regenerate a substantial amount of cartilage or reverse the damage caused by arthritis.

Compounds that have been shown to decrease pain and possibly protect our joints include Glucosamine Glycan and Chondroitin Sulfate.

injectionInjections


There are two types of injections which are routinely used.

> Cortisone (more info)

Cortisone helps to decrease the inflammation associated with arthritis. This is usually injected directly into the joint and can provide many weeks of pain relief. This is not a permanent fix for the disease. Cortisone is used to temporarily relief one’s symptoms. There are some side effects to these injections so make sure you discuss this with your doctor.

> Hyaluronic Acid (Commonly known as chicken injections)

Chicken Shots? Rooster comb injections is the description commonly used to describe the use of artificial synovial fluid injected into the joint to ease the pain and stiffness of arthritis.
The modern injections are all manufactured in a lab controlled biochemical process but the original versions were extracted from the combs of roosters and the name has stuck.
These are injections which are given into the knee once a week over three to five weeks. Hyaluronic acid is normally found in our joints and serves as a lubricant. This substance is available for injection and is showing promising results. Again this is a temporary treatment that may provide up to 6 months of pain relief.

Surgery

When the pain and other symptoms can no longer be managed by non-operative methods then surgery is your best option. The belief that one needs to be completely disabled before considering joint replacement is not only false but dangerous. Studies have shown that patients that wait too long to have their joints replaced can have a harder recovery and poorer outcomes. 

Arthroscopic Surgery

This procedure involves making 2-3 poke holes into the joint and removing torn cartilage or loose material from the joint. Although this procedure was commonly used in the past to treat arthritis, there are limited indications at this time for using arthroscopy in the knee. The main reason that its used less often is that is has not shown to provide any long lasting relief for moderate to severe arthritis. Its commonly used for treating cartilage tears.

Joint Replacement

Joint replacement can relieve the pain and disability of arthritis. Most patient can return to full function.

Click on the images below to learn more about joint replacement.

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Hip Replacement

Hip replacement surgery (THA) has proven to be one of the most successful operations in medicine.THA surgery can help relieve pain, increase mobility and improve a patient’s quality of life.  

a

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Knee Replacement

Knee replacement (TKA) is a surgical procedure that replaces a damaged knee joint, usually a result of arthritiswith an implant.  The dedicated physicians at Orthopedic Specialists of Oakland County are experts in caring for patients with knee pain. 

a

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Shoulder Replacement

Shoulder joint replacement (TSA) is less common than knee or hip replacement, however, it is just as successful in relieving joint pain and restoring a patient’s quality of life. 

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