I have Bursitis and Tendonitis! What is it?

I get so many patient’s that are diagnosed with bursitis and tendonitis and they have absolutely no idea what it is.  All they know is that they went to their doctor, they looked at the area of complaint for a second or two.  They saw that the patient can move the body part ok, but they had pain. The answer…BURSITIS or…..TENDONITIS.  What the heck is bursitis and tendonitis.  Lets begin by getting a definition, then we will break it down by location, the mechanism of injury and ultimately how to get rid of it (which is obviously the most important thing).

BURISITIS:

bursa

First, lets break the word down.  Burs- stands for bursa.  A bursa is a fluid-filled sac lined by a membrane.  It provides a cushion between bones and tendons and/or muscles around a joint. This helps to reduce friction between the bones and allows free movement. Bursae are filled with synovial fluid and are found around most major joints of the body.  -Itis stands for inflammation.  Therefore, when we put it together bursitis stands for inflammation of a bursa.  The most common locations for bursitis are in the shoulder, elbow and hip. But you can also have bursitis by your knee, heel and the base of your big toe. Bursitis often occurs near joints that perform frequent repetitive motion.  If you have bursitis, the affected joint may feel achy or stiff, hurt more when you move or press on it and may look swollen or red.  A lot of my patients get bursitis from throwing a baseball or lifting something over their heads repeatedly, leaning on their elbows for long periods of time, excessive kneeling like my carpet guys or scrubbing floors like my cleaning people and my patients that sit for long periods of time, especially on hard surfaces.  Does this remind you of someone?

TENDONITIS or TENDINITIS

tendon

Again, lets break it down.  Tendon-stands for a thick elastic band that attaches the muscle to a bone.  -Itis again is inflammation.  So putting it together means inflammation of a tendon.  Sometimes the tendons become inflamed for a variety of reasons, and the action of pulling the muscle becomes irritating.  If the normal smooth gliding motion of your tendon is impaired, the tendon will become inflamed and movement will become painful.  There are too many causes for tendonitis to even list.  Anything that you do can case tendonitis if the right mechanisms are there.  Unlike bursae which are not located all over the body, every muscle has a tendon so tendonitis can occur anywhere.  The most common sites are at the base of the thumb, elbow, shoulder, hip, knee and achilles tendon.

 

 

So I have Bursitis and/or Tendonitis, what do I do?  Usually by the time my patients get to me they have tried a long period of “wait and see”.  I usually tell people to avoid the “wait and see” mentality all together.  I know its tough these days, when you look everything up on the internet and it says that most things will go away on its own.  Although, this may be true sometimes, it is definitely not true all the time.  My philosophy is that if your body can handle it, your body won’t even let you know you have something wrong.  By the time your body gives you conscious awareness of a problem (a symptom) for example pain, swelling, redness, spasm, fever it should be looked at by a professional.  Again, most things are not severe, but what if there is something severe going on and you don’t have it checked by a professional, now we have a problem.  The worst thing that can happen with a non-serious condition is that your doctor sends you home and tells you that there is nothing wrong.  However, when you don’t go to a professional and there is something serious going on, the worse case scenario can be very severe. (just my two cents!!!).  Back to the treatment.  The first thing anyone wants to do when they have bursitis/tendonitis is stop the activity that caused it from happening.  Continued irritation will only make the condition worse.  If you are throwing you need to stop throwing, if you are kneeling you need to stop kneeling.  A lot of times just eliminating the mechanism of injury will heal the problem.  Another modality to use is ice.  If you look back into my heat vs. ice blog you can learn more about the benefits of ice.  Anti-inlammatories are helpful for these conditions as well because as we said -itis is inflammation so taking an anti-inflammatory will help reduce the inflammation and help with the overall pain.  I tell all my -itis patients that if you got it once you may be prone to getting it again so strengthening is usually very helpful to prevent further episodes.  There are a few cases that do not respond to general therapies like a just listed so more aggressive or advance therapies are available.  In my office we offer a class IV 15 watt laser therapy to heal tendonitis and bursitis.  We perform techniques like Active Release Technique (A.R.T.) and Graston technique.  We use Kinesio Tape and other supports to help.  Our physicians perform cortisone injections and even P.R.P. injections for the very advanced cases.  This is not the only way to treat it but a very effective combination is usually very successful with my patients.  If treated properly a full recovery is expected and when done correctly therapy prevents the prevalence of further episodes as well.

Do You Suffer From Low Back Pain? by Dr. Kelly Blundy & Dr. Josh Jagoda

You ‘ve heard about it, or maybe even felt it from time to time, but we come across it every day!  Yes, that uncomfortable neck pain that you have been experiencing, can really put a damper on your day and how you feel.  It can affect everything from driving, basic conversation, attitude,  or even sitting at your computer.

In many cases, we have seen neck pain that is accompanied by other symptoms such as shoulder pain, pain in between the shoulder blades, weakness, and even numbness and tingling into the hands.  When the weakness, numbness and/or tingling occurs, it tends to be a little more severe. This can be due to an affected nerve root, or maybe you have heard the phrase, “I have a pinched nerve.”  This is also known as radiculopathy. Radiculopathy’s can occur in the neck or the low back and is when one or more nerve roots are being irritated due to an injury. Some examples include disc herniation’s or disc bulges.  The pressure and/or inflammation that occurs near the spine typically causes the nerve to become more sensitive. Many patients often report numbness or tingling in addition to their pain.  If the neck is the area of injury, the arm, forearm or hands can likely be affected.  This is because the nerve begins in the neck and ends in the hand. So if the nerve is being irritated in any way it can cause symptoms at any point along the nerve. If the lower back is the area of injury, you may be experiencing pain, numbness or tingling into the hip, pelvis, thigh, leg or even the feet.  It is possible to have more than one nerve root affected at a time and this often results in multiple areas of the body experiencing pain.

“Hey, Doc, I just bent over to pick up a pen and my back/neck went out on me!”  That is a line we hear all the time!  Usually, within a few hours or days the patient typically tells us that they started to feel pain or other symptoms into their arms or hands.

Patients tend to believe that it was the act of bending over to pick up that pen that initially caused their pain.  What most people don’t realize is that our bodies can handle a lot before we ever begin to feel any symptoms. Think about the last time you may have had a visit with your dentist. You go in for your routine check-up and usually have to get a set of x-rays. Oh no!….. a cavity! But you don’t feel any pain in your tooth. How can that be? Well that’s because it takes a certain amount of pressure or damage to be done before our brains can register the sensation of pain.  What if we actually took care of the problem before enough damage was done to cause the sensation of pain or any other symptom?

Repetitive or improper use, lack of strength/flexibility, and what I call “poor spinal hygiene” or bad posture are some of the major causes and contributors to neck pain, back pain and of course, radicular nerve pain.

So, what is your next step? First, I recommend that you don’t take this lightly. You need to get evaluated by a medical professional, like a chiropractor, to make sure you can get a proper diagnosis of what the problem is and that your pain is not coming from another source.  Then, most importantly you will be given a treatment plan that will not only help ease your pain but also fix your problem.

I often get dealt questions such as “how long will this take, what should I do, heat or ice, etc? When I first see a patient who has these problems my first objective is to One, Identify the problem. Two, Get you out of pain and three, correct the problem!  As a healthcare professional, there are steps and specific goals that the doctor and patient have to take together before they can move forward with the care.  Much like diet and exercises, you need to have a strong foundation before you can advance to the next level.  The same is true for treatment of patients.

Phase I, which is known as the “Acute Phase,” is the period where the patient is in pain and has inflammation.  In order to progress to the next stage, it is very important to reduce any inflammation and ease pain so that the patient can move into the next phase of care.

Phase 2, is the corrective phase.  This is a stage of care where the doctor will start addressing the problem by restoring function to the bones, muscles, ligaments, and tendons. Restoring the function of these structures will ensure that the body is aligned properly, moving correctly and your pain levels are continuing to decrease.

Phase 3, is called the stabilization phase.  This is the most important phase. Continuing care and strengthening the area is of upmost importance.  Making sure that the joint is “stable” and strong will increase the likelihood that your problem will not return.

Below are our top 5 steps of things you should do if you are experiencing neck and/or back pain with radicular (nerve/numbness/tingling) symptoms.

 

  1. 1.    Get an evaluation in a timely matter –It is important to make sure you know what is going on with your body.  Making sure that you are healthy is extremely important and you want to make sure that this condition is not only treatable but also not getting worse.  Plus it takes less time and cost less to fix a problem in the beginning stages then waiting for it to become more severe.
  2. 2.    Write some questions down to ask the doctor – Being informed and prepared is critical.  Having a good working knowledge of your condition, when it started, how it occurred, and what you can do to help engages you and can accelerate your recovery time. 
  3. 3.    Be prepared to see other healthcare professionals – Sometimes you need to see other professionals to follow up with your care.  XRAY,MRI, CT scans, EMG/NCV’s may be necessary to properly diagnose your condition. We want to have the appropriate information to best treat your condition.
  4. Inquire about an Anti-inflammatory diet and/or other natural was to reduce inflammation and pain – A large portion of pain is due to inflammation in the body.  Things like arnica oil, essential oils, ice and diet are natural ways you can reduce inflammation within the body.  Always ask us “how to” cut down your inflammation is an important way to decrease your level of pain and heal faster.
  5. Follow up with care and stay consistent – You likely didn’t hurt yourself due to a single event. It takes time for your body to heal but there are things such as rehabilitation and diet that can speed up the process.   Having consistent care will only help your recovery, strengthen your body and fix the problem so it doesn’t occur again in the future.

 

Decrease Stress! No Problem… Just Breathe….. From your belly that is!

Decrease Stress! No Problem…

Just Breathe….. From your belly that is!

More and more studies are coming out about the power of breathing correctly. Due to our everyday stresses, we have a tendency to breath from our chest. This causes a decrease in oxygen to the right places and untimely increases stress to our body.  This type of chronic stress will affect your overall health and decrease your immune system.

What to do?

                                  Practice! Practice! Practice!

You can do this either sitting or standing. You will place one hand on your chest and the other hand on your belly. When you take that nice deep breath in, I want you to focus on pushing the hand that is on your belly out first. As you exhale, make sure you release all the air that you took in.  People, who take deeps breaths in but don’t let all the air out, will increase carbon dioxide in the body. Counting while you do this will be helpful. If it takes you 3 seconds to breath in, make sure you exhale for 3 seconds as well. The goal is to get to 10 seconds each way! As you are practicing this exercise you want to make sure that the only hand that is moving is the one on your belly. Try to not move the hand that is on your chest at all.

Consciously practicing your belly breath will increase oxygen through out the body, decrease stress, and increase your health!

Stress Management – Quick Strategies for Coping with Stress

The Quick Take Away:

  • Eat less sugar: sugar is an extraordinary stress-inducing food that undermines our health in countless ways.
  • Sleep more: go to bed earlier because you still have to get up at your usual time, so to get more rest – one the most effective stress relief behavior you can engage in, and it’s free and feels great.
  • Exercise more: the body’s response to exertion is categorically a must for health in general but a key strategy for melting stress
  • Say no … more often: reduce the demands on your schedule by simplynot committing to so many … things (for you, for your kids, at work).

We all do what we need to do to survive, “get by,” and in hopefully most cases, succeed.  In all of these, good, bad, or ugly, stress accumulates and adds to the load we’re already carrying through life.  Thankfully, we are surrounded with abundant information on how to productively quarantine, reduce, or ideally, dissipate the stress – the question is, have we looked into it yet?

There are none more powerful in managing stress levels than ourselves, and so we are charged with the responsibility of keeping tabs on how we are allowing stressors to affect us psychologically and ultimately, physically.  We understand a few of the physiological effects of chronic stress, and are tasked with finding practical methods to incorporate daily to prevent stress-induced deficiency.

Here are some great “weapons” in our arsenal that everyone can use to combat chronic stress:

  • Get Enough Sleep (usually at least 8 hours)
  • Exercise (doesn’t need to be much, at least 20 minutes a day, 3 days a week)
  • Drink water (you should never feel thirsty, if you are thirsty you need to drink more water)
  • Eat a well balanced diet (plenty of fruits and vegetables)
  • Get adjusted (a balanced body is a healthy body, adjustments keep the body in balance)

We need to practice removing ourselves from our everyday stressors, even if for a few seconds at a time while right in the middle of them, and we need to be on-purpose about it.

One particularly inconspicuous strategy that is fun and costs nothing is a “three second vacation.”  For three seconds, close your eyes and let your mind transport you to the most relaxing place on earth – sights, sounds, scents, everything.  Breathe it all in deeply for three seconds, and then resume your activity (extend duration and/or repeat as many times throughout the day as necessary).

On a larger scale, we challenge you to use some of the most gratifying activities you’ve come to enjoy to assist in the battle against stress.  They don’t necessarily need to cost anything (it doesn’t cost much to take a sketch pad out to draw a landscape or to get out and climb a tree…preferably your own tree), but a reasonable expense is also acceptable (a ride along the coast on a sunny day, top-down in a rented convertible, a round of golf, or a session out on the community airfield with a radio controlled airplane…however, if the expense or challenge of the mechanism adds stress, please find another coping mechanism to use).

We’re all different and there’s no sense in stressing about choosing coping mechanisms, so find your fun and you’ll discover a mechanism that works for you!

Fighting Inflammation

This is another great post from my friends at Bonfire Health about inflammation:

We tend to think of inflammation in terms of injuries such as a sprained ankle or a bug bite – those are what are described as ‘acute inflammation’. There’s a much more insidious and dangerous type of inflammation – chronic low grade or ‘silent’ inflammation caused by our lifestyle choices.

S.A.D. DIET AND INFLAMMATION

By now nearly everyone’s heard of omega-3 and omega-6 fatty acids, but most people don’t know the first thing about what they mean. If a person eats the Standard American Diet (S.A.D.), consisting of packaged processed food that is dominated by wheat flour, vegetable oils and sugars (think cereals, bread, pasta, pizza and all prepared snack foods), they are loading their bodies with omega-6 fats which promote inflammation which causes disease (cancer, heart disease, diabetes, obesity, autoimmune). If on the other hand, a person eats lots of organic vegetables, healthy fats, and quality organic proteins (grass fed beef, organic chicken, pastured pork, etc.), they provide a healthy supply of omega-3 fats which inhibit inflammation and promote health.