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.

Sciatica, Low Back Pain, Lumbar Spine Disc Herniations and Pinched Nerves!

We have been seeing a lot more sciatica in the practice lately.  I guess there could be many reasons for that.

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  • We have had some late season snow (the wet and heavy kind) and shoveling has been a hassle
  • It is the end of winter and patient’s have been sedentary for a few months and have been getting weak, or
  • People are just doing things they shouldn’t be doing.

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Everyone always ask me, “How did this happen to me?”  The answer is not that easy because there are so many reasons you can get Sciatica.  So I try to break it down:

Sicatica is caused when the sciatic nerve is being pinched.  The pinch could come from a lot of structures or reasons, but I will list the most common.

a) A herniated disc at L4, L5 or S1.  That means the jelly from inside the disc is coming out and putting pressure directly on the sciatic nerve.  The nerve gets compressed and causes sciatica.

b) Muscle spasm, most commonly at the Piriformis muscle.  What happens is that sometimes the sciatic nerve pierces right through the Piriformis muscle and when the muscle gets tight it squeezes the sciatic nerve in between it causing sciatic pain.

c) Arthritis!  That’s right, that good old Arthur-itis as my family calls it.  When the body develops arthritic spurs, these are little pieces of bone growth outside the normal bone.  These bone growths can also put pressure on the sciatic nerve at the levels of L4, L5 and S1 also.

d) Pregnancy is the lasty most common cause.  When the fetus starts to grow and the uterus expands it begins to move organs out f the way to make room.  Organs like the stomach and diaphragm move up (this causes the indigestion and acid reflux) and others move down, which can also push and compress the sciatic nerve causing sciatic pain.

Again, there so many other causes of Sciatica, but these are the most common I see at The Spine adn Health Center of Montvale.

Once we have diagnosed the exact cause of the sciatica we can then develop the correct treatment plan to rehabilitate.  The problem I see out there is that the cause of the sciatica is not properly diagnosed, it is then not treated properly and patients will either not see any improvment with their pain and discomfort or the relief will be short lived and the pain will come back over and over again.  At the Spine and Health Center of Montvale, we identify the exact cause and administer the proper treatment and that is why we ge tgood results.

I hope this answered a lot of questions about Sciatica and the causes.  I am always available for any questions you may have.  Just email me from the website if you’d like or call and I would be happy to answer any questions you may have.  If you are local, pop on in to one of the offices and say hi!

 

 

Dr. Kelly and Dr. Pete have completed the NSCA strength and conditioning symposium!

   Over this past weekend in association with the National Strength and Conditioning Association (NSCA) and the Association of New Jersey Chiropractors (ANJC) sports council, Dr. Kelly Blundy and Dr. Peter Wohl completed a 16 hour symposium for the Certified Strength and Conditioning Specialist (CSCS).  So many topics were covered including sport specific plans for strength, exercises, stretches, nutrition, etc.  The plans are for the in-season athlete as well as off-season, pre-season and post-season athletes.  These programs are designed for athletes of all levels and ages, from the junior high school child that wants to gain weight and power to the professional  athlete.

   We would like to invite any athletes that are looking to perform better and develop more strength, power and endurance to come on by.  We are now capable of handling full programs throughout the year.  With this knowledge, The Spine and Health Center of Montvale is now equipped to handle athletes at a much higher capacity.  Our programs will now be designed to not only improve performance, but to prevent injury as well.

   Please contact the office with any questions or to make an appointment.  Call us: 201-746-6577