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.

 

5 Simple Ways to Be Healthier and More Productive Without Leaving Your Desk

I saw this one on the internet and thought I would share it with you.  It comes from Entrepreneur, so I guess that means it is for important people, haha!  I hope you can use it:

We know physical health affects job performance, yet the demands of the day often win out over doctors’ orders. While studies show that a ten minute break for every 50 minutes of intense mental demand is required to keep your brain at its’ optimal performance, getting up from the desk is not always an option, especially for busy entrepreneurs. Follow these tips to stay healthy and productive even when desk-bound.

1. Boost your immune system with lemon water.“Squeezing half of a fresh lemon into an eight-ounce glass of water will kick-start the liver to metabolize waste more effectively, minimizing digestive bloating, gas, constipation and body pains”, says Naturopathic doctor Camille Nghiem-Phu. Bonus: lemon is an uplifting scent that can make you feel more energized and alert.

2. Get rid of your chair for better posture. “Poor posture obstructs proper blood flow and nerve conduction to our organs,” says Nghiem-Phu. Bad posture can also often lead to lower back, upper neck and shoulder pain resulting in headaches and poor concentration.

Switch up your desk chair for an inflatable exercise ball that allows you to keep your back straight while strengthening the core muscles. “Ensuring proper ergonomic positions will accelerate fresh oxygen delivery to the brain for mental sharpness,” says Nghiem-Phu.

3. Choose high-protein snacks. “Protein keeps the blood sugar stable to ward off the highs and lows of sugar-crashes that come from consuming only carbohydrates at mealtimes,” says Nghiem-Phu. Exchange your coffee and doughnut for high-protein snacks such as raw almonds, fruit, plain Greek yogurt or hummus and veggies and avoid refined sugars to ensure optimal mental performance all day long.

4. Drink more water than you think you need. Drinking water keeps the brain and muscles hydrated. We’ve all heard the advice to drink eight 8-ounces glasses of water a day, but it’s not one size fits all. Your weight in kilograms is equal to the ounces of water your body requires each day, according to the American Dietetic Association. So if you weigh 170 pounds (77kg) you should drink 77 ounces of water a day (or almost 10 eight-ounce glasses). Increase this number by 16 to 20 ounces when you exercise.

5. Stretch at your desk. Taking a break to do some stretches improves circulation allowing fresh oxygen delivery to the brain, and minimizes neck and shoulder tension that lead to headaches. Nghiem-Phu recommends the following stretches for the desk-bound:

  • With a straight back, bend your elbow, reaching your right hand towards the back of your head, for the area behind the left ear and bring your chin towards the right shoulder. Hold for 30 seconds and repeat on the other side.”This stretches the muscles at the back of the head that are typically tightened to cause migraines and tension headaches,” says Nghiem-Phu.
  • To stretch the neck and upper back, bring both hands to the back of the head and allow the weight to bring your head forward while keeping your back straight.
  • With your right hand on your right hip, raise the left arm to the ceiling. Bend sideways at the waist towards the right to stretch the obliques. Repeat on the other side. “This opens the rib cage to maximize air circulation in the lungs,” says Ngheim-Phu.
  • To stretch the upper back, stand up, place both hands on the desk in front of you and take a couple steps back so you’re bent at the hip with your arms outstretched and your head facing the floor.

Benefits of Movement

I saw this from a website that I subscribe to (bonfire health) and I liked it so I am going to share it with you:

Critical Concepts:  Lack of movement promotes stress.
There are many well-understood benefits of movement and activity, including improved cardiovascular health, weight loss, lean muscle mass and strength, balance, tone and appearance.  Science is now grasping the depth of the role of exercise in the realm of prevention of chronic diseases such as diabetes, CVD and obesity.  The latest research is now painting a broader picture for the benefits of movement in the realm of neurology, development and optimal health.

The primary purpose of movement and activity is to develop and condition the brain (Dr. John J. Ratey, Spark).

Our nervous system is an incredibly complex network of communication fibers and junctions that allow us to relate and adapt to our internal and external environments.  The nervous system, made up of the brain, the spinal cord and miles of nerves, depends on movement to restore the body to homeostasis – or a state of general balance and equilibrium.

This resting state is critical to health and healing.  Our lives have become frantic.  We rush through our days, seemingly never having enough time to complete tasks, slow down to eat, or relax and unwind.  So often we are stressed out in traffic or sitting in front of a computer or on the phone.  Most people spend far too much time in the “Go State” – fight or flight.  This constant Sympathetic Stress State keeps stress hormones coursing through our veins, wreaking havoc on our health.

One vital function of movement is its ability to “re-set” our nervous system from a “stress state” to a “rest and repair” state.

The cerebellum is the area of the brain that monitors movement.  The “body sense” that is derived from movement is called proprioception.  This body sense provides more data to our brain than all of our other incoming senses combined.  It is described by Nobel Prize Winner Roger Sperry as a brain nutrient.  The information is derived from the compression of spring-like mechanoreceptors in your joints.  When you move, they send signals to your brain.

This cerebella stimulation from movement of our joints will actually drive the body away from a stress state and back toward a rest and repair state.  This critical homeostatic mechanism is responsible for returning your body to a state of equilibrium.  In other words, movement reduces stress.

Lack of movement promotes stress.

If you live a sedentary life, you miss out on this effective “stress-buster.”  People who exercise regularly report less stress in their lives and experience fewer stress-related health problems.  Exercise has the additional benefits of increasing neurotransmitters (brain chemicals) that promote happiness, better sleep and increased sex drive.

Poor posture and fixed positions can create stress in the body.  Toxic and deficient movement patterns promote core weakness, muscle strain, inflammation and structural dysfunction.  When joints do not move properly, they create irritation to the nervous system that acts a lot like “static” or noise in our communication network.  This noxious stimulation or nociception changes the brain’s function and influences the body’s chemistry.  This type of joint dysfunction and associated nerve irritation is called “subluxation.”

Subluxations can occur in any joint, but the most devastating are found in the joints of the spine.  These spinal misalignments can be caused by trauma or bad habits (or both), and their ill effects on your health can be profound.  A distinctive quality of subluxation is joint fixation.  When a joint is fixed or “stuck” and not moving through its normal range of motion, a host of problems can arise.  Joint decay and degeneration (arthritis) occurs when a joint is not moving properly.  If a joint is fixated, proprioception (Body Sense) is reduced and nociception (noise) is increased – both of which promote stress in the body.

Healthy people practice regular spinal hygiene by utilizing the Life Extension Exercises.  A Bonfire best practice is to implement these into your daily routine to combat stationary work and postural stress.  Best results are achieved if you do this one-minute routine at least once every two hours at the computer or work station.  Nudge yourself into better habits by auditing your workstation for postural stress (read more here).  Make it a regular habit to get up and walk during your day.  It is very unnatural for you to sit for extended periods of time – no matter how important the project.  Dr. James Chestnut suggests a brilliant nudge: position yourself perfectly while sitting at the wheel in your car and then adjust your mirrors.  If you slouch during your drive, the mirrors will remind you to sit up.

A vital behavior for optimal health and function is to have your spine and nervous system evaluated regularly by a qualified chiropractor.  These doctors have a unique training and specialization in locating and correcting spinal misalignments that contribute to spinal stress.  This safe and effective method has been practiced widely for over one hundred years, and is now the second largest form of health care in the world.

Your brain and body expect and require movement for health – for life.  Get to it.

Summary Checklist

  • Add activity every day in every way
  • Calculate Energy Balance
  • Add Functional Training
  • Use variety in your workouts
  • Focus on the Intensity of your workouts
  • Gradually progress to a higher intensity
  • Adopt the Buddy System
  • Get your Spine checked by a chiropractor

“Healing on a Spare Donut…”

In case you get a flat, the temporary “donut” in your trunk is meant to get you off the road and to the nearest service station for proper repair ASAP.  Manufacturer’s instructions warn you to take it slow and easy when driving on them – those tiny tires aren’t designed to withstand the load of normal driving.  But regardless of that warning, you’ve probably seen some idiot speeding down the highway on one, oblivious to the potential risks.

Some people treat their health that way.  When they get an injury or a health problem they mask their symptoms with ‘spare tire’ medication, all the while continuing the activities that got them there in the first place.  They pay little attention to the risks of temporarily patching their problem with drugs and pass on fixing the CAUSE of their problem.  That can get you into trouble.

When it comes to acute or chronic health problems, the best policy is to fix the underlying cause of the problem the right way instead of masking the symptoms with medication. That’s the core philosophy of drugless Chiropractic care. In the short term drugs may bring you false comfort, but in the long run you’re risking a serious blow out.