Exercises and Stretches For Hip Pain

Exercises and Stretches for Hip Pain

From Versus Arthritis

Here are some exercises designed to stretch, strengthen and stabilize the structures that support your hip.

It’s important to keep active – you should try to do the exercises that are suitable for you every day. Repeat each exercise between 5–10 times and try to do the whole set of exercises 2-3 times a day.

Start by exercising gradually and build up over time. Remember to carry on even when your hip is better to prevent your symptoms returning.

If you have any questions about exercising, ask your doctor.

It’s also a good idea to try to increase your general fitness by going for a regular walk or swim, this will strengthen your whole body – which helps support your hip. It can also improve your general health, fitness and outlook.

Simple stretching, strengthening and stabilising exercises

The following exercises are designed to stretch, strengthen and stabilise the structures that support your hip. These exercises for hip pain (PDF, 983 KB) are also available to download and keep.

It’s important not to overstretch yourself if you’re in pain. It’s normal to feel some aching in the muscles after exercising, but you should stop and seek advice if you have joint pain that lasts more than a few days.

If you’ve had a hip replacement you will probably be advised to take it easy for the first six weeks and not to push yourself too much. Ask your physiotherapist what exercises they recommend you should start with and how to do them.

You may feel slightly uncomfortable during or after exercise, but this should settle within 24 hours. It shouldn’t be painful. If you feel any sudden pain stop exercising and seek medical advice.

An illustration of someone marching on the spot.

Hip flexion (strengthening)

Hold onto a work surface and march on the spot to bring your knees up towards your chest alternately. Don’t bring your thigh above 90 degrees.

An illustration of someone standing whilst holding onto a table, moving their leg backwards and keeping it straight.

Hip extension (strengthening)

Move your leg backwards, keeping your knee straight. Clench your buttock tightly and hold for five seconds. Don’t lean forwards. Hold onto a chair or work surface for support.

An illustration of someone standing and holding onto a chair, lifting their leg sideways.

Hip abduction (strengthening)

Lift your leg sideways, being careful not to rotate the leg outwards. Hold for five seconds and bring it back slowly, keeping your body straight throughout. Hold onto a chair or work surface for support.

An illustration of someone standing whilst holding onto a table, bending their knee towards their bottom.

Heel to buttock exercise (strengthening)

Bend your knee to pull your heel up towards your bottom. Keep your knees in line and your kneecap pointing towards the floor.

An illustration of someone squatting down, bringing their knees towards their toes.

Mini squat (strengthening)

Squat down until your knees are above your toes. Hold for a count of five if possible. Hold on to a work surface for support if you need to.

An illustration of someone laying on their back with one bent leg and one straight leg with a towel under it's knee. They're raising their foot off the floor.

Short arc quadriceps exercise (strengthening)

Roll up a towel and place it under your knee. Keep the back of your thigh on the towel and straighten your knee to raise your foot off the floor. Hold for five seconds and then lower slowly.

An illustration of someone laying down with their legs straight, pulling their toes and ankles towards them whilst pushing their knees to the floor.

Quadriceps exercise (strengthening)

Pull your toes and ankles towards you, while keeping your leg straight and pushing your knee firmly against the floor. You should feel the tightness in the front of your leg. Hold for five seconds and relax. This exercise can be done from a sitting position as well if you find this more comfortable.

An illustration of someone laying on their back with their knees bent and hands under the small of their back. They're pulling their belly towards the floor.

Stomach exercise (strengthening/ stabilising)

Lie on your back with your knees bent. Put your hands under the small of your back and pull your belly button down towards the floor. Hold for 20.

An illustration of someone laying on their back with their feet to standing, lifting their pelvis and lower back off the floor.

Bridging

Lie on your back with your knees bent and feet flat on the floor. Lift your pelvis and lower back off the floor. Hold the position for five seconds and then lower down slowly.

An illustration of someone laying on their back and pulling their knee toward their chest.

Knee lift (stretch)

Lie on your back. Pull each knee to your chest in turn, keeping the other leg straight. Take the movement up to the point you feel a stretch, hold for around 10 seconds and relax. Repeat 5-10 times. If this is difficult, try sliding your heel along the floor towards your bottom to begin with, and when this feels comfortable try lifting your knee.

An illustration of someone sitting with their knees bent and feet together, pressing their knees downwards.

External hip rotation (stretch)

Site you your knees bent and feet together. Press your knees down towards the floor using your hands as needed. Alternatively, lie on your back and part your knees, keeping your feet together. Take the movement up to the point you feel a stretch, hold for around 10 seconds and relax. Repeat 5-10 times.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

What to know about lower back pain when sitting

What to Know About Lower Back Pain When Sitting

Medically reviewed by Emelia Arquilla, DO— Written by Hana Ames on October 14, 2020. | From Medical News Today

The cause of pain in the lower back while sitting may involve posture, an injury, or a health condition.

Back pain is one of the most common medical problems in the United States. About 1 in 4 adults in the country have at least 1 day of back pain in any 3-month period.

Here, we describe the causes, treatments, and prevention of lower back pain while sitting.

What does it feel like?

Back pain may be acute, in which case it comes on suddenly and usually lasts a few days or weeks. Or, the pain may be chronic, lasting longer than 12 weeks.

Pain in the lower back may be sudden and sharp or a dull, constant ache.

Causes

A variety of factors can cause pain in the lower back while sitting, and the best approach to treatment depends on the cause.

The treatment plan might include over-the-counter pain relief medication, physical therapy, a new exercise routine, surgery, or a combination.

Posture

Poor posture can cause or worsen lower back pain. Improving posture involves changing a person’s position as they sit or stand. It can often ease or relieve the pain.

Injury

A person might injure their lower back while lifting something incorrectly, leading to a strain or sprain in the area.

The injury might instead result from trauma, sustained during sports or from a car accident, for example.

Sciatica

Sciatica happens when something presses on the sciatic nerve, which travels through the buttocks and extends down the back of the leg, and the issue can cause pain throughout the area.

The pain may be intense and feel like an electric shock or be a dull ache.

Herniated disk

A herniated disk refers to a disk in the spine bulging outward and pressing on a spinal nerve. Any disk in the spine can be affected.

Treatment for this condition usually involves medication and physical therapy.

Lumbar disk disease

Lumbar disk disease, also known as degenerative disk disease, is not actually a disease. Usually, it results from aging.

It occurs when the disks between the vertebrae of the spinal column wear down.

Spondylolisthesis

Spondylolisthesis involves a vertebra of the lower spine slipping out of place and pinching nearby nerves.

Home care strategies

A person may not need professional treatment for lower back pain while sitting.

Often, a person can take steps at home to relieve the pain and keep it from returning. Some strategies include:

Staying active

It can be tempting to rest as much as possible, but the medical community recommend keeping active to ease lower back pain.

Try not to do too much at once, however. Instead, try coupling physical therapy or a recommended form of exercise below with other home treatments.

Using heat and cold

Alternating between heat and cold can often help ease lower back pain.

Taking a hot bath or using a hot water bottle may help alleviate the pain. Heat can also increase blood flow to the area and promote healing in the muscles and tissues of the back.

Applying ice packs or bags of frozen vegetables to the area can also ease pain, but ensure to wrap them in a cloth first.

Heating or cooling sprays are also available over the counter, and they can stimulate the nerves in the area.

Taking pain relief medication

Nonsteroidal anti-inflammatory drugs, or NSAIDs can help ease pain in the lower back. Many, such as ibuprofen, are available without a prescription.

People tend to take these medications orally, but they also come as creams, gels, patches, and sprays.

Stretching and exercising

Exercises and stretches can help strengthen the lower back and prevent the pain from occurring.

Routines that focus on working the core, or abdominal, muscles may also help speed recovery from chronic lower back pain.

Yoga, for example, can help relieve pain in the lower back and neck, and other forms of exercise that may help include:

  • swimming
  • walking
  • Pilates

Stretches that can help alleviate lower back pain include:

  • Deep lunge: Kneel on one knee, with the other foot in front. Facing forward, lift the back knee up. Hold the position for 5 seconds.
  • Back stretch: Lie on the stomach, using the arms to push the upper body off the floor. Hold the position for 30 seconds before allowing the back to relax.
  • Sagittal core strengthening: Standing 3 feet away from a wall with the feet should-width apart, tighten the abdominal muscles, then reach through the legs to touch the wall, keeping the hips and knees bent. Use the hips to push the body back to a standing position, then extend arms and reach over the head and slightly backward.

Prevention

Lower back pain is more common in people with obesity and people who smoke.

Also, people who are infrequently active are more likely to have lower back pain, as are people who tend to be inactive but occasionally engage in strenuous exercise.

The best sitting position

The Department of Health and Human Services warn against slouching and recommend sitting up straight, with the back against the back of the chair and the feet flat on the floor.

They also recommend keeping the knees slightly higher than the hips when sitting.

Diagnosis

To determine the cause of back pain, a healthcare provider will ask the person about their medical history and perform a physical examination.

If the pain is acute, further tests are usually not necessary, unless the pain results from an injury.

The treatment for chronic pain depends on the cause, and surgery may be an option.

When to see a doctor

Seek medical attention if lower back pain is severe, lasting, or does not improve with stretches, exercises, and other home care techniques.

Also, contact a doctor if the pain results from an injury.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

12 Tips for Walking When You Have Sensitive Knees

Sensitive knees can be a challenge for walking, but it is a recommended way to maintain your function and reduce your symptoms. If you have knee pain due to osteoarthritis or other causes, you don’t have to let that keep you from starting a walking program.

A regular program of walking can reduce stiffness and inflammation and it won’t make most chronic knee conditions worse. Walking is the preferred exercise by people with arthritis, and can help you improve your arthritis symptoms, walking speed, and quality of life, according to the CDC.

Walking is part of a healthy lifestyle to keep your heart and bones strong and your joints functioning. Here are tips for walking when you have sensitive knees.

Why Walking Is Good for Your Knees

Your knee joint is composed of bone and cartilage. Cartilage doesn’t have a blood supply that is always nourishing it by the pumping action of the heart and so it relies on joint fluid for nutrition. Moving your joints is the way that you ensure the cartilage receives the nourishment it needs to stay healthy.

You may notice that your joints are stiff and sore in the morning or when you’ve been sitting and inactive during the day. By moving your joints, you help them maintain their function and you may help keep them functioning longer.

Regular exercise maintains and builds muscles, which you need to support your knee and maintain functioning. Weight-bearing exercise such as walking also helps maintain bone health.

Discuss your exercise options with your doctor and physical therapist when you have any condition that is causing knee pain. While walking is recommended for many people, it may not be appropriate for you.

Should You Walk When You Have Knee Pain?

If you have mild to moderate pain in your knees due to osteoarthritis, walking and other exercise helps mobilize your joint fluid and lubricate the joints. You should walk and do other exercises that move your knee joints. You are likely to find that the stiffness, pain, and fatigue improve with exercise.

If you have moderate to severe pain in your knees before you start walking, take it easy. Do a shorter walk at an easy pace or try an activity that doesn’t place much stress on the joint, such as water exercises in a pool. If joint pain remains severe, stop immediately as it is a sign of inflammation or joint damage that needs treatment.

If you have joint pain occasionally the day after a walk or run, you should take a day off and do a shorter workout or one that doesn’t put stress on the joint. If you always have joint pain after exercise, you may have to switch to a form of exercise that doesn’t put stress on the knees, such as cycling or swimming.

Tips for Walking With Sensitive Knees

Taking certain precautions can make it easier to continue your walking routine despite sensitive knees. Here are 12 ways to protect your knees when walking.

  • Add cycling: Incorporate cycling on a stationary bike, bicycle, or even an under-desk cycle to help keep your opposing muscles in shape for better support of the knee.
  • Aim for 6000 steps per day: A study found that people with osteoarthritis knee pain benefit most when they walk 6000 steps or more per day.2 If you wear a pedometer or use a phone app to track your steps, all of your steps during the day count. Make that your first goal. If you can eventually exceed that regularly without increasing pain, that is good.
  • Build your walking time: If you are new to walking, steadily build up your walking time following a plan for beginners. Walking can be broken up into 10-minute segments, with an ultimate goal of 30 minutes per day. Start at an easy or moderate pace as you build endurance. Eventually, aim to walk briskly at 2.5 to 3.5 mph or a pace that has you find challenging.
  • Choose softer walking surfaces: Walking on natural surface trails (dirt, bark dust, pea gravel) is easier on the joints. Although sometimes uneven, natural surfaces provide more balanced exercise. For even surfaces, choose a cinder track or asphalt rather than concrete. Note that flooring in malls and stores is primarily concrete.
  • Choose the right shoes: Shoes should be flat and flexible, bendable in the forefoot with a low heel-to-toe drop. Avoid high heels, pointy toes, and heavy shoes. Look for shoes with a wide toe box. Even a 1.5-inch higher heel can increase pressure on two common sites for knee osteoarthritis damage. Choose heels that are 3/4 inch or less.
  • Keep moving throughout the day: Get up and move around or stretch every 15 minutes. This will keep your joint fluid moving and nourish your knees. Even just a minute can help reduce the health risks of sitting and will be good for your joints.​
  • Lose excess weight: If you are overweight, losing even a few pounds can reduce stress on your knees. Diet is the most effective way to lose weight. You will be able to walk and exercise with less pain and discomfort after some of the excess weight has been lost.
  • Use cold packs after walking: You’ve done well by getting your joint fluid moving. You can apply cold packs afterward to help reduce inflammation.
  • Use inserts: When you have sensitive knees, avoid arch supports and shoes that have a high amount of arch support. You want your foot to move as naturally as possible. You can use over-the-counter orthotics that provide cushioning and support if you think that is helpful for you or they have been recommended by your doctor or podiatrist.
  • Use walking poles: Some people find that using trekking poles or Nordic walking poles helps them with stability and reducing joint fatigue when walking. Canes and other walking aids may be useful, depending on your condition.
  • Walk during low-pain times of the day: If you have a lot of pain or stiffness in the morning, simply try to get up and move around for a minute or two every half hour. You will better enjoy long walks at a time when you have fewer aches, and that will help you be consistent.
  • Warm up: You may benefit from applying heat to your joints before you walk, or walking after taking a warm shower or bath. Starting at an easy pace is recommended for everyone, but especially when you have stiff or sore joints. Start slow to get your joint fluid moving. Then you can pick up your pace after a few minutes.

A Word From New Mexico Orthopaedics

Walking is the most accessible form of physical activity and can help you maintain joint health. However, it’s not the only option. If your sensitive knees keep you from walking, you can get the physical activity you need by enjoying cycling, pool exercises, swimming, or water aerobics.

You should also include resistance exercise to build and maintain muscles, including any specific exercises recommended for your knees by your doctor or physical therapist. Balance exercises can also be beneficial. Once you are confident walking, you can even include them in your walking workouts. Just keep moving!

 


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Here's why your weight matters when addressing hip and knee pain

Here’s why your weight matters when addressing hip and knee pain

Article Featured on Scrubbing.in

Joint pain is one of the most common types of chronic pain. Many people experience aching joints, especially in the knees or hips, and assume it’s a natural part of aging. But there may be an underlying cause — your weight.

Think of your body like a car. Over time, the tires on your car wear down from carrying the full weight of your vehicle. Bigger, heavier vehicles require bigger, sturdier tires.

Your joints are just like tires — you use them all the time and they are constantly carrying the weight of your body, like the tires carry the weight of your car. And just like the tires, they feel the burden of any extra weight you carry. But unlike with a car, buying bigger joints to carry that extra weight isn’t an option.

The link between weight and joint pain

According to the Centers for Disease Control and Prevention (CDC), 70 percent of American adults are overweight or obese. This extra weight can put a burden on your joints, causing you to experience pain or inflammation. Being overweight affects the main weight-bearing joints, the hips and the knees, in two different ways.

First, the extra weight increases the joint reaction force within the joint. Over time, this extra joint reaction force, or pressure, causes increased wear and tear on the joint. The damage to the cartilage results in eventual arthritic changes on the joint and can cause you to experience decreased range of motion, stiffness, pain, swelling or warmth. If the damage causes severe pain, it can result in the need for medical attention.

Weight gain also results in increased inflammatory factors. Many inflammatory diseases and conditions that have been linked to being overweight or obese, including digestive disorders, autoimmune disorders, neurological issues, etc. Similarly. the inflammatory enzymes and factors in the body can cause your joints and the surrounding tissues to be painful.

Think about this, too — when you go up or down a set of stairs, it adds two to three times your body weight across your knee joints. That means someone who is 100 pounds overweight is actually adding 150 pounds of extra force across the joint than they would if they were a normal weight.

How to lessen the burden

However, losing even a small amount of weight can make a big difference when it comes to joint pain and inflammation.

study published in Arthritis & Rheumatism found that just one pound of weight loss resulted in four pounds of pressure being removed from the knee. Similarly, other studies have concluded that a pound of weight loss can remove six pounds of pressure off the hips. A 2010 study indicated that weight loss can lessen inflammation of the joints.

So if you’re experiencing joint pain, don’t just assume it’s because of your age — it could actually be your weight. Talk to your doctor about building a weight loss plan to help you accomplish your goals.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

All About Sacroiliitis

Article Featured on Spine Health | By Amish Patel, MD | Image Credit: Veritas Health

The term sacroiliitis is used to describe any inflammation in the sacroiliac joint, which is located on either side of the sacrum (lower spine) that connects to the iliac bone in the hip.

Sacroiliitis is often found as part of a feature of inflammatory conditions of the spinal column. As a group, these conditions and diseases are termed a “spondyloarthropathy” and include conditions such as ankylosing spondylitis, psoriatic arthritis, and reactive arthritis, among others.

Sacroiliitis may also be a component of other types of arthritis, such as ulcerative colitis, Crohn’s disease, or osteoarthritis.

Sacroiliitis is also a term that is sometimes used interchangeably with the term sacroiliac joint dysfunction, as technically either term can be used to describe pain that stems from the sacroiliac joint (or SI joint).

Sacroiliitis vs. Sacroiliac Joint Dysfunction

Both sacroiliitis and sacroiliac joint dysfunction are a common cause of sacroiliac pain, low back pain, and leg pain.

However, there are differences between the two conditions:

  • Sacroiliitis. In medicine, the term “itis” refers to inflammation, and sacroiliitis describes inflammation of the sacroiliac joint. The inflammation may or may not be caused by sacroiliac joint dysfunction.
  • Sacroiliac Joint Dysfunction. This condition generally refers to pain in the sacroiliac joint region that is caused by abnormal motion in the sacroiliac joint, either too much motion or too little motion. It typically results in inflammation of the SI joint, or sacroiliitis.

Sacroiliitis Symptoms

The most common symptoms of sacroiliitis include some combination of the following:

  • Fever
  • Pain, usually low back pain, leg pain (may be in the front of the thigh), hip pain, and/or buttock pain
  • Pain that is worse when sitting for a long time, and worse when rolling over in bed
  • Stiffness felt in the hips and low back, especially after getting out of bed in the morning or after sitting still for a prolonged period.

A wide range of factors may cause sacroiliitis or predispose one to developing sacroiliitis:

  • Any form of spondyloarthropathy, which includes ankylosing spondylitis, arthritis associated with psoriasis, and other rheumatologic diseases, such as lupus
  • Degenerative arthritis, or osteoarthritis of the spine, causing degeneration of the sacroiliac joints and in turn leading to inflammation and SI joint pain
  • A trauma that affects the lower back, hip or buttocks, such as a car accident or fall
  • Pregnancy and childbirth, as a result of the pelvis widening and stretching the sacroiliac joints during childbirth
  • Infection of the sacroiliac joint
  • Osteomyelitis
  • Urinary tract infection
  • Endocarditis
  • IV drug use/drug addition

If a patient has pain in the sacroiliac area and any of the above conditions, he or she may have sacroiliitis or sacroiliac joint dysfunction.

Sacroiliitis Treatment

The specific sacroiliitis treatments will be determined primarily by the type and severity of the patient’s symptoms, and the underlying cause of the sacroiliitis.

There is a wide range of nonsurgical options available. Most patients find that a combination of two or more of the following nonsurgical treatments can be effective in managing their symptoms:

Rest
A short period of rest may help calm the inflamed sacroiliac joints.

Heat and/or ice
Warmth or cold applied to the area will provide local pain relief. Application of a cold pack will help reduce the inflammation in the area. Application of warmth, such as a heating pad or hot tub, will help stimulate blood flow and bring healing nutrients to the area.

Sleep position
Changing one’s sleep position can help alleviate pain while sleeping and at waking. Most patients find it best to sleep on the side, with a pillow placed between the knees to keep the hips in alignment.

Medications
For many, over-the-counter pain medications, such as acetaminophen, and/or anti-inflammatory medications, such as ibuprofen, provide sufficient pain relief. Prescription medications may be recommended, such as tramadol (brand name Ultram), or a short course of narcotic pain medications, or muscle relaxants to help reduce painful muscle spasms.

Sacroiliac joint injections
For severe pain, a sacroiliac joint injection may be recommended both to confirm the sacroiliac joint as the source of the pain and to introduce the anti-inflammatory medication directly into the joint. The injection is done with fluoroscopic guidance, which is a type of live x-ray, to ensure correct placement of the needle in the joint. The injection typically includes both a numbing agent, such as lidocaine, and a steroid, which is a strong anti-inflammatory medication.

Injections can typically be done up to three to four times in one year, and should be accompanied by physical therapy and/or chiropractic or osteopathic manual manipulation to restore proper range of motion and rehabilitation.

Sacroiliitis exercises
A prescribed physical therapy program of stretching, strengthening and low impact aerobic conditioning is usually a part of most sacroiliitis or sacroiliac joint dysfunction treatment regimens. The therapy may be done by a physical therapist, chiropractor or other appropriately trained health specialist.

Other Sacroiliitis Treatments

As part of treatment for another condition
If sacroiliac joint mediated pain is a result of another condition, (such as ankylosing spondylitis, osteomyletis, etc.), then additional treatments will focus on treating the underlying cause of the SI joint symptoms as well.

Sacroiliac joint surgery
The vast majority of cases of sacroiliac joint mediated pain are treated with nonsurgical options. For severe, intractable pain that is unresponsive to nonsurgical options and interferes with the patient’s everyday life, surgery may be considered an option. The surgery is a sacroiliac joint fusion, which is designed to fuse the SI joint to stop the motion in the joint.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

3 Lifestyle Choices for Healthier Knees

3 Lifestyle Choices for Healthier Knees

Article Featured on Active Implants

The knee is one of the largest, most complex joints in the human body and the most common joint injured. While several common causes for knee pain exist, many lifestyle choices may reduce pain and postpone or eliminate the need for knee surgery in the future. Here are 3 tips for maintaining healthy knees and a healthier life:

Take care of your overall health

Taking better care of your physical and mental health will not only make for a happier and more fulfilled life, but can also improve the strength of your knees. Studies have shown that ailments such as back pain and depression have been linked to knee pain, so making even the simplest of changes like strengthening your core and losing weight can help stave off the prospect of knee surgery. Did you know losing 10 pounds relieves about 40 pounds of pressure on your knees?

Drink more water

Water is not only vital to healthy bones and skin, it is also vital to knee health. The cartilage in our knees is made up of mostly water – up to 80 percent when we’re properly hydrated. But as we get older, the water content gets lower, resulting in unhealthy cartilage and possibly degenerative joint disease. Lack of water can also lead to dehydration, which can drain your energy and make you tired. So drink up! The Institute of Medicine recommends an adequate intake is roughly about 13 cups of total beverages a day for men, and 9 cups of total beverages a day for women.

Keep moving

Knee cartilage depends on movement to stay healthy and heal. Aim to be active up to 30 minutes a day, five days a week doing any of your favorite knee-safe activities like walking, yoga, swimming or low-impact aerobics. Consider adding in knee exercises to your routine, such as marching, sit to stand/stand to sit, hamstring curls, heel raises and squats for added knee strengthening.

Even after making these healthy lifestyle choices, you may still experience knee pain or injury. If your pain gets to the point that you are unable to enjoy your favorite activities or if it affects your quality of life, it’s time to see a doctor to determine the cause of pain and choose a treatment plan that’s right for you.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Bone, Joint, and Muscle Infections in Children

Bone, Joint, and Muscle Infections in Children

Article Featured on AAOS

Children can develop infections in their bones, joints, or muscles. Often referred to as “deep” infections, the technical names for these conditions are:

  • Osteomyelitis (bone infection)
  • Septic arthritis (joint infection)
  • Pyomyositis (muscle infection)

This article covers the most common types of deep infections in children and includes the ways doctors identify and treat them.

Cause

Infections are usually caused by bacteria that are present in our normal living environment. The most common bacteria causing bone, joint, or muscle infections in children is Staphylococcus aureus (often referred to as “Staph” infections).

Bacteria can get into the body in a variety of ways. They circulate through the bloodstream until they reach a bone, joint, or muscle. Bacteria then leave the bloodstream and multiply in the bone, joint, or muscle tissues.

Description

Deep infections most often occur in the joints and at the ends of long bones where they meet to form joints. These include the hip, knee, and ankle joints of the leg, and the shoulder, elbow, and wrist joints of the arm.

The large muscle groups of the thigh, groin, and pelvis are the most common locations for deep muscle infections.

The reason infections occur in these areas is due to the way blood flows to these locations. There is a strong blood flow to the ends of bone near growth centers (called growth plates), the lining of the joints, and the large muscle groups. This allows bacteria to easily find their way to these areas.

The blood supply to the spine, pelvis, and heel is similar to that of the long bones, and infections often develop in these areas, as well.

Infections pose special risks to young children for a number of reasons:

  • Children under the age of three are easily infected. Their immune systems are not fully developed and they tend to fall down a lot, opening the skin to infection.
  • Infections spread quickly through a young child’s circulation system and bone structure.
  • Damage to bones and joints caused by infection can harm a child’s growth and lead to physical dysfunction. Infection of child’s hip joint is a surgical emergency.

Symptoms and Signs

Children who have infections of their bones, joints, or muscles often have the following:

  • Fever
  • Pain
  • Limited movement of the infected area — your child may limp or refuse to walk if the infection involves the legs or back
  • Infants may be irritable and lethargic, refuse to eat, or vomit

Many children who have bone, joint, or muscle infections have had recent injuries. The symptoms of infection are often masked by those of the injury. Because parents assume the injury will get better over time, it may take them longer to notice the infection.

It is important to bring your child to a doctor immediately if symptoms are not quickly resolving at home.

Doctor Examination

Medical History and Physical Examination

Make sure to tell your child’s doctor the circumstances surrounding the symptoms, such as when the symptoms began, and whether there was a prior infection or injury.

After discussing your child’s symptoms and medical history, your doctor will examine the painful area. He or she may ask your child to move the affected area to see whether movement increases the pain.

Tests

Other tests that may help your doctor confirm a diagnosis and plan your child’s treatment include:

  • Blood tests and tissue cultures. Tests on your child’s blood, as well as fluid and/or tissue from the infected area, can help identify the bacteria or other organism causing the infection. This information about the infection helps your doctor determine the most effective ways to treat it.
  • Imaging tests. Tests, such as x-rays, magnetic resonance imaging (MRI) scans, and ultrasound, provide your child’s doctor with pictures of the bones, muscles, and soft tissues in the affected area. Your doctor will look for swelling around bones and muscles, or fluid within the joints that are infected. This information helps your doctor when making the decision whether to treat the infection with antibiotics alone or to perform surgery to help resolve it.

Treatment

Antibiotic Treatment

Prescribing antibiotics is the mainstay of treatment for infections.

  • Intravenous. At first, your child will need to stay at the hospital to receive antibiotics through the veins (intravenous or IV). How long your child will stay in the hospital will depend on how severe the infection is. Most children with bone, joint, or muscle infections are in the hospital for 1 to 2 weeks.
  • Oral. For many children, the antibiotic is eventually changed to a form that can be taken by mouth (oral) and given at home.
  • PICC line. Some children can continue to receive an antibiotic by vein at home through a special intravenous device called a PICC (pronounced “pick”) line. This is a peripherally introduced central catheter (PICC).

The amount of time on antibiotics that is needed to resolve an infection varies from child to child but, in general, is 4 to 6 weeks for a bone infection and 3 to 4 weeks for joint or muscle infections.

It is very important to have your child take all of the antibiotics he or she is given, in exactly the way they are prescribed.

Surgical Treatment

In mild infections, antibiotics alone may resolve the condition. Many children, however, will need surgery to remove infected material (pus) from the area of infection. This will reduce pressure and inflammation and improve blood flow, which will make it easier for the antibiotics to reach the infected area. For most children, one surgical procedure is enough, but more severe infections may require two or more surgeries to help resolve the infection.

Infected biceps muscle

An infection in the biceps muscle has caused pus to accumulate in this child’s upper arm. During surgery, the pus will be drained so that antibiotics can effectively reach and resolve the infection.
Courtesy of Children’s Medical Center of Dallas

Outcome

Most children will completely recover from deep infections after proper treatment. They are not likely to develop the same infection again. In most cases, children have no further problems and return to all of their activities.

In general, children do better when the infection is recognized early. There is a greater chance for full recovery when the infection is quickly recognized and treated. The later the diagnosis is made, the more likely it is that the infection will cause greater damage to the bones, muscles and other tissues that are involved.

Some problems can occur in children who have serious and prolonged infections. These include blood clots, growth arrests, deformed bones, fractures through bone that is weakened from infection, bone death (called necrosis), and joint stiffness. However, these problems are rare.

Methicillin Resistant Staphylococcus Aureus (MRSA)

In many communities, deep infections are more frequently being caused by a particular type of bacteria known as MRSA. This bacteria is more able to resist antibiotics that previously worked well to treat these infections.

Currently, there are several antibiotics that work very well against MRSA and are tolerated very well by the children who are treated.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Common Knee Injuries

What to do if you think your joint replacement is infected

Article Featured on AAOS

Knee and hip replacements are two of the most commonly performed elective operations. For the majority of patients, joint replacement surgery relieves pain and helps them to live fuller, more active lives.No surgical procedure is without risks, however. A small percentage of patients undergoing hip or knee replacement (roughly about 1 in 100) may develop an infection after the operation.Joint replacement infections may occur in the wound or deep around the artificial implants. An infection may develop during your hospital stay or after you go home. Joint replacement infections can even occur years after your surgery.

This article discusses why joint replacements may become infected, the signs and symptoms of infection, treatment for infections, and preventing infections.

Description

Any infection in your body can spread to your joint replacement.

Infections are caused by bacteria. Although bacteria are abundant in our gastrointestinal tract and on our skin, they are usually kept in check by our immune system. For example, if bacteria make it into our bloodstream, our immune system rapidly responds and kills the invading bacteria.

However, because joint replacements are made of metal and plastic, it is difficult for the immune system to attack bacteria that make it to these implants. If bacteria gain access to the implants, they may multiply and cause an infection.

Despite antibiotics and preventive treatments, patients with infected joint replacements often require surgery to cure the infection.

Total knee implants

Examples of total knee implants. Joint replacement implants are typically made of metal alloys and strong, durable plastic called polyethylene.

Cause

A total joint may become infected during the time of surgery, or anywhere from weeks to years after the surgery.

The most common ways bacteria enter the body include:

  • Through breaks or cuts in the skin
  • During major dental procedures (such as a tooth extraction or root canal)
  • Through wounds from other surgical procedures

Some people are at a higher risk for developing infections after a joint replacement procedure. Factors that increase the risk for infection include:

  • Immune deficiencies (such as HIV or lymphoma)
  • Diabetes mellitus
  • Peripheral vascular disease (poor circulation to the hands and feet)
  • Immunosuppressive treatments (such as chemotherapy or corticosteroids)
  • Obesity

Symptoms

Signs and symptoms of an infected joint replacement include:

  • Increased pain or stiffness in a previously well-functioning joint
  • Swelling
  • Warmth and redness around the wound
  • Wound drainage
  • Fevers, chills and night sweats
  • Fatigue

Doctor Examination

When total joint infection is suspected, early diagnosis and proper treatment increase the chances that the implants can be retained. Your doctor will discuss your medical history and conduct a detailed physical examination.

Tests

Imaging tests. X-rays and bone scans can help your doctor determine whether there is an infection in the implants.

Laboratory tests. Specific blood tests can help identify an infection. For example, in addition to routine blood tests like a complete blood count (CBC), your surgeon will likely order two blood tests that measure inflammation in your body. These are the C-reactive Protein (CRP) and the Erythrocyte Sedimentation Rate (ESR). Although neither test will confirm the presence of infection, if either or both of them are elevated, it raises the suspicion that an infection may be present. If the results of these tests are normal, it is unlikely that your joint is infected.

Additionally, your doctor will analyze fluid from your joint to help identify an infection. To do this, he or she uses a needle to draw fluid from your hip or knee. The fluid is examined under a microscope for the presence of bacteria and is sent to a laboratory. There, it is monitored to see if bacteria or fungus grow from the fluid.

The fluid is also analyzed for the presence of white blood cells. In normal hip or knee fluid, there are a low number of white blood cells. The presence of a large number of white blood cells (particularly cells called neutrophils) indicates that the joint may be infected. The fluid may also be tested for specific proteins that are known to be present in the setting of an infection.

Treatment

Nonsurgical Treatment

In some cases, just the skin and soft tissues around the joint are infected, and the infection has not spread deep into the artificial joint itself. This is called a “superficial infection.” If the infection is caught early, your doctor may prescribe intravenous (IV) or oral antibiotics.

This treatment has a good success rate for early superficial infections.

Surgical Treatment

Infections that go beyond the superficial tissues and gain deep access to the artificial joint almost always require surgical treatment.

Debridement. Deep infections that are caught early (within several days of their onset), and those that occur within weeks of the original surgery, may sometimes be cured with a surgical washout of the joint. During this procedure, called debridement, the surgeon removes all contaminated soft tissues. The implant is thoroughly cleaned, and plastic liners or spacers are replaced. After the procedure, intravenous (IV) antibiotics will be prescribed for approximately 6 weeks.

Staged surgery. In general, the longer the infection has been present, the harder it is to cure without removing the implant.

Late infections (those that occur months to years after the joint replacement surgery) and those infections that have been present for longer periods of time almost always require a staged surgery.

The first stage of this treatment includes:

  • Removal of the implant
  • Washout of the joint and soft tissues
  • Placement of an antibiotic spacer
  • Intravenous (IV) antibiotics

An antibiotic spacer is a device placed into the joint to maintain normal joint space and alignment. It also provides patient comfort and mobility while the infection is being treated.

Knee Implant Compressors

(Top) These x-rays show an original knee replacement from the front and from the side. (Bottom) An antibiotic spacer has been placed in the joint during the first stage of treatment for joint replacement infection.

Spacers are made with bone cement that is loaded with antibiotics. The antibiotics flow into the joint and surrounding tissues and, over time, help to eliminate the infection.

Patients who undergo staged surgery typically need at least 6 weeks of IV antibiotics, or possibly more, before a new joint replacement can be implanted. Orthopaedic surgeons work closely with other doctors who specialize in infectious disease. These infectious disease doctors help determine which antibiotic(s) you will be on, whether they will be intravenous (IV) or oral, and the duration of therapy. They will also obtain periodic blood work to evaluate the effectiveness of the antibiotic treatment.

Once your orthopaedic surgeon and the infectious disease doctor determine that the infection has been cured (this usually takes at least 6 weeks), you will be a candidate for a new total hip or knee implant (called a revision surgery). This second procedure is stage 2 of treatment for joint replacement infection.

During revision surgery, your surgeon will remove the antibiotic spacer, repeat the washout of the joint, and implant new total knee or hip components.

An antibiotic spacer in a hip joint.

This x-ray shows knee components used in a revision surgery (stage 2). Note that the stems of the implants are longer to help support bone that has been compromised due to infection and removal of the previous implants.

Single-stage surgery. In this procedure, the implants are removed, the joint is washed out (debrided), and new implants are placed all in one stage.  Single-stage surgery is not as popular as two-stage surgery, but is gaining wider acceptance as a method for treating infected total joints. Doctors continue to study the outcomes of single-stage surgery.

Prevention

At the time of original joint replacement surgery, there are several measures taken to minimize the risk of infection. Some of the steps have been proven to lower the risk of infection, and some are thought to help but have not been scientifically proven. The most important known measures to lower the risk of infection after total joint replacement include:

  • Antibiotics before and after surgery. Antibiotics are given within one hour of the start of surgery (usually once in the operating room) and continued at intervals for 24 hours following the procedure.
  • Short operating time and minimal operating room traffic. Efficiency in the operation by your surgeon helps to lower the risk of infection by limiting the time the joint is exposed. Limiting the number of operating room personnel entering and leaving the room is thought to the decrease risk of infection.
  • Use of strict sterile technique and sterilization instruments. Care is taken to ensure the operating site is sterile, the instruments have been autoclaved (sterilized) and not exposed to any contamination, and the implants are packaged to ensure their sterility.
  • Preoperative nasal screening for bacterial colonization. There is some evidence that testing for the presence of bacteria (particularly the Staphylococcus species) in the nasal passages several weeks prior to surgery may help prevent joint infection. In institutions where this is performed, those patients that are found to have Staphylococcus in their nasal passages are given an intranasal antibacterial ointment prior to surgery. The type of bacteria that is found in the nasal passages may help your doctors determine which antibiotic you are given at the time of your surgery.
  • Preoperative chlorhexidine wash. There is also evidence that home washing with a chlorhexidine solution (often in the form of soaked cloths) in the days leading up to surgery may help prevent infection. This may be particularly important if patients are known to have certain types of antibiotic-resistant bacteria on their skin or in their nasal passages (see above). Your surgeon will talk with you about this option.
  • Long-term prophylaxis. Surgeons sometimes prescribe antibiotics for patients who have had joint replacements before they undergo dental work. This is done to protect the implants from bacteria that might enter the bloodstream during the dental procedure and cause infection. The American Academy of Orthopaedic Surgeons has developed recommendations for when antibiotics should be given before dental work and for which patients would benefit.  In general, most people do not require antibiotics before dental procedures. There is little evidence that taking antibiotics before dental procedures is effective at preventing infection.

    Antibiotics may also be considered before major surgical procedures; however, most patients do not require this. Your orthopaedic surgeon will talk with you about the risks and benefits of prophylactic antibiotics in your specific situation.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Does Weight Loss Affect Knee Pain

Does Weight Loss Affect Knee Pain?

Why does my knee hurt?

Knee pain is one of the most common complications of being overweight or obese. If you’re among the millions of people who experience chronic knee pain, even a small weight loss can help reduce pain and lower the risk of osteoarthritis (OA).

According to a 2011 report from the Institute of Medicine (IOM), of the roughly 100 million American adults who experience common chronic pain, nearly 20 percent, or 20 million people, have knee pain. This is second only to the number of people with lower back pain.

More than two-thirds of people in the United StatesTrusted are either overweight (with a BMI between 25 and 29.9) or obese (with a BMI of 30 or higher).

Those extra pounds increase the stress on your knees. That stress can cause chronic pain and lead to other complications such as OA.

How weight loss affects knee pain

Maintaining a healthy weight has many health benefits, including reduced risk of a number of diseases that include:

  • heart disease
  • type 2 diabetes
  • high blood pressure
  • certain types of cancers

Losing weight benefits knee pain in two ways.

Decreases weight-bearing pressure on the knees

Each pound of weight loss can reduce the load on the knee joint by 4 pounds. Lose 10 pounds, and that’s 40 fewer pounds per step that your knees must support. And the results add up quickly. Less pressure means less wear and tear on the knees. This lowers the risk of OA.

Reduces inflammation in the body

For years, OA was considered a wear and tear disease caused by prolonged excess pressure on the joints, particularly the knees, which, in turn, caused inflammation. But recent research suggests that inflammation is a key OA risk factor, rather than a consequence of OA.

Being overweight may increase inflammation in the body that can lead to joint pain. Losing weight can reduce this inflammatory response. One study suggests that just a 10 percent reduction in weight can significantly lower inflammation in the body. Another study found that even simply overeating triggers the body’s immune response, which increases inflammation.

The link between weight gain and OA

Being overweight or obese significantly increases a person’s risk for developing OA. According to John Hopkins Medicine, women who are overweight are four times more likely to develop OA than women who are a healthy weight. And men who are overweight are five times more likely to develop OA than men who are a healthy weight.

But losing even a small amount of weight can be beneficial. For women who are overweight, every 11 pounds of weight loss can reduce the risk of knee OA by more than 50 percent. Men who drop into the overweight category (BMI below 30) and men who drop into the normal weight category (BMI below 26) can reduce their risk of knee OA by 21.5 percent.

Easy ways to lose weight

There are steps you can take to start shedding pounds, including:

  • reduce portion sizes
  • add one vegetable to your plate
  • go for a walk after a meal
  • take the stairs rather than the escalator or elevator
  • pack your own lunch instead of eating out
  • use a pedometer

Taking the necessary steps to manage your weight can help protect your knees from joint pain and reduce your risk of OA.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

More Than Just Joints: How Rheumatoid Arthritis Affects the Rest of Your Body

More Than Just Joints: How Rheumatoid Arthritis Affects the Rest of Your Body

Article by Mary Anne Dunkin | Featured on Arthritis.org

The inflammation that characterizes RA can impact organs and systems, too.

You know that arthritis affects your joints. Painful, swollen knees or fingers are impossible to ignore. But did you know that other parts of your body – your skin, eyes and lungs, to name a few – may also be affected?

Rheumatoid arthritis is a systemic disease, meaning it can affect many parts of the body. For that matter, so can some of the drugs used to treat RA. Following is a listing by body part of the ways RA (and sometimes the drugs used to treat it) can affect you.

Many of these problems – such as bone thinning or changes in kidney function – cause no immediate symptoms so your doctor may monitor you through lab tests or checkups. For other problems – such as skin rashes or dry mouth – it’s important to report any symptoms to your doctor, who can determine the cause or causes, and adjust your treatment plan accordingly.

Skin

Nodules. About half of people with RA develop rheumatoid nodules – lumps of tissue that form under the skin, often over bony areas exposed to pressure, such as fingers or elbows. Unless the nodule is located in a sensitive spot, such as where you hold a pen, treatment may not be necessary. Nodules sometimes disappear on their own or with treatment with disease-modifying antirheumatic drugs (DMARDs).

Rashes. When RA-related inflammation of the blood vessels (called vasculitis) affects the skin, a rash of small red dots is the result. In more severe cases, vasculitis can cause skin ulcers on the legs or under the nails. Controlling the rash or ulcers requires controlling the underlying inflammation.

Drug effects. Corticosteroids, prescribed to reduce inflammation, can cause thinning of the skin and susceptibility to bruising. Non-steroidal anti-inflammatory drugs (NSAIDs), which treat pain and inflammation, and methotrexate, a widely prescribed DMARD, can cause sun sensitivity. People taking biologics, a sub-category of DMARDs designed to stop inflammation at the cellular level, may develop a rash at the injection site.

Bones

Thinning. Chronic inflammation from RA leads to loss of bone density, not only around the joints, but throughout the body, leading to thin, brittle bones. Exercise, a high-calcium diet and vitamin D can all help bones, but in some cases your doctor may need to prescribe a drug to stimulate bone growth or prevent bone loss.

Drug effects. Corticosteroids can also cause bone thinning.

Eyes

Inflammation and scarring. Some people with RA develop inflammation of the whites of the eyes (scleritis) that can lead to scarring. Symptoms include pain, redness, blurred vision and light sensitivity. Scleritis is usually treatable with medications prescribed by your doctor, but in rare cases, the eye may be permanently damaged. RA can also cause uveitis, an inflammation of the area between the retina and the white of the eye, which, if not treated, could cause blindness.

Dryness. The inflammatory process that affects the joints can also damage the tear-producing glands, a condition known as Sjögren’s syndrome. The result is eyes that feel dry and gritty.  Artificial tears, which are available over the counter, as well as medications your doctor prescribes, can keep eyes more comfortable and help prevent damage related to dryness.

Drug effects. Corticosteroids may cause glaucoma and cataracts. Hydroxychloroquine, in rare cases, causes pigment changes in the retina that can lead to vision loss. As a rule, people with RA should get eye checkups at least once a year.

Mouth

Dryness. Inflammation can damage the moisture-producing glands of the mouth as well as the eyes, resulting in a dry mouth. Over-the-counter artificial saliva products and self-treatment often helps. If not, your doctor may prescribe a medication to increase the production of saliva. Good dental hygiene is a must, as bacteria tend to flourish in a dry mouth, leading to tooth decay and gum disease.

Drug effects. Methotrexate can cause mouth sores or oral ulcers. For treatment, try a topical pain reliever or ask your doctor or dentist for a prescription mouthwash.

Lungs

Inflammation and scarring.  Up to 80 percent of people with RA have some degree of lung involvement, which is usually not severe enough to cause symptoms. However, severe, prolonged inflammation of the lung tissue can lead to a form of lung disease called pulmonary fibrosis that interferes with breathing and can be difficult to treat.

Nodules. Rheumatoid nodules might form in the lungs, but are usually harmless.

Drug effects. Methotrexate can cause a complication known as methotrexate lung or methotrexate pneumonia, which generally goes away when the methotrexate is stopped. Less common drugs, including injectable gold and penicillamine, can cause similar pneumonias. The condition goes away when treatment ceases; patients can usually resume the drug in a few weeks.

By suppressing your immune system, corticosteroids, DMARDs and biologics may increase your risk of tuberculosis (TB), a bacterial infection of the lungs. Your doctor should test for TB before initiating treatment and periodically after.

Heart and Blood Vessels

Atherosclerosis. Chronic inflammation can damage endothelial cells that line the blood vessels, causing the vessels to absorb more cholesterol and form plaques.

Heart attack and stroke. When plaques from damaged blood vessels break lose they can block a vessel, leading to heart attack or stroke. In fact, a 2010 Swedish study found that the risk of heart attack for people with RA was 60 percent higher just one year after being diagnosed with RA.

Pericarditis. Inflammation of the heart lining, the pericardium, may manifest as chest pain. Treatment to control arthritis often controls pericarditis as well.

Drug effects. While many RA medications, including methotrexate, other DMARDS and biologics may reduce cardiovascular risk in people with RA, other medications – chiefly NSAIDs – may increase the risk of cardiovascular events including heart attack. Your doctor will need to evaluate your risk when prescribing treatment for your RA.

Liver

Drug effects. Although RA doesn’t directly harm the liver, some medications taken for RA can.  For example, long-term use of the pain reliever acetaminophen (Tylenol) is considered a leading cause of liver failure. Liver diseases may also occur with long-term methotrexate use. Working with your rheumatologist to monitor your blood is key to preventing problems.

Kidneys

Drug effects. As with the liver, drugs taken for arthritis can lead to kidney problems. The most common offenders include cyclosporine, methotrexate and NSAIDs.  If you are taking these drugs long term, you doctor will monitor your kidney function to watch for problems.

Blood

Anemia. Unchecked inflammation can lead to a reduction in red blood cells characterized by headache and fatigue. Treatment consists of drugs to control inflammation along with iron supplements.

Blood clots. Inflammation might lead to elevated blood platelet levels, and blood clots.

Felty syndrome. Though rare, people with longstanding RA can develop Felty syndrome, characterized by an enlarged spleen and low white blood cell count. This condition may lead to increased risk of infection and lymphoma (cancer of the lymph glands). Immunosuppressant drugs are the usual treatment.

Drug effects. Aggressively treating inflammation with corticosteroids may cause thrombocytopenia, an abnormally low number of blood platelets.

Nervous System

Pinched or compressed nerves. Although RA does not directly affect the nerves, inflammation of tissues may cause compression of the nerves resulting in numbness or tingling. One relatively common problem is carpal tunnel syndrome, a condition in which the nerve that runs from the forearm to the hand is compressed by inflamed tissue in the wrist area, resulting in tingling, numbness and decreased grip strength.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.