Taming the pain of sciatica: For most people, time heals and less is more

Taming the pain of sciatica: For most people, time heals and less is more

Article by Steven J. Atlas, MD, MPH | Article Featured on Harvard Health

Despite being a less common cause of low back pain, sciatica is still something I regularly see as a general internist. Primary care doctors can and should manage sciatica, because for most individuals the body can fix the problem. My job is to help manage the pain while the body does its job. When a person’s symptoms don’t improve, I discuss the role of surgery or an injection to speed things up.

What is sciatica?

Sciatica refers to pain caused by the sciatic nerve that carries messages from the brain down the spinal cord to the legs. The pain of sciatica typically radiates down one side from the lower back into the leg, often below the knee. The most common cause is a bulging (“herniated”) disc in the lower back. Discs are tire-like structures that sit between the bones of the spine. If the outer rim of the disc tears, usually due to routine pressure on the lower back, the jelly-like inner material can come out and pinch or inflame the nearby nerve. Sciatica is most common in people 30 to 50.

How do you know if it is sciatica?

The key to diagnosing sciatica is a thorough history and a focused exam. Unfortunately, many patients expect an x-ray or MRI, and doctors, often facing time constraints, order one even though we know imaging tests don’t really help us treat early sciatica any better. The symptoms of sciatica are often worse with sitting or coughing, and may be accompanied by numbness or tingling in the leg. A physical exam can confirm that the sciatic nerve is involved, and I look for weakness or diminished reflexes in the legs that suggest that someone needs early referral to a specialist. (This doesn’t happen often.) With this information, I can make an initial diagnosis and start treatment.

Treating pain… and managing expectations

Many people think (understandably) that the worse the pain, the more likely something bad is going on. However, this isn’t true for sciatica. The body can reabsorb the disc material that is causing symptoms, even for those with severe pain. So, treatment focuses on controlling pain and keeping people as active as possible. If the pain is excruciating, lying down for short periods can help, but prolonged bed rest does not. So once the pain diminishes, I tell patients to get up and start walking short distances. Since sitting increases pressure on the discs in the lower back, I recommend avoiding prolonged sitting or driving. Many people try treatments like physical therapy, massage, acupuncture, and chiropractic manipulation, but evidence suggests that while these approaches may help typical low back pain, they are less helpful for sciatica. Over-the-counter pain medicines like ibuprofen and naproxen can help. When they don’t I may recommend short-term use of stronger, prescription pain medicines.

The good news is that for most (roughly three out of four) people, symptoms improve over a few weeks. Rarely, I’ll find weakness on exam, such as a foot drop, and refer for immediate surgical evaluation. For those not improving after six weeks, surgery is an option. We know surgery can speed up recovery, but by six to 12 months people who have surgery are usually doing about as well as those who decide to just give the body more time to heal on its own. Surgery involves removing the disc material that is affecting the nerve. It is generally a very safe procedure, and while complications are rare, they can happen. What’s more, 5% to 10% of people who have surgery will not be helped by it, or may have worse pain afterwards.

Patients often ask about spinal injections — where steroid medicine is injected into the affected area. It is worth considering for those with uncontrolled pain or for those with persistent, bothersome symptoms who want to avoid surgery. Injections can provide short-term relief. Like any procedure, it has uncommon risks including more pain, and it doesn’t seem to decrease the need for future surgery.

Staying patient-focused… and “hurt” doesn’t always mean “harm”

For most patients with sciatica, it’s worth seeing your primary care doctor. Patients who come in are often scared. Typically, it is pain the likes of which they may have never had. They want relief and, rightly, they want it now. That is the appeal of surgery and injections, but I also know that most will get better with time and can avoid even the uncommon risks of these procedures. When I see a patient in my office I can assess and identify the few who need immediate referral to a specialist. But for most, I try to reassure that hurt doesn’t mean harm, and that my treatments are geared to managing pain and keeping them active while the body fixes itself. For those not improving, I will get an MRI prior to referring for surgery or an injection, if the patient decides that speeding up recovery is right for them. For those who feel that they can manage the pain, I can reassure them that they can delay surgery for up to six months without risking long-term problems down the road.

Sources

  1. Herniated lumbar intervertebral diskNew England Journal of Medicine, May 2016.
  2. Evaluating and managing acute low back pain in the primary care settingJournal of General Internal Medicine, February 2001.
  3. Epidural corticosteroid injections for radulopathy and spinal stenosisAnnals of Internal Medicine, September 2015.
Tailoring Exercise to Your Age

Tailoring Exercise to Your Age

By Len Canter | Article Featured on US News

Exercise is a great way to stay youthful and even turn back the clock on aging. If you’re new to exercise or simply want a fitness reboot, here are ideas by the decade.

In Your 20s: Experiment with different workouts to find what you enjoy. Make exercise a regular habit that you won’t want to give up, even when career and family make heavy demands on you.

In Your 30s: Short on time? Try three 15-minute walks spread throughout the day. To stay fit and retain muscle, do cardio just about every day and strength training two or three times a week. If you’re new to exercise, take classes or have a personal trainer create a program for you.

In Your 40s: Enhance your weekly routine by doing both low-intensity exercise, like yoga for stress relief and flexibility, and high-intensity workouts, like interval training or a spin or kettlebell class, to boost calorie burn and muscle elasticity. Expect longer recovery times after high-intensity workouts, so make sure to get enough sleep.

In Your 50s: Regular exercise remains a must, but ask your doctor for modifications if you have any chronic conditions. Varying your workouts or taking up a new sport will engage your brain as well as different muscles. Get in at least one or two high-intensity workouts a week and try to take active vacations that include favorite pastimes like biking, hiking or even walking tours.

In Your 60s and Beyond: Stay fit and strong to stay independent longer, and stay socially engaged by taking group classes. Stick with strength training, but consider using machines rather than free weights for more control. Water workouts may be easier on joints, too, especially if you have arthritis. But always keep moving. Try tai chi for flexibility and balance, and go dancing for fun and fitness.

More information

The American Council on Exercise has more, including nutrition and sleep requirements by decade.

How long is the Recovery Period After Shoulder Surgery

How long is the Recovery Period After Shoulder Surgery

Article Featured on Premier Ortho

In the majority of cases, most shoulder injuries should not require surgical intervention. However, a major tear in the rotator cuff – the tendon and ligaments that are attached to and enfold the head of the arm bone or humerus – does usually require surgery. While the procedure can be performed with minimal invasion using an arthroscope, there is usually an extensive recovery period which can last for up to six months. The reason for this is that it takes some time for the tendon to heal and to re-attach properly to the bone. The recovery period will, of course, vary from patient to patient and depend on the severity of the tear.

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How Does a Surgeon Fix Scoliosis?

How Does a Surgeon Fix Scoliosis?

Most scoliosis surgeons agree that children who have very severe curves (45-50° and higher) will need surgery to lessen the curve and prevent it from getting worse.

The operation for scoliosis is a spinal fusion. The basic idea is to realign and fuse together the curved vertebrae so that they heal into a single, solid bone.

With the tools and technology available today, scoliosis surgeons are able to improve curves significantly.

Surgical Treatment for Scoliosis

General Questions About Surgery for Scoliosis

Do I need surgery?

If your curve is greater than 45-50°, it will very likely get worse, even after you are fully grown. This may increase the cosmetic deformity in your back, as well as affect your lung function. Surgery is recommended.

Curves between 40° and 50° in a growing child fall into a grey area — several factors may influence whether surgery is recommended. These should be discussed with your surgeon.

How successful is surgery for scoliosis?

Spinal fusion is very successful in stopping the curve from growing. Today, doctors are also able to straighten the curve significantly, which improves the patient’s appearance.

How straight will my spine be after surgery?

Because your spinal bones protect your spinal cord, your surgeon will straighten the bones only as far as is safe.

The degree of correction from surgery depends on how flexible your scoliosis is before your operation. In general, the more flexible your curve is, the better the correction from surgery. Your doctor can measure your flexibility before surgery with special x-rays called bending or traction films.

Most patients recover from surgery with curves that have been straightened to less than 25°. In many cases, these small curves are hardly noticeable.

I have back pain associated with my scoliosis. Will the surgery relieve it?

Immediately after surgery, there will be more pain than before, but this usually resolves over a period of a few weeks to a few months. Most patients report that their back pain is better at 1 year from surgery than it was beforehand.

Everyone — whether there is scoliosis or not — has some back discomfort from time to time. Expecting to never have any future back pain would be unrealistic.

General Questions About Surgery for Scoliosis

Do I need surgery?

If your curve is greater than 45-50°, it will very likely get worse, even after you are fully grown. This may increase the cosmetic deformity in your back, as well as affect your lung function. Surgery is recommended.

Curves between 40° and 50° in a growing child fall into a grey area — several factors may influence whether surgery is recommended. These should be discussed with your surgeon.

How successful is surgery for scoliosis?

Spinal fusion is very successful in stopping the curve from growing. Today, doctors are also able to straighten the curve significantly, which improves the patient’s appearance.

How straight will my spine be after surgery?

Because your spinal bones protect your spinal cord, your surgeon will straighten the bones only as far as is safe.

The degree of correction from surgery depends on how flexible your scoliosis is before your operation. In general, the more flexible your curve is, the better the correction from surgery. Your doctor can measure your flexibility before surgery with special x-rays called bending or traction films.

Most patients recover from surgery with curves that have been straightened to less than 25°. In many cases, these small curves are hardly noticeable.

I have back pain associated with my scoliosis. Will the surgery relieve it?

Immediately after surgery, there will be more pain than before, but this usually resolves over a period of a few weeks to a few months. Most patients report that their back pain is better at 1 year from surgery than it was beforehand.

Everyone — whether there is scoliosis or not — has some back discomfort from time to time. Expecting to never have any future back pain would be unrealistic.

Common Questions About Spinal Fusion for Scoliosis

What is involved with a spinal fusion surgery?

In a spinal fusion, the curved vertebrae are fused together so that they heal into a single, solid bone. This will stop growth completely in the abnormal segment of the spine and prevent the curve from getting worse.

All spinal fusions use some type of bone material, called a bone graft, to help promote the fusion. Generally, small pieces of bone are placed into the spaces between the vertebrae to be fused. The bone grows together — similar to when a broken bone heals.

Metal rods are typically used to hold the spine in place until fusion happens. The rods are attached to the spine by screws, hooks, and/or wires.

Exactly how much of the spine is fused depends upon your curve(s).

What is a bone graft?

A bone graft is primarily used to stimulate bone healing. It increases bone production and helps the vertebrae heal together into a solid bone.

In the past, a bone graft harvested from the patient’s hip was the only option for fusing the vertebrae. This type of graft is called an autograft. Harvesting a bone graft may require an additional incision during the operation. It increases the length of surgery and can cause increased pain after the operation because of an additional region of the pelvis being included in the procedure.

One alternative to harvesting a bone graft is an allograft, which is cadaver bone. An allograft is typically acquired through a bone bank.

Today, several artificial bone graft materials have also been developed.

How long does the surgery take?

Most fusions last from 4 to 8 hours, depending on the size of the patient’s curve and how much of the spine needs to be fused.

How much pain will I be in after surgery?

The amount of pain people report after surgery varies a great deal from patient to patient. The surgery is a major procedure that involves moving muscles and realigning the skeleton.

The first few days are usually quite uncomfortable, but most people improve rapidly by the third or fourth day, and they can walk around, and get in and out of bed well enough to go home. The pain continues to improve gradually and most teenagers can return to school by 2 to 4 weeks after surgery.

Mild pain may persist, but by 3 to 6 weeks after surgery, pain medicine should no longer be necessary.

What type of pain control will there be after the operation?

Pain control varies between different doctors and hospitals. In many cases, a PCA (patient controlled anesthesia machine) is used, which injects a small dose of pain medicine intravenously when you push a button. Some surgeons use an intravenous catheter (small plastic tube placed in a vein) to provide the medication in larger but less frequent doses. The pain relief system that your doctor is accustomed to using is probably the safest and most reliable for you after surgery.

On the second or third day after surgery, your doctor will most likely change your medication to pills or liquid pain relievers taken by mouth. These medicines are an opiate (morphine-like medicine.) Because these medications are known to be addictive if taken for a long time, you will be encouraged to switch to acetaminaphen as soon as possible after you go home.

Do the rods and other implants stay in my spine even after it has fused?

If rods are used in a fusion, they usually do not need to be removed. Very few people require rod removal, and this may be for a variety of reasons such as infection or broken rod.

Will fusion make my back stiff and unable to move?

The fused portion of your back will be permanently stiff. Most people have enough motion in the unfused portion of their backs to perform all activities of daily living and most sports. If you participate in activities that require a tremendous amount of flexibility, it may take awhile to adapt. Most people find that within a year or so their backs begin to feel “normal” when participating in those activities.

Can I have my scoliosis corrected without a fusion?

We wish that we had a method and materials that would straighten the spine and also allow normal motion between all the bones. Unfortunately, we do not have this capability. Anything we put in to hold the spine straight, also makes the spine stiff in the area of surgery.

Common Questions About Surgical Recovery

Most patients are in the hospital for 4 to 7 days, out of school for 2 to 4 weeks, and back into activities in 2 to 6 months.

How long do patients need pain medication after being discharged home?

Most surgeons prescribe strong pain medicines to patients after scoliosis surgery. Patients who have not used opiate pain killers before usually stop needing them within 2 to 4 weeks after surgery. If the patient has used these medicines frequently before surgery, it may take longer to stop needing them.

It is best to stop taking these strong medicines as soon as possible because they can be addictive if taken for long periods of time.

What limitations will I have right after surgery?

Your surgeon will detail any limitations you have after surgery. Most patients will be asked to avoid heavy lifting and to minimize the amount of bending forward for the first 6 to 12 weeks.

Does surgery lead to permanent restrictions on activities?

No, most patients are able to return to all their favorite activities and sports.Most patients return to non-contact sporting activities (running, weightlifting, exercises) approximately 4 to 6 months after surgery.

Before returning to all activities, including contact sports, the spine must be fully healed. It typically takes 6 to 12 months after surgery to obtain a solid fusion of the spine and get back to all activities.

Will I be able to walk after surgery?

Yes. Some patients may need physical therapy after surgery, but they are able to walk when they are discharged from the hospital.

When can I go back to school after the operation?

Most children miss between 2 to 4 weeks of school after surgery. It typically takes about 4 weeks before the spine is healed enough for carrying a backpack.

When will I be allowed to drive a car?

You will not be able to drive a car until you have healed well enough from surgery. In addition to being off of your narcotic pain medicines, you need to be moving around well enough to be safe. This typically takes 6 or more weeks.

When can I start hanging out with my friends again?

Your friends can visit you after surgery in the hospital and at home. Going out with your friends — like to school functions or the movies — can occur after you are off all pain medications and are feeling back to normal (this usually happens about 4 weeks after surgery).


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.

16 Ways You May Be Hurting Your Joints

16 Ways You May Be Hurting Your Joints

Your joints link bones together so you can bend your knees, wiggle your hips, and move your body. Learn how you might be preventing your joints from working their best.

Carry Extra Weight

Your joints, which link your bones together, are sensitive to heavy loads. Every pound on your frame puts 4 pounds of stress on your knees. It also strains your back, hips, and feet. That causes wear and tear that can lead to damage, aches, and pain. Being overweight also triggers inflammation. That can make all your joints, including in your hands, stiff, painful, and swollen.

Text Too Much

‘Texting thumb’ is a real thing. Your tendons can get irritated and lock your thumb in a curled position. All that looking down at your phone is just as bad for your neck and shoulders, too. Every inch your head drops forward raises the load on your muscles. If you bend your neck so far that your chin touches your chest, it’s as if your neck has to support the weight of 5 heads instead of just one.

Steep Price of High Heels

They might look fab, but the higher they rise, the more your weight tips forward. Your thigh muscles have to work harder to keep your knee straight, which can cause pain. When heels go up, so does the twisting force in your knees. If you wear them every day, you boost your odds for osteoarthritis. That’s when the bones and the cushioning between the bones break down.

Wear the Wrong Shoes

Worn-out shoes don’t support your feet and ankles enough. That’ll throw your knees, hips, and back out of whack. Also, make sure your sneakers are right for your sport. High tops for basketball, for example, can protect your ankles from sprains. But don’t go overboard. Too much cushion or arch support means your foot can’t move naturally, which could keep you in a cycle of pain.

Crack Your Knuckles

That satisfying pop comes from tiny bubbles bursting in the fluid around your joints. Or from ligaments snapping against bone. Despite what annoyed adults might have warned you, it doesn’t cause arthritis. Still, it might be smart to stop. One study showed that this habit may cause your hands to swell and weaken your grip.

Lug a Big Bag

Whether it’s a purse, backpack, or messenger bag, packing too much can cause neck and shoulder pain. Heavy weight on one shoulder throws off your balance and your walk. If you tend to carry things only on one side, the constant pull overstretches your muscles and tires out your joints. If you do that every day, your body’s going to let you know loud and clear.

Use Wrong Muscles for the Job

When you put too much load on little muscles, your joints pay the price. If you need to open a heavy door, push with your shoulder instead of your fingers. When you lift something off the floor, bend at your knees and push up with your strong leg muscles. When you carry something, hold it close to you in the palms of your hands instead of stressing your fingers.

Sleep on Your Stomach

It might help with snoring, but not so much with the rest of your body. Lying on your tummy pushes your head back, which compresses your spine. Your head also will face in one direction for longer stretches than if you sleep on your back. All that puts pressure on other joints and muscles.

Skip Stretching

You don’t need to be a yogi, but regular stretching can help strengthen your muscles and tendons. It also can make them more flexible. That allows your joints to move more easily and helps the muscles around them work better. That’s key to healthy and stable joints.

Skimp on Strength Training

Once you turn 40, your bones start to get a little thinner and more likely to break. If you build muscle with strength training, it slows bone loss and triggers new growth. So you not only get stronger muscles, but denser bones, too. Together, they stabilize your joints so you’re less likely to get hurt.

Smoke and Chew Tobacco

Here’s another reason to quit: Your joints will thank you. Nicotine from cigarettes and chewing tobacco cuts down on blood flow to your bones and to the cushioning discs in your back. It limits how much bone-building calcium your body can take in. It also breaks down estrogen, a hormone you need for bone health. And it slows new growth that thickens bones. All that makes your joints weaker and your hips more likely to break.

Don’t Get Quality ZZZs

You may wonder how poor sleep can affect your joints. One study found that people with arthritis felt more pain after restless nights. That made them take a closer look. One theory is that when you don’t sleep well, it triggers inflammation in your body. That might lead to joint problems over time. More research is needed, but in the meantime, it sure won’t hurt to get good shut-eye.

Slouch and Slump

Your body’s at its best when you work with it, not against it. That’s why posture matters. When you slump in your chair, it puts more stress on your muscles and joints and tires them out. It’s like always jamming on your car brakes when you could just ease down on the pedal instead. So keep your back straight and those shoulders back and down.

Ignore Pain

When you work out, you might think you just need to power through it. After all, no pain, no gain, right? It’s true that some muscle soreness is OK. But not if it lasts for days or if your muscles are swollen or too sore to move or to touch. Joint pain isn’t normal, so pay attention to it. If you think you overdid it, ease up on your exercises. If the pain won’t go away, check with your doctor.

Too Much Computer Time

It can literally be a pain in your neck — and your elbows, wrists, back, and shoulders. The problem isn’t just bad posture, but that you hold it for too long. That overworks your muscles. It also puts pressure on the discs in your back. If you’re in a soft chair, prop up your arms with cushions to take the load off your shoulders and your neck. Be sure to get up and move every hour.

Repeat Poor Form

When you run, bike, or play tennis, you use the same motions over and over. But if your form is bad, you’ll stress your body in all the wrong places. If you overload your muscles, it puts more pressure on your joints, and you can end up with an injury like tennis elbow.

 


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.

Scoliosis Treatment, Causes, Symptoms & Surgery

Scoliosis Treatment, Causes, Symptoms & Surgery

Medical Author: Charles Patrick Davis, MD, PhD | Medical Editor: Melissa Conrad Stöppler, MD | Article Featured on MedicineNet

What is scoliosis?

Scoliosis is a disorder that causes an abnormal curve of the spine, or backbone. The spine has normal curves when looking from the side, but it should appear straight when looking from the front. Kyphosis is a curve in the spine seen from the side in which the spine is bent forward. There is a normal kyphosis in the middle (thoracic) spine. Lordosis is a curve seen from the side in which the spine is bent backward. There is a normal lordosis in the upper (cervical) spine and the lower (lumbar) spine. People with scoliosis develop additional curves to either side of the body, and the bones of the spine twist on each other, forming a “C” or an “S” shape in the spine.

Scoliosis is about two times more common in girls than boys. It can be seen at any age, but it is most common in those over about 10 years of age. Scoliosis is hereditary in that people with scoliosis are more likely to have children with scoliosis; however, there is no correlation between the severity of the curves from one generation to the next.

What causes scoliosis?

Scoliosis affects about 2% of females and 0.5% of males. In most cases, the cause of scoliosis is unknown (known as idiopathic). This type of scoliosis is described based on the age when scoliosis develops, as are other some other types of scoliosis.

  • If the person is less than 3 years old, it is called infantile idiopathic scoliosis.
  • Scoliosis that develops between 3-10 years of age is called juvenile idiopathic scoliosis.
  • People who are over 10 years old (10-18 years old) have adolescent idiopathic scoliosis.

More than 80% of people with scoliosis have idiopathic scoliosis, and the majority of those are adolescent girls; the most common location for scoliosis is in the thoracic spine.

Medical literature often has more specific names or terms for scoliosis:

  • Kyphoscoliosis: a combination of outward and lateral spine curvature
  • Dextroscoliosis: curvature of the spine to the right
  • Rotoscoliosis (rotatory): curvature of the vertebral column turned on its axis
  • Levoconvex: curvature of the spine to the left
  • Thoracolumbar: curvature related to both the thoracic and lumbar regions of the spine

What are the causes of other types of scoliosis?

As stated above, idiopathic scoliosis and its subtypes comprise over 80% of all scoliosis patients. However, there are three other main types of scoliosis:

  • Functional: In this type of scoliosis, the spine is normal, but an abnormal curve develops because of a problem somewhere else in the body. This could be caused by one leg being shorter than the other or by muscle spasms in the back.
  • Neuromuscular: In this type of scoliosis, there is a problem when the bones of the spine are formed. Either the bones of the spine fail to form completely or they fail to separate from each other during fetal development. This type of congenital scoliosis develops in people with other disorders, including birth defects, muscular dystrophy, cerebral palsy, or Marfan syndrome (an inherited connective tissue disease). People with these conditions often develop a long C-shaped curve and have weak muscles that are unable to hold them up straight. If the curve is present at birth, it is called congenital. This type of scoliosis is often much more severe and needs more aggressive treatment than other forms of scoliosis.
  • Degenerative: Unlike the other forms of scoliosis that are found in children and teens, degenerative scoliosis occurs in older adults. It is caused by changes in the spine due to arthritis known as spondylosis. Weakening of the normal ligaments and other soft tissues of the spine combined with abnormal bone spurs can lead to an abnormal curvature of the spine. The spine can also be affected by osteoporosis, vertebral compression fractures, and disc degeneration.

There are other potential causes of scoliosis, including spine tumors such as osteoid osteoma. This is a benign tumor that can occur in the spine and cause pain. The pain causes people to lean to the opposite side to reduce the amount of pressure applied to the tumor. This can lead to a spinal deformity. In addition, researchers suggest that genetics (hereditary), muscle disorders, and/or abnormal fibrillin metabolism may play a role in causing or contributing to scoliosis development.

What are risk factors for scoliosis?

Age is a risk factor as the symptoms often begin between 9-15 years of age. Being a female increases the risk of scoliosis, and females have a higher risk of worsening spine curvature than males. Although many individuals who develop the problem do not have family members with scoliosis, a family history of scoliosis increases the risk of the disease.

What are scoliosis symptoms and signs?

The most common symptom of scoliosis is an abnormal curve of the spine. Often this is a mild change and may be first noticed by a friend or family member or physician doing routine screening of children for school or sports. The change in the curve of the spine typically occurs very slowly so it is easy to miss until it becomes a more severe physical deformity. It can also be found on a routine school screening examination for scoliosis. Those affected may notice that their clothes do not fit as they did previously, they may notice an uneven waist, or that pant legs are longer on one side than the other.

Scoliosis may cause the head to appear off center, leaning to one side or notice one hip or shoulder to be higher than the opposite side. Someone may have a more obvious curve on one side of the rib cage on their back from twisting of the vertebrae and ribs. If the scoliosis is more severe, it can make it more difficult for the heart and lungs to work properly. This can cause shortness of breath and chest pain.

In most cases, scoliosis is not painful, but there are certain types of scoliosis than can cause back pain, rib pain, neck pain, muscle spasms, and abdominal pain. Additionally, there are other causes of these nonspecific pains, which a doctor will want to look for as well to rule out other diseases.

What tests to health care professionals use to diagnose scoliosis?

If someone thinks he or she has scoliosis, see a doctor for an examination. The doctor will ask questions, including if there is any family history of scoliosis, or if there has been any pain, weakness, or other medical problems.

The physical examination involves looking at the curve of the spine from the sides, front, and back. The person will be asked to undress from the waist up to better see any abnormal curves, physical deformities, or uneven waist. The person will then bend over trying to touch their toes. This position can make the curve more obvious. The doctor will also look at the symmetry of the body to see if the hips and shoulders are at the same height, leaning to one side, or if there is sideways curvature. Any skin changes will also be identified that can suggest scoliosis due to a birth defect. A doctor may check your range of motion, muscle strength, and reflexes.

The more growth that a person has remaining increases the chances of scoliosis getting worse. As a result, the doctor may measure the person’s height and weight for comparison with future visits. Other clues to the amount of growth remaining are signs of puberty such as the presence of breasts or pubic hair and whether menstrual periods have begun in girls.

If the doctor believes a patient has scoliosis, the patient could either be asked to return for an additional examination in several months to see if there is any change or the doctor may obtain X-rays of the back. If X-rays are obtained, the doctor can make measurements from them to determine how large of a curve is present. This can help decide what treatment, if any, is necessary. Measurements from future visits can be compared to see if the curve is getting worse.

It is important that the doctor knows how much further growth the patient has left. Additional X-rays of the hand, wrist, or pelvis can help determine how much more the patient will grow. If a doctor finds any changes in the function of the nerves, he or she may order other imaging tests of your spine, including an MRI or CT scan to look more closely at the bones and nerves of the spine.

What types of specialists treat scoliosis?

Usually, a person’s primary care or pediatric physician notices the problem and consults an orthopedic surgeon or neurosurgeon who specializes in spine surgery. In addition, a rehabilitation specialist and/or a physical therapist may be consulted. Some patients may need a neurologist or an occupational therapist as part of the treatment team.

What is the treatment for scoliosis?

Treatment of scoliosis is based on the severity of the curve and the chances of the curve getting worse. Certain types of scoliosis have a greater chance of getting worse, so the type of scoliosis also helps to determine the proper treatment. There are three main categories of treatment: observation, bracing, and surgery. Consequently, there are treatments available that do not involve surgery, but in some individuals, surgery may be their best option.

Functional scoliosis is caused by an abnormality elsewhere in the body. This type of scoliosis is treated by treating that abnormality, such as a difference in leg length. A small wedge can be placed in the shoe to help even out the leg length and prevent the spine from curving. There is no direct treatment of the spine because the spine is normal in these people.

Neuromuscular scoliosis is caused by an abnormal development of the bones of the spine. These types of scoliosis have the greatest chance for getting worse. Observation and bracing do not normally work well for these people. The majority of these people will eventually need surgery to stop the curve from getting worse.

Treatment of idiopathic scoliosis usually is based on the age when it develops.

In many cases, infantile idiopathic scoliosis will improve without any treatment. X-rays can be obtained and measurements compared on future visits to determine if the curve is getting worse. Bracing is not normally effective in these people.

Juvenile idiopathic scoliosis has the highest risk for getting worse of all of the idiopathic types of scoliosis. Bracing can be tried early if the curve is not very severe. The goal is to prevent the curve from getting worse until the person stops growing. Since the curve starts early in these people, and they have a lot of time left to grow, there is a higher chance for needing more aggressive treatment or surgery.

Adolescent idiopathic scoliosis is the most common form of scoliosis. If the curve is small when first diagnosed, it can be observed and followed with routine X-rays and measurements. If the curve or Cobb angle stays below about 20-25 degrees (Cobb method or angle, is a measurement of the degree of curvature), no other treatment is needed. The patient may return to see the doctor every three to four months to check for any worsening of the curve. Additional X-rays may be repeated each year to obtain new measurements and check for progression of the curve. If the curve is between 25-40 degrees and the patient is still growing, a brace may be recommended. Bracing is not recommended for people who have finished growing. If the curve is greater than 40 degrees, then surgery may be recommended.

As explained above, scoliosis is not typically associated with back pain. However, in some patients with back pain, the symptoms can be lessened with physical therapy, massage, stretches, and exercises, including yoga (but refraining from twisting pressures on the spine). These activities can help to strengthen the muscles of the back. Medical treatment is mainly limited to pain relievers such as nonsteroidal anti-inflammatory medications (NSAIDs) and anti-inflammatory injections. These treatments are not, however, a cure for scoliosis and will not be able to correct the abnormal curve.

What is the treatment for scoliosis? (Continued)

There are several different types of braces available for scoliosis. Some need to be worn nearly 24 hours a day and are removed only for showering. Others can be worn only at night. The ability of a brace to work depends on the person following the instructions from the doctor and wearing the brace as directed. Braces are not designed to correct the curve. They are used to help slow or stop the curve from getting worse with good back brace management treatment. Intermittent or chronic discomfort may be a side effect of any treatments used to slow or correct the spinal curvature.

If the curve stays below 40 degrees until the person is finished growing, it is not likely to get worse later in life. However, if the curve is greater than 40 degrees, it is likely to continue to get worse by 1-2 degrees each year for the rest of the person’s life, a long-term effect of the disease. If this is not prevented, the person could eventually be at risk for heart or lung problems. The goals of surgery for scoliosis are as follows: correcting and stabilizing the curve, reducing pain, and restoring a more normal curve and appearance to the spinal column.

Surgery involves correcting the curve back to as close to normal as possible and performing a spinal fusion to hold it in place. This is done with a combination of screws, hooks, and rods that are attached to the bones of the spine to hold them in place. The surgeon places bone graft around the bones to be fused (spinal fusion) to get them to grow together and become solid. This prevents any further curvature in that portion of the spine. In most cases, the screws and rods will remain in the spine and not need to be removed. There are many different ways for a surgeon to perform the fusion surgery. It may be all performed from a single incision on the back of the spine or combined with another incision along your front or side. This decision is based on the location and severity of the curve.

Surgery recovery and scar formation varies some from person to person. A doctor will use medications to control the patient’s pain initially after surgery. A patient will likely be up out of bed to a chair the first day after surgery and will work with a physical therapist who will assist him or her in walking after the surgery. As the patient continues to recover, it is important to improve muscle strength. The physical therapist can help the patient with exercises for the muscles that will also help with the pain. Typically, a young person will miss about six weeks of school and may take about six months to return to their normal activities, although recovery time varies between individuals.

As with any surgery, there are risks of surgery for scoliosis. The amount of risk depends partially on the patient’s age, the degree of curve, the cause of the curve, and the amount of correction attempted. In most cases, the surgeon will use a technique called neuromonitoring during surgery. This allows the surgeon to monitor the function of the spinal cord and nerves during surgery. If they are being placed at increased risk of damage, the surgeon is alerted and can adjust the procedure to reduce those risks. There is a small risk of infection with any surgery. This risk is decreased with the use of antibiotics, but it can still occur in some cases. Other potential risks include injury to nerves or blood vessels, bleeding, continued curve progression after surgery, broken rods or screws, and the need for further surgery. Each of these is rare.

If a tumor such as osteoid osteoma is the cause of the scoliosis, surgery to remove the tumor is generally able to correct the curve.

People with degenerative scoliosis will often have more complaints of back pain and leg pain. This is related to the arthritis in the back and possible compression of the nerve roots that lead to the legs. Nonoperative treatment including physical therapy, exercises, and gentle chiropractic can help relieve these symptoms in some cases. People who fail to improve with these treatments may benefit from surgery. X-rays and possible MRIs will be obtained to plan for surgery. The surgery could include only a decompression or removal of bone spurs that are compressing the nerves. In some cases, a fusion will be necessary to stabilize the spine and possibly correct the abnormal curve. The cost of scoliosis surgery can be high; according to the Spinal Cord Society of surgeons, an average cost per operation (rod implants to straighten the spine) is $150,000 and may be higher or lower depending on the individual procedure.

Are there home remedies for scoliosis?

There are many home remedies that have been described for scoliosis; some involve herbal treatments, diet therapy, massage, physical therapy, stretches, certain exercises, and nutritional supplements like L-selenomethionine. A mattress that is composed of latex, memory foam, or cool gel (latex mattress infused with gel retains less heat than latex alone, also termed gel memory foam) and is adjustable (height of head and foot of bed can be adjusted) is recommended by some clinicians and patients. Patients are advised to discuss these treatments, especially exercises, with their doctor before starting any home remedies. Medical treatments are mainly over-the-counter pain medications when needed. Home remedies and medical treatments may reduce discomfort but do not provide a cure for scoliosis.

What is the prognosis for scoliosis?

School screening programs have helped to identify many cases of scoliosis early. This allows people to be treated with either observation or bracing and avoid the need for surgery in many cases. Most people with scoliosis can live full, productive, and normal lives with a relatively normal life expectancy. People with scoliosis are able to become pregnant and have children with no increased risk for complications. They may be at increased risk for additional low back pain during pregnancy. In general, as the degree of spine curvature increases, the prognosis worsens.

Newer advances in surgery have allowed for less invasive surgical methods that have less pain and shorter recovery periods. Surgery recovery time depends on the specific procedure that is performed; some may require an extended hospital stay with an in-patient stay at a rehabilitation facility (several weeks) while others may recover quickly and not require a rehabilitation facility. These techniques are still being developed, but the initial results are very promising.

Occasionally, untreated scoliosis can lead to deformity of the spine that is severe, painful, and result in the individual being unable to work or walk normally. Scoliosis may very rarely compromise breathing and cause death. Complications of pain and infections may rarely occur with treatments but may occur with surgery. Occasionally, patients are too optimistic about their treatments so patients are advised to discuss their expectations and follow up with their doctor to better understand the long-term prognosis and effects of their treatment.

The life expectancy has been reported to be reduced possibly by about 14 years in some individuals, especially those with more severe Cobb angle that is untreated but not all specialists agree with this controversial conclusion. Other clinicians either choose to avoid the controversy and say nothing while others suggest most people will have a near normal life span. Each individual with scoliosis should ask their treating physician about their life expectancy and potential for quality of life in the future with or without various treatment options.

Step-by-Step Exercises for a Stronger Back

Step-by-Step Exercises for a Stronger Back

By Len Canter | Article Featured on US News

Are you neglecting or even unaware of the muscles in your back? If so, you’re putting yourself at risk.

The trapezius is the diamond-shaped muscle that runs from neck to middle back and from shoulder to shoulder across the back. The latissimus dorsi — or “lats” — are the large back muscles that run from either side of the spine to your waist.

Here are two strength-training exercises that will help you develop these muscles for better upper body fitness.

Important: Start with a weight that allows you to complete at least eight reps with proper form, perhaps as low as 2-pound dumbbells. Build up to 10 to 15 reps for one complete set, and progress from one to three complete sets before increasing the weight. Never jerk the weights — controlled, steady movement is what brings results.

Standing dumbbell rows target the trapezius muscles as well as the upper arms and shoulders. Stand straight, feet shoulder-width apart, with a weight in each hand. Your elbows should be slightly bent, the dumbbells touching the fronts of your thighs, palms facing your body. As you exhale, use a slow, controlled movement to lift the weights straight up by bending the elbows up and out to bring the weights to shoulder level. Hold for a second, then inhale as you lower your arms to the starting position. Repeat.

Bent-over one-arm rows target the lats as well as the upper arms and shoulders. To work the right side first, stand to the right side of a bench. Place your left knee and left hand on it for support. Your back should be nearly parallel to the floor. Hold a dumbbell in your right hand, palm facing inward. Using only your upper arm, bend at the elbow to lift the dumbbell straight up to your waist as you exhale. Hold for a second and then lower it with control as you inhale. Complete reps, then switch sides and repeat.

You can also do bent-over rows using both arms at once. Stand with feet about shoulder-width apart. Hold a dumbbell in each hand and, bending from the waist, bring your back to nearly parallel with the floor. Keeping arms close to your sides, bend the elbows to lift the weights, bringing them up to waist level. Hold for a second and then lower the weights with control as you inhale. Repeat.

More information

The American Council on Exercise has more on exercises targeting the back muscles.

What is Knee Arthroscopy? Benefits, Preparation, and Recovery

What is Knee Arthroscopy? Benefits, Preparation, and Recovery

By Jon Johnson | Featured on Medical News Today

Knee arthroscopy is a procedure that involves a surgeon investigating and correcting problems with a small tool called an arthroscope. It is a less invasive method of surgery used to both diagnose and treat issues in the joints. The arthroscope has a camera attached, and this allows doctors to inspect the joint for damage. The procedure requires very small cuts in the skin, which gives arthroscopy some advantages over more invasive surgeries.

Knee arthroscopy surgery has risen to popularity because it usually requires shorter recovery times. The procedure typically takes less than 1 hour, and serious complications are uncommon.

In this article, learn more about what to expect from knee arthroscopy.

Uses and benefits

Knee arthroscopy is less invasive than open forms of surgery. A surgeon can diagnose issues and operate using a very small tool, an arthroscope, which they pass through an incision in the skin.

Knee arthroscopy surgery may be helpful in diagnosing a range of problems, including:

  • persistent joint pain and stiffness
  • damaged cartilage
  • floating fragments of bone or cartilage
  • a buildup of fluid, which must be drained

In most of these cases, arthroscopy is all that is needed. People may choose it instead of other surgical procedures because arthroscopy often involves:

  • less tissue damage
  • a faster healing time
  • fewer stitches
  • less pain after the procedure
  • a lower risk of infection, because smaller incisions are made

However, arthroscopy may not be for everyone. There is little evidence that people with degenerative diseases or osteoarthritis can benefit from knee arthroscopy.

How to prepare

Many doctors will recommend a tailored preparation plan, which may include gentle exercises.

It is important for a person taking any prescription or over-the-counter (OTC) medications to discuss them with the doctor. An individual may need to stop taking some medications ahead of the surgery. This may even include common OTC medications, such as ibuprofen (Advil).

A person may need to stop eating up to 12 hours before the procedure, especially if they will be general anesthesia. A doctor should provide plenty of information about what a person is allowed to eat or drink. Some doctors prescribe pain medication in advance. A person should fill this prescription before the surgery so that they will be prepared for recovery.

Procedure

The type of anesthetic used to numb pain will depend on the extent of the arthroscopy. A doctor may inject a local anesthetic to numb the affected knee only. If both knees are affected, the doctor may use a regional anesthetic to numb the person from the waist down.

In some cases, doctors will use a general anesthetic. In this case, the person will be completely asleep during the procedure. If the person is awake, they may be allowed to watch the procedure on a monitor. This is entirely optional, and some people may not be comfortable viewing this.

The procedure starts with a few small cuts in the knee. Surgeons use a pump to push saline solution into the area. This will expand the knee, making it easier for the doctors to see their work. After the knee is expanded, the surgeons insert the arthroscope. The attached camera allows the surgeons to explore the area and identify any problems. They may confirm earlier diagnoses, and they may take pictures.

If the problem can be fixed with arthroscopy, the surgeons will insert small tools through the arthroscope and use them to correct the issue. After the problem is fixed, the surgeons will remove the tools, use the pump to drain the saline from the knee, and stitch up the incisions. In many cases, the procedure takes less than 1 hour.

Back pain is extremely common, and surgery often fails to relieve it. Find out why your back hurts and whether surgery might help.

Back surgery: When is it a good idea?

Back pain is extremely common, and surgery often fails to relieve it. Find out why your back hurts and whether surgery might help.

Back surgery can help relieve some causes of back pain, but it’s rarely necessary. Most back pain resolves on its own within three months.

Low back pain is one of the most common ailments seen by family doctors. Back problems typically respond to nonsurgical treatments — such as anti-inflammatory medications, heat and physical therapy.

Back surgery might be an option if conservative treatments haven’t worked and your pain is persistent and disabling. Back surgery often more predictably relieves associated pain or numbness that goes down one or both arms or legs.

These symptoms often are caused by compressed nerves in your spine. Nerves may become compressed for a variety of reasons, including:

  • Disk problems. Bulging or ruptured (herniated) disks — the rubbery cushions separating the bones of your spine — can sometimes press too tightly against a spinal nerve and affect its function.
  • Overgrowth of bone. Osteoarthritis can result in bone spurs on your spine. This excess bone most commonly affects the hinge joints on the back part of the spinal column and can narrow the amount of space available for nerves to pass through openings in your spine.

It can be very difficult to pinpoint the exact cause of your back pain, even if your X-rays show that you have disk problems or bone spurs. X-rays taken for other reasons often reveal bulging or herniated disks that cause no symptoms and need no treatment.

Different types of back surgery include:

  • Diskectomy. This involves removal of the herniated portion of a disk to relieve irritation and inflammation of a nerve. Diskectomy typically involves full or partial removal of the back portion of a vertebra (lamina) to access the ruptured disk.
  • Laminectomy. This procedure involves the removal of the bone overlying the spinal canal. It enlarges the spinal canal and is performed to relieve nerve pressure caused by spinal stenosis.
  • Fusion. Spinal fusion permanently connects two or more bones in your spine. It can relieve pain by adding stability to a spinal fracture. It is occasionally used to eliminate painful motion between vertebrae that can result from a degenerated or injured disk.
  • Artificial disks. Implanted artificial disks are a treatment alternative to spinal fusion for painful movement between two vertebrae due to a degenerated or injured disk. But these relatively new devices aren’t an option for most people.

Before you agree to back surgery, consider getting a second opinion from a qualified spine specialist. Spine surgeons may hold different opinions about when to operate, what type of surgery to perform and whether — for some spine conditions — surgery is warranted at all. Back and leg pain can be a complex issue that may require a team of health professionals to diagnose and treat.


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.

Pinched Nerve in the Elbow or Arm

Pinched Nerve in the Elbow or Arm

Article Featured on WebMD

A pinched nerve happens when too much pressure is placed against a nerve by bones, tendons, muscles, or cartilage.

It can start in several places throughout your body, usually in the joints. When a pinched nerve is in your elbow, it’s called “ulnar nerve entrapment.” It can leave your arm and hand feeling sore, numb, or weak.

Causes

The ulnar nerve runs the entire length of your arm. It helps control the muscles in the forearm and hand. Sensations affecting your ring finger and little finger also travel though the ulnar nerve. Its most vulnerable point is at the elbow.

If you’ve ever hit your elbow, or “funny bone,” hard and felt a tingling down to your fingers, you’ve compressed your ulnar nerve.

Leaning on your elbow for a long time can also irritate the nerve. Whenever you bend your elbow, you’re forcing the nerve to stretch around the bones in the joint. If you sleep with your elbows bent, for instance, or you keep your elbows bent for a long time, you’re putting more pressure on your ulnar nerve.

A buildup of fluid in the elbow, caused by a condition such as bursitis, for instance, can also entrap the nerve.

Symptoms

One of the first signs that you may have a pinched nerve in the elbow is weakness in your hand. You may not be able to grip things as tightly as you used to or lift heavy things the way you once did.

Your hand may be more tender, more easily hurt, too. The ring finger and little finger may not be as strong and flexible as they used to be.

Other symptoms of ulnar nerve entrapment include:

  • tingling or numbness in the hand, especially the ring and little fingers
  • cold sensitivity in the affected arm or hand
  • tenderness at the elbow

These symptoms tend to come and go at first. You may notice them more when your elbow is bent. You may even wake up in the middle of the night with a tingling feeling in your fingers.

Who Tends to Get This?

Reasons for compression of the ulnar nerve in the elbow aren’t always known. You may not recall injuring your elbow or bending your elbow too much. Your chances of getting ulnar nerve entrapment are higher, though, if your elbow:

  • has arthritis
  • has been fractured
  • was dislocated
  • has been repeatedly injured

When Do I Call a Doctor?

If a pinched nerve in the elbow goes untreated for a long time, there could be permanent damage. Muscles controlled by the nerve may begin to get smaller and shorter. This is called muscle wasting, and it can’t always be reversed.

To avoid this problem, see a doctor quickly if you start to have severe pain, weakness, or tingling in your arm or hand. Even if your discomfort doesn’t feel serious, call your doctor if it’s been with you for at least 6 weeks.

Diagnosis and Tests

To get a proper diagnosis, you should see an orthopedist. Try to find someone who specializes in elbows and wrists.

If you have arthritis and you see a rheumatologist, you may want to start with that doctor. She may later recommend you to an orthopedist. What you might expect:

Medical review: Diagnosing the problem usually starts with a review of your medical history and your lifestyle. If you do a lot of heavy lifting or play contact sports, these would be helpful details to pass along.

Physical exam: Your doctor will likely do a physical exam of your arm, tapping the spot where the nerve crosses the bone in your elbow. The doctor may also want to see whether the nerve itself slides out of its proper position when your elbow bends.

You may be asked to put your arms in different positions and turn your neck from side to side to see whether that causes any pain or numbness. Your doctor may check the strength in your fingers and hand, and test for feeling in those areas.

X-ray: You might have an X-ray taken so your doctor can look for bone spurs or arthritis. These may be placing pressure on your nerve. Nerve conduction study: In this test, the doctor stimulates your ulnar nerve in various places. An area that takes longer to respond may be where the nerve is compressed.

This test is also helpful in diagnosing muscle wasting caused by nerve problems.

Treatment

Once you’ve been diagnosed with ulnar nerve entrapment, it will be time to decide how to treat the problem. The severity of the condition will help you and your doctor decide whether surgery or a less-invasive strategy is best.

Nonsurgical treatments include:

Nonsteroidal anti-inflammatory drugs: NSAIDs can reduce pain and inflammation.

A splint or brace: These can keep your elbow straight, especially while you’re sleeping.

An elbow pad: This helps reduce pressure on the joint.

Occupational and physical therapy: This will improve the strength and flexibility of your arm and hand.

Nerve-gliding exercise: Do this to help guide the nerve through the proper “tunnels” in the wrist and elbow. If nonsurgical options haven’t eased your symptoms or there is obvious muscle damage, surgery may be necessary. The goal of surgery is to remove pressure from the nerve. In some cases, the nerve is moved as part of the operation.

Some surgical treatment options include:

Ulnar nerve anterior transposition: This moves the ulnar nerve so that it doesn’t stretch over the bony parts of the elbow joint.

Medial epicondylectomy: This removes the bump on the inside of the elbow joint, which takes pressure off the ulnar nerve.

Cubital tunnel release: This removes part of the compressed tube through which the nerve passes in the elbow.

Self-care at Home

If you have surgery, physical therapy to regain your arm and hand strength will likely be advised. You might need a splint for a few weeks to help make sure the elbow heals properly.

Ongoing care for your elbow should include steps to avoid injuring or irritating the nerve further. You should be careful to avoid trauma to your elbow. You may also need to learn, with occupational therapy, how to hold your arm differently, stretch, or take frequent breaks when doing everyday activities such as working on your computer.


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.