My name is Uma Srikumaran. I'm an orthopedic surgeon with Johns Hopkins and Howard County General Hospital. I specialize in shoulder surgery. Shoulder arthritis refers to degeneration of the lining of the joint. The lining of the joint is made of smooth cartilage that can wear out over time or can be diseased by inflammatory conditions such as rheumatoid arthritis or from a traumatic condition or posttraumatic arthritis after a shoulder dislocation. The typical wear and tear arthritis is called osteoarthritis. Pain is the most common symptom of shoulder arthritis. Pain can occur throughout the.
Day and worsen with certain activities. ing and catching may also be noticed coming from the shoulder. As arthritis progresses the pain and stiffness will progress as well. Nonsurgical treatment for shoulder arthritis includes simple measures such as rest and activity modifications or avoiding activities that are painful for your shoulder. Nonsteroidal antiinflammatory medications can also be beneficial for pain relief. Other options include icing, physical therapy and cortisone injections that may also provide symptomatic relief. When nonsurgical treatments fail to provide pain relief over a period of time or the pain becomes unbearable, surgical shoulder replacement surgery is an option.
The goals of shoulder replacement surgery are pain relief as well as improved function so you may resume everyday activities. The surgery is performed under general anesthesia often with a nerve block and involves an open incision in front of your shoulder. The arthritic bone is carefully removed along with scar tissue and a metal prosthesis and a plastic component are inserted to recreate the ball and socket joint of the shoulder. Recovery after shoulder replacement surgery involves a one to two day hospital admission. After this, an outpatient physical therapy program is performed.
TMJ Exercises Stretches to Relieve Jaw Pain Ask Doctor Jo
Hey everybody, it's Doctor Jo. I got an email from Barry and he was having some TMJ pain. TMJ stands for temporomandibular joint which is your jaw joint right there. And I'm gonna show you today just some simple stretches and strengthening exercises to get that TMJ feeling better. So we're just gonna start off, you want to start off gently with these exercises, you don't want to push very hard because this joint is small and it can get irritated very quickly. The first one you wanna do is you're gonna use the palm of your.
Hand so you're not pushing with your fingers, but you're using just your palm. You're gonna put your palm on one side, doesn't matter because we're gonna do both. And you gonna keep your mouth and teeth aligned. So the jaw stays in one spot, your teeth stay aligned so they're not going back and forth like that. You're gonna keep it nice and still and you're gonna push your palm in that way. And just hold it in place. A nice little 5 second push. Good. See how my jaw's not actually moving but I'm just putting gentle pressure on one.
Side. Then after your do that maybe 35 times, 5 seconds a piece, then you're gonna switch and do the same thing on the other side. So make sure you don't just do one side and not the other side cause you wanna keep it even. The next one really simply, you're gonna open your mouth just a little bit and put your fingers inside but make sure you don't bite your fingers. You're not biting, your keeping again your jaw still and pushing pressure down this time. So you're gonna put your fingers in your mouth on your bottom teeth, and just.
Push down. See again my jaw's not moving. I'm not stretching it open, I'm keeping it in one spot. Again just start off with about 5 seconds of gentle pushing and do that about 5 times. The last one is to stretch out the join back here. You're going to put your palm on your chin and just push straight back. Again you wanna make sure that your teeth are in alignment. If your teeth are over here or over here and your moving it, you're going to irritate that joint. So just palm on the chin. And relax your jaw. And push straight.
Sacroiliac SI Joint Fusion for pain treatment
Borgess happens to be one of the premiere institutions in sacroiliac joint fusion. The SI joint, or the sacroiliac joint, is the joint between the sacrum bone and the ilium, which is a part of the pelvis, and the sacroiliac joint can become inflamed or unstable or degenerated in some patients, resulting in pain. There are nonsurgical treatments for sacroiliac joint pain that can work in a certain subset of patients. That includes physical therapy, chiropractor treatment, injections, or pain shots in the joint, but for those patients who don't get relief those treatments, they are a good candidate for a sacroiliac joint fusion.
We make an incision, an approximately two centimeter incision, on the lateral aspect of the patient's buttock. Through that incision using Xray guidance, we place three guide wires, and then we place screws over those guide wires to stabilize and fuse the joint. The three screws that we place in the sacroiliac joints have slots in the center of them, and we pack those with bone such that the slotted areas span the sacroiliac joint, and we can actually get bone growth or bony fusion across the joint through those screws.
The typical sacroiliac joint procedure that I am doing takes approximately 45 minutes to an hour. Patients usually spend a night in the hospital after surgery. They have restrictions for the first 12 weeks or so after surgery, bending and lifting restrictions. I can't even describe in words how great it is to see people improve after this surgery and other surgeries that we do in neurosurgery for pain. We actually do have patients coming from other states at times to have their sacroiliac joints fused. To anyone who is out there who has not gotten relief with their treatments, I would suggest that you talk to your family physician or.
Laser Therapy for Hand Pain Arthritis and Rheumatoid Arthritis
Cold laser is a great treatment for increasing blood flow and decreasing pain. We have multiple patients who have osteoarthritis or degeneration in their hands and fingers. Cold laser is a great treatment at increasing the blood flow, decreasing those pain sensors out of those joints in the hands and finger. And it's a very simple treatment. Cold laser is going to send energy in a signal into the muscles, fingers and cells to help trigger mechanisms to increase those blood flows. It get the little arteries to open up and dilate, rushing the blood in. It's going to get the healing mechanisms to ramp.
Up. It's also going to produce a lot more energy inside the cell. The mitochondria start producing ATP. That's your cells gasoline. So between these processes it helps decrease the pain stiffness that people feel. We've seen people with a big thick knuckles from either rheumatoid or an osteoarthritis and they responded really well to laser. We usually combine this with other treatments in the office but laser we're just going to do a quick demo up. We need glasses for that purpose because of the intensity of the class four laser.
All we really see is a little red light. That red light is shining along and marks where we're going from. Now, this laser as I can feel the warming sensation happening as I'm going across the skin, we just screen but it's dropping about 5 joules a second into each spot on my finger. The class four lasers can produce about 20 joules a second where the older class three lasers would produce about 5 joules in a minute. The difference is now the depth of penetration so we can make an impact deeper in the skin.
Causes Recovery Exercises for Tendonitis Elbow Pain
MUSIC PLAYING Tendonitis is an inflammatory condition of the tendon due to overuse or trauma. There's typically some degree of microtearing within the tendon, which leads to the inflammatory cycle. Common symptoms of tendonitis are pain at the elbow, either on the inside or the outside of the elbow, with lifting, gripping, carrying activities, even with opening doors or opening or closing jars or other containers. Tendonitis is caused by overusing the arm with gripping or lifting activities, or other things like golf or tennis, where there's actually too much stress on the tendon where.
The microtrauma has occurred. And that then leads to the inflammatory cycle. Treatment for an elbow tendonitis would initially involve resting, icing, and potentially taking some antiinflammatory medications, along with potentially bracing the site to allow for rest of the area for two to three weeks. After a period of two to three weeks of rest to allow the initial recovery, we would want to start stressing the tendon gently. We would perform some gentle stretches in order to do that. One stretch you would perform would be to bring the arm down like this, in order to.
Stretch the top part of the forearm muscles. We would perform 30 second stretches, two to three repetitions. And we could also perform a stretch with palm up, bringing the arm down like this, to stretch this side of the musculature. We would perform, again, two to three repetitions for 30 second stretches. These stretches should be performed two to three times a day in a completely pain free range of motion. Once we've started some pain free stretching, we can also starting stressing the tendons in a pain free way also. We could start performing some wrist extension exercises. We could perform.
10 to 15 repetitions, two to three sets. Again, also in a completely pain free range of motion. We can also perform wrist flexion. 15 repetitions, two to three sets, completely pain free. And then we can also hold the dumbbell on the end, and bring the arm down this way and this way. These should be performed one time per day, two to three sets of 10 to 15 repetitions, all maintaining pain free range. When we start the resistance exercises, a very light level of resistance should be used.
Hand Wrist Stretches for Arthritis Pain Relief Ask Doctor Jo
Hey everybody, it's Doctor Jo. Don't worry, I wasn't hunting Bambi, but here in the south, hunting is a really big deal, and sometimes your hand can start hurting. So I'm gonna show you some stretches for your hands and your fingers today. Alright, let's start with some wrist exercises. First you can keep your elbow bent, that's fine, and you're going to bring your fist downward so you're getting a stretch up here. You can either hold it for 30 seconds, if it's not too tight, or you can just do a slow motion going up and.
Down, and do that just 10 times repeatedly. So either 30 seconds holding it down, 30 seconds holding it up. Or rotating back and forth. And that's gonna get that wrist loosened up for you a little bit. Then you can turn your fist to the side and go down and up that way. So, same kind of thing, you can either hold it down for 30 seconds, hold it up for 30 seconds, or just do a slow movement back and forth about 10 times. Once you get your wrist.
Loosened up, then you're gonna start working on your fingers. So first usually what I'll do is I'll start closest to the hand and then move my way to the end. So bending at your joints on the outside here, you're going to just bring them down. If you want to push a little bit more with your other hand you can. Stretching those joints out a little bit. Same kind of thing, you can go 10 times just back and forth, a little pop in there, or you can hold it for 30 seconds. Then you're gonna move up to the next joint where you're.
Gonna curl your fingers down. You'll be able to see them all right there, and there getting those joints in the middle right there. Same kind of thing, you can hold it for 30 seconds, or you can just curl your fingers up and down to get them moving. And then the last joint on the end is usually the hardest. Sometimes people can just bend them without holding on to them with their fingers. I have to hold on to mine. Mine don't bend on their own. And just kind of curling them down and coming up. So, same thing, you can hold them for.
30 seconds, or you can do 10 just nice and slow moving back and forth. Then the last once to get your thumb involved a little bit, is just to touch each finger with your thumb. Get that moving back and forth. You can circle around, or you can go back the other way, or you can alternate. And there you have it, that should loosen up your wrist and your fingers. So all you hunters out there, or anybody who has arthritis in their hands and wrists in general, those are some good stretches to get you loosened up and get you going.
KT Tape AC Joint Sprain
This application is for acromioclavicular joint or AC joint separation, where the collar bone separates from the shoulder blade. This can cause inflamation at that joint, and this is how we tape for it. In this application the point of pain is often at the tip of the shoulder where the collar bone meets the shoulder blade now I'll put a red dot just indicate where that typically is. and also positioning is important, we're going to come up in a good posture as well as approximating the joint, which means.
To push the shoulder into the body, so you're actually closing that joint down. For our first strip of tape, we're going to tear an Istrip off the roll tearing the paper in the middle we're going to place that tape on full stretch the middle section of tape and we're going to place that full stretch section over that point of pain and what I'm doing here is actually bringing this piece back a little bit because I'd like to leave this front piece a little short just so I don't end up in the the armpit area, and as I took that paper off.
I'm leaving no tension on the tape as I will back here, I'm just removing the paper and then laying the tape down with no stretch for my next piece I'm tearing off another Istrip, again tearing the paper in the middle and now placing the tape on full stretch in the middle section of the tape this is the point of pain and I'm placing that piece down and what I'm doing here again is going down the arm a bit and I'm leaving this end of tape short with no tension, this area of skin just behind the collar bone by the neck tends to be.
Very sensitive and on the arm, again I'm taking that paper off, and just laying that piece of tape down with no stretch. For my third piece I'm tearing off another Istrip. In this demonstration I'm using multiple colors to show the different layers of tape again full stretch on the middle section of tape and again, where that tape is being stretched I'm placing over that point of pain. and from here I'm just removing the paper and laying that tape down with no stretch on the ends And for my last piece, I'll use another Istrip.
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