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Are you 55 years old or older and still pain free? Chances are you have osteoarthritis and don't know it. X-rays show arthritic changes in eight out of every 10 adults age 55 and older. Knees, hips, and spines are affected most, in that order. Older adults with leg pain may have arthritic changes in both the hip and spine. They sometimes have a total hip replacement (THR) only to develop groin and buttock pain next. Or suddenly they have muscle weakness that isn't related to the THR. In these cases, lumbar spinal stenosis (LSS) may be the problem. LSS occurs when age-related changes narrow the canal where the spinal cord and nerves travel. Bone spurs, thickened ligaments, and worn-down joints are just some of the changes leading to LSS. These doctors from Baylor College of Medicine offer other orthopedic surgeons some guidance. They say that when a patient with a recent THR has severe pain after the operation, look for infection, an unstable implant, or LSS. Location of the pain is a key...
Last month, the American Pain Society added to its recommendations to health care providers regarding the diagnosis and treatment of low back pain .
In addition, the Society decided to discuss openly procedures that could be risky to sufferers of low back pain, including recommendations on surgery and other invasive therapies.
Unfortunately, there is not a significant body of good evidence to justify unquestioningly embracing these new recommendations. It is difficult to find well-done clinical studies which support the use of a number of the more invasive treatments used for chronic low back pain.
The initial set of guidelines for the management of chronic low back pain were published in "Annals of Internal Medicine" last October. However, these recommendations dealt more with the initial evaluation of a low back pain patient, and included thoughts on what type of x-rays to order in addition to more conservative treatments such as massage/manipulation and exerci...
Q. I definitely want to avoid lymphedema. Is there anything I can do to ward it off, or is lymphedema totally random? A. The very best thing you can do to help prevent lymphedema is to make sure you get full range of motion back in your arm, whether after surgery or radiation. Favoring the arm on your affected side, hunching your shoulder protectively, being too stiff to stretch your arm up over your head and around towards your back–these are all things that will make it easier for lymphedema to gain a foothold. I have a friend who’s a physical therapist specializing in lymphedema treatment. In fact, we became close as she gave me daily massages to relieve my own swollen arm. (Just as getting a tummy tuck is the silver lining of a tram flap reconstruction, a daily massage is the big plus of having lymphedema!) This friend says that women who’ve had surgery, particularly a mastectomy with lymph node removal (even if just a single node) need physical thera...
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