Spinal Stenosis

   Back pain is one of the most common physical ailments experienced in the United States currently. It is estimated that almost 75% of people will experience back pain at some point in their lifetime. For some, this back pain can be chronic and debilitating. Just like any major joint in the body, the back, or spine, also develops arthritis and degenerates gradually over time. Often, this "wear and tear" can lead to narrowing of the space within and between the joints of the spine causing what is called "spinal stenosis". The weight absorbing discs in between the bones of the spine also deteriorate with time, losing height, and may budge into the spinal canal causing further narrowing.

   Within the spine live many nerves originating from the spinal cord which extends outwards to all the muscle, tissue and organs of the body that control our daily locomotion and bodily functions. When narrowing or "stenosis" occurs at any area within the spine, the nerves that pass through may become compressed and irritated.  This irritation can lead to a variety of symptoms ranging from pain, numbness, tingling and "electrical sensations", to muscle cramping and early muscle fatigue with simple activities. People with spinal stenosis may also complain of pain radiating into hips, leg and feet, accompanying early muscle fatigue with walking or prolong standing. Stenosis can also affect the neck, or "cervical spine" which can lead to similar type symptoms in the shoulders, arms and hands. With all of the information that has been uncovered about spinal stenosis it is still unclear whether there is a correlation between the risk of developing spinal stenosis and sex, ethnicity or genetic predisposition.

What can you do about it?

   If you experience any of the above symptoms, it is recommended to have a thorough evaluation from your primary care physician as well as an orthopedic spine specialist, as these symptoms may have a variety of other potential causes. Inform your physician of all medication you are taking and any present or past medical conditions. If you do have spinal stenosis, there are treatment options available. Many patients with mild to moderate cases of stenosis will respond to courses of anti-inflammatory medications as well as physical therapy. Physical therapy is targeted at strengthening the "core" or the muscles that support the lower back and over time can improve posture, strength, flexibility and endurance when practiced regularly. In more severe cases, patients may benefit from cortisone injections or possible surgery to relieve the compressed nerve.

For an evaluation, please call 847-690-1776 Dr. Gregory N. Drake

Fall Risk Factors
Causes and Risk Factors

Falls don't "just happen," and people don't fall because they get older. Often, more than one underlying cause or risk factor is involved in a fall. A risk factor is something that increases a person's risk or susceptibility to a medical problem or disease.

As the number of risk factors rises, so does the risk of falling. Many falls are linked to a person's physical condition or a medical problem, such as a chronic disease. Other causes could be safety hazards in the person's home or community environment.

Risk Factors

Scientists have linked a number of personal risk factors to falling.

• Muscle weakness, especially in the legs, is one of the most important risk factors. Older people with weak muscles are more likely to fall than are those who maintain their muscle strength, as well as their flexibility and endurance.

• Your balance and your gait -- how you walk -- are other key factors. Older adults who have poor balance or difficulty walking are more likely than others to fall. These problems may be linked to a lack of exercise or to a neurological cause, arthritis, or other medical conditions and their treatments.

• Blood pressure that drops too much when you get up from lying down or sitting can increase your chance of falling. This condition -- called postural hypotension -- might result from dehydration, or certain medications. It might also be linked to diabetes, neurological conditions such as Parkinson's disease, or an infection.

• Some people with postural hypotension feel dizzy when their blood pressure drops. Other people don't feel dizzy, even if their blood pressure drops a lot when they get up.

• Your reflexes may also be slower than when you were younger. The increased amount of time it takes you to react may make it harder to catch your balance if you start to fall.

• Foot problems that cause painful feet, and wearing unsafe footwear can increase your chance of falling. Backless shoes and slippers, high-heeled shoes, and shoes with smooth leather soles are examples of unsafe footwear that could cause a fall.

• Sensory problems can cause falls, too. If your senses don't work well, you might be less aware of your environment. For instance, having numbness in your feet may mean you don't sense where you are stepping.

• Not seeing well can also result in falls. One reason is that it may take a while for your eyes to adjust to see clearly when you move between darkness and light.

• Other vision problems contributing to falls include poor depth perception, cataracts, and glaucoma.

• Wearing multi-focal glasses while walking or having poor lighting around your home can also lead to falls.

• Confusion, even for a short while, can sometimes lead to falls. For example, if you wake up in an unfamiliar environment, you might feel unsure of where you are. If you feel confused, wait for your mind to clear or until someone comes to help you before trying to get up and walk around.

• Some medications can increase a person's risk of falling because they cause side effects like dizziness or confusion. The health problems for which the person takes the medications may also contribute to the risk of falls.

• The more medications you take the more likely you are to fall. People who take four or more prescription drugs have a greater risk of falling than do people who take fewer drugs. You should check with your doctor if you think your medications are causing dizziness or unsteadiness. Your doctor can tell you which drugs, including over-the-counter medicines, might cause problems. Do not change your medications on your own.

What a Fall Might Mean

Be sure to talk with your doctor if you fall, as well. A fall could be a sign of a new medical problem that needs attention, such as an infection or a cardiovascular disorder. It could also suggest that a treatment for a chronic ailment, such as Parkinson's disease or dementia, needs to be changed.

Most Falls Happen at Home

Although falls can happen anywhere, well over half of all falls happen at home. Falls at home often happen while a person is doing normal daily activities. Some of these falls are caused by factors in the person's living environment. For instance, a slick floor or a poorly lit stairway may lead to a fall.

Other factors that can lead to falls at home include

• loose rugs

• clutter on the floor or stairs

• carrying heavy or bulky things up or down stairs

• not having stair railings

• not having grab bars in the bathroom

But here's the good news: Falls are preventable. Falling is not an inevitable result of aging, and there are steps you can take to improve your balance and decrease your chances of falling. Muscle strength and flexibility, which are an imperative part of maintaining good balance, decrease with age, especially for sedentary adults, but these can be partially restored with the right physical therapy program.

Studies have shown that attention to certain risk factors, such as impaired balance, can significantly reduce rates of falling. Considerable evidence indicates that the most effective fall reduction programs involve systematic fall risk assessment and targeted interventions. Additional research reveals that a physical therapist-prescribed exercise program targeting balance and strength can be effective in improving a number of balance and related outcomes in older people with mild balance impairment.

Physical Therapy Solutions is the only facility in the northwest suburbs of Chicago with a comprehensive balance program. Assisted with a medical history from your doctor, we can perform specific tests to determine your ability to maintain your balance as well as your risk of falling. Our computerized equilibrium tests can evaluate the sensory and motor parts of your balance system. Sensory tests assess inner ears, eyes and sense of touch in your feet and joints that contribute to balance control. Our motor tests will measure your ability to execute coordinated movements, both voluntary and involuntary, to maintain your balance. All of these tests will help define the cause of your balance problem and are the foundation of devising a unique, individualized program for you. We utilize a state-of-the-art balance machine and our balance therapy programs have a 98% balance improvement success rate.

Rupangi Patel PT, Co-founder/CEO of Physical Therapy Solutions Group, is a physical therapist with more than 25 years of experience gleaned over two continents. She has been serving the Northwest suburban area since 1990 and she opened her own clinic in 2005. Rupangi is skilled in evaluating and treating various orthopedic and neurological conditions and has expertise in vestibular rehabilitation. She has undergone extensive training in the treatment of patients with balance and mobility ailments, with a particular focus on dizziness.

For more information or to schedule a consultation, please call: Physical Therapy  Solutions 847-240-2000.