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

 

Endoscopic Carpal Tunnel Surgery

Do you have difficulty completing activities of daily living such as picking up pills, buttoning buttons, holding utensils, or have a weak grip? A condition called carpal tunnel syndrome (CTS) may be the likely cause. Patients who suffer from CTS may also report symptoms such as numbness in the thumb, index, and middle fingers throughout the day. Tens of thousands of people each year are treated for CTS.

Evaluation by a physician specializing in hand surgery can lead to a proper diagnosis, which can lead to proper treatment.

WHY DOES IT OCCUR?

The carpal tunnel is a space in the hand where 9 tendons and a nerve pass though the forearm to the hand. Swelling around the tendons can occur, which leads to less room for the nerve. This leads to numbness and tingling in the fingers or even pain in the hand. Occasionally, the pain in the wrist can lead to elbow or even shoulder pain. Swelling around the nerve can be from several causes: fractures, thumb arthritis, pregnancy, rheumatoid arthritis, and thyroid problems. Diagnosis of CTS can be made through an electromyelogram (EMG). However, X-rays are usually needed to assess other conditions such as arthritis, fractures, and dislocations. This allows for proper, individualized treatment for the hand.

WHAT ARE THE TREATMENT OPTIONS?

CTS can be treated with a variety of methods all varying on the degree of nerve compression. Night splints for the wrist are usually the first step. Occasionally injections are helpful to decrease the swelling around the nerve. Some patients need surgery to relieve the pressure on the nerve. The newest technique for carpal tunnel release is an endoscopic release with an incision at the wrist level rather than in the palm. This allows the surgeon to see the nerve through a camera and release the pressure on the nerve through a small ½ inch incision. This has led to much less pain and swelling, faster recovery, and smaller scars. Many patients return to work within a couple days or even the next day after surgery. Many patients do not have stitches after surgery, but have surgical glue used to close their incisions.

WHAT ARE THE BENEFITS TO ENDOSCOPIC CARPAL TUNNEL RELEASE VS THE TRADITIONAL INCISIONAL CARPAL TUNNEL RELEASE?

Carpal tunnel surgery is performed as outpatient surgery. Endoscopic carpal tunnel surgery has decreased pain, swelling and down time for patients as compared to open surgery. Newer research has shown that endoscopic carpal tunnel is as effective as the larger incision techniques with the same long lasting benefit.

Traditionally, a large incision in the palm of the hand and wrist was required to see the nerve and tendons. This allowed for relief of the compression on the nerve. Patients typically had a longer recovery with pain in the palm of the hand and even difficulty with grasping items. As techniques evolved, surgeons began making smaller incisions in the palm to release the nerve compression. This led to a faster recovery and decreased pain. Typically, full recovery is seen from a few weeks to a few months after surgery.

To schedule your individualized consultation,please call Core Orthopedics & Sports Medicine at 847-690-1776.

 
Physical Therapist and Your Balance Problems
 
Physical therapists offer numerous options for treating balance problems, based on each person’s needs. They are trained to evaluate multiple systems of the body, including the muscles, joints, inner ear, eye tracking ability, skin sensation, and position awareness in the joints (proprioception). Physical therapists are experts in prescribing active movement techniques and physical exercise to improve these systems, including strengthening, stretching, proprioception exercises, visual tracking, and inner ear retraining. 
 
Your physical therapist can help treat your balance problems by identifying their causes, and designing an individual treatment program to address your specific needs, including exercises you can do at home. Your physical therapist can help you:
 
Reduce Fall Risk. Your physical therapist will assess problem footwear and hazards in your home that increase your risk of balance problems or falling. Household hazards include loose rugs, poor lighting, unrestrained pets, or other possible obstacles.
 
Reduce Fear of Falling. By addressing specific problems that are found during the examination, your physical therapist will help you regain confidence in your balance and your ability to move freely, and perform daily activities. As you build confidence in your balance and physical ability, you will be better able to enjoy your normal daily activities.
Improve Mobility. Your physical therapist will help you regain the ability to move around with more ease, coordination, and confidence. Your physical therapist will develop an individualized treatment and exercise program to gradually build your strength and movement skills.
 
Improve Balance. Your physical therapist will teach you exercises for both static balance (sitting or standing still) and dynamic balance (keeping your balance while moving). Your physical therapist will progressively increase these exercises as your skills improve.
 
Improve Strength. Your physical therapist will teach you exercises to address muscle weakness, or to improve your overall muscle strength. Strengthening muscles in the trunk, hip, and stomach (ie, “core”) can be especially helpful in improving balance. Various forms of weight training can be performed with exercise bands, which help avoid joint stress.
 
Improve Movement. Your physical therapist will choose specific activities and treatments to help restore normal movement in any of your joints that are stiff. These might begin with "passive" motions that the physical therapist performs for you, and progress to active exercises that you do yourself.
 
Improve Flexibility and Posture. Your physical therapist will determine if any of your major muscles are tight, and teach you how to gently stretch them. The physical therapist will also assess your posture, and teach you exercises to improve your ability to maintain proper posture. Good posture can improve your balance.
Increase Activity Levels. Your physical therapist will discuss activity goals with you, and design an exercise program to address your individual needs and goals. Your physical therapist will help you reach those goals in the safest,
fastest, and most effective way possible.
 
Once your treatment course is completed, your physical therapist may recommend that you transition to a community group to continue your balance exercises, and maintain a fall-proof home environment. Many such community groups exist, hosted by hospitals, senior centers, or volunteer groups.
 
Your physical therapist may recommend that you consult with other medical providers, including:
  • An eye doctor, to check your current vision needs.
  • An ear doctor, to check your outer and inner ear status.
  • Your personal physician, to review your current medications to see if any of them may be affecting your balance.
Can this Injury or Condition be Prevented?
To help prevent balance problems, your physical therapist will likely advise you to:
  • Keep moving. Avoid a sedentary lifestyle. Perform a challenging physical activity each day to keep your muscles strong and flexible, and your heart and lungs strong. Use your body as much as you can to walk, climb stairs, garden, wash dishes by hand, and other daily activities that keep you moving. If you work out or follow a fitness program, keep it up!
  • Have yearly checkups for vision and hearing. Make sure your vision prescription is up-to-date.
  • Carefully manage chronic diseases like diabetes, whose long-term side effects can include balance problems. These side effects can be greatly reduced by following the recommended diet and medication guidelines given to you by your physician.
  • Monitor your medications. Make note of any medications that you think may be affecting your sense of balance, and talk to your physician about them.
  • Report any falls to your physician and physical therapist immediately. They will evaluate and address the possible causes.
Your physical therapist will also prescribe a home exercise program specific to your needs to prevent future problems or injuries. This program can include strength and flexibility exercises, posture retraining, eye-tracking and vestibular exercises, and balance exercises.
 
Physical Therapy Solutions is the only facility in the northwest suburbs of Chicago with a comprehensive balance and fall risk program along with a strengthening 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 28 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. Rupangi and her team of six therapists have helped thousands of patients get back to enjoying their daily living. For more information or to schedule a complimentary consultation, please call: Physical Therapy Solutions 847-240-2000.

 

 

 


 


 
 
 
 

FALL RISK

Risk Increases with Age

Many people have a friend or relative who has fallen. The person may have slipped while walking or felt dizzy when standing up from a chair and fallen. Maybe you've fallen yourself.

If you or an older person you know has fallen, you're not alone. More than one in three people age 65 years or older falls each year. The risk of falling -- and fall-related problems -- rises with age.

Falls Lead to Fractures, Trauma

Each year, more than 1.6 million older U.S. adults go to emergency departments for fall-related injuries. Among older adults, falls are the number one cause of fractures, hospital admissions for trauma, loss of independence, and injury deaths.

Fractures caused by falls can lead to hospital stays and disability. Most often, fall-related fractures are in the person's hip, pelvis, spine, arm, hand, or ankle. Hip fractures are one of the most serious types of fall injury. They are a leading cause of injury and loss of independence, among older adults. Most healthy, independent older adults who are hospitalized for a broken hip are able to return home or live on their own after treatment and rehabilitation. Most of those who cannot return to independent living after such injuries had physical or mental disabilities before the fracture. Many of them will need long-term care.

Tell Your Doctor If You Fall

If you fall, be sure to discuss the fall with your doctor, even if you aren't hurt. Many underlying causes of falls can be treated or corrected. For example, falls can be a sign of a new medical problem that needs attention, such as diabetes or changes in blood pressure, particularly drops in blood pressure on standing up. They can also be a sign of problems with your medications or eyesight that can be corrected. After a fall, your doctor may suggest changes in your medication or your eye wear prescription. He or she may also suggest physical therapy, use of a walking aid, or other steps to help prevent future falls. These steps can also make you more confident in your abilities.

Ways to Prevent Falls

Exercise to improve your balance and strengthen your muscles helps to prevent falls. Not wearing bifocal or multifocal glasses when you walk, especially on stairs, will make you less likely to fall. You can also make your home safer by removing loose rugs, adding handrails to stairs and hallways, and making sure you have adequate lighting in dark areas.

Fear of Falling

Many older adults are afraid of falling. This fear becomes more common as people age, even among those who haven't fallen. It may lead older people to avoid activities such as walking, shopping, or taking part in social activities.

If you're worried about falling, talk with your doctor or another health care provider. Your doctor may refer you to a physical therapist. Physical therapy can help you improve your balance and walking and help build your walking confidence. Getting rid of your fear of falling can help you to stay active, maintain your physical health, and prevent future falls. For more information or to schedule a FREE FALL RISK ASSESSTMENT consultation, please call: Physical Therapy Solutions 847-240-2000.

Physical Therapy Solutions is the only facility in the northwest suburbs of Chicago with a comprehensive balance and fall risk program along with a strengthening 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 31 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. Rupangi and her team of eight therapists have helped thousands of patients get back to enjoying their daily living. For more information or to schedule a FREE FALL RISK ASSESSTMENT consultation, please call: Physical Therapy Solutions 847-240-2000.