Managing Lower Back Pain

By Robert A. Kayal, MD, FAAOS 

Low back pain stemming from sciatica, spinal stenosis or other causes is a common debilitating condition. According to the National Institute of Neurological Disorders and Stroke (NINDS), it is also the most prevalent cause of work-related disability. Lower back pain is not just uncomfortable, though. If left untreated, it can lead to potentially serious medical problems. Don’t put off having a qualified NJ orthopedic surgeon address your low back pain to determine its cause—and the best course of treatment for your symptoms.


SCIATICA: Sciatica is a type of low back pain found most commonly in adults between the ages of 30 and 50 years old. Sciatic pain can be chronic and tends to affect one or both legs as well as your back. Sciatica is the result of sciatic nerve compression. The affected nerve runs from the lower back, past the buttocks and down through each leg. Symptoms of sciatica can include:

• Long-lasting pain intensified by sitting
• Tingling, burning or numbness
• Weakness in the affected leg 

A herniated disc in the low back is a common cause for nerve compression. Bulging or herniated discs are often just a sign of aging, but can result from trauma such as a car accident. Sciatica that is related to disc problems can be treated non-surgically through rest, physical therapy and medication. In some cases, surgery is required to manipulate the disc into its proper position and provide pain relief. Expert NJ back surgeons can repair herniated discs and guide you in post-surgical rehabilitation exercises to strengthen core muscles. Stretching and exercises can alleviate and prevent low back pain in many people.

SPINAL STENOSIS: Another possible cause of low back pain is spinal stenosis. Your spinal cord is surrounded by a number of protective structures, including vertebrae, muscles and ligaments. Spinal stenosis is the narrowing of these structures; picture a tunnel that has suddenly grown smaller inside. The primary cause of this spinal stenosis is arthritis. During arthritis, the discs in your back lose fluid and harden. This reduces the diameter of the space surrounding your spinal cord while causing symptoms similar to sciatica. These include:

• Burning or tingling in the buttocks, thighs or lower back
• Weakness in the legs and feet
• Low back pain that increases upon standing or walking

The experts at Kayal Orthopaedic Center may suggest a variety of treatment options for spinal stenosis. All are designed to relieve your low back pain and to increase your daily level of function. Lumbar traction and other forms of physical therapy can manage your symptoms and decrease associated nerve compression. Anti-inflammatory medications reduce swelling around the spinal nerve, and may be taken orally or through a series of steroid injections. Alternative therapies such as acupuncture may also be beneficial to spinal stenosis patients, and your Kayal Orthopaedic specialist can provide information about these options.

Kayal Orthopaedic Center surgeons often perform laminectomy and fusion procedures to correct severe cases of spinal stenosis. During a laminectomy, your NJ back surgeon removes fragments of bone and soft tissues that are causing nerve pain. Back fusion permanently attaches two or more vertebrae together to create a stronger spinal structure. This may offer pain relief when alternative therapies have not been successful.

Don’t let low back pain interfere with work, family and activities! Call Kayal Orthopaedic Center today at 201-447-3880 to schedule an appointment with our NJ orthopedic specialists. Online appointment scheduling is also available through Sage Intergy Practice Portal: a convenient way to manage all of your orthopaedic healthcare needs.

Ask the Kayal Orthopaedic Center Expert:

By Robert A. Kayal, MD, FAAOS

UPPER EXTREMITY PAIN: FAQs ABOUT COMMON ELBOW INJURIES 

It’s no secret that, while exercise and recreation keep us healthy, they occasionally lead to nagging aches, injuries and musculoskeletal pain. When left unaddressed, these conditions may become chronic, requiring a long-term hiatus from offending activities. To prevent this, it’s important to discuss pain and immobility with a qualified NJ orthopedic expert.

Whether caused by (1) overuse, (2) wear and tear, (3) repetitive motion, or (4) sports and conditioning, a slow-healing elbow injury is frustrating and restrictive. Our orthopedic surgeons see a variety of elbow conditions, and two of the most prevalent are golfer’s elbow and tennis elbow. It is not unusual to see increasing elbow injuries during the NJ autumn, since the mild weather spurs enthusiasts to spend their time outdoors.

GOLFER’S ELBOW: Also known as medial epicondylitis, golfer’s elbow impacts patients who are overusing forearm muscles and tendons. The condition begins when microscopic tendon tears lead to ongoing inflammation and pain—which can come on gradually or quickly. Golfer’s elbow is typically caused by repetitive, improper technique in your golf swing, baseball pitch, racquet sport or weight training regimen. Pain may become worse as you grip a club or racquet, throw a ball, twist a doorknob or flex wrist to forearm.

Golfer’s elbow symptoms may include pain and soreness inside the elbow; stiffness when making a fist or straightening the arm; and numbness or tingling that radiates into the lower arm or hand. To diagnose this elbow condition, your orthopedic specialist will perform a thorough examination and discuss your activities/medical history.

After ruling out other damage using x-ray or MRI, our team may recommend rest, ice, physical therapy and brace immobilization. If symptoms persist, you may need one or more cortisone shots, in combination with rehab. In rare cases, surgery is recommended. Surgery for golfer’s elbow typically entails removing damaged tissue, shaving the bone and repairing or reattaching the tendon to take pressure off of the elbow joint.  

TENNIS ELBOW: Similar to golfer’s elbow, tennis elbow occurs when microtendon tears develop into pain and inflammation. This pain occurs on the exterior of the upper arm near the elbow, and is often caused by racquet sports. However, tennis elbow may also be caused by repetitive wrist twisting—as when using a screwdriver, painting a wall or moving a computer mouse.

Tennis elbow symptoms include worsening joint pain, weakening grasp, and discomfort that radiates from the outer elbow into the forearm and hand. Pain typically worsens when the wrist is bent backward, or while grasping something and straightening the elbow. Extreme stiffness may also prevent full arm extension.
  
To diagnose this elbow condition, your Kayal Orthopaedic surgeon will examine your arm, discuss your activity and medical history—and may recommend an x-ray to rule out other joint conditions. Like golfer’s elbow, the best treatments for tennis elbow include rest, ice, physical therapy, anti-inflammatory medications and immobilization. However, persistent or recurring tennis elbow may need surgical debriding, or “cleaning up” of damaged tissue. Your surgeon can also clean out scar tissue and repair/reattach the extensor tendon to take stress off of the elbow joint.

Are You Limited by Elbow Aches, Pains and Immobility? 

CALL THE KAYAL ORTHOPAEDIC CENTER TODAY!

If elbow pain, stiffness and numbness are preventing you from enjoying your favorite activities, it’s time to call our team of leading NJ orthopaedic surgeons. Our helpful staff can arrange an initial consultation, schedule elbow imaging and return you to the links, court or baseball diamond quickly and safely. Call 201-447-3880 today—or login online to request an appointment through our Sage Intergy Portal.

Shoulder Problems? Ask the Kayal Orthopaedic Center Expert!

By Robert A. Kayal, MD, FAAOS

FAQs about Shoulder Injuries

Your shoulder joint is composed of a variety of bones, muscles, tendons and ligaments. Because of its extreme range of motion, it is an inherently unstable joint that is prone to injury. Shoulder pain occurs for a variety of reasons, including degeneration, arthritis, falls, impacts or traumatic accidents. 

Kayal Orthopaedic Center, PC is a leader in NJ shoulder repairs. Successfully treating hundreds of cases of shoulder pain, restricted mobility and structural damage each year, we’ve developed a unique treatment approach that’s customized to the individual needs of each patient. Educating patients in a detailed, easy-to-understand manner, we then perform thorough assessments and outline possible treatment options—so you can decide which course of action you’d prefer to follow. Most importantly, we prioritize aftercare to ensure complete rehabilitation and freedom from shoulder pain. 

Common Questions about Shoulder Injuries

1. HOW DO SHOULDER INJURIES OCCUR?

In cases where acute trauma did not cause your shoulder injury, we look for underlying causes. These may include wear and tear on your shoulder muscles and joints, the presence of arthritic conditions, and lifestyle or occupational factors that have led to repetitive stress. You can also injure your shoulder without realizing it by incorrectly lifting something heavy or carrying heavy objects over long distances.

2. WHAT ARE SOME OF THE MOST COMMON SHOULDER INJURIES?

Some of the most frequently of the most frequently occurring shoulder conditions treated by the Kayal Orthopaedic Center include:

• Tendonitis and bursitis: Tendonitis occurs when the shoulder tendons become inflamed, causing pain and mobility restrictions. Bursitis is a similar affliction that affects the bursa, a fluidic sac which shields and protects your shoulder.
• Shoulder dislocation: A dislocated shoulder, which occurs when the humerus bone is physically separated from the socket of the shoulder, causes severe pain and impedes movement and range of motion.
• Frozen shoulder: Generalized inflammation can restrict shoulder movement, typically leaving patients unable to raise the affected arm beyond a certain threshold.
• Rotator cuff tears: Usually caused by repetitive stress, a rotator cuff tear occurs when tendons and muscles in the shoulder’s rotator cuff weaken and tear.
• Sprains: A shoulder sprain occurs when shoulder ligaments tear, and is typically caused by acute stress.  
  
• Labral tears: The shoulder’s labrum is a stabilizing tissue which compensates for the overall lack of support in the relatively shallow joint of the shoulder. A labral tear increases your likelihood of suffering a dislocated shoulder, and while this condition most commonly affects older patients, it can also occur suddenly as the result of an acute injury. Symptoms of a labral tear include aching pain in the shoulder joint, sudden restrictions of movement often described as a “catching” sensation, and activity-specific pain that occurs during shoulder movement.
• Shoulder fractures and bone breaks: Both collar bone and shoulder bone fractures can cause shoulder pain, and usually occur as the result of heavy force being applied against the bone during an accident.
• SLAP lesions: “SLAP” is an acronym for “Superior Labral tear, Anterior to Posterior.” It refers to an injury affecting the ball-and-socket joint of the shoulder, in which the superior labral ligament develops a lesion from overuse, typically as the result of strenuous or repetitive overhead movement. Symptoms include a constant but dull (rather than sharp) pain in the shoulder, and those affected by SLAP lesions typically report being awakened during the night by shoulder pain.
• Shoulder problems for the “overhead athlete”: Athletes who engage in sports that require a lot of overhead movement, such as softball, baseball and tennis, often develop rotator cuff problems and are at increased risk of both SLAP lesions and labrum tears. Stretching both before and after activity—and taking care to use proper form—can help you avoid these conditions.

3. WHAT METHODS ARE USED TO DIAGNOSE THE SPECIFIC NATURE OF A SHOULDER INJURY?

In our clinic, we use cutting-edge imaging and diagnostic technologies which include arthrograms and arthroscopic examinations, CT scans, X-rays and MRI scans. These are used to supplement physical examinations, during which we will make an initial assessment of your injury.

4. HOW ARE SHOULDER INJURIES TREATED?

It depends on the nature of the injury, but we favor minimally invasive and rehabilitative treatments before resorting to surgery. During your aftercare, we prioritize physiotherapy and range-of-motion recovery techniques to speed healing and minimize the possibility of further injury.

WANT TO LEARN MORE?

CALL THE KAYAL ORTHOPAEDIC CENTER TODAY!

On behalf of my team of leading NJ orthopedic surgeons, I invite you to contact us if you have questions about shoulder pain, or wish to arrange a consultation appointment for shoulder pain or a shoulder injury. My staff has elite credentials and the breadth of experience to successfully treat any shoulder injury, no matter how minor or serious, with compassionate and attentive care. To schedule an appointment today, call 201-447-3880.