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Thu, 25 Jun 2020

The Importance of ACL Injury Prevention

The ACL, anterior cruciate ligament, is a band in the knee that connects the femur to the tibia. It helps keep the joint stable as you walk, run, jump and make other leg movements. It is also one of the most commonly torn ligaments in the body. Injuries of the ACL often require surgery and rehabilitation, which can be damaging for students’ and professional athletes’ careers, and this is the reason why it is so important to focus on ACL injury prevention.

The ACL can be injured in several ways such as:

  • Suddenly stopping and changing direction quickly
  • Slowing down while running
  • Landing from a jump incorrectly
  • Direct contact or collision

A torn ACL is one of the most frequently reported sports-related injuries orthopedic surgeons see. Some of the sports where ACL injuries can often occur are soccer, football, tennis, basketball, volleyball and gymnastics. When an ACL injury happens, you might hear a “popping” noise that’s followed by pain and swelling. After this happens, the knee can be unstable and movement can cause wear and tear on the cushioning cartilage (meniscus) of your knee.

ACL injuries often require some sort of surgical repair and a minimum of six months to a year of rehabilitation. Having a focus on ACL injury prevention is crucial. Many ACL injuries can be prevented by strengthening the muscles around the knees, along with exercises to help increase balance, flexibility, core strength and stability. Having proper technique and form during sports and physical activities are key.

Here are a few tips to keep in mind for helping with ACL injury prevention:

  • Stretch and warm-up prior to the activity
  • Practice proper landing after jumps with your knees directly over your feet
  • Crouch and bend at your knees and hips when you pivot
  • Focus on strengthening your hamstrings, quadriceps, hips and thighs

Working with physical therapy specialists, like Joshua Bintz, PT, DPT, and Amanda Askey, PTA, is a good place to start for assessing how you can best modify movements to prevent ACL injuries. Therapists and clinicians can identify and target weak muscle and provide ways to improve strength and assist in preventing injuries.

Contact us today for more information or to schedule your appointment.

Fri, 22 May 2020

Outpatient Knee Replacement and the Benefits

Knee Replacement Surgery by Miller Orthopedic Surgeons

Outpatient knee replacement is a great way to get a patient in and out of the hospital on the same day. Not everyone qualifies or prefers this method, but many do. Outpatient total knee replacement is becoming more and more common of a surgery. Many, however, do not know what to expect with an outpatient procedure and therefore just stick to inpatient. Outpatient procedures do have their benefits, so it is important to be informed. A good orthopedic surgeon, such as total joint specialist Kent Boese, MD, can help you decide the best option for your knee replacement.

Total knee replacements (also called total knee arthroplasty), both inpatient and outpatient, are very similar. The biggest difference is in where post-op recovery is spent and the length of a hospital stay. The process of a total knee replacement is the removal of damaged bone or cartilage and the insertion of a prosthesis. The healthy bone and cartilage are resurfaced to help with the support of the implant. So, after the removal of the damaged bone and cartilage, the new joint is fused into place. This procedure is intended to reduce pain and increase the mobility of the patient. The goal is an improved quality of life.

Some Benefits to outpatient total knee replacement:

  • Lower infection rates
  • Recover in the comfort of own home
  • More Convenient
  • Cheaper

Outpatient surgery is an option because of less invasive surgical techniques, less blood loss, better pain control, and better anesthesia practices than were previously available. This allows people to be up and walking shortly after surgery. This is not a procedure that is appropriate for everyone, but through careful discussion with a fellowship-trained, Board Certified Surgeon, such as Dr. Kent Boese, a proper diagnosis and treatment plan can be decided.

 Many people will ask the same question about newer procedures, is it Safe?

Many different studies have found that in the proper candidate, outpatient is just as safe as inpatient knee replacement surgery. A lot of it comes down to ensuring the surgeon is a skilled, trained surgeon. Overall, most studies do not find a major increase of risk from inpatient to outpatient. It is important to address any concerns or complications before or after the surgery with the surgeon or nurse navigators to ensure a better outcome and recovery for the patient.

One important thing to note about outpatient procedures is they can turn into an inpatient procedure if needed. This means that after surgery if something is questionable in the post-op evaluation, the surgeon can request the patient to stay overnight to be monitored. This helps resolve unforeseen complications that may have arisen. The patient will have a careful evaluation to be cleared for discharge to be sent home, but even once they get home, it is extra important that the patient have someone around to help monitor them in the case of complications. Communication is very important throughout the entire process.

A nurse navigator is there to help both in and outpatient knee replacement patients. The nurse is there to guide the patient through any problems or questions that might arise before or after surgery. The nurse is there to help put the patient’s mind at ease while helping monitor their recovery status for all knee replacements.

One important thing to note when choosing outpatient surgery is that it is extra important for the home to be prepared prior to the surgery. Because there is less immediate supervision following the surgery, the patient needs to be sure to eliminate potential causes of slips, trips and falls in the home.

There are risks involved with all knee replacements, but there are also so many benefits to people being able to walk around and be more mobile than they have been in years. Outpatient knee replacements have patients up and walking by that afternoon and on their way to recovery. Choose a surgeon that can help prepare you, educate you, and get you back out doing the things you love.

If knee pain is keeping you from doing the hobbies you love then it’s time to schedule an appointment. We are here to help you, give us a call 712-323-5333 (Council Bluffs) or 402-991-9958 (Omaha) or click here to request an appointment.

Fri, 01 May 2020

Part 1: Return of the Athlete

Athletes and Injuries: Returning to Sports After COVID-19

Whether you’re a coach, parent of an athlete, or an athlete yourself, life without sports is tough. Sports fill so many roles in our lives. Beyond just filling up our schedules, sports are often a primary social source for people, an outlet for stress and energy, a source of self-esteem and accomplishment. In the past several weeks, many of those roles have been taken away from us; and while it’s all for very good reasons, it doesn’t make it any easier. But for most athletes, sports will resume. Kids will go back to their clubs, high schools will turn the lights on the field, weekend warriors will step onto the court once more. Many of us are looking forward to that day, but how are we preparing, especially those involved in highly organized and competitive sports at the AAU, high school, collegiate, and professional levels?

Many athletes, whether recreational or competitive, are attempting to stay in shape somehow: home workouts from coaches, streaming videos to the living room, or just getting creative with what you have available are all good options. But what if it’s not enough? What are the risks of returning to whatever field, court, or pitch on which you find yourself after not having practiced in your typical routine or intensity for several weeks? In a recent article on SI.com, Brian Burnsed discussed what we’ve seen in the past from situations that can be compared to our current experience with restrictions related to COVID-19:

“… athletes’ muscles and ligaments will need adequate time to recalibrate to their sports’ demands. After the 2011 NFL lockout that kept players away from team medical personnel and strength and conditioning coaches for four months, Achilles tendon tears leapt from an average of eight per season to 12 in training camp and the preseason alone, according to a study done that year. Similarly, a 2012 report found that NBA injury rates jumped after the league’s 2011 lockout, including a rash of ACL tears among stars like Derrick Rose, Ricky Rubio and Baron Davis. Nine players tore ACLs in the two years after the lockout, a figure that dropped to an average of a little more than two per year in subsequent seasons.” 1

ACL and Achilles injuries nearly always require a surgical repair and then a minimum of six months of rehabilitation, often closer to one-year. Any increase in risk to an injury like this should prompt many athletes to re-evaluate their training regimen and coaches to reconsider their practice and workout schedules for the first few weeks of practice with these athletes. Between limited offseason training, shortened pre-season practices, and potential alterations to competition schedules, few athletes will return to their respective sports under normal circumstances.

So, what can we do to minimize this risk of injury associated with extended time off?

  • Athletes
    • Do everything you can to stay in shape. Listen to your coaches and trainers. Try to maintain a sleep schedule. Eat well: poor quality protein = poor quality muscle. Go online and see what professional athletes are doing to workout. Use whatever random things you can find to load your body and maximize intensity.
    • Understand what this will look like: you normally work out at least five days per week in a high intensity and structured program – now say you’re working out three days a week at your own discretion. Most studies show a notable drop off in strength after three weeks of detraining. Maybe you can extend that number out a bit longer because you are doing something a few days a week, but we can all likely agree you will have some loss after eight or more weeks of isolation. Not only will you have strength loss, but muscle memory loss as well. It sounds silly, but your muscles will forget how to coordinate to jump/cut/sprint efficiently. So now you show up to practice and you’re weaker and uncoordinated. You fatigue a bit earlier in practice than you normally would, you get into a situation that requires max effort but your form is sloppy and your power fades, you plant your foot in the ground… That’s when injuries are most common and we didn’t even talk about the effects of detraining on ligaments, bones, etc.
  • Parents
    • Help your kids and encourage them to do the things listed above. That may look different in each house, but do what you can.
    • Keep an eye on your athletes as they return to sports. If they’re showing signs of pain or injury, talk to them about it. The likelihood is greater that an athlete may try to hide an injury because they’re already behind or there’s less time to earn that starting spot.
    • Don’t get stressed or upset if your athlete gets subbed out of a game more frequently or for longer stretches. The coach may be taking precautions to not overuse/overwork them early in the season.
  • Coaches:
    • I have seen many posts on social media encouraging athletes to do all they can to keep up their fitness. Keep contacting and pushing your athletes with this. Especially encourage high speed and high intensity training in athletes whose sports demand cutting, acceleration/deceleration, and jumping. (soccer, basketball, football, volleyball). These sports already carry an increased risk of injuries like ACL tears and these movements must be performed frequently to maintain proper mechanics, endurance, and muscle memory.
    • Realize your athletes will not return at the point they left off. In some way, even if it’s small, athletes will be behind where they normally would be at the beginning of the season. Their nutrition, sleep, and workouts have all been affected during this time and may mean you have to ease them in a bit more than usual.
  • Fans
    • We all want sports back, but realize these athletes will need time to prepare the right way. Give them time. Once things start to trend back to whatever normal might look like in the future, sports will not and should not instantly resume. Otherwise, you might see your favorite player sidelined for the next year or possibly their career.

The time will come, sports will return, you’ll be able to go back to the gym, but no one should expect it to be business as usual. In the coming articles, we will look at other areas of fitness beyond sports including running, weight management, and more.

Sources Cited:

  • Burnsed, Brian. “What Does the Coronavirus Do to an Athlete’s Body?” Sports Illustrated, Maven, 6 Apr. 2020, www.si.com/more-sports/2020/04/06/effects-of-coronavirus-on-athletes-bodies.


Thu, 23 Apr 2020

Everything You Need to Know About Endoscopic Cubital Tunnel Release

While Endoscopic cubital tunnel release might sound intimidating, it shouldn’t if you have a great orthopedic hand doctor. It is a minimally invasive, surgical technique that uses cutting-edge technology. This is a surgery used to treat cubital tunnel syndrome, also known as ulnar nerve entrapment at the elbow. 

The cubital tunnel is located behind the bony bump on the inside of the elbow. When someone does Endoscopic cubital tunnel release, they are trying to decompress the ulnar nerve, where it passes through the cubital tunnel. This is essentially to give the nerve more space. Similar to carpal tunnel, the tunnel-like structure that is the cubital tunnel can sometimes pinch the ulnar nerve. This nerve controls the sensation to the pinky and ring fingers as well as the hand and inner side of the forearm. This compression makes hands and arms to often begin to feel a numb and tingling sensation. Sometimes, beyond just numbness and tingling, the compression of the ulnar nerve can affect the gripping and motor skills of the hand, due to the small muscles attached. It will often feel like it does when someone hits their funny bone really hard because the ulnar nerve is the thing otherwise known as the funny bone.

Signs of cubital tunnel syndrome:

  • Pain on the inside of the elbow
  • Numbness, pain or tingling in the hand
  • Feeling like the pinky has fallen asleep, especially when the elbow is bent.
  • Loss of muscle mass in the hand (muscular atrophy)
  • Lack of coordination and weakness in fingers
  • Difficulty gripping things, especially with the ring and pinky fingers

If your condition is keeping you from being able to do everyday activities, surgery is often suggested. It is best to see a specialist for this, such as Miller Orthopedic’s hand doctor, Dr. Caliste Hsu. She is trained in this type of surgery. The first step in the surgery would be making a very small incision behind the bony bump in the elbow. This is followed by taking a couple tools, such as retractors, and putting them in the incision to help locate the ulnar nerve from the other nerves. Then a small camera on a tube is put into the incision, this is the portion that makes the procedure endoscopic. The camera allows the surgeon to see inside to determine the best way to decompress the ulnar nerve and then stabilize it. Once it is determined that the nerve and elbow are stable, the surgeon removes the tools and stitches the patient back up. The camera allows for the surgeon to see what cuts are being made without having to make a large incision, such as what is required when doing open cubital tunnel release. Patients can often return to work in about a week following the surgery. Keep in mind that this can vary based on the line of work and what is required for their occupation.

The minimally invasive method is important for a faster recovery because of less scarring, pain, and swelling than other methods of cubital tunnel release. Sometimes, after this surgery, it does take a decent amount of time to for the person regain all of the previous sensations they once felt.

Some advantages of endoscopic versus open cubital tunnel release:

  • Smaller incision
  • Less pain post-surgery
  • Smaller scar
  • Quicker recovery
  • Less pain and trauma to tissues and in surgery

Most patients who qualify for open cubital tunnel release also qualify for endoscopic cubital tunnel release. So, if you want relief from your cubital tunnel syndrome with less pain and less recovery time, come in and see Dr. Caliste Hsu, today!

Tue, 18 Feb 2020

Jumper’s Knee

free sports injury clinic

Jumper’s knee is a condition that involves an inflamed patellar tendon. This is why it is also called patellar tendonitis. The patellar tendon is the tendon that connects the kneecap to the shin bone. This is a condition that gradually weakens the tendon and can eventually lead to muscle tears if left untreated.

Jumper’s knee arises from overuse in the joint. This is often from sports that require a lot of jumping on hard surfaces. The constant jumping and force of the leg hitting the ground causes strains and stress to the tendon. If left untreated, the condition usually worsens.

It is important if you think that you have jumper’s knee to go see a specialist. They can help diagnose and come up with a treatment plan to prevent the condition from worsening. Some symptoms include:

  • Pain under the knee cap
  • Swelling
  • Bruising or redness
  • Leg or calf weakness
  • Pain when bending
  • Stiffness when squatting, kneeling, or jumping

Once someone with this condition comes in and is diagnosed with “jumper’s knee” there are a few ways it is often treated. The biggest thing doctors typically say is to take a break from the sports or activities that caused the injury.

Tips on treatments for the condition:

  • Rest
  • Ice
  • Compression (taping, wraps or straps just under the knee cap)
  • Ibuprofen or other pain relieving, swelling reducing medicine
  • Physical Therapy (this can be at home or with a physical therapist to start to know the best exercises and strategies for each individual)

It is important to note that sometimes, when the condition is not treated or the person does not rest the knee to allow it to heal, it can worsen. In some situations, surgery can be required. This is another reason why it is crucial to come in and see a doctor when you start exhibiting symptoms. It is also always a good idea to see a physical therapist upon diagnosis to help provide some guidance on the best way to get you back in the game more quickly.

Miller Orthopedic Specialists offers a free, walk-in sports injury clinic in Council Bluffs from 10:00 – 11:00 a.m. and by appointment in Omaha. The initial consultation is free, but extra will be charged for x-rays, supplies, or follow-up visits if needed. This is a great opportunity to come in and see a specialist to get peace of mind without having to pay a hefty doctor bill. Your specialist can also provide input on what activities you are able (or unable) to participate in. Getting a general timeline and advice on what to do while recovering can make the recovery go more smoothly.

Contact us today for more information or to schedule your FREE* consultation. 

Wed, 29 Jan 2020

If the Shoe Doesn’t Fit, Don’t Wear It

Podiatry in Omaha & Council Bluffs

Some people choose their shoes because they like the style or color. Other people choose their shoes because they fit the requirements by their job. Then, there are the people that choose shoes based on the comfort and support provided. A combination of these things can often contribute to the choosing of shoes. However, many people do not realize the importance of properly fitting footwear.

When choosing shoes is it important to look for a few things. Some people do not know not know why the fit of a shoe really matters. Improperly fitting footwear is a common cause of foot and ankle injuries. They can also further exacerbate other health conditions that are common. Seeing a podiatrist to assist in the process of choosing properly fitting footwear is also a great idea. It will help eliminate some of the guess work for what kind of shoes to get.

Proper Shape

First, it is important to choose shoes that take the natural shape of the foot. The heel should not be slipping around and the ball of the foot should fit into the widest part of the shoe. Pointed toes often cause the foot to be squished into the shape of the shoe, which is not good.

Signs Your Shoes Don’t Fit

  • Pain and discomfort
  • Callouses
  • Blisters
  • Bruising on toenails
  • Skin irritation (especially around toenails)
  • Bruising on the tips of toes

Here are some tips when going to the store to buy footwear:


  • Keep heels less than 2 ¼ inches tall. Too high of a heel can put unnecessary pressure on the ankle and balls of the feet that can cause injuries over time.
  • Consider shopping at the end of the day after walking around. This means your feet are more swollen than usual, and thus it is easier to be sure the shoes still fit, even with swollen feet.
  • Make sure the shoes are not ones that have to be broken in later. Walk around in them some to make sure they are comfortable both walking and standing.
  • Remember that not all shoes fit the same way, so do not rely solely on size, and be sure to try on both shoes to ensure they do not only fit one foot properly.

Another thing to consider if foot pain persists no matter what type of shoe, is a custom orthotic. Many people think it is only important to get orthotics if they have a specific condition such as plantar fasciitis, arthritis or diabetes. However, custom orthotics are a good idea for most people. A custom orthotic will help provide the kind of comfort needed for the individual. A certified podiatrist would be best suited to help each individual find the orthotic that works best for each individual’s feet.

Shoes and orthotics cannot solve everyone’s foot problems. They can help reduce some of the pain, but it is important to see a podiatrist to understand what things are causing the issues. Podiatrists can help devise a diagnosis and treatment plan to help reduce foot pain or injuries. Dr. Panesar is a Board Certified Podiatric Surgeon who can provide advice on what kind of shoes or orthotics would work best for each individual, and he can determine whether the problem goes deeper than just improperly fitting shoes.  Even if a custom orthotic or shoe is not ordered, a podiatrist can help provide recommendations for things to avoid or to purchase in order to help avoid any further foot problems that might occur from improperly fitting shoes.


Do you have pain in your feet? Our podiatry doctor is here for you. Click here to Contact us today for a consultation. 


Mon, 23 Dec 2019

Hip Pain May Not Be Because of a Hip Problem

 If you are experiencing hip pain there could be a variety of things impacting it. Sometimes, the hip pain is due to something wrong in the hip, other times it is a deeper, different problem all together. The following injuries could be causing your hip pain. 

hip pain and joint replacement


Many times, hip pain is due to a hip injury, such as a fracture. Fractures of the hip are more common as people get older. Often, hip fractures happen in conjunction with falling. The risk of falling is increased in the icy winter, so it is always important to be careful and to remember to walk like a penguin on the ice.


Arthritis is another big factor in causing hip pain. When arthritis hits in the hip, physical therapy is often ordered to help strengthen the muscles around the joint. A joint replacement is often needed once the more conservative treatment options have failed.


One other common cause of hip pain is bursitis, which stems from an inflammation of fluid-filled sac or the bursa. These sacs help cushion tendons, muscles and ligaments. Thus, when they swell it can cause a lot of tenderness and pain. Not all hip pain stems from an issue within the hip, sometimes it is something different.


Another reason one might be experiencing hip pain is sciatica, the inflammation of nerve roots from the spinal cord. Often times, this causes hip pain and pain that shoots down the leg. Sciatica can occur because of a variety of reasons such as spinal stenosis, which is often from osteoarthritis, spasms in the lower back, or bulging or ruptured disks. This pain, despite often occurring in the hip, is actually from an issue in the spine.

Peripheral Neuropathy

The sciatic nerve is not the only nerve that can become inflamed and pose as a hip problem. Peripheral nerves are another set that, when inflamed, can cause hip pain. This is often caused in pregnancy, but there are other triggers for it as well, including diabetes and too tight of clothing.

Receive a Proper Diagnosis Today

A proper diagnosis is crucial when trying to take care of hip pain. For instance, if someone were to get a cortisone shot in their hip, but the issue is a ruptured disk in their back, then the injection is not going to do a ton of good. Proper diagnosis is important to know the proper treatment plan. It can help people know what exercises might help or hurt their condition. It is also important for the patient to know if there is a deeper underlying condition that could be more serious of an issue than they originally anticipated.

If you are experiencing hip pain, come in and see one of our total joint doctors or come see our spine specialist if the pain is running through your back or leg as well. They can help provide a proper diagnosis and determine the root cause of the condition. This will help them work with you to come up with an individualized treatment plan to best address your pain. 

Contact Miller Orthopedic Specialists today for your individualized treatment plan for your hip pain today!


Wed, 13 Nov 2019

How to Treat Your Spine Better

spine doctor in Omaha & Council Bluffs

It is estimated that 80 percent of adults will experience back pain at some point in their lives (National Institute of Neurological Disorders and Stroke). There are a lot of factors that can lead to people experiencing back pain.

Age and Weight

Age is something that often leads to an increased amount of back pain. When people get old, their body often gradually starts to wear out. Thus, it is important to try to limit the breakdown of the body by staying as healthy as possible. Weight is an added stress to the spine, which often leads to back pain. Maintaining a healthy weight is a good way to minimize some of that potential pain.

Job Strain

Some people have a lot of physical strain in their jobs. Employees who have a lot of lifting and twisting will often lead to back pain. However, people who sit at a desk all day without adequate back support will often eventually start to feel the pain too. It is important to remember to stretch and walk around to give your spine a break if you are constantly sitting down all day or straining your spine.


Many people think that as long as they get out and exercise that it can limit their back pain. While exercise is important, it is important to be careful. Many “weekend warriors” do not exercise during the week and then do the strenuous activity on the weekend, which can cause pain to the spine. It is important to remain active throughout the week as well. Swimming is often a good option for those already suffering from back or neck pain. Also, always remember to stretch before and after to help reduce extra muscle tension and improve mobility.

Proper Lifting

People constantly hear the phrase, “Lift with your legs, not your back.” However, many people do not really know what that means. Be sure to stand as close to the object as possible. With bended knees, make your arms level with the top of the item. Then, be sure to keep your back straight and head down. Some things might be harder to do this with than others, so do not be afraid to ask for help. These tips will help limit some awkward twisting or pulling of your spine that often occurs with the improper lifting of objects.

How You Sleep

How people sleep can have an impact on back pain too. It is not only a matter of how one lays but making sure to get enough sleep so the whole body may be well-rested is important. Sleeping on one side is typically considered better than sleeping on the stomach. This method reduces some of the pressure on the spine that occurs when someone is on their stomach. It is recommended to have a pillow between the legs for this method, to increase support. It also can help with breathing and apnea, which often force people to awaken in the night. The more people are awake during the night, the less rested they will be in the morning.

Sleeping on one’s back with proper support under the knees to help with the natural curve of the spine is typically considered the best sleeping position for a healthy spine. Having proper neck and back support with pillows and mattresses are also important in helping with back pain. However, if people already have some back conditions, like a herniated disc, for instance, then a specialist might suggest a different sleeping position to help reduce pain and to open the spinal joints.

Stay Hydrated

One simple thing that can help maintain a healthy spine is staying hydrated. This is a small thing that can help the disks in the spine maintain their height, which minimizes the chance of bulging disks and lessens the pressure on the spine.

Contact a Specialist

It is good for someone to see a specialist if they have back pain. Spine specialists can help come up with a customized treatment plan to help diagnose the current issue, find methods to reduce pain, and give suggestions on other ways to prevent some future back pain.

Dr. Ricart is a Board Certified, fellowship-trained spine doctor. He is fluent in both Spanish and English and is accepting new patients in both Omaha and Council Bluffs. If you’re having issues with your spine then maybe it’s time to give Dr. Ricart a visit!

Contact Miller Orthopedic Specialists to have our specialists help relieve your back pain!

Mon, 14 Oct 2019

Treatments for Osteoarthritis in the Hand

hand arthritisOsteoarthritis is a common cause of hand pain. This disease is one of the most common forms of arthritis. This is a very common reason people experience pain or stiffness in their hands. Osteoarthritis is a form of degenerative arthritis, meaning the cartilage is being broken down due to the rubbing of bones on other bones. This often causes pain, inflammation, decreased range of motion, and stiffness.

If you are experiencing osteoarthritis there are a few things you can do to help ease that pain in your hands. Different things work for different people, so it is important to note that not everything will provide relief for all.


Hand exercisesExercise is one thing that can help ease the pain. This is something that might be painful during, but it can help build up those muscles around the arthritic joints. Maintaining daily range of motion is very important in helping with arthritis. This can help minimize some of the stiffness and help gain some strength in the hands that otherwise might dissipate as the arthritis progresses. So it is important to do various squeezing and stretching exercises every day.

Ice and Heat

Moist heat is another option that can help with some of the stiffness or pain. This is something that can be really good before a lot of use in the joints, such as first thing in the morning. Icing arthritic joints at the end of the day or activities can help. It is important to only ice or heat them for no longer than about 20 minutes at a time. These are both simple, inexpensive ways to help relieve some pain.

Cortisone Injections

Cortisone injection is often a treatment method for those with Osteoarthritis. This can help patients regain some range of motion and reduce some pain. It is important to note that this does not always work for everyone.

The things listed above are just a few common, non-surgical methods used to help relieve some pain caused by arthritis in the hand. These are good things with which to start once diagnosed with osteoarthritis in the hand. However, these are not cure-all options and many times patients eventually need something more.

Orthopedic Surgery

While these treatments can help the process slow down and relieve some pain, osteoarthritis is currently a disease without a cure. Many people will look to surgeons to help assist them when they need more help than what they can do at home. Surgery is an option that is used once the conservative treatment methods have failed. The goal of surgery can vary. Some include:

  • Restoring as much function as possible
  • Eliminating or minimizing pain to a tolerable level
  • Reconstructing joints
  • Fusing of joints

When needed, hand and finger joint replacement surgery can be done, similarly to how knee and hip replacements are done for arthritis.

Contact a Hand Specialist at Miller Orthopedic

If you are experiencing hand pain, visiting a hand specialists who can provide a proper diagnosis and treatment is important. Dr. Hsu is a hand surgeon who is fellowship trained and Board Certified. She can help work with patients experiencing hand pain or arthritis. Through a thorough examination, Dr. Hsu will come up with the best treatment plan for each individual patient.

Fri, 27 Sep 2019

Physical Therapy as a Treatment for Lower Back Pain

Guest article from Dr. Brent Wells

If you suffer from lower back pain, you’ve probably already searched for ways to help treat it. While there are various natural methods, sometimes they might not always work, especially if you have severe pain. However, there is one treatment to consider: physical therapy.

Physical therapy is not only a great holistic option, but provides incredible results. It usually will not only stop your pain, but also help your overall well-being. This article will explore more behind why physical therapy is a helpful treatment for lower back pain. You’ll also discover some techniques your physical therapist might use to help you.

What is Low Back Pain?

Low back pain is when the muscles around the lower portion of the back are either injured or sprained in some way. Low back pain can also be caused by a type of injury or disease to your spinal cord which results in tingling nerves or severe inflammation. If not treated, low back pain can lead to less mobility and other health issues.

What Causes Lower Back Pain?

There are a few things that can cause lower back pain. This includes:

Why Physical Therapy is an Ideal Treatment for Lower Back Pain

If you’re looking for a way to help treat your lower back pain without the use of surgery, physical therapy is ideal. This is because it works to:

  • Lower your pain levels
  • Increase mobility and flexibility
  • Help restore strength to your body

These are just a few of the many benefits that physical therapy will offer for lower back pain sufferers. In fact, many physical therapists will work to teach you how to deal with any painful flare-ups that might occur after your sessions. This can help to keep you calm while also reducing your pain.

Physical Therapy Techniques to Help Heal Lower Back Pain

There are many different techniques that a physical therapist will use to help heal lower back pain. Below are some you’ll find if you decide to use this form of therapy.

❏  They Will Use Various Modalities

Many physical therapists will encourage the use of modalities. This includes using cold or heat compresses, ultrasounds, and TENS (transcutaneous electrical nerve stimulation) therapy. These will work to naturally encourage your nerves to calm down while also reducing inflammation.

Depending on your needs, your therapist might recommend you use more intense versions of modalities for relief. Below is more information about these helpful modalities.

❏  Cold/Heat Compresses

Many physical therapists will ask you use to cold or heat compresses on your lower back. This is because this treatment can help to significantly calm down irritated sections in your body causing your pain.

Cold compresses will help to reduce swelling and inflammation. Heat compresses will help to release tight muscles and stop tension. Because of this, both of these can be very helpful when it comes to treating your lower back pain.

❏  Ultrasounds

Ultrasounds are a very helpful way to treat lower back pain. They will emit vibrations in the area where the ultrasound device is placed. This then works to release soft vibrations and heat to the area which helps to loosen the muscles in it. There have been a few studies which have shown that ultrasounds can help with lower back pain. They also can work to improve flexibility.


TENS therapy uses electric currents to encourage nerve stimulation. The TENS therapy machine is a very small device that is connected to electrodes. These electrodes are then placed on your body with a sticky tape. Once they have been applied, your physical therapist will turn the machine on. It will then start to release soft electric currents.

Depending on your needs, your physical therapist will either lower or increase the electrical impulses. You’ll need to have a few of these sessions done in order to have long-lasting results.

❏  Back Pain Exercises and Stretches

Back pain exercises and stretches will also usually be implemented into a treatment plan for you. This includes doing lumbar strengthening stretches (such as knee-to-chest ones) or various types of easy aerobic activities like walking and swimming. These exercises and stretches will usually be customized by your physical therapist depending on your needs.

❏  Spinal Manipulation

A few physical therapists might also implement common chiropractic techniques, such as spinal manipulation. This includes moving and adjusting your spine to help realign it. The movements will also encourage the reduction of inflammation around your spinal cord.

By doing these manipulations, it will also cause your body to release endorphins. These natural pain-killers can help to reduce lower back pain. Most sessions last only a few minutes and eventually can lead to the complete elimination of lower back pain.

❏  Deep Tissue Massage Therapy

You might be surprised to learn that many physical therapists also offer massage therapy services. Many physical therapists have seen the incredible impact that a deep tissue massage can have on lower back pain. This is because it helps to release tension and strain around the muscles near your spine. Because of this, it can help stop inflammation, calm irritated nerves, and even boost your immunity.

Massage can also help to encourage more flexibility in your body. This can help to not only reduce your lower back pain, but encourage you to be more active.

Most massage sessions will last for about an hour. They will involve various techniques depending on your needs. Some that your therapist might use are QL muscle massage and gluteus medius massage.

Physical therapy is an excellent treatment to use when it comes to naturally healing lower back pain. Your physical therapist will use various techniques, such as exercise and massage, to help provide you with relief. These treatments not only help to decrease and eventually eliminate your pain, but improve many other aspects of your health as well.

About Dr. Brent Wells

Dr. Brent Wells, D.C. founded Better Health Chiropractic & Physical Rehab in Alaska in 1998 and has been a chiropractor for over 20 years. His practice has treated thousands of patients from different health problems using various services designed to help give you long-lasting relief.

Dr. Wells is also the author of over 700 online health articles that have been featured on sites such as Dr. Axe and Lifehack. He is a proud member of the American Chiropractic Association and the American Academy of Spine Physicians. And he continues his education to remain active and updated in all studies related to neurology, physical rehab, biomechanics, spine conditions, brain injury trauma, and more.


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