Health Tips

Torrance Orthopaedic & Sports Medicine Group
Orthopedic Doctors
Physical, Hand & Aquatic Therapy

Two locations:

23456 Hawthorne Blvd.,
Suite 300
Torrance, CA 90505-4716

El Segundo

Phone: 310-316-6190
Fax: 310-540-7362

By Date: Current | 2016 | 2015 | 2014 | 2013 | 2012

By Topic: General Orthopedics | Neck, Back & Spine | Shoulder, Elbow & Upper Extremity | Hand, Wrist & Forearm | Hip & Pelvis | Knee & Upper Leg | Foot, Ankle & Lower Leg

December 29, 2014
Tennis Elbow Develops Gradually

This is a painful condition almost always caused by overuse, commonly in sports such as tennis but also among anyone stressing a particular forearm muscle—the extensor carpi radialis brevis (ECRB)—repetitively. Plumbers, painters, cooks, carpenters, auto workers, and cooks are all at a higher risk of developing tennis elbow than the rest of the population. Those between the ages of 30 and 50 are diagnosed most often, but anyone can get it.

Because the ECRB tendon gets inflamed and/or damaged, symptoms include burning or pain along the outside of the elbow and a weak grip, especially when doing the activities that caused the condition. A weak handshake is also common.

An orthopedic doctor specializing in the hand and elbow areas is best qualified to diagnose tennis elbow. He or she will perform a physical exam, use imaging, and sometimes electromyography (nerve testing) to arrive at the correct diagnosis.

Most people get relief from tennis elbow without surgery. A combination of treatments such as rest, physical therapy, anti-inflammatory medications, activity modification (correcting an improper tennis stroke, for example), equipment modification, bracing, and steroid injections may help. An orthopedic doctor may recommend surgery if these treatments do not return a patient to health within a reasonable amount of time. Surgery can almost always be done on an outpatient basis.

December 19, 2014
"My leg hurts and my kneecap is drooping!"

The quadriceps muscles are located above the knee in the front of the leg. One of the most powerful muscles in the body, they are critical to good performance in running and jumping sports. This also makes them vulnerable to injury through overuse, sudden, forceful movement, and weakness due to other health problems. Middle-aged people who run or jump during exercise are most commonly affected. Not warming up or cooling down properly also contributes to this type of injury.

There are many different symptoms of a quadriceps tear, including a drooping kneecap. Patients usually feel pain and hear a popping sound at the time of the injury. Swelling, cramping, or bruising may occur. It may be hard to walk if the knee is buckling, and it may not straighten all the way.

Quadriceps tears can be small and partial or severe and completely torn away from the knee. Keeping the knee in a brace and using crutches is often enough to treat a small tear. Severe tears usually require immediate surgery. No matter the severity, an orthopedic doctor can create a recovery plan to return you to health and sports. Your goals and lifestyle will be considered carefully by the doctor.

December 8, 2014
Foot Pain: How does a previous orthopedic injury lead to arthritis?

Foot pain can be caused by a number of problems, but osteoarthritis, brought on by general wear and tear and aging, is the most common cause. That's because as we get older, our bodies don't repair cartilage as fast. Obesity and family history are also factors in the onset of osteoarthritis. Pain, tenderness, swelling, stiffness, reduced range of motion, and trouble walking as a result are the most noted symptoms.

Because the foot and ankle are such complex areas—28 bones and 30 joints in a very small space—they can be vulnerable to injury throughout our lives. Once a joint is injured, the body can actually secrete hormones into it that cause the cartilage to deteriorate several times faster than the normal rate, bringing on arthritis symptoms. This is called post-traumatic arthritis. It can happen to people earlier in life than osteoarthritis, especially if their injury happened when they were young.

Treatment for arthritis of the foot and ankle varies. Conservative therapies such as anti-inflammatory medications, custom foot orthotics (shoe inserts), custom shoes, injections like cortisone or joint lubricants, activity modification, and physical therapy are effective for most patients. An orthopedic foot doctor and can correctly diagnose and create a tailored treatment program appropriate for a patient's particular symptoms. Earlier treatment may prevent or prolong the onset of more severe symptoms, which may warrant surgery. There are different surgical options, depending on how the arthritis has affected the area.

December 1, 2014
"My shoulder pain is getting worse!"
When Shoulder Replacement Becomes an Option

When shoulder pain keeps you from doing a favorite sport or activity, sometimes taking a break or trying something new is best. An orthopedic doctor may also recommend physical therapy, injections, ice, or medications that reduce inflammation. But shoulder pain that's still getting worse and starts to keep you from everyday activities such as reaching into overhead cabinets, caring for yourself, or sleeping well should send you back to the doctor.

Patients with this severe type of pain may be candidates for shoulder replacement surgery. There are many reasons shoulder replacement is an option. Arthritis caused by aging, injury, or inflammatory conditions can lead directly to the destruction of the shoulder joint. Trauma that shatters the bones in the shoulder joint or issues that disrupt the blood supply to the bones may also compromise the joint beyond the scope of conservative treatments.

The decision to have shoulder replacement surgery is made by the patient and patient's family. It's based on the orthopedic doctor's thoughtful recommendation after careful study of the patient's current health problems, health history, imaging and other test results, and when appropriate, consultation with the patient's other doctors. The goal is to get the patient as free from pain as possible and back to doing what they love to do.

Because the shoulder is a very complex joint, many patients opt for a board certified, fellowship trained surgeon who specializes in shoulder problems. The shoulder doctors at Torrance Orthopaedic & Sports Medicine Group are trained in the most current minimally invasive shoulder replacement techniques. This is key to helping speed recovery and reducing any risks during and after surgery.

November 25, 2014
When are injections the best choice?

There are three types of injections commonly used in orthopedic medicine:

• Cortisone is a steroid injection that is used to relieve more severe pain for those with symptoms of advanced osteoarthritis or another chronic condition or injury. A single cortisone injection can give anywhere from weeks to months of pain relief. A series of injections can be given. Patients who do not respond to cortisone may be candidates for surgery.

• Lubricant injections are for those with mild or moderate joint pain where the natural lubricant is no longer working optimally. These types of injections are made from hyaluronate, which is found in rooster combs and is very similar to the substance already naturally occurring in human joints. It's marketed under brand names such as Synvisc and Euflexxa. Lubricant injections are often given with long-term joint protection as a goal, before the joint is too degraded.

• PRP (platelet rich plasma) injections are used to speed up healing after surgery, or for an injured area that did not require surgery. PRP is made by taking the patient's own blood, spinning it in a centrifuge, extracting the healing cells, and re-injecting them in concentrated amounts into the same patient's damaged body part. It's been used successfully in a variety of patients. Athletes who need to return to their sports quickly are often good candidates for PRP injections.

November 13, 2014
Hip Pain: Causes Can Begin in Childhood

Not all hip pain is associated with arthritis. FAI, or femoroacetabular impingement, is a condition where the hip bones form in an abnormal shape during childhood. The hip is a ball and socket system with cartilage between the bones. With FAI, there is extra bone on the ball, socket, or both. It wears down the cartilage and eventually can become painful.

Who gets FAI symptoms?
1) Many people with FAI don't feel pain for decades after their hips have formed
2) Some people never have pain
3) People with FAI who are extremely athletic can develop symptoms from the teenage years on

How is FAI pain treated?
Conservative treatments include activity modification, physical therapy to strengthen the hip muscles, and anti-inflammatory medications. If those treatments do not work, hip arthroscopy surgery may be necessary. During the surgery, the orthopedic surgeon's goal is to trim and reshape any bone deformities and repair damaged cartilage.

November 7, 2014
Heel Pain That Won't Go Away

Our heels bear many tons of weight for every mile we use them. They're well-suited to this: protected with fat pads, thick skin, and shored up by the Achilles' tendon, one of the toughest tendons in the body. When the heel is injured, it needs special attention because we depend on it so much.

Depending on whether the pain is under or behind the heel, an orthopedic doctor can tell what the most likely course of treatment should be. The key is paying attention. If your heel pain isn't going away, it's time to see the doctor. The right diagnosis and treatment greatly increases the chances of the pain subsiding and not turning into a more serious chronic condition.

Your doctor will thoroughly examine your heel and may ask you to stand or walk in certain ways in order to properly diagnose your injury. Common treatments are rest, activity modification, stretches, shoe inserts, ice, and anti-inflammatory medications, depending on the specific problem you have. Surgery is rarely necessary.

November 6, 2014
Hand Pain and Numbness: Carpal Tunnel Syndrome

Carpal tunnel syndrome happens when the tissues in the wrist swell and put pressure on the median nerve running into the hand. Feelings of numbness and tingling in the hand, a sharp "shock" feeling in the thumb and adjacent fingers, pain that travels up the arm, and muscle weakness at the base of the thumb are the most common symptoms.

Heredity is an issue with carpal tunnel syndrome because wrist anatomy contributes to symptoms. So if your closely related family members have it, you have a greater chance of also developing it. Repetitive use of stretching and flexing the wrists and hands can also cause the condition, as can hormonal changes during pregnancy, a wrist fracture, and certain chronic or inflammatory medical conditions such as diabetes, rheumatoid arthritis, and thyroid problems. Carpal tunnel syndrome is most common in older patients.

Other conditions can cause some carpal tunnel syndrome-like symptoms, so it's important to see an orthopedic doctor, preferably one specializing the hand and arm area, to get the correct diagnosis. The doctor will get your medical history, do a thorough physical examination with tests, and sometimes take x-rays.

Carpal tunnel syndrome usually gets worse without treatment. If caught early, non-surgical solutions like hand therapy, bracing, splinting, anti-inflammatory medications, activity modification, and injection therapy may be sufficient. More advanced or severe cases may require surgery.

October 31, 2014
Heel Pain That Won't Go Away

Our heels bear many tons of weight for every mile we use them. They're well-suited to this: protected with fat pads, thick skin, and shored up by the Achilles' tendon, one of the toughest tendons in the body. When the heel is injured, it needs special attention because we depend on it so much.

Depending on whether the pain is under or behind the heel, an orthopedic doctor can tell what the most likely course of treatment should be. The key is paying attention. If your heel pain isn't going away, it's time to see the doctor. The right diagnosis and treatment greatly increases the chances of the pain subsiding and not turning into a more serious chronic condition.

Your doctor will thoroughly examine your heel and may ask you to stand or walk in certain ways in order to properly diagnose your injury. Common treatments are rest, activity modification, stretches, shoe inserts, ice, and anti-inflammatory medications, depending on the specific problem you have. Surgery is rarely necessary.

October 16, 2014
A "Slipping" Elbow

When an elbow joint has become unstable, it may feel like it's sliding out of place, or it may pop or feel like it catches when moving it in certain ways. Previous elbow surgery, an elbow deformity, or in most cases, a fall on an outstretched hand are the most common causes of elbow instability.

An orthopedic doctor is well-equipped to properly diagnose elbow instability. During an exam, he or she will typically:
• Take a medical history
• Ask about any falls or physical trauma
• Move the elbow in many directions, looking and listening for various symptoms
• Test arm strength
• Rule out nerve damage
• Rule out conditions other than elbow instability

It's common for the orthopedic doctor to take an x-ray because they are so effective at showing subtle misalignments, fractures, and dislocations. An MRI is not always necessary to properly diagnose elbow instability, but if the doctor determines he or she needs a closer look at the elbow's surrounding soft tissues, the MRI will enable that.

Most cases of elbow instability can be treated with a nonsurgical prescription of physical therapy, medications, activity modification, and/or bracing. If there is a fracture or severe soft tissue injury, surgery is usually required. Athletes with less severe instability but who need to perform at high levels may require surgery to get them back to full function.

October 10, 2014
CSI Knees: Orthopedic Style

Why should you go to an orthopedic doctor when you're having knee pain? The knee is like a puzzle. It's a complex structure that needs a thorough examination before the right diagnosis and treatment can be given. Knee pain can be caused by flat feet, incorrect exercise form, spine misalignment, muscle imbalance and defects, arthritis, bone fragments, cartilage tears, tendon tears and ruptures, disease…the list goes on. It matters whether the knee is achy or if sudden pain is involved or both. Pain can be in the back, side, front, top, or bottom of the knee. It can feel deep or closer to the surface.

Each piece of information matters to an orthopedic doctor. MRI scans and x-rays can give clues, but they don't always tell the whole story. It's the combination of a thorough exam, which includes your medical history, activities, and overall health, plus high quality imaging, plus your orthopedic doctor's training and experience in treating thousands of patients before you, that will get you the right diagnosis and treatment. Once all of the clues to your problem have been scrutinized carefully and correctly, your recovery prescription will be custom-tailored for you.

October 7, 2014
Walkers & Teens: Protect your hamstrings...

While anyone of any age can strain or tear a hamstring (back of the upper leg) muscle, people who are older and do walking as their primary exercise are especially vulnerable. Over-striding in combination with the muscle imbalance that can come from a single-sport regimen can be a setup for injury.

A hamstring injury happens when the muscle is suddenly forced to contract while it's stretched out and bearing a lot of weight, such as body weight plus the force of sudden motion. Activities like sprinting, basketball, football, soccer, and dancing put athletes at risk. Teens are also more at risk because their muscles are still growing and the hamstrings and quadriceps (top front leg muscles) don't grow at the same rate. This muscle imbalance can put extra strain on the hamstrings.

Dynamic stretching warm-ups and regular stretching cool-downs can help keep the hamstrings free from injury, as well as strengthening exercises and being mindful not to over-stress the muscles when they are fatigued.

Hamstring injuries are painful when they first occur, causing sharp pain in the back of the leg and, when the injury happens while in fast motion, the need to hop on the other leg or even fall to the ground. Swelling, visible bruising, and weakness often follow.

Most people are able to heal from a hamstring injury without surgery. The RICE (rest, ice, compress, elevate) method, medications, physical therapy, and sometimes knee bracing are usually enough for full healing. Surgery is usually necessary when the hamstring pulls completely away from the bone or the muscle has a severe tear.

Once a hamstring injury occurs, it is more likely to happen again. Early treatment increases the likelihood of a full recovery, so see a doctor right away if you think you may have a hamstring injury.

September 26, 2014
POP QUIZ: Which toe gets broken the most?

Nearly a quarter of all the bones in the body are in the feet. These small bones bear body and impact weight with every step and jump. They can fracture after too much direct and repeated stress. The pinky-toe metatarsal/phalanges (forefoot/toe) bones are most commonly fractured. (Did you guess correctly?!)

Symptoms include sharp pain, swelling, and tenderness over the metatarsal bone. There's a catch, though—many X-ray images do not detect a stress fracture unless it's displaced. More sensitive types of imaging are required for detecting these small fractures. If you have any symptoms of a toe fracture, see an orthopedic doctor right away for the most accurate diagnosis. Because they're so experienced at knowing what to look for and what imaging tests to conduct, they're mush more likely to find a fracture if it's there.

Letting a toe fracture go untreated can result in pain for a longer period, improper healing, and make you vulnerable to a more serious fracture.

Treatment for most toe fractures includes wearing non-weight bearing boots, immobilization, or surgery. Surgery is only necessary for displaced fractures. Prognosis is good to excellent in most cases.

September 18, 2014
"My shoulder feels 'loose'!"
Shoulder Dislocation and Instability

Athletes or anyone who performs overhead repetitive motions with their arms can be vulnerable to shoulder problems like dislocation (ball pops out of the socket) or instability (shoulder joint moves slightly in and out of the socket), feeling "loose." Volleyball players, swimmers, racquet sport players, baseball players, and double-jointed people are especially prone to these conditions. Trauma victims can also get these types of shoulder injuries. Once instability or dislocation happens, it's more likely to happen again because the tendons and ligaments around the joint have been stretched beyond the normal range or damaged. Nerve damage can also occur.

Instability symptoms may include:
• Joint feeling like it is moving around too much
• Pain
• Swelling, numbness, weakness, and bruising

Dislocation symptoms may include the above, plus:
• Severe pain while the joint is dislocated
• Observing that the ball of the joint is not in its socket

A shoulder can become dislocated in a forward, backward, or downward direction. If you pop the shoulder back into joint yourself, tell your doctor which direction your dislocation happened in, and whether you have dislocated it before.

Your orthopedic doctor will do a thorough physical examination and take images of your shoulder to find out how damaged your shoulder is. Once that's clear, he or she will design a treatment program to get you back to health. In most cases this will involve one or more of the following: temporary or permanent activity modification, anti-inflammatory and/or pain medicine, injections, and physical therapy. More severely damaged shoulders may require surgery to repair tendons and structures that cannot be rehabilitated by conservative treatments.

September 11, 2014
Protect Your Joints with These Healthy Foods

Joints get worn out from all the activities we do. But eating a healthy diet can slow the natural cartilage degeneration that happens with age and overuse. Here are some super foods that can help:

1. Nuts high in vitamin E (almonds, sunflower seeds, hazelnuts, peanuts) defend against free radicals, which destroy healthy cell membranes in the joint area.
2. Omega-3 sources like wild salmon or a splash of flax-seed oil on a side dish protects against the chronic joint inflammation that begins in our 30's and contributes to joint cartilage breakdown.
3. Black beans, pineapple, and spinach are high in the mineral manganese, which plays an important role in the formation of bone.
4. Popeye wasn't kidding: eat your spinach. Kale, okra, and dairy products like cheese and yogurt are also great sources of calcium, another essential mineral for bone health.
5. Collagen isn't just for pretty skin—your joints need a lot of it, too. Blackberries and raspberries, fish, carrots, red apples (eat the peel—wash well!), citrus fruits, unprocessed high-protein foods, oysters, and garlic help the body produce more collagen naturally.

September 4, 2014
"Creak! Pop! Ouch!"
Hip Joint Osteoarthritis

Osteoarthritis is a major problem for the general population. The CDC reports that:
• Of persons ages 45–64, 30.3% report doctor-diagnosed arthritis
• Of persons ages 65 or older, 49.7% report doctor-diagnosed arthritis*

There are different types of arthritis, but osteoarthritis is by far the most common form of the disease. Osteoarthritis affects most weight bearing joints, especially knees and hips. It is "degenerative," meaning it comes on gradually, wearing away the cartilage that covers the ends of the bones.

This results in a hip that is usually more stiff and painful in the morning than in the afternoon. Rotational movements like getting in and out of the car are often the most difficult. Other symptoms include crepitus (creaking and popping), warmth, and inflammation.

There is no cure for osteoarthritis, but non-surgical or surgical management commonly address the symptoms. Treatments include anti-inflammatory medication, physical therapy, and exercise modification. More advanced, very painful cases of osteoarthritis often require surgery, ranging from arthroscopic debridement to total joint replacements. A hip replacement can last 15-25 years.

*MMWR 2013; 62 (44) 869- 873. [Data Source: 2010- 2012 NHIS]

August 28, 2014
"Will the big bump on my wrist go away on its own?"

If that big bump is a common problem called a ganglion cyst, it's extra synovial (lubricating) fluid that your body secreted into your soft tissue instead of the nearby joint or tendon. It usually won't go away on its own. People of any age can get a ganglion cyst after being hit hard on the hand, but most ganglion cysts appear in adulthood and are related to repetitive motion. For example, bowlers, racquet sport players, and some musicians are prone to ganglion cysts of the hand and wrist.

See a doctor to find out more about your bump. Proper diagnosis often involves ultrasound or MRI imaging and a thorough medical examination to determine the cause. Once the doctor determines what the bump is, he or she can recommend treatment.

Ganglion cysts can be removed without complications right in the doctor's office. (Don't try this, but...many decades ago a common treatment was to hit the cyst with a bible--the blow would rupture it!) It can return after it's been removed, especially if it's caused by repetitive motion and the patient continues doing that motion. If the cyst causes neurological problems, it must be removed immediately. Anyone with tingling, numbness, or shooting pain should see a doctor right away.

August 22, 2014
Injured Ankles Need Physical Therapy

Because ankles bear so much weight, they need serious help after an injury. Do not ignore lasting pain, swelling, bruising, or the inability to keep weight on your ankle. Get a diagnosis from your orthopedic doctor if you're not healing! Failure to do so can leave you with an ankle that doesn't work right, which can be painful and affect your gait, and in turn cause problems throughout your whole body.

One common ankle injury, a talus fracture, happens at the talus bone at the lower part of the ankle joint. The joint is very important for gait, especially when walking on uneven surfaces. Talus fractures result from high impact forces such as those sustained from a car accident, or a high-velocity fall from skating, snowboarding, or falls from high elevation.

Injury to the talus often results in a major loss of motion and function. Many talus fractures require surgery to align the bone, allowing it to heal properly. A fracture that is not displaced may only require casting for 6-8 weeks, but most patients will undergo surgery because of the forceful nature of the injury.

Post-surgical recovery from a talus fracture involves staying off the affected ankle in order to protect it. An assistive device like a pair crutches, a walker, or even a wheelchair will be necessary.

Physical therapy is crucial to restoring range of motion and function of the ankle joint because by this point the joint has been immobilized for several weeks. There are two stages to physical therapy for this injury. The first is to teach proper use of the the cane or walker or wheelchair and give exercises that keep the leg muscles strong for future walking. The second stage is to rehabilitate the ankle itself with range of motion and strengthening exercises. Throughout both stages the therapist may use heat, ice, electrical stimulation, or massage to help reduce problems with pain, swelling, immobility, and scar tissue.

August 14, 2014
Does your lower back seize up?

There are several reasons someone can have lower back pain. Muscle spasms, which are spontaneous, involuntary muscle contractions, are a particularly painful type. They are usually caused by a sudden twisting-type injury and are followed by immediate acute pain, although sometimes the pain can take longer to set in. Muscle spams can also be a symptom of an underlying problems such as tendon or ligament tears, or a stressed or injured spinal column.

An orthopedic spine doctor can diagnose whether the muscle spasm is simply that or something more complex. Once the right diagnosis is reached, the right treatment can be given. For muscle spasms not caused by underlying problems, the treatment can include anti-inflammatory medications, physical therapy (with an emphasis on strengthening the core muscles), and ice or heat.

August 7, 2014
"My elbow is locking up..."

Cartilage injuries in the elbow typically happen gradually with repetitive stress. Sometimes, though, injury to the cartilage occurs after an impact. It's common to feel a locking sensation when bending the elbow back and forth, described by most patients as if there's "something in there not letting the joint move." Tenderness and swelling in the joint are common, too.

Treatment for this type of orthopedic condition is arthroscopic removal of the loose cartilage fragments or cartilage repair. The arthroscope and surgical instruments are small, so the incisions for the surgery are minimal. This allows shorter recovery time and faster return to activities compared to traditional surgical techniques. Surgery outcomes are good to excellent. Physical therapy may be necessary to get range of motion back and to help with post-surgical pain and swelling.

July 31, 2014
"It hurts to climb stairs!"

Any pain that is persistent or keeps you from doing what you like to do is worth getting checked out. If your lower leg just below the knee hurts when you climb stairs, you may want to see an orthopedic doctor. Among other things, an irritated bursa can cause you pain and can be treated by your doctor.

A bursa is a jelly-like sac that cushions and decreases friction between soft tissues like tendons, bones, and muscles. When it gets irritated, the condition is called bursitis. Pes anserine bursitis affects the bursa on the shin bone (tibia) 2-3 inches below the knee.

Pain comes on gradually. It's typical to have swelling and tenderness when the area is pressed. Continued physical activity and climbing stairs also causes pain.

Athletes, especially runners, and people with osteoarthritis are most commonly affected. Activities that can cause or make pes anserine bursitis worse are:
• Not stretching before a running-type workout
• Too much running on hills
• Increasing exercise/mileage suddenly
• Osteoarthritis of the knee
• Tight hamstring muscles
• Obesity
• Having the knee or lower leg turn out while in motion
• A torn meniscus on the inner side of the knee

Treatments include physical therapy, activity modification, stretching tight hamstrings, weight loss to alleviate joint and muscle pains, anti-inflammatory medications, and icing. Your orthopedic doctor can inject the bursa with a steroid and anesthetic solution if the pain is more severe. Surgery is rare, but your doctor can remove the bursa during an outpatient procedure if necessary.

July 23, 2014
Treat Your Bent Toes

There are many ways to treat deformed, bent toes, a condition called hammer toe. In this condition the one or more of the middle toes can become bent at the second joint, resembling a hammer. This often causes calluses or corns on the top of that joint or at the tip of the toe.

What causes hammer toe?
--Shoes with a narrow toe box and/or high-heeled shoes can force the toes into a bent position
--Muscle imbalance between the top and bottom muscles of the toes

Treatment Options
Conservative treatment starts with shoe modification. Your orthopedic foot specialist can recommend a shoe that is roomy, has cushioning and padding, and is wider at the toes. A simple prescription for toe straps, cushions, and corn removers can be given. Physical therapy can help with gaining range of motion by stretching and strengthening tight toe muscles.

Will I need surgery?
When conservative methods fail, your doctor may recommend surgery. The procedure is typically done on an outpatient basis with local anesthetic. The recovery period usually allows walking but not strenuous hikes or similar activities. Post-op physical therapy may be needed.

July 16, 2014
SHOULDER PAIN: Does a tear need surgery?

The upper part of the shoulder socket has a ligament called the SLAP ligament (Superior Labrum Anterior to Posterior). It stabilizes the long head of the bicep tendon and keeps the ball joint in place in its socket. Damage to the SLAP ligament most often results in shoulder pain and weakness. Activities like throwing a ball or reaching overhead become especially difficult.

Common Causes:
• Sports related activities that involve repetitive ball throwing
• Lifting a heavy object
• Falling on an outstretched arm

An arthrogram, MRI and arthroscopy along with physical special manual tests are the most reliable means of diagnosing a SLAP tear. Treatments depend on the severity of the tear and the patient's health and lifestyle. Physical therapy is recommended for all types. Small, stable tears may be left to heal on their own while unstable ones may require surgical reattachment or removal.

July 10, 2014
ADD to LOSE: Simple Tricks to Keep Arthritis at Bay Longer

Our sedentary (tv, computers) and singularly focused (one sport or activity) lifestyles can wear our bodies down too quickly. This causes us a lot of health problems, one of the most common being arthritis. No one wants joint pain to keep them away from their favorite things. So rather than have to completely avoid your favorite activities, why not add something good into your routine? You'll likely lose something bad...

• ADD: stretching several times a day, every 30 minutes if you're sitting or standing for long periods, and
LOSE: weight by improving muscle tone; swelling/fluid retention by improving circulation; stiffness by improving range of motion
• ADD: a new type of workout/activity every week to break up your regular training/routine, and
LOSE: the risk of injury to overtaxed joints; weight by using muscles in new ways; pain and stress from overuse of certain areas of the body
• ADD: just 10 minutes of daily core strengthening (see our May 29th post "What makes a successful lifelong athlete?"), and
LOSE: poor posture that stresses joints
• ADD: one cup of vegetables to one meal every day, and
LOSE: extra weight that puts pressure on joints

July 3, 2014
Hip Replacement: Is it time?

Nearly 4 million* people each year go to the doctor for orthopedic hip problems. Fewer than 10%** of those visits results in hip replacement. So how do you know if you're going to end up among them?

Our doctors weigh in:
Todd A. Shrader, MD says, "If you're having hip problems, see an orthopedic doctor so you can have specialized care aimed at getting you back to as close to 100% of normal as possible. That's the real advantage to being treated by an orthopedic surgeon. It doesn't mean you need surgery. You're just in the hands of someone who is in tune with your problem and has a ton of experience helping people a lot like you."

What about pain?
"Sharp, debilitating pain, or pain that keeps a person from their normal sporting activity should be enough to bring someone in to see a doctor," says Glenn J. Huber, MD. "If the pain is keeping you from comfortably doing the activity that you're trying to do, whether it's an activity of daily living or a sporting activity, then it shouldn't be ignored."

Once you see a specialist, he or she can evaluate you by thoroughly investigating your medical condition and history. It's likely they'll take images of your hip before creating a treatment plan for you.

June 27, 2014
"Squeaker's Wrist" (ATTN: tennis/racquet and rowing athletes)...

Squeaker's wrist occurs when the fluid-filled sacs (bursae) that rest between the tendons and thumb/forefinger wrist bones become irritated. It's a common condition among people who play racquet sports and do rowing activities.

• Swelling around the carpal bones
• Pain and crepitation (creaking, cracking, grating sounds)

X-rays may be unable to detect the inflammation in the carpals, so often an Ultrasound may be required.

Treatment options:
• Anti-inflammatory medications
• Cortisone injections into the bursae
• Physical therapy to address biomechanics, pain, and swelling.
• Some require cases surgery to remove the bursae
Symptoms are usually relieved immediately after the surgical procedure, and normal activities can be resumed after 6 weeks.

June 19, 2014
Young Athletes Can Protect Their Spines

When athletes ages 11-17 have low back pain, the most common cause is a fracture of the pars interarticularis, which is part of the vertebra bone. Genetics can play a role in predisposing a young athlete to this type of fracture, but overworking the area in sports is the main culprit. Volleyball, gymnastics, football, and weight lifting are among those often reported.

When the pars is fractured, the condition is called spondylolysis. Treatments include taking a break from the activity causing the back pain, anti-inflammatory medication, physical therapy, and wearing a back brace. Rare cases may require surgery.

Prevention is key to young athletes having a fulfilling sports experience. Some basic tips include resting (even bones need time off!), wearing proper footwear so torque and deceleration don't overload the spine, stability exercises to strengthen the core muscles and improve stability, and improving hip mobility, which is connected to healthier spine movement.

June 13, 2014
Taking your ankles for a hike with Dad this weekend?

The beautiful weather and many opportunities for outdoor activities around the South Bay make it a great time to talk about these often neglected body parts: your ankles. Keeping them strong with stretching, and also balance and strengthening exercises helps a lot. It also helps to have good proprioception, the awareness of where your body is in space. If you know where you are in relation to other objects and more importantly, where and how your feet will land if you are up in the air or on unstable ground (like on a canyon hike with Dad), your chances of landing safely increase.

Here are some suggested exercises that combine ankle strengthing and balance:
1. Stand on one leg, hold for 45 seconds, switch.
2. Stand on one leg, have someone throw a ball back and forth with you 15 times, switch legs. Repeat 2 more times. (Be sure to throw the ball to each side and high and low.)
3. Squat with balance shifted to one leg, or half-squat with one leg out front, switch. Make sure your hips are pushed backward (like you're sitting back into a chair) so that your knee is directly on top of your ankle on the weight-bearing leg.

Stay safe this weekend, and enjoy the weather and family! If you have an ankle or other orthopedic problem, we're here if you need us at 310-316-6190 on Saturdays (walk-in or appointment) 9-1 or any weekday (appointments only) 8:30 am - 5:30 pm. Any of our doctors can treat you for ankle problems. Our foot and ankle specialist is Kenneth K. Park, MD:

June 5, 2014
Elbow Expectations: Stressed Elbows Are More Likely to Develop Osteoarthritis
Osteoarthritis is common as we age, especially in weight bearing joints like the hips and knees. Even though elbows are the least likely joint to succumb to this often painful condition where the cartilage deteriorates, they're not immune. Prior elbow injuries are the usual culprit that cause elbow arthritis. The ligaments surrounding overworked elbows tend to destabilize over time, resulting in more wear and tear on the elbow cartilage. Professional baseball pitchers and tennis players, and people doing hard physical jobs often complain of elbow problems related to osteoarthritis.

Earlier Symptoms:
• Pain
• Loss of range of motion
• Grating
• Locking

Later Symptoms:
• Swelling
• Numbness in outside two fingers

Conservative treatments include physical therapy, activity modification, pain medications, corticosteroid injections, and joint fluid improvement injections. There are many surgical options for those who do not improve after trying conservative treatments: arthroscopy, elbow replacement, contracture release, and surface renewal are among the most successful.

May 29, 2014
What makes a successful lifelong athlete?
Keeping your body physically active and powerful for many decades requires two key orthopedic elements: stable joints and core stability. A stable body happens all over, not with just abdominal crunches. There are hundreds of core exercises you can do intentionally, and many you can do in everyday life with just a little increased awareness of good posture.

Here are a few of our favorites:
1. Go around as much of the day as possible pretending like someone is going to punch you in the stomach. You'll feel your stomach, back, and even gluteus muscles contract inward to stabilize you as you prepare for the fake impact.

2. Stand up straight and balance on one leg.

3. Balance on one leg, keep the upper body erect, and squat down, keeping your knees over your ankles.

4. Plank: get into the top of a push-up position and hold your abs, lower back, and gluteus muscles in. For added difficulty, balance your feet on a bosu ball (1/2 exercise ball). Side planks with the body sideways and one arm up are also great for the core.

5. Even during aerobic activity, be mindful of your core. Use it to stabilize your movement instead of letting your moving limbs pull you around

May 27, 2014
Knee Arthritis: When is it time for a joint replacement?
There are three types of knee arthritis, osteoarthritis (gradual wearing away of cartilage), rheumatoid arthritis (inflammatory, any age), and post-traumatic arthritis (may occur after a knee injury). Knee osteoarthritis is the most common, affecting middle aged and older people. It is caused by the knee cartilage gradually wearing away. Many people with knee arthritis seek diagnosis and treatment from an orthopedic doctor.

• Gradual onset of pain in most cases
• Pain and swelling, often worse in the morning or after periods of inactivity
• Increased pain with certain activities, including stair climbing, walking (especially with hills), and kneeling
• Difficulty bending and straightening the knee
• Knee pain affected by weather changes

Seeing an orthopedic doctor while you're in the early stages of knee arthritis may help prolong the life of your knee cartilage. Your doctor may prescribe physical therapy, lifestyle changes, exercise routine changes, use of a knee brace, or other conservative treatments to accomplish this and reduce your symptoms. Medications, injections, and supplements may be also be helpful. Patients who do not respond to the more conservative treatments and who are experiencing severe pain are typically candidates for surgical procedures, ranging from arthroscopy to knee replacement.

May 16, 2014
Numbness, tingling, or shooting pain in your foot? Don't ignore symptoms of nerve damage, which can be irreversible...

There is a tunnel in the foot going from the inside of the ankle bone through the ligaments stretching across the foot. It's called the tarsal tunnel, and the nerves inside it can become compressed, resulting in tarsal tunnel syndrome (TTS).

This can happen from various forms of swelling: varicose veins, swollen tendons, inflammation from diabetes or arthritis, or the swelling that occurs after an ankle or foot injury. It can also be caused by scar tissue, flat feet, fallen arches, and any variety of lumps and bumps in the foot, such as bone spurs or cysts, that could put pressure on the nerves.

• Tenderness and aching
• Sharp pain around the inner part of the foot and ankle
• Radiating pain along the inner or outer part of the foot
• Numbness
• Tingling or burning

Conservative treatment options for TTS include a change of footwear, anti-inflammatory medications, rest, ice, or a local cortisone injection. More treatments done in physical therapy can also be very beneficial. If after conservative treatment symptoms continue for several months, tarsal tunnel release surgery may be necessary.

May 6, 2014
Scapula Fractures: You may remember the ride in the ambulance...
Because the scapula (shoulder blade) is surrounded by several muscles, it typically does not get injured. Scapula fractures account for just 1% of bone fractures. A high impact force such as a motor vehicle accident or a fall from high up usually causes a scapula fracture. Many additional injuries often accompany the fracture because of the extreme force to the body. A full medical exam and imaging of all the tissues and bones surrounding the scapula may be performed as a result.

• Pain with arm movement
• Swelling
• Bruising

Treatment for scapula fractures includes placing the arm in a sling and gradually initiating physical therapy to avoid developing a frozen shoulder and elbow contracture. It's not normal for treatment to involve surgery, but depending on the severity and location, it may be warranted.

April 30, 2014
Sprain or Strain? RICE and see a doctor!
People often use the terms interchangeably, but sprains and strains are not the same. A SPRAIN refers to an injury, over-stretch or tearing of a ligament, which attaches bone to bone. A STRAIN involves injury to a tendon or muscle. A tendon attaches muscle to bone.

Symptoms can be similar:
--Sprain symptoms can include pain, swelling, and bruising. Loss of function is sometimes experienced.
--With strains, people often experience pain, muscle weakness, spasms, and a loss of muscle function.

Treatment for both is similar: RICE method

Seek medical attention for sprains and strains when:
1. You experience severe pain
2. You cannot put weight on the injured joint
3. The injured area looks deformed
4. There is numbness over the injured area
5. You cannot move the injured limb or body part

April 24, 2014
Athletes! Stiff and painful hips in the morning?
Your Hips Don't Lie…

A labral tear is a tear in the soft elastic tissue surrounding the outside rim of the hip socket. The labrum helps to hold the head of the femur (ball on the top of the upper leg bone) in place. Labral tears typically occur gradually, but sudden trauma can also cause damage.

Some symptoms of a labral tear are:
• Catching, clicking, and pulling in the hip
• Hip is stiff and painful in the morning
• Deep pain in the groin on the affected side

The injury is common among young and middle-aged athletes, especially those in sports such as football, hockey, soccer, and running. Several years ago, before better imaging techniques like MRI scans became widely available, labral tear injuries were often diagnosed as "groin pulls."

Treatment does not have to include surgery. Non-surgical options include physical therapy, changing exercise routines, and medications.

In more severe cases, surgical procedures such as arthroscopic debridement (shaving the torn portion of the labrum) or arthroscopic repair (securing the torn portion to its normal position) can be performed. In very severe cases, arthroscopic labral reconstruction (adding to the torn labrum with a graft) may be necessary.

April 14, 2014
Guard Your Wrists!
If you've ever had a broken wrist, you're not alone…it's the most common type of broken arm. Depending on the position of your hand when you got injured, it could be one of these two kinds: Colles or Smith.

Colles fractures happen more often than Smith's fractures. Colles are typically seen in people over the age of 50 and occur in women more than men. The fracture usually happens when the patient falls on an open hand with the palm down. A break occurs on the end of the radius (the larger bone in the forearm) where it meets the thumb bone. There is usually a clear deformity, swelling, and pain at the wrist.

A Smith fracture is less common and occurs mostly in young men. This fracture is also usually caused by a fall, but by landing on the BACK of the hand and wrist instead. Just like Colles fractures, the radius is also broken, but it can be displaced in the opposite direction.

Treatment for both types of fractures depends on the severity of injury. Immobilization by cast or splint is the primary goal early in the healing and rehabilitation phase. Even when casted, it is important to maintain finger range of motion, and to control pain and swelling. Depending on the displacement of the bones or severity of the break, surgery may be needed.

April 3, 2014
Prevent Ankle Sprains
The most common ankle sprain is of the lateral kind, with damage occurring when one “rolls” the ankle--the foot rolls under while the leg moves outward. Symptoms include tenderness, swelling, bruising, and pain on the outer portion of the ankle.

Increase your chances of preventing an ankle sprain by:
• warming up before exercising
• gently stretching the area
• training gradually, increasing the amount of activity in your sport rather than suddenly performing at a high level
• wear properly fitted footwear that is in good condition
• use extra caution on uneven surfaces, uphills, and downhills
• for those who have had previous sprains, use tape or a brace under proper medical instruction

Sprain Treatments
The RICE method is recommended after a sprain occurs:
Rest--do not put your weight on the ankle as long as it is painful to do so; crutches may be necessary
Ice--for the first three days following the sprain, ice the area for 10-20 minutes every 1-2 hours
Compression--apply an elastic bandage; it should feel like pressure is applied but should not restrict circulation; a doctor or physical therapist can also help with bracing
Elevate--to reduce swelling, keep the ankle above the heart for 2-3 hours a day

Early weight bearing and balance training is recommended. A physical therapist can teach these. Taping and bracing helps stabilize the ankle. Most people recover fully, but 20% of people who experience a lateral ankle sprain develop instability and have recurrent sprains.

March 26, 2014
Spinal fusion is surgical procedure that permanently connects two or more vertebrae in the spine. An orthopedic surgeon may recommend fusion to fix broken bones, stabilize the spine after the removal of a herniated disk, relieve chronic back pain, fix spinal deformities, or correct spondylolisthesis.

During spinal fusion, the surgeon places bone or a bone-like material in the space between two vertebrae, and metal plates, screws, and rods may also be used to hold the vertebrae together. Depending on the extent of the procedure and spinal segments fused, most patients spend 2-3 days in the hospital after the procedure.

Pain and discomfort may be experienced afterward, but the symptoms are usually well-managed with medication. It may take several months for bone healing or fusing to occur. The surgeon may recommend wearing a back brace, use of a bone stimulator, and physical therapy as part of rehabilitation.

March 20, 2014
Piercing Finger, Hand, or Elbow Pain?
Radial tunnel syndrome occurs when the radial nerve is entrapped in the supinator muscles, which are the muscles helping to rotate the forearm. This condition is common with people who play racket sports like tennis and with spin bowlers.

• Pain around the elbow when resistance is placed on the middle finger during extension (straightening)
• Cutting, stabbing, and piercing pain at the back of the hand or top of forearm

An orthopedic doctor can correctly diagnose radial tunnel syndrome by conducting a thorough physical exam. Images are usually taken to rule out other possible problems.

Stretching, technique modification, physical therapy, and neoprene bracing are common treatment methods. More severe symptoms may require surgery to reduce pressure on the affected nerve.

March 13, 2014
Knee Pain and a "Giving Way" Sensation?
Patella Dislocation

When the knee-cap (patella) dislocates, it moves laterally, or to the outside. Patients often describe the knee as "giving way" or feeling unstable.

• Direct trauma from an accident or blow
• Non-contact movements such as extreme twisting
• Damaged or defective femoral groove, the area where the kneecap meets the shinbone (tibia)
• Damaged or defective tissues controlling the position of the kneecap

• Popping, bruising, swelling, and pain quickly follow dislocation
• Knee buckling
• Sideways-sliding kneecap
• Knee "catches" during movement
• Pain while sitting
• Tenderness on the inner portion of the knee
• Creaking and cracking sounds during movement

If your orthopedic doctor suspects a patella dislocation, he or she will perform a thorough physical exam and take x-rays and/or MRI scans to rule out damage to other structures, such as ligaments and cartilage.

Options vary depending upon the extent of the injury and whether other soft tissues have been damaged. Icing, bracing, taping, and anti-inflammatory medications are common treatments for most dislocations. Surgical repair is only done in severe cases.

Some patella dislocations cause damage to the underside of the kneecap and other leg bones, which can result in arthritis and further pain later. Doctors sometimes recommend arthroscopic surgery to alleviate this.

March 4, 2014
TURF TOE: Toe Pain that Lasts

Turf toe is a term used to describe an injury to the joint capsule of the big toe. It's called turf toe because the injury is common among athletes who play turf sports like soccer and football.

Turf toe occurs when the big toe is hyperextended with the heel raised, during direct impact, while changing direction, or accelerating or decelerating. (Imagine the big toe being stepped on and pinned down, or caught on the ground or something else while the rest of the body is still in motion.)

Symptoms include:
• Tenderness
• Swelling
• Toe stiffness
• Redness over the bottom of the big toe

Treatment options can vary from orthotics to anti-inflammatory medications, proper body mechanics, stretching, and cortisone injections. Even though symptoms may persist for a long time, the prognosis is good to excellent.

February 26, 2014
Shoulder pain? Visible bump on top of the shoulder? See an orthopedic doctor...

Acromioclavicular Dislocation (AC) is diagnosed when the collar bone and shoulder blade become separated from each other. It can be caused by a blow or fall that tears or damages the ligaments that hold the two bones closed. Contact sports, falling on the ice, falling on an outstretched arm, or having an impact on the point of the shoulder blade, such as when being launched over the handlebars of a bicycle, are common situations reported to cause AC.

There are six grades of AC dislocation, one being the least severe and six being the most.

Common Symptoms:
• Pain when moving the arm overhead or sleeping on the injured shoulder
• Swelling
• Bruising
• Popping sound when joint is moved
• Visible bump on the top of the shoulder
• Weight of the arm pulls shoulder down

The vast majority of AC injuries can be treated non-surgically. This includes the use of a sling, cold packs, anti-inflammatory medications, and completing a physical therapy program.

In the less common cases of severe injuries, surgery may be required to either shave the end of the collarbone or reconstruct the ligaments. The goal of surgical and non-surgical treatments is to restore and rebuild range of motion, strength, and flexibility.

February 21, 2014
Outer Hip Pain Can Be Caused by Trochanteric Bursitis

Trochanteric bursitis is the inflammation of the bursa (fluid-filled sac near a joint) on the greater trochanter, or bony part of the hip. Bursa sacs are located throughout the body and act as a cushion between bones and soft tissue. Healthy bursa reduce friction and irritation, but inflamed bursa cause discomfort and pain.

When the hip bursa becomes irritated or inflamed, it causes pain at the hip on the outside of the hip and thigh or in the buttock.

Causes for irritation can range from overuse, incorrect posture, injury, previous surgery, rheumatoid arthritis, spine problems, bone spurs, or calcium deposits. It's most common in women and middle-aged and older individuals.

Common Symptoms of Trochanteric Bursitis:
• Pain that increases with getting out of the car or from a low seat
• Pain walking up stairs
• Pain while lying on the affected side

Treatment for Trochanteric Bursitis does not usually require surgery. Doctors typically design a treatment plan that fits well with an individual's lifestyle. It can include activity modification, anti-inflammatory medications, corticosteroid injections, and physical therapy. The condition usually improves with measures like these.

Acute (sharp) pain, any pain that interferes with daily activities, or when the area is red, swollen or warm should be evaluated by an orthopedic physician.

February 11, 2014
Cubital Tunnel Syndrome: Tingling Pinky & Ring Finger
The ulnar nerve travels from the neck, down into the hand. It can be entrapped or constricted at several sites along the path.

Whether the entrapment occurs at the elbow, hand or wrist, pain and numbness symptoms are reported. When the constriction occurs at the elbow (medial epicondyle), it's called Cubital Tunnel Syndrome.

Tingling, numbness, pain, and weakness are some of the symptoms commonly felt on the pinky and half of the ring finger. If symptoms interfere with activities of daily living, we recommend contacting your orthopedic doctor.

Conservative treatments include stopping any activities that cause the symptoms, avoiding leaning on elbow, and keeping the elbow extended during sleep. Other measures involve bracing or splinting, anti-inflammatory medications, steroid injections, and physical/occupational therapy.

In severe cases, surgery may be necessary to relocate the nerve or shave a portion of the medial epicondyle.

February 4, 2014
Helping Osteoporosis of the Spine: Vertebral Compression Fractures
Osteoporosis of the spine causes damage and weakening of the vertebrae bones. As people with osteoporosis age, even everyday activities and minor missteps or falls can cause small fractures in the vertebrae. The waistline area or just above it are the most common sites for these fractures. Most fractures of this type are not painful, but some do cause pain and/or misalignment, and they require an orthopedic doctor's care.

Non-surgical therapies include pain medication and bracing. Depending on the underlying cause and severity of a patient's osteoporosis, there may still be a chance of more fracturing, even with these treatments.

Kyphoplasty and Vertebroplasty are minimally invasive surgical procedures that strengthen the fractured vertebrae by adding bone cement inside them. Kyphoplasty uses a ballon to inflate a damaged vertebra, which reshapes and realigns it, before filling it with the bone cement. Vertebroplasty injects bone cement into a vertebra to provide stabilization and strength, but does not address reshaping or realignment issues in the same way as Kyphoplasty.

In both procedures, the patient can usually remain awake but sedated or treated with a local anesthesia. Careful study of each patient's compression fractures can help an orthopedic physician advise if either procedure is appropriate.

January 16, 2014
Treat Your Elbows Kindly - Olecranon bursitis
Swelling at the elbow joint can have many causes. Olecranon bursitis is one of them. The olecranon is the tip or end of the elbow joint. Bursitis describes the inflammation of the bursa (a sac of fluid in the joint that decreases friction).

Anyone who spends a lot of time leaning on the tips of their elbows is at particular risk for this sometimes painful condition. An injury or broken skin leading to infection can also cause it.

Local tenderness and swelling are common signs and symptoms associated with this type of bursitis.

Your orthopedic doctor may take images of your elbow to rule out bone spurs and foreign bodies. He or she may want to take a small amount of fluid from the bursa to see if gout or infection play a role.

Conservative treatment includes the use of ice, compression, anti-inflammatory medications, and avoiding direct contact and impact. Surgery is very seldom recommended except in chronic conditions, and even then is often only for cosmetic purposes.

January 9, 2014
KNEE PAIN: Injury or Gout?
Gout symptoms appear when excessive uric acid builds up in a particular area of the body. Gout in a joint is often mistaken for an orthopedic condition or injury because it has similar symptoms. These can include pain, swelling, and increased temperature in the area or joint, often the knee or big toe.

Treatment includes diet modifications and anti-inflammatory medications. A patient with severe, chronic gout may need a partial arthroscopic removal of the synovial membrane, a soft tissue in the knee. Exercise is normally recommended to help gout symptoms. Low impact cardiovascular sports like cycling and swimming are usually safe.

Here is a short list of foods to avoid or limit:
• Meat, poultry, fish
• Fat
• Alcohol
• Foods containing high-fructose corn syrup

Drink plenty of water and increase consumption of:
• Complex carbs (whole grain, fruits and vegetables)
• Low fat or fat-free dairy

January 3, 2014
Rigid big toe for no reason? Let a TOSMG orthopedic doctor help!
"Hallux Rigidus"
Hallux refers to the big toe. Rigidus describes the stiffness of the joint, in this case, the "knuckle of the big toe."

Big toe rigidity is common among adults without any preceding trauma. The cause is unknown, though a genetic predisposition is suspected.

Symptoms are often found on both big toes and include stiffness with bending or straightening of the big toe, local swelling, and tenderness.

Conservative treatment may include stretching, orthotics, anti-inflammatory medication, and cortisone injections. Surgery is sometimes performed in order to increase mobility, but outcomes can be unpredictable.