Pain Management Services in Lansdale, PA
Common Ortho Questions
Periodically, Central Montgomery Orthopedics will post new articles on this page that respond to frequently asked questions, so be sure to check back often. Click on the links below to see the answer to the corresponding question.
I banged my right knee hard three months ago. The MRI showed it was only bruised. It still wants to give way on steps or often just walking.
Dr. Spellman: Hurt much?
Not really. Just feels unstable.
Dr. Spellman: If you straighten your knee can you "set" or contract your quad?
Do you mean the muscles on the front of my thigh? Not really. The left side contracts firmly. The right feels very spongy when I try to lock my knee straight.
Dr. Spellman: Thought so. The quads control the knee and their proper function is essential for knee stability.Do I need a brace?
Dr. Spellman: No. You need to get your quads working again.
Good. I'll be in.
The bump on top of my shoulder has been hurting for about six months. My neighbor said it was tendonitis and would go away with some Advil but it hasn’t.
Dr. Spellman: That bump is your AC joint. It’s where the collarbone meets the acromion, which is the front projection of the shoulder blade.
I’ve got one on the other side, but it doesn’t hurt.
Dr. Spellman: This is where a shoulder separation occurs. That’s not a dislocation of the ball joint but a sprain of the ligaments between the clavicle and the acromion.
Years ago I had an injury but in a few weeks it was ok. Why is it hurting now?
Dr. Spellman: There’s a cartilage that gradually wears out after injury.
Can this be fixed?
Dr. Spellman: Quick and easy.
I understand supplements with glucosamine can help my joints. Should I take it for my back?
Dr. Spellman: Good question. It's an unproven theory so far, but it makes sense. We know that as the cartilage surface of joints wear, the bone underneath makes more bone.
Like if I am carrying a piece of drywall overhead I spread my hands out to support the load.
Dr. Spellman: Exactly. But when this happens in the spine, the broadening of the bone surfaces can encroach on the channels for nerves.
That's spinal stenosis isn't it?
Dr. Spellman: Right. So if we can reduce the wear on the joints of the so spine over the years by taking glucosamine, we may be able to minimize spinal stenosis.
I am forty. I'll start taking it now.
Since I retired I've been getting a lot of pain in my hip. It really bothers me when I sleep on that side at night.
Dr. Spellman: Have you had an x-ray?
They said it showed some arthritis.
Dr. Spellman: That's expected. But the arthritis may not be causing the pain.
What else could it be?
Dr. Spellman: The bony bump on the outside of your hip, about where your palms touch with your hands at your side: does it hurt to press hard there?
Yes, it really does.
Dr. Spellman: The pain could all be from tendonitis. It's easy to treat.
Good, I'll be in.
I've been sedentary for too long, so six months ago I started walking, then running on a treadmill. For two weeks, the ball of my foot's been hurting, even just walking around.
Dr. Spellman: Seen anyone?
They did x-rays in the E.R. and said they were o.k.
Dr Spellman: Classically, stress fractures follow an abrupt increase in activity. A bone scan/MRI would be diagnostic while the x-ray is often negative.
What else might be?
Dr. Spellman: Often the third metatarsal 1phalangeal joint becomes inflamed and symptoms mimic a stress fracture. We can sort all this out be examination.
And get me running again?
Dr. Spellman: Almost always.
Five days ago I slightly twisted my ankle on the stairs. The next day it was fine. Since waking this morning, it hurts too much to walk.
Dr. Spellman: Is it warm and terribly painful?
Excruciating. I can't even move it.
Dr. Spellman: Ever have gout?
No, but my father does.
Dr. Spellman: Commonly the first appearance of a gout attack is a few days following minor trauma.
I thought that was just the big toe joint.
Dr. Spellman: Any joint can be affected. Often the ankle or joints of the mid foot. Nothing else commonly comes on so fast and hurts so much.
I've got to work.
Dr. Spellman: With a small injection today, you'll be better tomorrow. Then we'll watch for a second episode before doing further investigations.
I'm told my knee is wearing out and there's not much more to be done until I'm ready for a replacement. It's pretty achy most of the time, and golf is less fun.
Dr. Spellman: Have you had viscosupplementation?
Is that the series of lubricating jelly injections? I've heard it works pretty well.
Dr. Spellman: Generally speaking, the less worn the knee, the better it works. But we're finding patients who've been told to start thinking about a total knee replacement have about a fifty-percent change of getting at least six months of significant improvement from the first series.
Dr. Spellman: Negligible with the product we're currently using.
Sounds like a no-brainer. I'll be in.
I'm 69. My index and long fingers now hurt, and I can't make a fist. A neighbor was told she had to live with her arthritis.
Dr. Spellman: This is unusual for arthritis, but very common for a kind of tendonitis.
I thought that was just in the shoulder.
Dr Spellman: Not really. “Trigger fingers” often don't cause classic catching or snapping but simply pain in the first knuckles out from the hand, and it hurts too much to make a fist.
This isn't arthritis?
Dr. Spellman: No. The joints are fine. The tendons that flex the fingers catch in tunnels in the palm, but the pain is referred to the knuckle joints.
Can this be fixed?
Dr. Spellman: Easy. A tiny injection or two works 90% of the time.
Good I'll keep my golf clubs.
My wrist pain just won't go away. It's kind of dull and hurts right in the middle on the back. Should this be happing at twenty-two?
Dr. Spellman: Any injury?
No. But when I lift in the gym it hurts more.
Dr. Spellman: Ever had a sort of squishy bump there?
No. But my friend had a ganglion cyst there that was removed.
Dr. Spellman: Right. As you know, a ganglion is a jelly filled cyst that comes out of the joint and finds its way to the surface at the back of the wrist.
But I've no lump there.
Dr. Spellman: Often the ganglion never reaches the surface but stays beneath the sheath of ligaments across the back of the wrist. It's called a subligamentous ganglion. They hurt quite a bit.
Is this a big deal?
Dr. Spellman: Not at all. Usually a tiny injection or two will fix it.