April 2019

Download The Full April 2019 Issue PDF

Subscribers Only — When aches, pains and other symptoms stem from a problem with the musculoskeletal system (meaning the bones, muscles, cartilage, tendons, ligaments and joints) your doctor may order an imaging test to help determine the underlying cause.   More...

Ask The Doctors: April 2019

In the past, TENS units for home use were available only through a physical therapist or other clinician. The units have been simplified, and you can now buy one without a prescription. According to Cleveland Clinic physical therapist Kelly Kinsey, PT, "The old units that came through physical therapists could be set to meet individual needs. The parameters could be altered and varied for comfort and changed to address different types of pain." The simplified TENS units you get without a prescription are not as customizable. They are programmed to the most commonly beneficial settings and comfort level.   More...

Microbiome and Inflammation

Keep beneficial bacteria in a healthy balance: 1. Avoid unnecessary use of antibiotics. For example, donít take an antibiotic for a cold, which is caused by a virus. 2. Eat foods that contain microorganisms, such as yogurt, sauerkraut and pickled vegetables. 3. Eat a plant-based diet. Good bacteria feed on greens and other vegetables. 4. Some foods contain prebiotics, which can alter the microbiome in beneficial ways. Examples include: - Onions - Leeks - Asparagus - Garlic - Bananas - Oats and barley 5. Eat more fiber, which enriches the good bacteria. 6. Consider a probiotic supplement.   More...

Steroid Shots for Knees and Hips

Subscribers Only — "If we're seeing a patient early on, when they have mild-to-moderate changes inside the knee joint, they have a much better chance of the injection lasting a long time," Golnick says. The effects of the injection can last for three months or more in someone with mild-to-moderate arthritis, but those with more severe arthritis could have a return of symptoms within a fewweeks.   More...

Do You Need More Vitamin D?

Subscribers Only — The primary source of this vitamin comes from exposure to the sun. The body already contains precursors for vitamin D. It is converted to a usable form when ultraviolet B (UVB) rays from the sun hit the skin. About 10 to 20 minutes of exposure to the sun (without sunscreen) a day can generate an adequate amount of usable vitamin D. It's important to put sunscreen on after 20 minutes to prevent burning and protect against skin cancer.   More...

Watch Out for Concussions

Subscribers Only — "You also need a good cervical spine examination because there can be two different injuries, one to the brain and one to the area of the spine where the skull meets the neck," says Dr. Figler. People who have degenerative changes in the spine are particularly vulnerable to cervical spine injury. This may cause headaches and neck pain as well as more dizziness and lightheadedness.   More...

Why Ultrasound?

Ultrasound, which uses high-frequency sound waves to look at organs and structures, is a high-spatial resolution modality that provides greater internal detail of a structure. With the same muscle injury, "we can see the individual fibers of the muscle and early changes of the injury," says Dr. Delzell. Both MRI and ultrasound can detect large tears in tissue. "But microtears and chronic injury are better seen on ultrasound," she says.   More...

In The News: April 2019

Getting physical therapy early for musculoskeletal pain was associated with a reduction in long-term opioid use in a study published in JAMA Network Open (December 2018). Opioids are powerful pain medications, but they should be used cautiously due to the potential for addiction. Nondrug methods, such as physical therapy, can be effective for musculoskeletal pain. For the study, researchers analyzed health insurance claims data from 2007 to 2015 on about 89,000 adults with conditions causing shoulder, neck, knee or low back pain. Close to 30 percent of them received at least one physical therapy session within three months of a diagnosis. This was associated with an approximately 10 percent reduction in the number of opioid users three months to one year later. Among those who took opioid drugs, early physical therapy resulted in about a 10percent reduction in the amount of the drug used.   More...