Why am I always hunched over when I walk?

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Many people notice that as they age, they have a tendency to be “hunched over” when they stand or walk. Perhaps they have tried to correct this and stand up straight but feel that it is difficult and even painful. These same people typically also note that they have become shorter as they age. This is often a source of concern and frustration for people because they feel a loss of pride with a change in posture and stature and they feel that it may be related to the loss of vitality and activity that they have also experienced with age.

What causes a hunched over posture?

Fortunately, we know that there is often an anatomical cause for these changes with age, and we also know that there are treatments.

Lumbar Facet Arthropathy

Lumbar facet arthropathy is a medical term for arthritis in the spine, and it is one of the most common reasons why people feel more comfortable when hunched over as they age. This arthritis is typically present in the back portion of the spine, where there are multiple joints that allow you to bend forward and backward. With age, these joints become arthritic and painful. Typically, the first symptom that people notice is that it hurts when they lean back. This is because with the lumbar facet joints become narrower with leaning back. Eventually, these joints become so arthritis that they are bone-on-bone, even when you are simply standing up straight. To create more space, people will find themselves leaning forward.

Compression Fractures

Compression fractures are a cause of both height-loss as well as hunching over. The spine is made up of bone, and bones tend to become thinner with age. As the bone thins, it can no longer hold up under stress and can become compressed. Due to body mechanics, these compression fractures occur more frequently in the front of the spine than in the back. This can contribute to feeling hunched over. Unfortunately, people that experience one compression fracture are more likely to have multiple compression fractures. While we can never fully restore the height of a compressed vertebra, we can sometimes partially restore the height and help prevent additional compression fractures from occurring.

Lumbar Spinal Stenosis

Lumbar spinal stenosis refers to a narrowing around your spinal cord. The spinal cord is housed in a protective structure called the spinal canal. This runs from your brain all the way to your tailbone. As people age, inflammation throughout the spine leads to bony overgrowth and thickened ligaments. Since your lumbar spine (the low back portion) bears most of your weight, it tends to develop the boniest overgrowth and the thickest ligaments. This can put pressure on your spinal cord and cause pain, especially when you’re standing or walking for prolonged periods. Due to natural biomechanics, this pressure can be relieved by leaning forward. Many people find themselves leaning forward when they walk and even relying on walkers and shopping carts to help them lean forward and relieve the pressure on their spinal cord. Doctors even learn about this in medical school and call it, “the shopping cart sign.”

What can I do?

The first step is to talk to your doctor. You may need x-rays or even an MRI. These tests can help determine why you are hunched over.

Fortunately, there are treatments for these issues. Whether it’s selectively cauterizing painful nerves, restoring height to a compressed vertebra and injecting cement so that it doesn’t get worse, injecting steroids around a compressed spinal cord, or even supporting the spinal canal so that it isn’t pressuring the spinal cord, there are safe and minimally-invasive treatments available – and many of these can even be done in your doctor’s office.

David G. Currie, MD
David G. Currie, MD

Spinal Stenosis

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The spinal column has open spaces that create passageways for the spinal cord and the spinal nerves. However, a serious condition occurs when the spinal column narrows thus putting pressure on the spinal column and nerves. This painful compression of the nerves is known as spinal stenosis.

The pressure that occurs can cause pain, weakness, numbness and is most common in the cervical and lumbar regions of the spine since the spinal column can narrow at any point from the head to the tailbone, including the center of the spine.

Causes of Spinal Stenosis

The cause of spinal stenosis is commonly caused by excess growth of the bone around the spinal nerves which is the result of osteoarthritis. It can also result from a dislocation or a fracture of the vertebral bone, or by soft tissue intruding into the spine’s open spaces. Other culprits are herniated discs, tumors, and thickened spinal ligaments which press against the spinal nerves.

Spinal Stenosis Symptoms

Symptoms vary depending on the location and severity. Pain can radiate down the back, arms, and legs, indicating that there is a problem. The development of spinal stenosis can affect a person’s involuntary and voluntary functions, such as breathing, walking, and even bladder and bowel control.

Spinal Stenosis Treatments

Treatment options may include anti-inflammatory pain relievers, such as ibuprofen and aspirin, muscle relaxants, or other pain relief medications. Physical therapy may also be recommended as stretching and adjusting posture may alleviate some pain and help patients get relief from the discomfort associated with spinal stenosis. However, if these methods are not helping relieve your pain, medical procedures are available from your physician, such as:

  • Epidural injections
  • Nerve blocks
  • Spinal Cord Stimulation

Surgical options can include decompression surgery (laminectomy) or laminoplasty. These procedures can be helpful for some people with severe pain. Both create more space between the bones which helps reduce inflammation and pain. There are other surgical interventions which may be less aggressive, but not all patients are good candidates.

When To Call A Doctor

If you believe you may have spinal stenosis now and are experiencing pain, you should see your physician and get help. In the meantime, you can apply ice to the area to reduce inflammation or heat to soothe stiff joints and relax muscles

Resolute Pain Solutions physicians have received extensive training in Pain Management and stay current with new and up-to-date procedures throughout the year. To schedule an appointment, please call (866) 228-7676 or complete the contact form.

Common Symptoms of a Sinus Infection

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If you have ever had a sinus infection (also known as sinusitis), you know how painful this condition can be. It typically results in swollen, inflamed nasal cavities and can last for a long time. Here is some information on common symptoms associated with this issue and when you may need to see a doctor.

Sinus Infection Causes

In most instances, a sinus infection will be caused by some sort of virus. However, there are some cases where allergies, nasal polyps, a deviated septum and even a tooth infection can trigger sinusitis. If the infection clears up relatively quickly it is known as acute sinusitis. If it lasts for two months or more, it is called chronic sinusitis.

Sinus Infection Symptoms To Look Out For

The most common symptom of a sinus infection is pain. There are several different sinuses located both above and below the eyes, any of which can hurt a great deal if an infection sets in. Many people feel pain on one side of the nose, in the forehead, between the eyes or in the teeth and upper jaws. But as bad as the pain may be, the nasal discharge that typically accompanies sinusitis is also no fun. You may have to blow your nose a great deal to get rid of the greenish-yellow discharge coming from your infected sinuses.

These are just a few of the common symptoms. Others include a sore throat, cough, headache and earache.

When to Visit a Doctor

In most instances, a sinus infection will eventually clear up on its own. However, there are other times where medical attention may be necessary. If your infection has lasted for several weeks and keeps returning, or if you have a fever along with sinus issues, please see your doctor so he or she can treat the problem properly. There may also be some underlying condition causing the infection that needs to be addressed.

Get in touch with your nearest Questcare Medical Clinic location if you or a loved one is suffering from a sinus infection. Contact us online to schedule an appointment or to learn more about how we can help.

Common Symptoms of a Sinus Infection

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If you have ever had a sinus infection (also known as sinusitis), you know how painful this condition can be. It typically results in swollen, inflamed nasal cavities and can last for a long time. Here is some information on common symptoms associated with this issue and when you may need to see a doctor.

Sinus Infection Causes

In most instances, a sinus infection will be caused by some sort of virus. However, there are some cases where allergies, nasal polyps, a deviated septum and even a tooth infection can trigger sinusitis. If the infection clears up relatively quickly it is known as acute sinusitis. If it lasts for two months or more, it is called chronic sinusitis.

Sinus Infection Symptoms To Look Out For

The most common symptom of a sinus infection is pain. There are several different sinuses located both above and below the eyes, any of which can hurt a great deal if an infection sets in. Many people feel pain on one side of the nose, in the forehead, between the eyes or in the teeth and upper jaws. But as bad as the pain may be, the nasal discharge that typically accompanies sinusitis is also no fun. You may have to blow your nose a great deal to get rid of the greenish-yellow discharge coming from your infected sinuses.

These are just a few of the common symptoms. Others include a sore throat, cough, headache and earache.

When to Visit a Doctor

In most instances, a sinus infection will eventually clear up on its own. However, there are other times where medical attention may be necessary. If your infection has lasted for more than 10 days and keeps returning, or if you have a fever along with sinus issues, please see your doctor so he or she can treat the problem properly. There may also be some underlying condition causing the infection that needs to be addressed.

Get in touch with your nearest Jupiter Medical Specialists Clinic location if you or a loved one is suffering from a sinus infection. Contact us online to schedule an appointment or to learn more about how we can help.

Sciatica Nerve Pain

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What is Sciatica?

Sciatica (sigh-at-eh-kah) is a term used to describe the symptoms of pain such as tingling, numbness, or weakness in the leg. The pain typically begins in the lower back and travels down the buttock and then down the large sciatic nerve in the back of each leg. Although sciatica is not a medical diagnosis, it is a symptom of an underlying medical condition.

What Causes Sciatica?

Common lower back problems such as a herniated disc, degenerative disc disease, spondylolisthesis, or spinal stenosis often cause sciatica symptoms.

What Are Symptoms of Sciatica?

Physicians may diagnose a patient with sciatica if they have one or more of the following symptoms:

  • Leg pain that is often described as burning, tingling, or numb
  • Difficulty moving the leg, foot, and/or toes
  • Sharp pain which makes it difficult to stand or walk
  • Constant pain on one side of the buttock or leg
  • Radiating pain down the leg and possibly into the foot
  • Lower back pain

Sciatic pain can vary from infrequent and annoying to constant and debilitating. The sciatic nerve is the largest single nerve in the body and is made up of individual nerve roots which start in the lower back. Symptoms occur when the large nerve is compressed or irritated at or near its point of origin.

How Is Sciatica Treated?

The condition will need to be treated if it is severe with ongoing flare-ups of sciatic nerve pain, so it does not worsen over time. It’s best to share all your symptoms with your physician so the best approach can be made to design a treatment program.

Resolute Pain Solutions physicians have received extensive training in Pain Management, and stay current with new and up-to-date procedures throughout the year. To schedule an appointment, please call (866) 228-7676 or complete the contact form.

How to Protect Yourself from UV Rays

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With July being UV Safety Month, this is a good time to provide some tips that can help protect you from ultraviolet (UV) rays and minimize your chances of developing skin cancer. You do not need to avoid the sun completely, of course, but be smart when you are outside. Not only will you reduce your UV risk, you will also lower the chances of suffering a severe sunburn that may necessitate a trip to your nearest emergency medical center.

Shade is a Good Thing

UV rays are typically at their peak between 10 a.m. and 4 p.m., so try to avoid being in direct sunlight during those hours. One way of telling how strong the sun’s rays are is by using what is known as the “shadow test.” The rays of the sun are at their strongest when you are taller than your shadow.

Wear the Right Clothing

Even though it may seem like it would be too hot to cover yourself properly while outside during the summer, you need to wear as much clothing as you can to cover your skin. Different clothes will provide you with different levels of protection from UV rays. For example, dark-colored clothing will protect you better than light-colored clothes. Fabrics that are tightly woven are more protective than those that are loosely woven.

Choose Your Sunscreen Wisely

The best defense against UV rays, of course, is sunscreen. But you cannot simply grab the first bottle or can off the shelf and assume you will get the right protection. You need to find products that offer protection against both UVA rays and UVB rays, and have an SPF (sun protection factor) of at least 30.

In addition, if you go for a swim or participate in an activity where you will sweat a lot, you need to re-apply your sunscreen when you get out of the water or dry off. There is no such thing as a “sweat-proof” or “waterproof” sunscreen. In fact, manufacturers are no longer allowed to put those terms on their labeling.

If you would like more information on protecting yourself from UV rays, or you have a medical condition that requires immediate attention, contact your nearest Jupiter Medical Specialists Clinic location. One of our skilled staff members will be ready to help.

How to Protect Yourself from UV Rays

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With July being UV Safety Month, this is a good time to provide some tips that can help protect you from ultraviolet (UV) rays and minimize your chances of developing skin cancer. You do not need to avoid the sun completely, of course, but be smart when you are outside. Not only will you reduce your UV risk, you will also lower the chances of suffering a severe sunburn that may necessitate a trip to your nearest emergency medical center.

Shade is a Good Thing

UV rays are typically at their peak between 10 a.m. and 4 p.m., so try to avoid being in direct sunlight during those hours. One way of telling how strong the sun’s rays are is by using what is known as the “shadow test.” The rays of the sun are at their strongest when you are taller than your shadow.

Wear the Right Clothing

Even though it may seem like it would be too hot to cover yourself properly while outside during the summer, you need to wear as much clothing as you can to cover your skin. Different clothes will provide you with different levels of protection from UV rays. For example, dark-colored clothing will protect you better than light-colored clothes. Fabrics that are tightly woven are more protective than those that are loosely woven.

Choose Your Sunscreen Wisely

The best defense against UV rays, of course, is sunscreen. But you cannot simply grab the first bottle or can off the shelf and assume you will get the right protection. You need to find products that offer protection against both UVA rays and UVB rays, and have an SPF (sun protection factor) of at least 30.

In addition, if you go for a swim or participate in an activity where you will sweat a lot, you need to re-apply your sunscreen when you get out of the water or dry off. There is no such thing as a “sweat-proof” or “waterproof” sunscreen. In fact, manufacturers are no longer allowed to put those terms on their labeling.

If you would like more information on protecting yourself from UV rays, or you have a medical condition that requires immediate attention, contact your nearest Questcare Medical Clinic location. One of our skilled staff members will be ready to help.

Disc Herniation with a Pinched Nerve

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There is often confusion when diagnosing neck or back pain since many refer to their discomfort as being a pinched nerve or a herniated disc. The diagnosis is often correct because the two conditions are the most common problem of the pain, but they are both different issues that just happen to occur at the same time.

Typically, a herniated disc occurs in the cervical spine (neck) and the lumbar spine (back). Disc pain tends to most often take place in the lower back (disc herniation lumbar) where most weight-bearing and movement in the spine occurs. A pinched nerve is caused by a herniated disc protrusion pressing against the nerve. In most cases, a herniated disc is not painful, it’s the leaking gel substance, which it contains that pinches, inflames, and irritates the nearby nerve.

A spine is made of twenty-four bones called vertebrae, but the lumbar (lower back) bears most of the weight of the body. In between each of the five lumbar vertebrae (bones) is a disc that acts like a tough fibrous shock-absorbing pad that prevents the vertebrae from rubbing together. A disc is filled with a gel-like center and if the disc ruptures or bulges (bulging disc), the gel substance escapes and causes irritation to the spinal nerves resulting in inflammation, pressure, and pain. Some may also experience leg pain, numbness, and tingling.

The spine contains many nerves, which branch out and travel to various parts of the body. If a bulging disc herniates, it usually presses on the spinal cord or spinal nerves. These nerves pass through small areas between the vertebrae and the discs, so if a herniated disc presses into the area, it can compress (“pinch”) the nerve which results in the pain associated with the herniated disc.

What Causes A Herniated Disc?

A herniation may develop instantly or gradually over weeks or months. Many factors increase the risk such as lifestyle choices, aging, and poor posture. Obesity, inadequate nutrition, and lack of regular exercise, as well as tobacco use, contribute to the condition. As the body ages, biochemical changes can cause the discs to dry out and be less capable to absorb shock from movement. Additionally, body mechanics such as incorrect lifting and twisting combined with daily wear and tear stress the lumbar spine. Rheumatoid arthritis and genetics may also contribute if a family has a history of the problem.

When to seek medical attention for a herniated disc?

It’s important to seek medical attention if one is experiencing numbness, weakness, tingling, extreme burning, or pain. While an x-ray may be able to rule out acute fractures, usually advanced imaging techniques such as a CT or MRI scan are usually needed to determine the presence, location and extent of disc herniation. Sometimes a myelogram (injection of dye) is needed so the physician can view the problem area with more ease.

How Is Disc Herniation Treated?

Disc herniation is most often initially treated with conservative management including a trial of medication and physical therapy. Medications include anti-inflammatories, muscle relaxants, or nerve pain medications. If this fails, a trial of spinal injections can be offered. “Cortisone epidural” injections are the most common injection utilized for disc herniation. This is usually performed by a trained pain physician and is done in the outpatient setting. Epidural cortisone injections include deposition of a combination of steroids with a local anesthetic under x-ray guidance into/near the area of disc herniation. Sometimes, a series of 3 injections must be performed to achieve maximal benefits.

Often and over time, the herniation will shrink, and the pain will subside and perhaps eventually disappear entirely. If patients fail to respond to conservative management and/or cortisone injections, referral to a spine surgeon may be recommended. Patients who continue to have symptoms and are not a surgical candidate may be offered advanced interventional pain therapies such as spinal cord stimulation.

Resolute Pain Solutions physicians have received extensive training in Pain Management, and stay current with new and up-to-date procedures throughout the year. To schedule an appointment, please call (866) 228-7676 or complete the contact form.

Chronic pain that affects the chest, abdomen and pelvis.

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The Chest (which is sometimes referred to as the Thorax), the Abdomen, and the Pelvis host many vital organs, like the heart, lungs, kidneys, bowels, and bladder. Acute pain in these areas is usually an alarming sign that directs our attention to seek medical care to make sure nothing serious is going on that needs immediate intervention. But how about when all the tests come back negative and the pain is becoming the disease itself, or when there is some underlying disease that is causing a lot of pain that is affecting the quality of life?

Here comes the role of Pain Physicians to evaluate the different sources of pain and suggest possible treatments and therapies. Some of these pain syndromes could be divided into different areas:

Chronic Pain of the Chest:

-Any injury to the ribs could cause a long and lasting pain, e.g. Fracture after a fall, or an injury after surgery (Post-Thoracotomy Syndrome). This can lead to chronic pain in the nerves adjacent to the ribs, a condition called Intercostal Neuralgia. Your physician may suggest interventions like Intercostal nerve block or neuropathic pain medications or sometimes both. In refractory cases, the physician may suggest Spinal Cord Stimulator (SCS) or Peripheral Nerve Stimulator (PNS).

-Another common chronic pain condition that affects especially elderly patients is Shingles (also called Herpes Zoster caused by Varicella Zoster Virus), could linger for many weeks or months after the initial lesions appear and could be very painful. Your physician could recommend a combination of injections, medications or a new topical therapy that uses high doses of Capsaicin applied through patches at the doctor’s office.

Chronic Pain of the Abdomen:

-Not uncommon after certain surgeries, like after hernia repairs, some patients may develop ongoing pain at the incision site, here a specific Ultrasound-Guided Nerve Block could help to relieve the pain, or in refractory cases, a specific type of Spinal Cord Stimulator called DRG (Dorsal Root Ganglion) Stimulator could be recommended by your doctor.

-Some of the Gastrointestinal pathologies like Chronic Pancreatitis, Pancreatic cancer, or other sympathetically mediated syndromes could respond well to targeted sympathetic chain blocks like Celiac Plexus Block or Superior Hypogastric Plexus Block.

Chronic Pain of the Pelvis:

-Chronic Pelvic Pain sometimes could be a very challenging problem that requires the collaboration of multiple specialists like Gynecologists, Gastroenterologists, and Urologists along with pain physicians for proper diagnosis and treatment. Chronic pelvic pain can have multiple causes, it can be a symptom of another disease, or it can be a condition in its own right. If the pain appears to be caused by another medical problem, treating that problem may be enough to eliminate the pain. However, in many cases, it’s not possible to identify a single cause of chronic pelvic pain. In that case, the goal of treatment is to reduce your pain and other symptoms and improve your quality of life. Some of these syndromes are Endometriosis, Interstitial nephritis, Irritable Bowel Syndrome, or Pudendal Neuralgia.

-After proper evaluation and testing your pain doctor may recommend different treatment modalities like physical therapy, psychotherapy, neuropathic pain medications or specific type of injections like image-guided nerve blocks that may include Ganglion of Impar block.

-Luckily there are new treatments and therapies that are emerging to help in managing these challenging syndromes like DRG-Spinal Cord Stimulator and Peripheral Nerve Stimulator. Please discuss with your doctor if you qualify for one of these therapies.

Our physicians at Valley Pain Consultants will help you and offer a fast, safe and effective treatment. To schedule an appointment, please call (480) 467-2273 or complete the contact form.

Reducing Your Risk for Osteoporosis

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Osteoporosis is, unfortunately, an all-too-common problem in the U.S., with an estimated 10 million sufferers. What is even worse is that as many as 34 million people, according to the National Osteoporosis Foundation, have low bone density – a major factor in determining whether someone is at risk of developing the condition. Here is some information that could help you reduce your chances of becoming one of these statistics.

Make the Right Choices

There are ways that you can either substantially lower your risk of getting osteoporosis or possibly even prevent it altogether. By implementing some healthy lifestyle changes, you could substantially impact the strength and overall health of your bones and minimize your osteoporosis risk later in life. These are some of them.

  • Boost your intake of calcium and vitamin D – Both calcium and vitamin D are vital to the health of your bones. Consider taking daily supplements to ensure you get the proper amount of both nutrients – after talking to your doctor to make sure he or she recommends doing so.
  • Get active – There are several different types of exercises that can significantly strengthen your bones, especially weight-bearing exercises such as jumping rope, walking, running, yoga, aerobics and others. Anything that requires your bones to support your body weight will help.
  • Change your diet – While vitamin D and calcium – as well as magnesium – are vital, it is just as important that your diet help provide the energy you need to stay active. For example, if your diet is high in caffeine and salt, that could play a role in causing bone loss and, ultimately, osteoporosis. You will also want to maintain the ideal weight for your body type. It is important that you are neither overweight nor underweight.

Contact Us About Osteoporosis

These are just a few of the things you can do to lower your chances of developing osteoporosis. If you would like more information or you need treatment for this condition, get in touch with your nearest Questcare Medical Clinic location.