Orthopedics - Palm Beach County, FL

Bursitis

Bursitis is an inflammation of the bursa, a fluid filled sack that cushions the junction of two bones. Both sides contain lubricating fluid which normally eliminates friction in the area while maintaining smooth muscle movement over the bone. Sudden extreme pressure or continuous strain can cause inflammation. Pain from bursitis can be very disabling and any joint in the body can be affected by bursitis. However, shoulders, knees and elbows are most commonly effected. Acute bursitis may heal with time if the joint is immobilized. Patients may consider using crutches or slings. Or, complete bed rest may help relieve the pressure on the affected area. In severe cases, your doctor may recommend surgery.

Bursitis is probably the most common hip joint condition. When it does not respond to traditional simple measures such as a modification of activities or a trail of anti-inflammatory medicines, then many times it is appropriate to consider referral to an orthopedic surgeon for better delineation of the problem. The suffix "itis" in medicine refers to an inflammation or irritation. A "bursa" is a fibrous covering overlying a bone. Hence, bursitis is an irritative condition overlying the bones in the hip -- typically the part of the femur known as the Great Trochanter. Frequently, an injection with a cortisone type preparation will be tried to see if the symptoms are alleviated. Many times, however, the focus of attention may be to determine if some other condition exists.

Avascular Necrosis

Avascular Necrosis or Aseptic Necrosis of the hip represents a condition where the hip has at least temporarily lost the critical blood supply to the ball part of the hip. This can cause a condition where the bone begins to collapse at this weakened site and then arthritis can begin. This is the condition many people identify with Bo Jackson who eventually underwent hip replacement surgery for the treatment of this disorder. There are several factors which have been statistically identified with this condition, but for the vast majority of patients, there is no know cause.

Arthritis of the Hip

Arthritis is a gradual wearing down of the smooth gliding surfaces of the hip joint. When this occurs, raw bone becomes exposes within the hip joint which becomes painful with activity. This may have occurred due to a variety of reasons but frequently the end result is the same -- increasingly persistent pain and decreasing activity level. First line treatments include modification of activity and use of an anti-inflammatory medicine or perhaps Tylenol type products. Sensitivity of the stomach and intestines many times makes prolonged use of the anti-inflammatory medicines difficult. When the condition becomes particularly severe, then surgery is indicated. The most common procedure is Total Hip Replacement which aims at resurfacing both the cup and the ball surfaces. A frequent misconception of patients is that they are too old for this type of surgery since it is extensive. However, the vast majority of patients undergoing hip replacement surgery are easily within the retirement age group and usually do excellent.

Tendonitis

The tendon is the tissue connecting the tissue to the bone. A slight injury can make the tendon inflamed and torn. This condition is known as tendonitis. This is a painful condition, and takes quite a while to heal since the muscle is in constant use. When the torn area does not heal, it leaves a reminder -- a scar in the tendon which can cause pain. The pain usually disappears in a few weeks, but with older people, the pain can remain and even get worse over time. The injury can occur any place a tendon joins a muscle to the bone.

Arthritis

Arthritis is an inflammation of a joint usually accompanied by pain and frequently changes in structure. Contrary to popular belief, arthritis is not inherited. Arthritis is not caused by bad weather or stress, although these conditions may cause the symptoms to worsen. While there is no specific therapy -- rest, passive exercise and anti-inflammatory drugs are usually prescribed. If the condition is severe enough, bed rest may be recommended. The use of exercise and physical therapy is important in maintaining range of motion of the affected joints. The drug most often prescribed for relieving the pain of arthritis is still aspirin. However, Naprosyn and Ibuprofen are also used in treatment. Surgical replacement of the joint has been effective in very severe forms of arthritis.

Rheumatoid Arthritis

Although arthritis most commonly occurs in person over the age of 50, rheumatoid arthritis can strike at any age. The symptoms include aching of the joints, swelling, stiffness, fever and fatigue. This type of arthritis sometimes goes into remission when the symptoms disappear. However, when the symptoms reoccur, it can be more severe. Your physician may prescribe anti-inflammatory drugs to relieve pain. A low impact exercise program interspersed with rest periods may help reduce stiffness. In extreme cases, rheumatoid arthritis can affect the heart, lungs and the nerves.

Knee Problems

In a normal knee, the space between the thigh and shin bone is filled with fluid and cartilage. This serves as a cushion and shock absorber. In an arthritic knee, the cartilage deteriorates, causing the bones to rub against each other. This results in pain and stiffness. Since the knees are major weight-bearing joints, they are often severely affected by arthritis. Losing excess body weight is often recommended as a first step in relieving some of the pain. Light to moderate exercise can also help. Short walks and swimming are often recommended to help keep joints limber and reduce the stiffness. In addition, ice or heat packs on the affected joint may provide relief. Your doctor may also prescribe anti-inflammatory medication. When the arthritis becomes so severe that is intolerable, surgery may be advised. Depending on the diagnosis, a partial or total knee replacement may be recommended. Results of these procedures have been excellent, and most patients are able to return to a more comfortable and active lifestyle.

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