Work-Related Trauma and Acute Injuries

Originally published on GilTepperMD.com

 

Following up from my previous blog, today we will discuss some of the more common injuries sustained at work, how to treat them, and tips for prevention. Hundreds of thousands of accidents occur within the workplace every year, the severeness of which can vary greatly. Aside from knowing one’s legal rights and the ability to receive compensation, it is important to have these injuries treated physically in addition to legally. Below are some of the most common accidents that occur within the walls of a workplace.

Back Injuries

Injuries and pain in the back are the most common workplace grievances, with 5-10% of those documented becoming chronic among patients. Whether working in an office setting or a construction site outdoors, nearly every employee is exposed to the risk of back injury. Poor posture or prolonged sitting can lead to poor muscle development, pinched nerves, and damaged discs within the spine.

Specific injuries to the back include muscle strains or sprains, and herniated discs. These affect over 1 million workers, which attributes to 20% of all workplace injuries and illnesses. Aside from effective employee training, the best way to prevent sustaining a back injury is to understand basic lifting, moving, and carrying procedures when working in an environment that requires all three. Back injuries can be extremely debilitating, and can even lead to weight gain and poor physical function due to loss of mobility.

Hernia

There are several types of hernias that one can endure, with some of the most common work-related being inguinal and hiatal. Inguinal hernias are when the intestines protrude through a weak spot or opening in the lower abdomen. Though it is more common in men than it is women, these can be caused by extremely heavy lifting, coughing, or old age, as the abdomen wall weakens over time. Hiatal hernias are when the stomach begins to extend up into the diaphragm. These typically come with age as well.

Hernias are generally easy to deal with in terms of pain, as a small bulge may appear around the affected area. Leaving it untreated does not necessarily increase one’s chances of worsening the injury, but depending on the severity of the symptoms, seeking treatment options would not be unwise. Should you feel “fullness” or pain upon lifting, consult a physician immediately. Surgery is sometimes required to treat these injuries. In less serious cases, the hernia can easily be pushed back into its proper position.

Arthritis

Arthritis is any rheumatic disease that affects joints, the surrounding tissue, and other connective tissue in the area. This is the most common disability in America, and can worsen within a workplace setting. Osteoarthritis specifically is more prevalent in workplaces, as this is associated with knee and/or hip pain. Outdoor professions like construction or agriculture typically put those at risk due to heavy lifting and constant movement in unnatural positions (kneeling or crawling).

Rheumatoid arthritis is a disorder defined as chronic inflammation in the joints of the hands and feet. Given the chronicfactor, this can make life difficult, especially within a workplace setting. Achy fingers or wrists can make typing challenging, as well as lifting anything at all. Work with a Rheumatologist to determine the best form of treatment for you, which can come in the form of medication, a change in diet, exercise, and physical therapy.

Early diagnosis is key in treating arthritis in order to prevent loss of mobility. Exercise and weight management programs are very helpful, but the consultation of a medical professional beforehand should never fall by the wayside.

Carpal Tunnel Syndrome

Associated with the peripheral nervous system, carpal tunnel is the compression of the median nerve around the wrist. This is very common in individuals who type on a computer on a daily basis, or work with their hands in general. Symptoms range from numbness, to weakness, to muscular atrophy. Carpal tunnel is more common in women, though nearly everyone is at risk. Some contributing factors to this condition include pregnancy, pre existing wrist injuries, arthritis, diabetes, and family history.

In terms of treatment, the first step is avoiding any activity that can worsen your condition. Wearing a wrist splint, therapeutic stretching, or medications have been found to work best, but surgeries are not uncommon in order to relieve more extreme cases.

Sciatica

Many lower back injuries can lead to this debilitating condition, which is caused by the compression of the sciatic nerve; a set of five paired nerves located in the lumbar spine. The entire nerve runs the length of the pelvis all the way down to the foot, passing through the buttocks and hip. Sciatica is caused by spinal disorders that compress the nerve like a herniated disc, lumbar spinal stenosis, tumors, or trauma to that area, of which many workplace incidents can contribute to.

Rotator Cuff Injury

The rotator cuff is a collection of muscles and tendons on the shoulder that connect your upper humerus to the joint, keeping it firmly in place. An injury sustained to the rotator cuff is often caused by consistent overhead movements like reaching or lifting objects. This is especially common in painters, athletes, or individuals in construction. The injuries themselves can range from minor inflammation to complete tears of the tissue.

Some symptoms to look out for include a deep ache within the shoulder, pain upon lifting either arm, and arm weakness in general. While this typically treated through rest, depending on the severity of the injury, leaving it motionless for too long can actually have adverse effects. Consult your physician immediately if you experience a sudden loss of mobility following an injury. This may be a complete rotator cuff tear.

Prevention comes in the form of carefully strengthening these muscles through exercise and stretching. In addition to shoulder workouts, strengthening the chest and back muscles are just as important for support around the shoulder blade.

Meniscus Tear

The meniscus is the cushioning disc located within the knee meant to keep the joint steady and balance your weight accordingly, of which there are two. A tear of this disc can be very crippling. Any sudden twisting or turning while the foot is planted can lead to this, which is not uncommon in sports or manual labor careers. The menisci weaken with age as well; another factor worth noting.

A minor tear may result in simply swelling and slight pain, which can be treated with rest and applied heat. A moderate tear will limit your mobility a little bit more, but walking is still possible. As a result of this, swelling will be more severe and stiffness is often felt as well. Be sure to be much more cautious in this case. A severe tear can cause the knee to catch, or lock, preventing you from straightening it due to pieces of the torn meniscus being able to move throughout the joint.

The location of the tear plays a large role in determining treatment. Tears on the outer edge of the meniscus are typically able to heal on their own thanks to a large blood supply. All that is needed in this case is a brace or resting period. Tears located on the inner part of the meniscus need much more assistance with healing because of less blood flow.

Surgical repair may be required in some cases, such as to remove torn pieces floating about. A total meniscectomy is required in very extreme cases, which is the removal of the entire meniscus, though this is generally avoided due to the increased risk of osteoarthritis.

Thank you for reading! Follow me on Twitter for more, and be sure to stay tuned for more pieces on orthopedics and spinal health.

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When Spinal Surgery is Right for You (Pt. 3)

Now that we’ve come to part three of my spinal surgery blog series, we will cover even more spinal conditions, how they can be treated, and if surgery is necessary, specifically, those of the degenerative nature.

Degenerative spinal conditions often come with age, and can lead to chronic pain disruptive of one’s daily activities and lifestyle. Consider the constant weight and pressure applied to the spine and neck day in and day out. This, over a long period of time, can lead to loss of function. More specifically, discs begin to lose elasticity, ligaments start to calcify, and arthritic pain in general is increased.

Like with all conditions, medication and physical rehabilitation can provide more or less relief for certain individuals, but surgery may be required in more severe situations. Surgeries performed for degenerative disorders involve removing whatever part of the spine is causing the compression in order to relieve stress on the surrounding nerves, and thus, relieve pain. Some of those conditions include herniated discs, degenerated discs, and bone spurs.

  • herniated disc is when the inner material of said disc is exposed, compressing nearby spinal nerves. The surgical consideration to correct this includes removing the exposed material, or the entire disc.
  • Degenerative disc disease can occur in any motion segment /joint along the spine. When the cartilage lining the joints begins to wear out, those joints become irregular, much more stiff, and can begin to swell; another source of pressure being applied to the surrounding nerves. Surgery can range from complete removal/replacement of the joint causing the pain, to relieving the pressure in the nerves in order to relieve pain.
  • Bone spurs are the human body’s natural response to spinal column stresses. The bones attempt to straighten themselves out, which typically results in growths along the spine affecting nerve passages. Undergoing surgery for this requires removal of the spurs, or the entire joint depending on their severity.

If you or someone you know is affected by degenerative disc disease, herniated discs, arthritis, or bone spurs, consult your medical professional to discuss options before deciding on surgery. Regular rehabilitation can help in relieving pain, but minimally invasive surgery has been proven to be a safe, successful alternative.

Originally published on GilTepperMD.com

When Spinal Surgery is Right for You (Pt. 2)

Welcome back, friends. As discussed in my previous blog, spinal conditions and the types of surgeries that ensue can be complex. Exploring a number of other spinal issues, I thought covering the following would be appropriate.

At times, a stabilizing spinal reconstruction with disc replacement or fusion technique may be most suitable for return to action. There are several types of options here, one of the most common being spinal fusion surgery. This is done by a surgeon fusing two vertebrae together to form a single, stable cohesive unit that prevents movement, which is often the cause of pain.

Patients suffering from spondylolisthesis are the best candidates for this surgery, as this is an unstable misalignment of two or more vertebrae that causes painful movement. Fusing said vertebrae with proper alignment, using rods and screws can prevent continued and progressively deteriorating pain. However, spinal fusion is not for everyone, and is not considered a long-term option. The joint can wear over time, leading to the familiar pain that was once cured. That said, I have been performing this surgery successfully since the early 90’s and have followed some pleased patients for nearly 20 years.

Motion sparing procedures have gained FDA approval recently and are increasing in popularity. Here choices include interspinous devices and artificial disc replacement (ADR). Spinal disc replacement or arthroplasty may serve in select patients as an appropriate choice for procedure. It combines a minimally invasive technique and motion sparing principles while decompressing the nerves and stabilizing the segment. As a principle FDA investigator on such artificial disc since 2003, I have performed this operation with remarkable and sustainable success over the years. I am pleased with the recent adoption and FDA approvals.

Laser spine surgery seems to be more of a dated technique now that minimally invasive surgery not including a laser has become a staple among hospitals across the world, and has been found to be much more effective. In the past, patients may have undergone this procedure due to spinal stenosis, herniated discs, or sciatica. However, the actual use of lasers was later discovered to be not much more effective than traditional methods, paving the way for minimally invasive surgery.

Coflex is another alternative to standard surgical practices that involves a stabilization procedure excluding rods and screws for patients suffering from spinal stenosis. Coflex’s signature device is a titanium implant that stabilizes the spine following surgical decompression, helping maintain your spine’s normal foraminal height and motion. This implant allows for much more flexibility compared to rods and screws, but is much stronger as well thanks to its titanium makeup. Additional benefits of this procedure include a much shorter recovery period, lasting relief for years to follow, minimal blood loss upon being surgically implanted, and more natural movement.

When Spinal Surgery is Right for You (Pt. 1)

Enduring back pain and debilitating discomfort can be incapacitating for patients of all ages. If traditional forms of conservative treatment do not seem to be alleviating this suffering, spinal surgery may be the next appropriate step.

It’s important to understand conservative spinal care for those who feel they may need surgery to see if these strategies relieve pain beforehand. These can include applying ice or heat, physical therapy, moderate exercise, or simply waiting. Non impact home exercise routines, stretching, rolling and core build up programs can be both helpful and prevent future bouts. Swimming breast stroke for 20-30 minutes daily builds up supporting spine muscles. Back pain can go away with time, but know signs of a serious case when waiting to seek the help of a medical professional. Should you experience a fever or decreased bowel/bladder control, consult a physician immediately.

Though spine surgery should be a last resort option for many people, back surgery of any kind can be extremely effective in relieving persistent pain. One common debilitating symptom is radiating pain. Sciatica is often a strong indicator of someone suffering from a damaged disc. This is an intense pain that can be felt in the lower back, buttocks, thighs, and legs. If you or someone you know experiences this sensation, traditional forms of rehabilitation are recommended before considering surgery. Up to 90 days in which a patient exercises and takes care of their back have been shown to alleviate this pain, but surgery can do so at a faster rate depending on the severity of one’s pain.

Microdiscectomy is a type of surgery for patients suffering from such damaged spinal disc, due to disc tear and deterioration over time with protrusion. This can cause the sides of the damaged disc to bulge outward and apply pressure to any surrounding nerves. In more extreme cases, the disc core can herniate and compress the more delicate interior of the spine. With the advent of improved magnification and illumination in surgery this can be performed in a non disruptive minimally invasive fashion. One can expect to return to an active routine much improved in a short time.

Spinal stenosis is common among older patients. This is when the area surrounding the spine is narrowed, leading to a higher risk of pain through protruding discs or ligaments. A few signs of this include leg pain upon standing up or walking short distances that is then relieved when sitting, pain leaning forward or backward, and sciatica. Spinal fusion or a laminectomy can help if physical therapy and medication fails to do so.

In my next blog, I will be covering a number of other spinal conditions and how to treat those as well.