Health & Wellness

QUESTION: “I have osteoarthritis in my knee. Does this mean that I eventually will need a knee replacement?”

ANSWER: Osteoarthritis is essentially the breakdown of the cartilage of your joints over time. This can occur through normal wear and tear of the joint as we age, but can be accelerated by other causes.

Factors such as obesity, injuries, surgeries and genetics can increase the speed at which the joint breaks down. Think of your cartilage like the tread on a tire. Over many miles, the tread wears down based on the load placed on the wheels, the alignment of the vehicle, daily impact and the type of use. When that tread wears down too much, it’s time to get a new tire. As the cartilage breaks down, eventually the bone and nerve endings are exposed and can be painful.

NOW WHAT?

The first line of treatment with osteoarthritis is to manage the pain starting with over-the-counter or prescription medications. Physical therapy can be helpful to strengthen the weakened joint and improve range of motion. Many patients find short-term relief with cortisone shots for pain and/or gel injections that lubricate and increase the shock absorption of the joint.

If these conservative measures are no longer helpful, surgical intervention through a joint replacement may seem like your only option. However, advancements in regenerative therapies are providing a new hope for many patients struggling with arthritis pain and can delay or possibly even prevent the need for a joint replacement. These newer treatments use biologic elements such as your own adult stem cells and platelets to ease the pain. In many cases, they might regenerate lost cartilage.

As a form of regenerative medicine, stem cell procedures activate your body’s own stem cells to encourage healing and speed repair for bone, muscle, joint, soft tissue and nerve injuries.

Teams across Greater Cleveland will join together to honor those facing Alzheimer’s disease during Alzheimer’s & Brain Awareness Month by participating in The Longest Day on June 20. The sunrise-to-sunset event recognizes the strength, passion and endurance of caregivers and those living with Alzheimer’s disease. Proceeds benefit the Alzheimer’s Association.

Held annually on the summer solstice, The Longest Day symbolizes the seemingly endless journey so many facing Alzheimer’s disease are asked to endure. Participants will complete activities including running, cooking, hiking and playing bridge to help advance Alzheimer’s care, support and research. The Cleveland area has more than 20 teams.

Wayne Heritage of North Olmsted will host his annual bridge tournament, “Memories and Matchpoints” at the Rocky River City Hall on The Longest Day in honor of his wife, Prudence, who is suffering from the disease. This is the third year for the tournament, which raised over $6,500 in 2015 with 120 bridge players from the Cleveland area. Space is still available for anyone interested in joining the tournament.

Al Keim of Mentor is helping to promote Brain Awareness Month by hosting an event on June 18. Al and his family will be hiking in memory of his father, Woody Keim, at the Cleveland Metroparks North Chagrin Reservation. They invite anyone to join them. The “Woody’s Wanderers” goal is $2,000.

To join or support either team, email [email protected] or call 216-342-5606. To start your own team or to learn more about The

Longest Day, visit alz.org/thelongestday. Alzheimer’s is the nation’s sixth leading cause of death. More than five million Americans are living with Alzheimer’s, including 210,000 in Ohio. The number nationwide is estimated to grow to as many as 16 million by 2050, according to the Alzheimer’s Association 2015 Alzheimer’s Disease Facts & Figures report.

QUESTION: Why does my leg hurt and feel numb sometimes? Is this related to my lower back?

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ANSWER: Numbness or tingling sensations in the legs could definitely be related to your back. What you are describing sounds like lumbar spinal stenosis, but it’s important that you have your spine evaluated to determine the exact cause and course of treatment.

Another problem that can cause numbness is neuropathy, which is a complication from diabetes, or peripheral vascular disease. Seeing a spine specialist can help pinpoint the problem.

Stenosis is a medical term simply meaning narrowing, so essentially this is “spine narrowing.” The nerves of the spine are getting pinched as they exit from the spinal canal through the center hole between the bones, which is called the foramen.

This nerve compression can result in sciatic pain that radiates down through your leg. You may also feel a loss of strength and fatigue in the legs as the sciatic nerve is pressed and becomes inflamed and irritated.

Many find that leaning forward may relieve the pressure and stop the pain — this is referred to as the “shopping cart sign.” It’s also common for this type of pain to happen during specific activities, or it can come and go rather than being a constant sensation.

A combination of conditions can lead to spinal stenosis, including facet arthritis and disc degeneration, which occurs in everyone to some extent, through aging. As we get older, the height between the vertebral bodies is decreased, thus reducing the space available for the nerves to exit from the spine. Pinched nerves are a very common occurrence.

WHAT CAN YOU DO?

First, have your spine evaluated by an orthopedic surgeon to determine the severity of your condition. Although it is best to start with a surgeon, most cases will be treated non-surgically.

Don’t kid around when it comes to vaccinations. Adults need them too, according to the Centers for Disease Control.

HERE’S WHAT TO  GET

• An annual flu shot. Sixty percent of people who wind up in the hospital from flu complications are 65 and older.
• Td to Tdap – tetanus, diphtheria and pertussis (whooping cough). All adults should get the Tdap vaccine if they did not get it as a teen. If you did, then you need a Td (tetanus, diphtheria) booster shot every 10 years. Again, check with your doctor.
• A shingles (Zoster) vaccine for everyone 60 and older. Younger? Ask your doctor if you should get the shot.
• A pneumonia shot (pneumococcal vaccine) for folks 65 and up or for anyone younger with certain chronic conditions.

QUESTION: “When a muscle or joint problem gets really painful, do I have to go to the ER, or do urgent care centers provide orthopedic care?”

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ANSWER: When pain becomes unmanageable, many believe they need to go to the emergency room. But the ER is primarily designed to serve life-
threatening emergencies. An urgent care center may be able to help you, but you will likely be seen by a generalist — not an orthopedic specialist. In both cases, you will walk out with a referral to have a second appointment with a specialist.

A facility such as GO Ortho is a good option. This office is staffed by orthopedic specialists but accepts walk-ins and same-day appointments. This enables patients to get in with a specialist to take care of their pain much sooner than typical orthopedic offices, which might not have an open appointment for weeks.

A GO Ortho visit is charged as a regular orthopedic office visit and not as an ER/emergency level visit that may come with a high cost to the patient.

GO Ortho is an independent practice housed at Hillcrest Hospital and cares for a wide range of orthopedic conditions from acute pain resulting from breaks or sprains to chronically painful conditions. Because you are seeing an orthopedic specialist, conditions can be quickly and more accurately diagnosed as well as treated properly. GO Ortho staff are trained to provide sophisticated treatments, advanced orthopedic imaging and outfit patients in the latest in slings, braces, casting and other support devices.

While we do advocate going to the ER when you are faced with a severe medical problem, most orthopedic pains and conditions are not life-threatening and are best treated by an orthopedic specialist.