Penn Orthopaedics

Penn Orthopaedics

Thursday, October 16, 2014

When to Seek a Spinal Evaluation

The spine is an interesting and unique structure, one of the most important parts of your body. It is instrumental to the support, strength, flexibility and range of motion our bodies have. The spine also protects the spinal cord, which carries signals from the brain to other parts of the body.

Harvey E. Smith, MD
Arthritis and degenerative wear-and-tear problems can significantly affect the spine and can lead to back or neck pain, numbness and weakness. Issues with your spine can also impact your hands, arms legs and feet.

So, how do we know when that pain in the back or neck is something that needs to be checked out?

Warning Signs

Trauma. If you’ve had any type of traumatic injury, such as a fall or were involved in a motor vehicle accident, you want to have your back or neck pain checked out by a doctor.

Fever. If you are dealing with back or neck pain, it is important to keep an eye on any type of fever you have. When a fever doesn’t break and is accompanied by pain in the back or neck area, it may be a sign of an infection.

Numbness or Tingling. If you’ve dealt with numbness or tingling for some time and traditional over-the-counter medication has not worked, you could have nerve irritation or damage caused by a herniated disc, spinal stenosis or other disc diseases.

What Type of Doctor Should I See?

When dealing with chronic pain of the spine or the aftermath of an injury, many types of physicians can help you manage pain, repair damage and, in many cases, regain a comfortable range of motion.

The Penn Orthopaedic Spine Service treats patients suffering from arthritis, degenerative wear and tear problems affecting an individual’s joints and disks, as well as abnormalities that cause pain, numbness and weakness in the back or neck area.

Harvey E. Smith, MD, Assistant Professor of Orthopaedic Surgery, sees patients with a range of spine and back conditions. When asked about his philosophy of care, Dr. Smith offered the following: “Our role is to help patients understand their diagnosis and the treatment options available, which usually include – both - operative and non-operative. We will never push patients one way or another. We simply try to educate them as much as possible and work with them to decide which option is best for them. The patient really needs to comfortable and confident with their decision.”

The Region’s First Musculoskeletal Center

The Penn Musculoskeletal Center, the first of its kind in Philadelphia, is revolutionizing the way musculoskeletal care is delivered. The Center provides the latest diagnostic techniques and the most advanced surgical and non-surgical options for a range of musculoskeletal disorders, injuries and pain found in muscles, ligaments and tendons, and bones – including spine.

The Center brings clinicians together from numerous specialties, including orthopaedics, rheumatology, physical medicine and rehabilitation, pain medicine and musculoskeletal radiology. This team-based model of care creates a seamless, integrated patient experience and the most efficient process of diagnosis and appropriate treatment.

“I truly believe that Penn Medicine provides the highest level of care for those suffering from spine and neck injuries or disorders,” said Dr. Smith. “That care has elevated even more with the opening of the Penn Musculoskeletal Center at Penn Medicine University City. We now have this tremendous situation where multiple services have been brought together under one roof.”

Learn more about how the expert specialists at
the Penn Musculoskeletal Center can help get you back to living pain-free.

Question and Answer with Dr. Plastaras

Christopher T. Plastaras, MD, is the Director of the Penn Spine Center. Dr. Plastaras is a physiatrist who specializes in the non-operative treatment of musculoskeletal injuries. Dr. Plastaras practices at Penn Medicine Rittenhouse. Below is a recent Q&A with Dr. Plastaras.

Dr. Plastaras

For those of us who are not familiar with the specialty, please tell us the role of a physiatrist?

Physiatrists specialize in non-surgical physical medicine and rehabilitation (PM&R) for patients who have been disabled as a result of a disease, condition, disorder, or injury. We diagnose conditions, treat injuries using non-surgical methods and lead the patient’s expanded treatment team.

Our focus is to work with patients to develop a comprehensive program that enables them to get back to the life they want to live after injury or disease – without surgery. And a majority of the time, we are extremely successful.

What is the physiatrist's role in providing medical diagnosis and treatment?

We work with a comprehensive team all focused on rehabbing the patient. This team includes physical therapists, occupational therapists, recreational therapists, rehabilitation nurses, psychologists, social workers, and others.

There are also a number of diagnostic tests and treatments that we perform and prescribe. Those include: therapeutic exercise, prosthetics/orthotics, pain medications, EMG (electromyography), NCS (nerve conduction studies), soft tissue injections, joint injections, spine injections, musculoskeletal ultrasound, interventional spinal therapeutics and spasticity management.

If surgery is required, Penn Orthopaedics has a host of fantastic surgeons to treat the patient.

What is your philosophy of care?

We focus on conservative treatment measures whenever possible.

Our practice’s philosophy centers on a famous quote by Benjamin Franklin, “An ounce of prevention is worth a pound of cure.” We take the time needed to accurately pinpoint the source of the ailment and then work with the patient to design an aggressive non-operative management plan.

The Penn Musculoskeletal Center recently opened at 3737 Market Street. Can you explain the benefits of this new Center to patients?

The beauty of the Penn Musculoskeletal Center is that it brings clinicians together from numerous specialties, including orthopaedics, rheumatology, physical medicine and rehabilitation, pain medicine, spine surgery and musculoskeletal radiology. This team-based model of care creates a great patient experience.

 Everyone is really pleased with this new space and both patient and care providers are already seeing the benefits.

Today is World Spine Day, any tips to prevent back pain?

Although I treat all types of patients, I do see a large number of individuals dealing with spine related problems including neck pain and low back pain.

There are many steps individuals can take to prevent back pain -- and all focus around general health and wellness. It is important to regularly take part in moderate exercise. Not only is it great to keep your body moving, it helps to keep your weight under control.

Making sure you get restful, regular sleep is also a good way to prevent injury. An example I often share is around an individual that stays up late a few nights in a row. One night, this person is so exhausted that they fall asleep in their recliner. This unnatural sleeping position puts their neck and back in awkward positions and can lead to much pain and discomfort.

Another tip that seems so simple, but can really help an individual avoid neck and back pain has to do with how you use your smartphone. Hold your device at eye level or as close to eye level as you can. Looking down for long periods may cause postural problems and neck pain.

The Region’s First Musculoskeletal Center

The Penn Musculoskeletal Center, the first of its kind in Philadelphia, is revolutionizing the way musculoskeletal care is delivered. The Center provides the latest diagnostic techniques and the most advanced surgical and non-surgical options for a range of musculoskeletal disorders, injuries and pain found in muscles, ligaments and tendons, and bones.

The Center also brings clinicians together from numerous specialties, including orthopaedics, rheumatology, physical medicine and rehabilitation, pain medicine, spine surgery and musculoskeletal radiology. This team-based model of care creates a seamless, integrated patient experience and the most efficient process of diagnosis and appropriate treatment.


Learn more about how the expert specialists at
the Penn Musculoskeletal Center can help get you back to living pain-free.

Monday, October 13, 2014

Best Exercises for Knee Pain

It’s a dilemma many face: You want to exercise, but your knees or other joints hurt too much to do anything strenuous.

Rather than get caught in cycle of not exercising because your knees hurt  and your knees hurt because you are not exercising, here are some exercise ideas for your aching knees.

Spinning®/Bike Riding

Arthritis Awareness
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Any type of activity that removes pressure from your knees and back is a great exercise.

If fitted properly for a bike, this is a great activity that gets you moving and keeps your knees protected. That’s because most of the weight falls on your seat – not on your knees like in walking or running. Properly fitting shoes also helps center the pressure on the ball of your foot and takes the pressure off of your knees.

Swimming/Water Aerobics

Water exercises are extremely beneficial because the water acts as natural resistance to your body. When you work out in the water, your body is tasked to push against that resistance and build muscle. At the same time, the water makes you buoyant and takes pressure off of your joints. This is why so many fitness experts refer to swimming as the perfect aerobic exercise.

Walking

Most experts agree that walking is one of the best forms of exercise. You can do it anywhere, it costs nothing but a good pair of shoes and you can do it in any climate. When beginning a walking program, start slowly – walk only 20 to 30 minutes at a time, three to five times a week. Gradually build up endurance by walking longer and more frequently.

It is also suggested that you visit a shoe store that offers shoe-fitting consultation. Finding the right support and cushion can help minimize your knee pain.

Learn more helpful tips for living with bone and joint pain.

The Region’s First Musculoskeletal Center

The Penn Musculoskeletal Center, the first of its kind in Philadelphia, is revolutionizing the way musculoskeletal care is delivered. The Center provides the latest diagnostic techniques and the most advanced surgical and non-surgical options for a range of musculoskeletal disorders, injuries and pain found in muscles, ligaments and tendons, and bones.

The Center also brings clinicians together from numerous specialties, including orthopaedics, rheumatology, physical medicine and rehabilitation, pain medicine, spine surgery and musculoskeletal radiology. This team-based model of care creates a seamless, integrated patient experience and the most efficient process of diagnosis and appropriate treatment.

Learn more about how the expert specialists at
the Penn Musculoskeletal Center can help get you back to living pain-free.

Exercising with Arthritis

Exercise is crucial for everyone, especially those suffering from arthritis.

“Sometimes, my patients think that the only way to relieve pain is to stop all physical activity,” said Craig Israelite, MD, orthopaedic surgeon and Co-director of the Knee Service at Penn Medicine. “Keeping active is actually very good for individuals suffering from joint pain or arthritis. Exercises that work the muscles and tendons provide stability and strength around the joint.”

You don’t need to run a marathon or lift weights for hours to increase strength, improve flexibility and reduce joint pain. There are many non-weight-bearing activities you can do to keep in shape, including:

Arthritis Tips
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Range-of-motion exercises: These exercises (also known as stretching or flexibility exercises) help to relieve stiffness and increase joint mobility. The goal is to get your joints moving in their normal range of movement. Examples include raising your arms over your head or rolling your shoulders back and forth. It is recommended that these exercises be done daily or at least every other day.
  • Yoga
  • Pilates
  • T'ai chi
Strengthening exercises: Strong muscles help support and protect joints. A workout program that includes weight or resistance training can help to maintain current muscle strength or increase it. These type of exercises should be done every other day, but allow an extra day in between if joints become painful or swollen.
  • Wrist curls
  • Overhead arm raises
  • Seated rows
Aerobic or endurance exercises: These types of activities can improve your cardiovascular health, give you more energy and help to maintain or reduce weight. Having control of your weight reduces the pressure on affected joints. Try to include 20-30 minutes of aerobic exercise three times a week.
  • Walking
  • Bike-riding
  • Swimming
Learn more helpful tips for living with bone and joint pain.

The Region’s First Musculoskeletal Center

The Penn Musculoskeletal Center, the first of its kind in Philadelphia, is revolutionizing the way musculoskeletal care is delivered. The Center provides the latest diagnostic techniques and the most advanced surgical and non-surgical options for a range of musculoskeletal disorders, injuries and pain found in muscles, ligaments and tendons, and bones.

The Center also brings clinicians together from numerous specialties, including orthopaedics, rheumatology, physical medicine and rehabilitation, pain medicine, spine surgery and musculoskeletal radiology. This team-based model of care creates a seamless, integrated patient experience and the most efficient process of diagnosis and appropriate treatment.

Learn more about how the expert specialists at
the Penn Musculoskeletal Center can help get you back to living pain-free.

Friday, October 10, 2014

Bone and Joint Health Awareness: Are You at Risk for Arthritis?

Arthritis affects over 50 million U.S. adults and continues to be the most common cause of disability in the nation.

Arthritis is inflammation of a joint - resulting from a disease, infection, genetic defect, injury, overuse or other cause. There is no known cure, but proper early treatment can help prevent further joint damage.
do you have joint pain?
Click to enlarge

At a Glance

  • Arthritis is not one single disease - there are 100+ types.
  • Women are more likely to be affected by arthritis than men.
  • Two-thirds of arthritis sufferers are under the age of 65.
  • Overweight people are four to five times more likely to develop arthritis.
  • The three main types are:
    • Osteoarthritis (OA), the most common form, is a degenerative disorder that causes the breakdown of cartilage in the joints.
    • Rheumatoid Arthritis (RA) is an autoimmune disease that causes inflammation in the joints along with possible joint and bone damage.
    • Juvenile Arthritis (JA) includes a number of autoimmune and inflammatory conditions affecting kids age 16 and under.

Treating Arthritis

Although there is no way to reverse cartilage loss or arthritis, there are numerous options to help relieve symptoms. Treatment of arthritis can include medications, injections, occupational and physical therapy, surgery and changes to one's lifestyle (specifically rest, exercise and healthy eating).

The Region’s First Musculoskeletal Center

The Penn Musculoskeletal Center, the first of its kind in Philadelphia, is revolutionizing the way musculoskeletal care is delivered. The Center provides the latest diagnostic techniques and the most advanced surgical and non-surgical options for a range of musculoskeletal disorders, injuries and pain found in muscles, ligaments and tendons, and bones.

The Center also brings clinicians together from numerous specialties, including orthopaedics, rheumatology, physical medicine and rehabilitation, pain medicine, spine surgery and musculoskeletal radiology. This team-based model of care creates a seamless, integrated patient experience and the most efficient process of diagnosis and appropriate treatment.

Learn more about how the expert specialists at
the Penn Musculoskeletal Center can help get you back to living pain-free.

Friday, October 3, 2014

Revolutionizing Patient Care

Suburban Life magazine profiled Penn Presbyterian Medical Center’s newest facility, Penn Medicine University City. More than a building, the article says it is a revolutionary leap into the future of health care, expanding outpatient services in ways most hospitals can only dream about.

The building, which opened in August, houses more than 100 exam rooms, nearly half of which are part of the Penn Musculoskeletal Center, a facility that offers an innovative and unique multidisciplinary approach to treating musculoskeletal disorders, injuries and other conditions. Michele Volpe, executive director of PPMC, L. Scott Levin, MD, FACS, chair of Orthopaedic Surgery, and Alyson Cole, assistant executive director of PPMC, are quoted throughout the feature.

Read the full article to find out how Penn Medicine is revolutionizing patient care.



Monday, September 29, 2014

Taking Patient "Happiness" More Seriously

Healthcare is becoming more consumer-focused by the day, with some healthcare organizations now taking steps to improve the patient experience. It starts with executives like Fabian Marechal, director of service line operations for the new Penn Musculoskeletal Center, who joined Penn Medicine after years in the hospitality sector.

One of the most important lessons from hospitality, he says, is that people must feel cared for. So front line staff greet customers like a doorman or concierge at the Ritz, and walk them over to the kiosk to help with registration.

"I think all of this helps patients be more engaged in their care,” said Marechal. “[It shows] people are going to listen to me, people are going to acknowledge me. It changes your mindset from the get-go."

Read the full story.