I have heard that applying ice to an injury helps reduce pain and swelling. How does this work?

First, cold on the skin eases pain by slowing down the rate that pain sensors in the skin send pain messages to the brain. Second, the body responds to cold by closing down blood vessels in and under the skin. This decreases the amount of warm blood to the area.


A recent study of how tissues respond to cold packs demonstrated what happens when the cold pack is removed. The skin and upper layers start to warm up again, but the deeper tissues actually get colder. This is because the blood from the deeper tissues moves to the cold upper tissues to help rewarm them. The reduced blood flow from the deeper tissues causes a drop in temperature.

I started playing handball last summer. This fall I began to have sharp pain along the inside edge of my lower leg. The pain gets worse when I play handball and better when I rest. Is there any kind of test that could tell me what the problem is?

There are a variety of problems that can affect the lower leg, including tendinitis, muscle injury, or a pinched nerve. Some can be diagnosed with a physical examination.


Sometimes no further testing is required, and treatment can begin right away. Other times, X-rays or other imaging studies may be necessary. For example, lower leg pain caused by a condition called medial tibial stress syndrome (MTSS) can be diagnosed with a bone scan. This involves an injection of a radioactive substance that is absorbed or taken up by areas in the bone where change is occurring. In the case of MTSS, the bone scan shows an increase in the metabolism of the bone and a decrease in bone density. This is typically present in both legs, even if symptoms only exist on one side.


Other problems are better viewed using magnetic resonance imaging (MRI) or plain X-rays. Don’t hesitate to have a physician evaluate your symptoms. Early treatment can make a big difference in swiftly and safely getting you back on the court.

What kinds of patients do chiropractors treat?

The majority of people treated by chiropractors have neck and back pain. A small number see chiropractors for other problems, such as asthma, hypertension, thyroid, allergies, and menstrual difficulties.


Chiropractors also treat other musculoskeletal problems. These include wrist sprains, shoulder separations, headaches, dizziness, and carpal tunnel syndrome.

What does “complementary and alternative therapy” mean?

There’s been a trend over the last 30 years for Americans to seek care outside traditional medicine for illnesses, diseases, and conditions such as cancer. There are dozens of choices for alternative care. These include yoga, T’ai Chi, acupuncture, spiritual healing, herbal remedies, diet therapies, naturopathic, and many more.


When patients use traditional medicine along with these other methods, the other methods are called complementary. Patients may use them to cope with the side effects from standard medical treatments. In this case, complementary means “add to or complete.” Alternative means the patient uses these methods instead of traditional medicine.


Alternative and complementary therapies are based on a different way of thinking than traditional medicine. Instead of viewing diseases as something that can be treated and cured, the idea is that the mind-body connection is out of balance, and restoring this balance allows the body to heal itself.


Some people seek alternative and complementary care to keep in good health and prevent disease. Alternative care is thought to affect physical, emotional, and spiritual health.

Our eight-year old son has Ewing’s sarcoma, a tumor of the bone. In his case, the tumor is located in one of the forearm bones. The surgeon is planning to remove the tumor and fuse the two forearm bones together to hold the arm in a better position. What can we expect after surgery?

The fusion surgery joins the two bones of the forearm together. After surgery, your son will probably be placed in a cast that will go up above the elbow for about six weeks. After the cast is removed, a splint that helps elbow motion will be applied for another six weeks. Each surgeon may have an individual plan, so you should also discuss this question with your doctor.

Sometimes I wake up at night and my hands will be numb or one whole arm has gone to sleep. If I get up and move around, this goes away but it worries me. What can I do to prevent this from happening?

Pressure on the nerves as they leave the neck and travel down the arm can cause this to happen. Sometimes this kind of numbness occurs because you have slept in the same position for too long. It can also happen if your bed and pillow do not give you enough support for your head and neck.


The first place to start is with a check of your mattress, which should be firm. It should not sag or be so hard that it doesn’t have any give to it. Your pillow can be made with feathers, foam, or other manmade materials, but it should be firm enough to support your head and neck in a straight line. There are pillows made just for this purpose. They can be purchased in many retail bedding stores, a medical supply store, or from a local chiropractor or physical therapist.

I injured my back in a work-related activity. Workers’ compensation is covering my medical expenses. I see there is an ongoing study at the clinic for anyone who has a back injury. The notice says that anyone on workers’ comp can’t participate. What’s different about workers’ comp that keeps me from being part of the study?

Every study is different, and you may have to contact the study group directly for their answer. Sometimes workers’ compensation patients have more serious injuries than other patients. This difference could make it impossible to compare results. In other studies, certain treatment steps may be required that would delay patients’ return to work. Government-funded research also has some restrictions based on whether patients are covered by private insurance, self-pay, or workers’ compensation.

I read an article in a magazine about arthritis and some of the new studies on how to prevent this disease. Why is it necessary to do so many studies and repeat the same ones over and over? Isn’t this a waste of money that could go directly to treatment?

Scientific research can seem to repeat itself. But it is important to repeat an experiment several (if not many) times for a few reasons. The scientist must be able to show that the results didn’t happen by chance. Repeating the results helps show this. Having a different group of scientists perform the same experiment helps confirm or validate the information.


It is also possible for a scientist to come to the wrong conclusion based on very good data. A second or third group may be able to look at the results differently and form a more accurate conclusion.


Finally, important discoveries have been made when research is repeated. Sometimes this happens when a mistake is made the second time through. Data that can be reproduced bring our knowledge of arthritis and other medical conditions to the next level.

When it comes to physical activity, is it more important for boys or girls to learn basic movement skills?

Both groups need basic movement skills. Research has shown that having these skills makes kids more likely to do organized physical activities in their teenage years. This can lead to a lifetime of healthy habits.


There are some gender differences, though. It seems that, when it comes to physical activity during adolescence, it’s more important for girls to have basic movement skills than for boys. Improving girls’ skills just a little may encourage them to do another hour of physical activity per week. Researchers think that boys are more encouraged to do sports generally, so skills are less important for them.


It’s never too early to teach kids basic movement skills. Examples include running, jumping, catching, throwing, and kicking. Researchers think the best “window of opportunity” may be during the preschool and early elementary years.

Do physical skills have something to do with whether or not kids play sports?

Movement skills have something–but not everything–to do with how active kids are. Researchers studied movement skills in over 1,800 teens. The skills were running, jumping, catching, throwing, striking, and kicking. These skills predicted how much time teens spent in organized physical activity, such as basketball and tennis. (Interestingly, this result did not hold for “nonorganized” physical activity, such as pick-up games and doing things for fun.)


The link between skills and activity was especially strong for girls. For girls, improving skills just a little might mean doing 50 more minutes of physical activity a week. Because boys are generally more encouraged to do sports, skills may not be as important for them.


Keeping active during the teenage years could make for a lifetime of healthy habits. Movement skills need to be learned early, such as during preschool, to get the most benefit.

How is arthroscopic surgery different from regular surgery?

The arthroscope is being used more and more in surgical procedures. This device works like a TV camera below the skin. It lets surgeons see the area they’re working on without making big incisions.


Arthroscopy is less invasive than regular “open” surgery. Because of the reduced stitching time, arthroscopy can go more quickly. Patients usually heal faster. And they may have less pain and fewer complications.
 
In general, arthroscopic surgery has proved to be safe and effective. Your doctor can tell you more about how it works.

Does sports medicine help professional baseball players lose less time to injuries?

Not necessarily. A study looked at injuries in Major League Baseball. Researchers thought there would be fewer injuries among baseball players in recent years, since sports medicine and training have gotten more advanced.


The opposite was true. Between 1989 and 1999, baseball players’ injuries actually increased 40 percent. And the missed days these injuries required went up 53 percent.


These results were, of course, disappointing. But sports medicine itself may not be to blame. Lots of other changes have happened in Major League Baseball. For example, players’ careers now go on longer. And players are more likely to return to sport more quickly after a major injury. These things may make some players more prone to injury.


It’s possible that sports medicine has managed to reduce some kinds of injuries while others have been on the rise. Clearly more research is needed in this area.

I’ve heard that my symptoms of rheumatoid arthritis will improve during pregnancy. My doctor told me there might be less joint pain and less swelling. Can you explain this?

About two-thirds of women with rheumatoid arthritis have fewer symptoms during pregnancy. This improvement starts as soon as the pregnancy begins and lasts until six weeks after the birth. No one knows the exact cause for these changes in arthritic joints during pregnancy. Most likely, there is an increase in the body’s natural cortisone, a hormone that combats inflammation (swelling, redness, and heat in the joints).

I thought studies showed that women could lower their risk of breast cancer by keeping physically active. Now I see that recreational activity may not lower my risk of breast cancer. Is this true?

Recent research seems to show that recreational pursuits may not lower your risk of breast cancer. But remember, physical activity–even just 10 minutes worth–has been shown to be beneficial to your health. Recreational activity can improve your muscle tone, help keep your weight down, boost your immune system, and even lift your mood!


Scientists admit they don’t know what it is about certain activities that helps reduce the risk of cancer. More studies may yet find which recreational activities impact breast cancer risk the most. Until more is known, stay active at home, work, and play.

I was told that doing household activities at a moderate intensity may lower my risk for breast cancer. What exactly does this include?

A long-term study spanning a woman’s natural lifetime was recently reported. The researchers said that women who do household activities at a moderate level may lower their risk of breast cancer. “Moderate intensity” refers to getting the heart rate up and breaking a sweat.


Unfortunately, the researchers did not specify exact activities. The women in the study reported their activities, and each activity was rated according to how hard it was. If you follow the same guidelines with your household activities (increase your heart rate and break a sweat), then you should get the same benefit as the women in the study.

I have arthritis in my hips and knees, and I can’t exercise on a regular basis. Will my risk of breast cancer increase because I can’t exercise?

There is no quick and easy answer to this question. It is not known whether physical inactivity is a risk factor for breast cancer. However, being active and exercising regularly over a lifetime do help reduce a person’s risk for this cancer.


The first step is to work with your physician to control your symptoms of arthritis. Then begin a gradual program of activity and exercise, under the direction of a physical therapist.

What is a visual analog scale, and why do doctors use it?

A visual analog scale (VAS) is a tool doctors use to pinpoint the extent of pain. Doctors have patients look at a scale from zero (no pain) to 100 (the worst pain) and point to the place that best describes what they feel.


VAS seems to capture differences between patients and conditions. It’s a popular way for doctors to learn the intensity of pain. VAS can help doctors suggest the right treatment. If the pain is very minor, for example, it’s unlikely that surgery is needed. After treatment, VAS can help doctors gauge whether pain has been reduced. This gives information about the success of the treatment.

If there’s no gravity in space, does that mean astronauts don’t use their muscles? What’s the effect of this over time?

Space travel “unloads” the muscles, putting them in a state of weightlessness. This means the muscles aren’t working as usual, which can cause them to shrink and become weak over time.


Scientists at NASA are concerned about this problem, especially as space flights get longer. Researchers are developing special muscle training programs that can be done quickly and easily, so astronauts can maintain muscle size and strength in flight.


Doctors apply this research to prescribe just the right amount of exercise for their patients who are on bed rest or unable to use an injured limb. Muscles can stay fit without over-working.

Does stretching actually change the muscles? Or does it only feel that way?

Researchers are still investigating exactly how stretching works. For a long time, they believed that stretching eased muscle tension. But one study found that stretching reduced tension only briefly–or not at all. This led a Swedish group of researchers to look at the physical sensations people have while stretching, and whether these sensations change the more you stretch.


A group of men in the military did a two-week stretching program for their thighs. Afterward, they reported that thigh stretches felt less intense. Researchers believe that this change in sensation may lead to changes in the muscles themselves, such as better flexibility and range of motion.


Researchers don’t know why a stretch might produce less sensation over time. But they do know that stretching generally makes people feel good. In sports, in the workplace, in everyday life–stretching has a multitude of benefits for the body and mind.

I have no flexibility in my muscles at all. Sometimes stretching actually hurts. How much do I need to stretch to make the discomfort go away?

If stretching hurts, you may want to consult a physical therapist about different stretches to try. If you do these stretches regularly, you’ll probably feel less tension within just a few weeks.


Researchers recently put military men on a two-week stretching regimen. After stretching each leg for a total of 80 seconds four times a week, participants found leg stretches to be less intense. This suggests that it doesn’t take long to “adapt” to the sensation of stretching.


A little stretching can go a long way. Ask a physical therapist for safe and comfortable stretches you can do to get started.