Sciatica is a common complaint among Americans and according to Harvard Medical School, about 40% of people in the U.S have reported having sciatica sometime in their life. Sciatica can be caused by a plethora of spinal conditions, some of the most common are listed below:

Herniated Disc

This is the most common cause of sciatica and occurs when the discs that are found between the vertebrae undergo trauma or damage and the gel-like center of the disc begins to herniate through the outer wall. The herniation causes irritation and inflammation of the sciatic nerve.

Degenerative Disc Disease

Degenerative Disc Disease is a condition where the discs found begin to thin and weaken over time which results in reduced space between the vertebrae. When the space is reduced, the sciatic nerve can become impinged.

Spinal Stenosis

This occurs when the spaces that surround the spinal cords begin to narrow. This abnormal narrowing can pinch the sciatic nerve roots as they leave the spine resulting in sciatica.

A spinal condition that affects the lumbar vertebrae – spondylolisthesis – is a disease that causes a lower vertebra to slip forward over the vertebrae directly beneath it. The change in vertebral positioning can cause impingement or irritation of the sciatic nerve.

Facet Joint Arthritis

Lumbar osteoarthritis is degenerative arthritis in the low back that causes pain, stiffness and inflammation in the facet joints of the vertebrae. There are two facet joints on the back of each vertebra that connect the bones of the spine. Wear and tear on facet joints on the lower spine cause the cartilage between the joints to break down and causes inflammation and sciatica.

Ultimately, when you have sciatica the goal is to decrease your discomfort and increase your mobility by reducing pressure on the sciatic nerve. In most cases, time and treatment are successful in resolving sciatica pain. According to Mayo Clinic, about 90 to 95% of the time, sciatica cases will be resolved with time and non-surgical treatments. However, if your symptoms persist despite all efforts, surgery might be considered. Oftentimes, surgery is considered for those whose leg pain or weakness is persistent after methods of non-surgical options are unsuccessful. Your physician will ultimately tell you the best solution for your specific needs.

Physical Therapy

Physical Therapy can be an excellent option to treat sciatica because it involves stretching. Stretching can improve your flexibility and strengthens the muscles of your core and lower back. In addition to going to see a Physical Therapist, staying active can also ease your sciatica symptoms.

Corticosteroid Injections

This treatment option delivers medication directly to the sciatic nerve via an injection. Corticosteroid injections are often a temporary solution that can provide weeks or months of pain relief.

This is a common minimally invasive surgical procedure when sciatica is caused by a large disc herniation. In a microdiscectomy, the surgeon removes the small part of disc material that is compressing the sciatic nerve.

If you find yourself experiencing sciatica symptoms, it is important to stay as active as possible and try to introduce some conservative methods of pain relief. Sometimes, conservative options don’t give you immediate relief, especially if your pain is caused by an irritation of the sciatic nerve. This is when it is best to allow your physician to offer you more aggressive methods of pain relief for your sciatica.

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If an early infection is missed or is asymptomatic and left untreated, the disease can spread to the heart, nerves, brain, and even the joints, causing Lyme arthritis – inflammation in the joint tissue.

“Lyme arthritis most commonly affects one joint, typically the knee, and presents as pain and swelling without any injury or trauma,” explains Shawn Potteiger, D.O., sports medicine physician at Premier.

Additionally, when Lyme disease spreads, “Patients experience warm, swollen joints with increased pain when the knee or joint is fully straightened or bent,” states Itai Gans, M.D., sports medicine surgeon at Premier. “Joint swelling can increase and decrease, move between different joints and become quite painful, which can limit the ability to walk, at times,” says Gans.

Diagnosis for Lyme disease is done through lab testing. Luckily, the illness can successfully be treated with antibiotics. If joint swelling progresses, patients may need to seek orthopaedic care to treat fluid buildup.

It’s important to routinely check your body from head to toe when being in a common area for exposure (i.e. wooded or tall grassy landscapes). Early recognition and treatment are essential to minimize the risk of long-term degenerative changes of the joints. Contact your healthcare provider immediately if you experience any of these symptoms or find a tick on your body. If possible, save the tick for evaluation by your provider.

If you need orthopaedic care, Drs. Gans and Potteiger see patients in Collegeville, Exton and Malvern. To schedule an appointment, please call the office at 610-644-6900.

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Conditions treated include:

• Sprains, strains and fractures
• Joint and muscle soreness from physical activity
• Sports injuries
• Sudden pain in the neck or back causing trouble moving

This is orthopaedic care when you need it most!

Premier Orthopaedics also offers same-day or next-day in-person appointments in Malvern, Exton, Collegeville, and Coatesville.

For an appointment with one of our specialists or for more information about our services, please call 610-644-6900 or visit the office’s location page.

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1. Fractures. Most winter injuries are the result of a slip and fall. It can be an icy driveway or a wet kitchen floor. “We usually see a spike in fractures during the winter months,” says joint surgeon Dennis McHugh, D.O. “Hip fractures have been especially prevalent this year.” To prevent fractures, be aware of your surroundings at all times. Make sure your shoes fit well and take smaller steps. Avoid uneven surfaces and be sure to avoid any standing water or ice.

2. Foot and ankle injuries. Falling does not necessary result in a fracture. Injuries to the ligaments, tendons and soft tissue are also a risk during the colder months. “We see a lot of people who twist their ankle taking out the trash or who step on a curb wrong,” says podiatrist Vincent Muscarella, DPM. “When the lower body isn’t stable, the weight of the upper body causes sprains and strains in the lower extremities. The best way to prevent these types of injuries is to slow down.” Simple things like getting out of a car can result in injury if ice or slush is present. Take your time, be aware of your surroundings and wear the right shoes for the environment.

3. Snowblower injuries. With winter comes snow. And as we all know snow needs to be removed from certain areas, like sidewalks and driveways. Many people with bigger properties use snowblowers. This piece of heavy machinery certainly has its benefits but also comes with inherent risks. “Never, and I mean never, stick your hand into a snowblower to clear a jam or for any other reason,” advises John Pasquella, D.O., hand and wrist surgeon. “Snowblowers retain torque even when stalled. You clear the snow and the machine releases that torque a turn or two and you are at risk of severe laceration or worse. Always use a shovel, broom, or other instrument to clear a snowblower jam. Brooms are temporary. Fingers are forever.”

4. Sports injuries. The winter months provide the elements for many outdoor activities. Skiing, sledding, snowboarding, and even running. All of which can provide a day of fun and exercise. But be careful. “Many winter activities take place near stationary objects, like trees,” says Timothy Amann, D.O., sports medicine specialist and orthopaedic surgeon. “You get going downhill, even just running, and your momentum can take you into a tree, log, rock or car.” Injuries range from bumps and bruises to paralysis. Some can even be fatal. Know your limits. Only participate in outdoor activities in designated areas away from objects and other people.

5. Concussions. Lastly, head injuries, mostly concussions, are a common winter injury. Concussions can result from a variety of activities, including those discussed above. If you fall and hit your head do not take any chances – call your doctor immediately. Symptoms vary, and only a qualified professional should diagnose this injury.

Sometimes no matter what, accidents happen. When they do, we are here for you. If you take a tumble and need orthopaedic care, call Premier Orthopaedics in nearby East Norriton at 610-630-4414 or visit premierortho.com.

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Tis the season for holiday injuries

By Eric Zabat, M.D.

Every December families around the world come together to celebrate the holidays.

Bread is broken, traditions are renewed, and gifts are exchanged.

Locally, this is no exception; I like to think the Philadelphia area embraces the holidays like no other.

However, there is a small downside to all the revelry that accompanies our diverse celebrations – an increase of injuries.

During December, my colleagues and I tend to see an uptick in injuries that are related to the holidays.

Here are some basic injuries we see and how you and your loved ones can avoid them, and in turn avoid coming to see me.

Fractures

Common broken bones that appear over the holidays are wrists, ankles and shoulder blades. Most are the results of falls. Wet shoes cause slick spots that turn dangerous. Stairs become slippery. Even tripping over our four-legged friends can result in a fracture. Again, being aware of the terrain, whether inside or out, can prevent fractures of every kind.

Concussions

Slips and falls on slick ice, falling off ladders and roofs putting up decorations, trips and falls while walking or exercising. We see them all. Concussions are serious injuries that will really put a damper on your holiday plans. Make sure you watch where you walk, take smaller steps, and have good fitting shoes. Also, at night make sure you can see where you are going. People hit slick spots at night… a lot.

Lacerations/other

Both kids’ and adults’ gifts come entombed/encased in hard plastic casing. You know the ones – tough hard, glued plastic you cannot rip and that require a decent pair of scissors. Often, people are in a rush or distracted and the scissors or knife they meant to cut into the plastic with cuts into them. Hands are particularly at risk but punctures to the torso are not uncommon. If you have ANY sharp instrument in your hand, even scissors, give it your full attention. Your children or spouse would much rather wait a few extra seconds for their present than be loading up the car and bringing you to the emergency room.

This list of pointers may seem common sense, but this is 2020. Paying a little bit more attention this next week may be the difference between spending precious holiday time with family and friends… and spending it with me or my colleagues in the Emergency Room. Either way we are here for you when you need us.

Happy Holidays!

Eric Zabat, M.D. is a non-operative orthopaedic physician who specializes in sports medicine. He sees patients in Premier’s Collegeville, Exton and Malvern locations. Call 610-644-690 for an appointment.

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Common orthopaedic injuries caused by toys include fractures, strains and sprains, concussions and dislocations. While every toy has the potential to result in an accidental wound, outdoor items ­- such as trampolines, scooters and bicycles – are causing an increase in injuries. These toys can be dangerous if used improperly or by a child who is too young.

While trampolines are an enjoyable gift that many children love, they are a leading cause of sprains, fractures, concussions and serious neck or spinal cord injuries. Orthopaedic surgeon Anne Colton, M.D., from Premier’s Broomall office, notes, “Typically, these injuries are caused when there are multiple children jumping at the same time, young children bouncing with older kids, or adolescents performing high-risk stunts (e.g., flips and somersaults).” To prevent injuries, Dr. Colton recommends that only one child jumps at a time, children under six years old do not use a trampoline, and adults provide supervision at all times. Additionally, it’s critical to keep up with a trampoline’s maintenance by checking the springs, bars, netting and landing surface, to help guarantee that the area is safe.

Items such as scooters and bicycles can lead to broken bones and head injuries from a fall. When gifting this type of toy, make sure it is age-appropriate to the child, and if so, the child has good coordination. Be sure to purchase protective gear as well. Shawn Potteiger, D.O., a sports medicine physician from Premier’s Collegeville, Exton and Malvern offices, states, “Wearing proper equipment, such as helmets, pads and wrist guards, will aid in preventing possible injuries that can occur from moving or stationary motor vehicles, pedestrians, potholes, or other hazards.”

Parents should make sure a scooter or bike is assembled correctly before the child uses it. Dr. Potteiger recommends that “bicycles should be adjusted so that there are 1-3 inches between the child and top tube of the bike. The seat height allows a slight bend at the knee when the leg is fully extended, and ensures the seat and handlebars are level.” Parents can teach their children how to properly use and maintain a scooter or bicycle. When riding, adult supervision is necessary to make sure that the area is safe, and the child is not going too fast or performing stunts. Adolescents should remember “see and be seen” whenever using a scooter or bicycle on a roadway by wearing bright or fluorescent colors and avoiding riding at night. In addition, it’s important that adolescents wear proper footwear, like sneakers, when using scooters and bicycles. Most importantly, toys should be age-appropriate, and children should demonstrate proper coordination using them.

To prevent any emergency visits this season, be sure to do your homework before purchasing, read all warning labels, and learn how to properly use the toy first before teaching your children. From our Premier family to yours, we wish you all a safe and happy holiday season.

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