ONS physicians present free health seminars in the community on topic related to orthopedics, neuro/spine, sports medicine, physiatry, and physical therapy. At the end of each seminar our audience has a chance to ask questions. Here are some of their questions and the doctors’ answers:
Q) I have arthritis in my big toe, how many injections is it safe to have in the toe joint?
Cortisone shots can be very helpful. Usually, the first shot helps the most and some patients don’t have to have more shots. We do not recommend more than 3-4 cortisone injections per year. There are other side effects to be aware of beyond that.
Q) Do I need to buy the expensive inserts for my shoes or are the over-the-counter inserts just as good?
Many over-the-counter orthotics work well. You don’t always need to spend $400 for a good orthotic. Have your doctor evaluate your condition and based on your doctor’s advice, decide whether you would like to try the less expensive types of orthotics.
Q) I have arthritis in my feet are graphite inserts for my shoes an over-the-counter item? How stable are these and do they limit motion?
The goal of wearing graphite inserts is to stabilize the foot and is to provide support. Graphite does not bend like other materials may and since each person is different with regards to weight and whether or not they are male or female, your best result would be to have an orthotic evaluation.
Q) How does stretching the Achilles tendon help with foot conditions like plantar fasciitis?
Stretching creates increased force through the front of the foot and helps to distribute the pressure. For example, for people who suffer from pain related to plantar fasciitis find relief in the morning by wearing a brace to bed that keeps the Achilles stretched and ready to walk.
Q) How important is it to stretch before activity and how do I get around the pain when I’m stretching?
Warm up is done to increase the temperature of the muscles and joints. It’s best to get the heart rate up and warm the muscles instead of stretching cold muscles where you may feel pain or injure them. Start with dynamic movements like lunges or walking up and down stairs. Stretch after you’ve warmed up.
Q) If you have chronic pain and you are starting exercise is it good to stop exercising when you feel discomfort or push thru discomfort?
What is suggested is to exercise in increments, for example, if you plan to walk for 5 minutes and feel discomfort after 1 minute, sit down and rest then resume walking after you rest some. Repeat this over and over until you get your time in. Soon those minutes will get longer and you will be able to go the straight 5 minutes without rest.
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