Dr. Kendall J. Keck, MD

Joint problems include bursitis and arthritis. Bursitis is the inflammation of a fluid-filled sac cushion on the outside of a joint, causing symptoms including pain and swelling. Arthritis is the inflammation and damage of a joint due to wear and tear or disease. There are several treatments for arthritis, but if the damage progresses far enough, joint replacement may be necessary. In joint replacement, a metal or plastic implant is surgically placed within the joint to make movement easier.

Bone problems include scoliosis, fractures, and osteoporosis. Scoliosis is a curvature of the spine, making the normally straight spine look like a 'C' or 'S.' It is treated with braces or surgery. Osteoporosis is a disease that causes bones to weaken and break easily. It's most common in women, especially older women. Fully half of all women over 65 have osteoporosis. Fractures are any break in the bone. They can be a simple crack or a severe and complicated shatter. Osteoporosis causes fractures in people who have it, but other causes are trauma (such as a fall) or overuse.

Tendon and ligament problems most often result from injury or overuse. Two good examples are ligament tears and tendonitis. The most common ligament tear is the ACL tear in the knee. This ligament supports and stabilizes the knee and is most often torn during sports activities. Tendonitis happens when a tendon, which connects muscles and bones together, becomes irritated and inflamed. This happens most often in older patients who push their bodies too far, leading to pain and swelling. Treatment for both tendon and ligament problems usually includes rest, ice, and supporting the area to let it heal.

Pain and numbness problems can be caused by overuse, disease, an injury, or a compressed nerve. Lower back pain and carpal tunnel syndrome are two of the most common conditions patients encounter. Lower back pain may be caused by sore muscles that have been overworked, or an injury to the disks separating the vertebrae in the spine. Lower back pain usually goes away on its own within a few days, but it may require medical treatment depending on the cause. Carpal tunnel syndrome occurs when the nerve at the base of the palm becomes trapped or pinched. Symptoms include tingling, pain, numbness, or weakness in the hand. Treatment involves rest and sometimes steroid injections.

Because the musculoskeletal system involves so much of the body, problems here can be incredibly varied in their type and severity. Some musculoskeletal problems will go away on their own or only require rest, while others may require medication, physical therapy, or even surgery.

Tendon transfer surgery can be performed on the arms, hands, feet, or other areas of the body where a muscle becomes unable to pull on its tendon. A nearby tendon is detached from its bone, but kept connected to its muscle, nerves, and blood supply. The loose end is connected to the bone that the patient could not move. After the attachment heals, the patient will be able to move that part of the body by flexing the newly connected muscle.

One of the benefits to tendon transfer surgery is that it does not have to be performed right away after an injury. It can be successful even if the affected area has been paralyzed for years. It does take time to retrain the brain to use a different muscle for movement, but the surgery is a powerful option to restore needed motion.

During trigger finger surgery, the tendons at the base of the affected finger are identified and the sheath is opened up, allowing the tendons to move freely without getting stuck. This can be done through a tiny incision in the palm, or even without an incision at all, using the tip of a needle. Most people are able to move their fingers normally, bending and straightening their finger without catching or popping, right away after surgery. Although patients may have some pain and stiffness as they heal, recovery is quick.