Tag Archives: joint pain

cracking knuckles

True or False: Cracking Your Knuckles Can Lead to Arthritis

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Crack. Pop. Click. These sounds jump from the joints of the many children and adults who are in the habit of cracking their knuckles.

If you cracked your knuckles as a child, you may have been warned that it could cause you to develop arthritis later in life. Is this true? Probably not, according to a handful of studies on the subject. While cracking your knuckles may not cause arthritis, some researchers believe that habitual cracking could create some problems later on. Not to mention that the incessant pops and clicks are likely to be a major annoyance to those around you.

Evidence for the Health Claim
Your knuckles are the joints in your fingers and toes. They are located where two bones meet, and they are bathed in a liquid called synovial fluid, which lubricates the joints. Sometimes a bubble of gas develops in the synovial fluid, and when the joint is manipulated in certain ways (eg, when a person is bending or compressing his or her hand), the bubble can burst, making an audible popping or cracking sound.

Arthritis is an extremely common problem for older adults, with the majority of people over age 65 have signs of the condition. There are two major forms of arthritis. Rheumatoid arthritis results from inflammation of the joints and can cause pain, redness, swelling, and eventually deformity and loss of function. Osteoarthritis, the most common form, results from wear and tear on the joints over time, which is why it tends to affect older adults.

While there is no reason to believe that knuckle cracking would lead to rheumatoid arthritis, it makes sense that habitual trauma to a joint might eventually cause tissues to break down and wear away leading to osteoarthritis. In fact, some researchers have reported cases of people who habitually cracked their knuckles and went on to develop osteoarthritis or other joint problems. For example, in a case report published in the British Medical Journal, researchers report that a man who habitually cracked and popped many of his joints had damage in his right hand indicative of arthritis.

Another study published in the Proceedings of the Institution of Mechanical Engineers simulated the act of cracking knuckles and found that the energy used to crack your knuckles is enough to damage the cartilage in your joints.

Do these reports mean knuckle cracking can lead to arthritis? Or are they just chance findings, since so many people develop osteoarthritis whether they crack their knuckles or not?

Evidence Against the Health Claim
While individual reports may cite cases in which voracious knuckle crackers develop arthritis, other studies tell a different story.

In 1975, Dr. Robert L. Swezey and Stuart E. Swezey conducted a study of 28 nursing home residents who could recall whether or not they had cracked their knuckles earlier in life. After performing x-rays on the participants’ hands, the researchers concluded that there was no link between habitual knuckle cracking and arthritis.

Another study, published in the Annals of Rheumatic Disease, looked at a group of 300 habitual knuckle crackers. The researchers found that the participants who cracked their knuckles regularly did not experience more cases of osteoarthritis. Knuckle crackers, however, were more likely to have hand swelling and reduced grip strength in their hands. Whether the knuckle-cracking caused the swelling and loss of hand function or those with hand problems were just more likely to crack their knuckles, the researchers could not say.

Researchers also compared a group of people with osteoarthritis in the hand with those who did not have the condition. The two groups were asked whether they cracked their knuckles and, if so, the duration and the frequency of this behavior. When the researchers analyzed the findings, they found no correlation between knuckle cracking and the development of osteoarthritis.

knuckles

Conclusion
Some people who crack their knuckles do it out of habit or boredom. Many others say it helps relieve joint pain and tension and allows for a greater range of motion in their joints. If you are in the habit of cracking your knuckles, the evidence available today suggests that it will not cause you to develop arthritis. While some insatiable knuckle crackers may go on to develop problems down the road, the occasional painless cracking is probably harmless.

Keep in mind, though, that while cracking your knuckles seems like nothing more than an innocent, mindless habit, for the person sitting next to you, it may be just as irritating as the sound of fingernails on a chalkboard.

by Krisha McCoy, MS

More PTandMe articles about arthritis can be found here:

   

 

REFERENCES:

Brodeus R. The audible release associated with joint manipulation.J Manipulative Physiol Ther. 1995;18:155-164.

Castellanos J, Axelrod D. Effect of habitual knuckle cracking on hand function.Ann Rheum Dis. 1990;49:308-309.

Protapapas MG, Cymet TC. Joint cracking and popping: understanding noises that accompany articular release.J Am Osteopath Assoc. 2002;102:306.

Swezey RL, Swezey SE. The consequences of habitual knuckle cracking.West J Med. 1975;122:377-379. Available at: http://www.pubmedcentral.gov/picrender.fcgi?artid=1129752&blobtype=pdf. Accessed July 11, 2006

Watson P, Hamilton A, Mollan R. Habitual joint cracking and radiological damage.Br Med J. 1989;299:1566.

Watson P Kernohan WG, Mollan RA. A study of the cracking sounds from the metacarpophalangeal joint.Proc Inst Mech Eng. 1989;203:109-118.

3/17/2011 DynaMed’s Systematic Literature Surveillance DynaMed’s Systematic Literature Surveillance: Deweber K, Olszewski M, Ortolano R. Knuckle cracking and hand osteoarthritis.J Am Board Fam Med.2011;24(2):169-174.

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PTandMe therapists

Clinic Spotlight: PT & Me Therapists

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This month we are featuring stories from some of our PT & Me therapists. We asked them how they got into the awesome world of physical therapy and what they enjoy about it. These are their stories…

Kelly_wilson
Name:
Kelly Wilson, PT, DPT at University Physical Therapy – 8 locations conveniently located throughout the New River Valley in Virginia

Why did you chose physical therapy as a career?
I took an anatomy class in high school with a teacher who absolutely changed my life. I could not get enough of the curriculum and wanted to learn more about how we work and how we can make ourselves better. I stayed after school one day to ask how I could learn about this topic forever. My teacher suggested that I look into physical therapy. I started shadowing a PT in my hometown and loved it! I was hooked!

What is your favorite thing about going to work each day?
I get to work with the absolute best people on the face of the planet.


Name:
Lea Ann Rumlin, PT, Clinic Owner at DeKalb Comprehensive Physical Therapy – Lithonia, Georgia

Why did you chose physical therapy as a career? 
I had an opportunity to observe a PT in high school and found it was very interesting. I thought it was cool to observe a diverse variety of ailments in people.

What is your favorite thing about going to work each day?
I’ve been doing physical therapy for a long time, but it still feels new. I feel blessed to have the opportunity to help people.


Name:
Wendy Richards, MSPT, DPT at Port City Physical Therapy – Portland, Maine

Why did you chose physical therapy as a career? 
I wanted to be in a helping profession. Growing up in rural Maine most of the careers were either in healthcare or nursing. That is why I was drawn to physical therapy. I especially liked the stroke patient rehab and spinal rehab aspect of it. Helping people with paralysis was especially fulfilling.

What is your favorite thing about going to work each day? 
I enjoy working in a team environment. Working in an outpatient climate and helping patients to get better. Being able to resolve their limitations and improve their lives.


Name:
Jocelyn Zolna-Pitts, PT, Director at Metro Spine & Sports Rehabilitation – Chicago, Illinois

Why did you chose physical therapy as a career?
It combined my interest of medicine with sports. I was always interested in medicine and helping others.

What is your favorite thing about going to work each day?
The daily satisfaction of watching people get better. The challenge and variety of problems patients face and solving their problems through critical thinking with them. I enjoy the fact that you get to play every day at work and it’s a lot of fun!

Throwing Injuries

Guidelines to Prevent Throwing Injuries

In this monthly series, we examine the proper ways to exercise and prevent throwing injuries in baseball. If you have any sudden significant increase in pain, swelling, or discoloration while performing or following exercise, discontinue immediately and contact your primary care provider.


PUSH UPS
Start on your stomach with your hands below your shoulders. Maintain a straight line from your ankles, through your hips, to the shoulders. Extend your elbows pushing your stomach away from the floor.


BICEP CURL
Begin seated with your elbow extended and palm facing forward. Bend the elbow as far up as you can without flexing your shoulder or rotating your wrist.


TRICEP DIP
Find two even surfaces to support your upper body with your elbows bent (a chair with arm rests works well). Extend your elbows pushing your body up toward the ceiling. Lower slowly.


OVERHEAD TRICEP EXTENSION
With your shoulder in full flexion overhead, hold a weight in your hand with your elbow bent behind your head. Straighten your elbow toward the ceiling without changing the angle of your shoulder.

This information was written by Advance Rehabilitation Physical Therapy, an outpatient physical therapy group with 24 locations in Georgia and Florida. Advance Rehabilitation is a physical therapy practice that focuses on providing the highest quality rehabilitation services. We specialize in physical therapy, sports medicine, industrial rehabilitation and athletic training. Our staff includes highly-trained professionals that serve as a bridge between injury and recovery to help patients get back to pre-injury status as quickly as possible. For more information click here.

See the entire Guidelines to Prevent Throwing Injuries series here:

   Prevent Throwing Injuries

   prevent throwing injuries

throwing injuries PTandMe

Increased Risk Zones

Work Related Stress & Increased Risk Zones: Part 1 of 2

INCREASED RISK ZONES
All Risks Increase with Duration, Frequency and Magnitude.

• Excessive Force

• Repetition of Activity (Can irritate tendons and increase pressure on nerves)

• Awkward Posture (Can compress nerves and irritate tendons)

• Sustained Static Posture (Can restrict blood flow and damage muscles)

• Unsupported Positions

• Motion (Increased speed or acceleration when bending / twisting, can increase the amount of force exerted on the body)

• Compression (Grasping sharp edges like tool handles, can concentrate force on small areas of the body, reducing blood flow and nerve transmission, and damaging tendons and tendon sheaths)

• Inadequate Recovery Time (Overtime, lack of breaks, & failure to vary tasks)

• Vibration of Tools (From vibrating tools, can decrease blood flow, damage nerves, and contribute to muscle fatigue)

• Whole Body Vibration (From driving trucks or operating subways, can affect skeletal muscles and cause low-back pain)

• Effects of Temperature (Cold temperatures can adversely affect a worker’s coordination and manual dexterity while Heat stroke can be very serious as when the body becomes unable to control its temperature, it rises rapidly, the sweating mechanism fails, and the body is unable to cool down.)

• Environment (Slip/Fall hazard-Uneven Floor Surfaces)

• Material Handling Guidelines:
Weight Loading over 50lbs
Lift Speed greater than 5/minute
Vertical Lift Exceeds 3ft
Carry over 1 minute
Sustained Push/Pull over 30 seconds
Static reach holding tasks over 1 minute

Part two of our Work Related Stress & Increased Risk Zones can be found here

work related stress

Sources:
1) Ergonomics: The Study of Work, U.S. Department of Labor, Occupational Safety and Health Administration, OSHA 3125, 2000 (Revised)
2) T. R. Waters, “Manual Materials Handling”, in: Physical and Biological Hazards of the Workplace 2nd. Edited by P. Wald and G. Stave. New York: John Wiley and Sons, 2002.
3) Ergonomics and Musculoskeletal Disorders, Centers for Disease Control and Prevention/ National Institute for Occupational Safety and Health (NIOSH) © Fit2WRK 2015 R.Gagne

PT News

This Month in PT News. Featuring articles from PTandMe partnering clinics!

2. Kick the Pain of Gout
Written by the Therapy Team at the Jackson Clinics – Middleburg, VA

In this age of gyms on every corner and fitness-focused reality television shows and entire networks, it’s easy to think of a high-impact workout as a panacea for all kinds of physical ailments. Read more

3. Four Ways to Make Holiday Travel Pain Free 
Written by Therapy Team at Momentum Physical Therapy – San Antonio, TX

‘Tis the season for holiday travel. The hustle and bustle is unavoidable with people moving through airports, piling into traffic, and some even traveling by bus to reach their destination. Read more

Safe Lifting Practices

Safe Lifting Practices: Back Injury Prevention

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Whether you are getting ready for a move, or need to lift things at work, it’s important to use safe lifting practices. Don’t end up with a hurt back – use these tips to keep yourself injury free.

• ESTABLISH A BASE OF SUPPORT: Use a wide, balanced stance with one foot in front of the other. Make sure that you have firm footing and that your feet are a shoulders-width apart. This staggered stance gives you the stability of not falling over and being able to secure the load.•

• KEEP YOUR EYES UP: Looking slightly upward will help you maintain a better position of the spine. Keeping your eyes focused upwards helps you keep your back straight.

• GET A GOOD GRIP: with your palms and make sure you have an adequate hold on the object. Be certain you will be able to maintain a hold on the object without having to adjust your grip later. You can use gloves to help maintain an adequate grip, but don’t rely on gloves because they can desensitize the fingers and make you unable to feel the object.

• LIFT GRADUALLY WITH YOUR LEGS: without using jerky motions. By using your leg strength, your chance of lower back injury is greatly reduced.

• TIGHTEN YOU STOMACH MUSCLES: as you begin the lift and keep you head and shoulders up.

• PIVOT  DON’T TWIST: Move your feet in the direction of the lift. This will eliminate the need to twist at the waist.

• WEIGHT: A lighter load normally means a lesser risk of injury. The weight of the object should be within the capacity of the person to handle safely.

• HANDLING: It is easier to pull or push a load than it is to lift, put down or carry.

• KEEP THE LOAD CLOSE: Holding a 20 lb. object with your hands 20 inches from the body creates more compressive force on your low back than holding it 10 inches away. This is because the muscles in your back have to work to counterbalance the weight when it is further from the body. As the compressive force on your low back increases, so does the risk of muscle strains, ligament sprains and damage to the disks in the spine.

• FREQUENCY: The more times a load is handled, the more tired the muscles become, making it easier for the person to be injured.

• DISTANCE: The farther the load has to be moved, the greater the risk of injury.

• DURATION TIME: Where the job involves repetitive movements, reducing the time spent on handling will help to ensure the movements are not causing unnecessary strain.

• FORCES APPLIED: Forces should be applied smoothly, evenly and close to the body. Forces exerted should be well within the capacity of the person, and the person should maintain proper posture.

• NATURE OF THE LOAD: Loads that are compact, stable, easy to grip, and capable of being held close to the body are much easier to handle.

• TERRAIN: Rough ground, steep slopes, slippery and uneven floors, stairs and cluttered floors make moving a load awkward and increase the chance for injury.

• ENVIRONMENT (CLIMATE & LIGHTING): If it is too hot, too humid, too cold or the lighting is inadequate, the capacity to work safely is reduced.

• CONDITION OF THE WORKPLACE: Safe and comfortable working conditions, with adequate space to perform the task, and tools and equipment that are well-maintained, make their job safer.

• AGE/GENDER: Young and old workers alike may be at an increased risk of injury from manual materials handling activities. Ensure abilities of employees are in line with functional job requirements.

• TRAINING: Proper training for the specific task is vital to reduce injury.

• TEAM LIFTING: If one person cannot lift or move a heavy, large or awkward object safely, organize a team lift. Team lifting reduces the risk of injury, reduces fatigue and makes the task much easier.

• RAISE/LOWER SHELVES: The best zone for lifting is between your shoulders and your waist. Put heavier objects on shelves at waist level, lighter objects on lower or higher shelves.

• AVOID LIFTING FROM THE FLOOR: Lifting from the floor can greatly increase your risk of injury for two reasons. Firstly, it is difficult to bring objects close to your body when picking them up from the floor, especially large objects where your knees can get in the way. Secondly, your low back must now support the weights of your upper body as you lean forward, in addition to supporting the weight of the item you are lifting. Lifting the same 20lbs from the floor more than doubles the amount of force on your low back when compared with lifting is from waist height. Even a one pound object lifted from the floor increases you risk of injury if you use a bent over posture.

• GET HELP WHEN YOU NEED IT: Don’t try to lift heavy or awkward loads on your own. Even though the muscles in your upper body may be strong enough to handle the load, the muscles, ligaments and disks in your lower back may be injured because of the additional forces they have to withstand. Get help from a co-worker, and whenever possible, use a cart, hand truck or other mechanical device to move the load for you.

PROPER LIFTING TECHNIQUE

proper lifting

IMPROPER LIFTING TECHNIQUE

improper lifting

POSTURE

Posture diagram

GOOD POSTURE

good posture

BAD POSTURE

bad posture

what to expect from physical therapy

What to Expect from Physical Therapy

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PHYSICAL THERAPY IS INTENDED TO MAKE CHANGES WITHIN YOUR BODY

We will accomplish this in several different ways. First, through the use of manual therapies, such as massage and mobilization of the joints. The goals of change are to:

  • Stretch short tissues to make them longer.
  • Strengthen weak tissues to make them stronger.
  • Improve and correct bad/abnormal biomechanics and asymmetries to alleviate pain and take the stress off the body.

THERE ARE SEVERAL THINGS THAT WE EXPECT DURING THE PHYSICAL THERAPY PROCESS, ESPECIALLY IN THE EARLY STAGES OF PT

  • You can expect that you will be sore after the first visit, and most likely the first 2 – 3 weeks until their body gets adapted to PT. Your body is just not used to doing the things that we are going to ask it to do, so there will be a period of adjustment.
  • The pain WILL move. As we make changes to your tissues and mechanics, the stresses on your body will change, thus altering where you will feel the pain or your symptoms.
  • The pain WILL change in terms of intensity, meaning that your pain is expected to fluctuate along the 10 point scale, starting between your high and low levels and changing based on your position, activity, and stress on the body.
  • The pain may also change in terms of the quality of pain. The pain may be: sharp, dull, achy, throbbing, burning, tingling, numbing.
  • It is important to know that all of the aforementioned statements are completely normal. There is nothing that you will experience that will surprise us. Everything that you experience will be normal. Even if what you feel is not normal to you, it is normal for your condition and what your body is experiencing.
  • Physical therapy is not an overnight miracle. Improvement takes time. It is important to understand that no one gets better every day from day one until they leave. Everyone will have good and bad days. In the beginning, you will have more bad days than good. As time progresses, this ratio should flip-flop and you should be having more good days than bad.

If you are looking for a physical therapist, we have you covered with over 500 locations nationwide!

physical therapy near me

 

This article was written by Life Fitness Physical Therapy, an outpatient physical therapy group with fourteen locations in the surrounding Baltimore, Maryland area. Life Fitness Physical Therapy is focused on improving the quality of life for their patients. They strive to provide individualized, evidence-based care that meets every patient’s unique needs. Their objective for each patient is to restore their function, achieve their goals and have them resume an active lifestyle as quickly as possible. For more information click here.

Protect, Stretch & Rest: General Tips

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These are some general healthy tips to remember during your day-to-day activities.

• If you are doing strenuous, household or outdoor work protect your hands with gloves in order to prevent injury and/or loss of moisture.
• Take frequent breaks or switch to a new activity. Overuse of repetitive motions, such as pressing buttons, can cause tendonitis of the elbow or lead to Carpal Tunnel Syndrome.
• If you find yourself sitting at your computer for hours each day, stop each hour and stretch your fingers, arms and the rest of your body to help prevent injury to your bones, joints and muscles.
• If you have pain during your activity, stop. Pain is one of the ways your body is letting you know that you are overextending a particular muscle group.

Common Football Injuries

Common Football Injuries

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Football is one of the most popular sports played by young athletes, and it leads all other sports in the number of injuries sustained. In 2007, more than 920,000 athletes under the age of 18 were treated in emergency rooms, doctors’ offices, and clinics for football-related injuries, according to the U.S. Consumer Product Safety Commission. Physical therapy can provide specific treatment to a number of specific football injuries. Here are a few injuries that can happen during a football game or practice:

KNEE INJURIES
Knee injuries in football are the most common, especially those to the anterior or posterior cruciate ligament (ACL/PCL) and to the menisci (cartilage of the knee). These knee injuries can adversely affect a player’s long-term involvement in the sport. Football players also have a higher chance of ankle sprains due to the surfaces played on and cutting motions.

Physical therapy treatment for knee injuries may include:
• Exercises to help promote recovery. Specifically, therapists will design a program to strengthen the whole leg as well improve its range of motion.
• Balance exercises to allow the return to daily activities (including work and sports) while decreasing the risk of falls and reinjury
• Hands-on treatment to keep the knee joint from becoming stiff
• Ice and vasopneumatic pressure to reduce swelling and pain

SHOULDER INJURIES
Shoulder injuries are also common. The labrum (cartilage bumper surrounding the socket part of the shoulder) is particularly susceptible to injury, especially in offensive and defensive linemen. In addition, injuries to the acromioclavicular joint (ACJ) or shoulder are commonly seen in football players.

Physical therapy treatment for shoulder injuries may include:
NON-SURGICAL
Most labral tears will respond well to non-surgical treatment and may be just one component of a multi-factored pathology of the aging shoulder. Physical therapy will typically address a labral tear from the biomechanical approach of improving the motion and reducing the repetitive injury. If the inflammation and mechanical stress on the structures can be reduced then the tissue has a chance to heal.
SURGICAL
If the athlete has had surgery to the shoulder, the therapist will follow a specific protocol to apply just the right amount of strain on the shoulder to keep it safe after surgery. A sling may be recommended in the early stages but the therapist will get the arm moving with assistance within a relatively short period of time. Physical therapists will give instructions on how to provide varying levels of assistance to the arm for motion in safe planes in front of the body, and eventually throughout the entire range of motion. Once the tissues are healed, the therapist will begin to put resistance on the support structures in order to improve the mechanics of motion and reduce the risk of another injury.

kid football player

CONCUSSIONS
Football players are very susceptible to concussions. A concussion is a change in mental state due to a traumatic impact. Not all those who suffer a concussion will lose consciousness. Some signs that a concussion has been sustained are headache, dizziness, nausea, loss of balance, drowsiness, numbness/tingling, difficulty concentrating, and blurry vision. The athlete should return to play only when clearance is granted by a health care professional. It is recommended that players go though a concussion baseline test before the start of the season. Results from baseline tests (or pre-injury tests) can be used and compared to a similar exam conducted by a healthcare professional during the season if an athlete has a suspected concussion. More information here.

Physical therapy treatment for concussions may include:
EVALUATION: The physical therapist will take time to talk with you and perform a thorough examination of your condition.
THERAPY: The physical therapist will plan a treatment program suited to your individual condition, which will involve exercises for your balance, vision, inner ear and more in order to restore brain function.
TEACHING: Physical therapists will spend time reviewing information with you regarding your diagnosis and progress as well as answering your questions. This empowers the patient to make a lifelong impact on their health.
RETURN TO SPORT: Physical therapists are uniquely qualified to guide you towards a safe return to sport. A therapist can guide recovering athletes through a stepwise protocol to keep patients symptom free,  and to prevent serious, life-threatening conditions associated with a second head injury due to early return to football.

OVERUSE INJURIES
Low-back pain, or back pain in general, is a fairly common complaint in football players due to overuse. Overuse can also lead to overtraining syndrome, when a player trains beyond the ability for the body to recover.

Physical therapy treatment for overuse injuries may include:
Pain-relieving techniques (such as ice) and decreasing or modifying painful activities. This diagnosis often occurs from muscular tightness or weakness which causes posture to get out of alignment. A physical therapist will educate and assist in proper stretching and strengthening exercises for the back. They may perform hands on, manual therapy techniques to further increase joint flexibility. The final phase of rehab will involve strengthening during functional activities and education to prevent the injury from recurring.

RESOURCES:
U.S. Consumer Product Safety Commission
www.cpsc.gov

Stop Sports Injuries
www.stopsportsinjuries.org

REFERENCES:
Preventing Football Injuries. http://www.stopsportsinjuries.org/STOP/Prevent_Injuries/Football_Skating_Injury_Prevention.aspx

PT News

This Month in PT News. Featuring articles from PTandMe partnering clinics!

old man tennis

1. Tennis and Golf: Keep Swinging as You Age
Written by the Therapy Team at the Jackson Clinics Physical Therapy – Middleburg, VA

It’s a hard fact to swallow: Age eventually catches up with all of us, no matter how active we may be. Unless we work to maintain strength and flexibility, we slowly lose both as we age. Read more

track girl

2. Bridging the Gap
Written by Jess VandenBerg MS, AT, ATC, CSCS at the Center for Physical Rehabilitation – Grand Rapids, MI

If you have ever rehabilitated an athletic injury, you know there is a big difference between completing your rehab, and returning to competition. You are pain free, have full range of motion, and are completely functional, but are you prepared for the true demands of your sport, both mentally and physically? Read more

spine

3. Is There an Association Between Radiological Severity of Lumbar Spinal Stenosis and Disability, Pain, or Surgical Outcome?
Written by the Therapy Team at Oregon Spine and Physical Therapy – Eugene, OR

Last week I wrote a blog about a new research article about the shoulder and MRI. It helps us better understand the role of an MRI when trying to figure out the best plan to deal with a painful or injured body part. The old belief that an MRI is the “gold standard” is rapidly dying when it comes to understanding what to do with muscle and joint pain. Read more