Click a link below to learn more about common orthopaedic problems.
Amputation occurs when a finger, hand, foot or leg becomes detached from the rest of your body. These injuries usually occur as a result
of a traumatic event such as a car accident or industrial machinery mishap. Skilled surgeons can sometimes re-attach severed
body parts using microsurgery to reconnect nerves, blood supplies and other structures within the appendage.
Anterior cruciate ligament (ACL) tear is a common athletic injury. The anterior cruciate ligament (ACL) is the major stabilizing ligament of the knee. It runs
from the thighbone to the shinbone through the center of the knee where it prevents the knee from buckling. Tears usually
occur with a sudden change in direction or when something stops a person abruptly.
Arthritis is the wearing away of the protective tissue layer that covers the bone ends inside joints. This layer acts as a shock absorber.
As it wears, the joint becomes achy, swollen and eventually deformed. Arthritis can occur at any age after an injury to a
joint.
Broken bones are also called fractures.
Bulging disc is not necessarily a cause of back pain and is a normal process of aging. Discs are basically shock absorbers that hold a
lot of water. Each disc begins to lose its water and its shock absorber effect starting in our late teens. As it does, it
flattens and the edges bulge outward, just as a deflated air mattress would.
Bunions are misaligned big toe joints. These joints become swollen and tender, causing the first joint of the big toes to slant outward
and the second joint to slant inward at an sharp angle. Bunions affect more women than men. Although a tendency to have bunions
can run in families, wearing poor-fitting shoes (that are pointy, too narrow or too tight) can cause bunions. Treatment varies
according to the severity of the deformity and the pain it causes, and can range from anti-inflammatory medication and new
shoes with orthotic inserts to surgery.
Bursitis is inflammation of bursae — small sacs located between bone and other moving structures such as muscles, skin or tendons.
The bursa allows smooth gliding between these structures. Bursae are all over the body, but the ones closest to joints (hips,
knees, shoulders, elbows) tend to become irritated more often. Bursitis is usually temporary and occurs mainly as result of
overuse.
Carpal tunnel syndrome is a potentially disabling wrist disorder caused by a compressed nerve or increased pressure on the wrist. Any medical condition
that causes swelling of the tissues in the carpal tunnel (a narrow passageway running from the palm of the hand to forearm)
such as thyroid problems, rheumatoid arthritis and diabetes, can lead to carpal tunnel syndrome. Carpal tunnel syndrome is
associated with overuse of the wrist. This can occur from performing repetitive hand motions, such as those performed by computer
users, cashiers, assembly-line workers, sewing machine operators and musicians. Symptoms include numbness or tingling in the
thumb, index, long and sometimes ring fingers; trouble grasping or dropping objects; weakness in the hand; discomfort or pain
that occurs frequently at night or early in the morning, which starts in the hand and can radiate all the way to the shoulder.
Click here for tips on preventing carpal tunnel syndrome.
Cartilage tears affect the protective tissue between joints such as knees, elbows and shoulders. See also meniscus tears.
Collateral ligament tears can affect the medial collateral ligament (on the inside of the knee joint), or rarely, the lateral collateral ligament (attached
outside the knee joint). These ligaments supply stability to your knee for side-to-side movement, even during normal walking.
Injury to these areas usually occurs after a strike from the side such as a football tackle.
Contracture is painful deformity of a joint resulting from continued muscle shortening ( spasticity). When a muscle is not regularly put through its full range of motion, its tendons shorten. This makes stretching the muscle
even more difficult, setting up a cycle of even more shortening and decreased stretch. The muscle may develop fibrous scar
tissue, further preventing full range of motion.
Contusions are bruises. A blunt force such as a kick, fall or blow often causes a bruise to soft tissue. Contusions usually produce
discoloration, swelling and pain. Rest, Ice, Compression and Elevation (R.I.C.E.) is one treatment for contusions.
Cubital tunnel syndrome is a condition that affects the ulnar nerve that crosses your elbow through a passage called the cubital tunnel. The symptoms
are very similar to the pain that comes from hitting your funny bone. Causes include trauma to the elbow, frequent bending,
constant use of the elbow and constant direct pressure on the elbow.
Degenerative disc disease (DDD) causes pain when discs wear out, narrowing the space between vertebrae. With less space available, nerves can become compressed
and painful. All discs lose their water content and degenerate as we grow older, but some people’s discs degenerate faster
than others. Some people experience much more pain from these degenerative changes than others. DDD will often present as
sudden, unexpected back pain following a small injury, or as a gradually worsening low back pain.
Degenerative spondylolisthesis, also known as a slipped disc, is a condition in which one vertebra slips forward onto the one below it. This usually occurs
because the back part of the slipped vertebra is not connected to the body the way it should be. In adults, the most common
cause is degenerative disease (such as arthritis) and the slip usually occurs between the fourth and fifth lumbar vertebrae. Symptoms can include lower back pain, pain in
the thighs and buttocks or tenderness in the slipped area. Leg weakness or numbness can result from pressure on nerve roots
and can cause pain to radiate down the legs. Other causes of spondylolisthesis include stress fractures (caused by repetitive
hyper-extension of the back, commonly seen in gymnasts) and traumatic fractures.
Diabetes-related foot conditions include Charcot foot, diabetic peripheral neuropathy, poor circulation and ulcers. These conditions are complications of
diabetes and, if left untreated, can lead to amputation. Charcot foot is a form of arthritis that causes rapid degeneration of foot bones, muscles and ligaments. It usually occurs in conjunction
with neuropathy (damaged nerves). Diabetic neuropathy affects the nerves in your foot and may leave your feet unable to feel pain, heat and cold. Poor circulation is poor blood flow in the feet as a result of narrowed blood vessels. This condition reduces the amount of oxygen and nutrients
that get to your feet, which can make injuries heal more slowly. Ulcers are sores caused by too much pressure on a part of your foot. These sores may go undetected because of neuropathy, and may
not heal properly because of poor circulation. People with diabetes must take especially good care of their feet because their
disease puts them at risk for these conditions. That means wearing proper footwear, bathing feet daily, protecting feet from
injury, working to improve circulation and having feet checked regularly by a doctor. Einstein’s Diabetes Foot Care Program
helps people with diabetes and peripheral vascular disease monitor their health of their feet.
Dislocated kneecap is what happens when your kneecap pops out of place, usually to the outside of the knee.
Dislocated shoulder and elbow are common injuries. Shoulder dislocation occurs when the ball at the top of the upper armbone (humerus) comes partway or
all the way out of the socket. Both partial and complete dislocation cause pain and unsteadiness in your shoulder. Your muscles
may spasm from the disruption, and this can make it hurt more. When your shoulder dislocates time and again, you have shoulder instability. A dislocated elbow occurs when the bones in the elbow are pulled apart, causing the ligaments that keep the bones together
to stretch or tear. Most elbow dislocations are caused by falling on an outstretched hand.
Failed back syndrome is not a single disease but a collection of conditions that emerge after any number of surgeries or other treatments. Patients
with failed back syndrome have undergone one or more surgical procedures and continue to have debilitating pain. This pain
may be caused by recurring disc herniation, excessive scarring, or injury to nerve roots. Einstein’s Failed Back Program helps evaluate and treat people suffering with failed back syndrome.
Foot and ankle instability is a condition in which ligaments in the foot and ankle don’t provide consistent support to foot and ankle bones. That is,
they have a tendency to give way. Instability often results when ligaments don’t heal well after a sprain or other injury.
Your foot and ankle may feel sore, swollen and unstable. Treatment may include physical therapy, wearing a brace or special
boot and in severe cases, surgical reconstruction.
Fractures are breaks in bones. Broken bones can result from falls, accidents or traumatic injuries. Severe breaks may require surgery
to repair. However, most fractures are treated by immobilizing broken bones in casts or splints until they have grown back
together.
Frozen shoulder, also called adhesive capsulitis, is a painful condition characterized by severe loss of motion in the shoulder. It may follow
an injury to the shoulder, but can also arise with no warning or prior injury.
Ganglion cysts are hard, bony-feeling lumps under the skin that can occur on the back of the wrist, the palm side of the wrist or on a finger
joint. These non-cancerous bumps occur when a sac beneath your skin fills with jelly-like fluid that will not drain. Sometimes
this is caused when linings of tendons or joints poke a tear in the ligaments covering them. If the cysts aren’t causing any
pain or discomfort, they usually won’t require treatment. In many cases, they will eventually go away on their own. Ganglion
cysts can be treated by draining them with a needle (aspiration) or by surgical removal.
Growth plate injuries are essentially fractures that occur in children and teens. A growth plate is an area of growing tissue at the ends of long
bones such as arms and legs. The plates determine the future length and shape of mature bones; they close during adolescence
to form permanent bone. About half of all growth plate injuries affect the outer bone of the forearm at the wrist. Growth
plate injuries are usually caused by a fall or blow to a limb, however, overuse (a young pitcher continually practicing his
fastball) can cause chronic problems. These injuries are treated with a combination of methods that may include casting, surgery
and exercise or physical therapy.
Hammer toes are a toe deformity in which the middle joint of a toe has a permanent sideways bend in it. Tight shoes can aggravate hammer
toes and cause pain. Hammer toes are usually treated by wearing shoes that fit over the deformity, sometimes with orthotic
inserts. Badly deformed toes may need to be straightened through surgery.
Heel spurs are abnormal growths on the heel bone. Heel spurs result from calcium deposits that form when tissue (plantar fascia) that
runs from heel to forefoot pulls away from the heel area. This condition is often seen in people with flat feet, but can also
be caused by obesity or poor shoe choices. Treatments can include wearing better-fitting shoes and using orthotic inserts,
stretching exercises and losing weight.
Herniated disc occurs when the outer lining of a disc in the spine becomes torn, allowing the soft inner disc material to stick out, which
can put pressure on nearby nerves. Herniated discs tend to cause sciatica or leg pain, due to this pressure on the nerves.
Impingement syndrome is painful irritation of the tendons and/or fluid sac (bursa) attached to the rotator cuff in the shoulder. The tendons and
bursa rub against one another whenever you raise your arms over your head. But continuous overhead or repetitive shoulder
movements, such as throwing, can cause irritation and pain that doesn’t go away.
Knee instability is a condition usually caused by an anterior cruciate ligament injury. This ligament is a major stabilizer of the knee.
Ligament injuries are common in athletes and active people. Ligaments on either side of a bone can be strained or torn by overuse or by a fall
or traumatic injury. Sometimes a "snap" or "pop" is heard and the joint attached to the ligament feels loose or wobbly.
Meniscus tears are tears in knee cartilage (meniscus) – a small, horseshoe-shaped, mobile shock absorber between the bone ends inside the
knee joint. There are two in each knee on either side of the knee. Meniscus tears are extremely common with ACL injuries.
Myelopathy, also known as cervical spondylotic myelopathy (CSM), is caused by compression of the spinal cord in the upper spine. Arthritis
causes bony spurs to form, which then grow into the spinal canal and compress nerves in the spinal cord. Symptoms of myelopathy
include neck pain, problems with balance, numbness in the hands and fingertips and difficulty with fine movements such as
buttoning a shirt. Conditions that can cause myelopathy include multiple sclerosis and amyotrophic lateral sclerosis (also
known as ALS or Lou Gehrig’s disease).
Nerve compression can be the painful result of many back conditions, including spinal stenosis (which puts pressure on the spinal cord), herniated
discs and many others. This condition occurs when a degenerated or injured vertebra or disc places pressure on nearby nerves,
causing pain to radiate through the spine and into the arms or legs. Nerve compression can also occur when a tumor presses
on surrounding nerves.
Nerve injuries are usually the result of compression, overstretching or trauma. Nerves send messages from parts of the body to the brain
and from the brain to parts of the body. Motor nerves send messages about movement, while sensory nerves send messages about
pressure, pain and temperature. Injured nerves can stop sending or receiving messages and can become hypersensitive to pain.
Hand surgeons can repair injured nerves by stitching them back together.
Neuromas are painful buildups of extra tissue in nerves. They usually result when a nerve between the third and fourth toes is pinched.
This can happen when too-tight shoes press foot bones together. Treatment usually involves wearing wider shoes and taking
anti-inflammatory medicines. Very painful neuromas may require cortisone injections to relieve inflammation and pain. If the
condition doesn’t clear up, you may need surgery to remove the extra tissue.
Osteoarthritis is the most common form of arthritis ( Osteo is Greek for bone; arthritis means joint inflammation.) Osteoarthritis (OA) is an inevitable part of aging and can affect
any joint. It usually develops after age 45; about half of men and women over age 65 have it to some degree. OA is caused
in part by wear and tear on a joint over time. It develops as cartilage – smooth tissue that cushions bones and keeps them
from rubbing against each other – breaks down. This leads to joints becoming painful, warm to the touch, reddened and swollen.
When the cushioning system of the joint is lost, the bones may grind painfully against each other. The joint can begin to
stiffen, and movement is impaired. OA typically strikes the weight-bearing joints (knees, hips, back, feet); hands; and spine.
The knee is the most commonly affected joint.
Osteoporosis (brittle bones) is a condition in which bones lose calcium, causing them to become fragile and more likely to break. If left untreated, osteoporosis
can progress painlessly until a bone does break, such as a hip, spine or wrist or rib. This disease affects more women than
men; 80 percent of those with osteoporosis are female. You may be at increased risk for osteoporosis if you have a family
history of brittle bones; suffer from autoimmune disorders such as diabetes, rheumatoid arthritis or asthma; are extremely
thin; or are a postmenopausal woman or a man with low testosterone levels. Children with such conditions as cystic fibrosis,
celiac disease and inflammatory bowel disease are also at increased risk of osteoporosis because they can not absorb nutrients
such as calcium properly. There are steps you can take to help prevent osteoporosis. These steps include getting enough calcium
in your diet or through supplements, as well as Vitamin D to ensure your body absorbs the calcium. Getting regular exercise,
especially weight-bearing or resistance exercise, builds stronger, denser bones. Avoiding smoking and heavy drinking can also
improve bone health. Long-term use of some medicines (corticosteroids, anticonvulsants) can speed up bone loss.
Osteonecrosis (bone death) is what happens when a segment of bone within the joint suddenly loses its blood supply and ‘dies.’ This condition usually
affects older patients; the cause is not always known but high-dose steroid treatments for other medical conditions can cause
osteonecrosis.
Pediatric and congenital deformities of the feet refer to conditions in which the foot is twisted out of a normal position. Congenital means something you are born with.
One example of a congenital foot deformity is clubfoot— a condition in which the sole of an infant’s foot is turned inward and the heel is turned upward. Deformities can also be
acquired through illnesses. For instance, some children with cerebral palsy or another neuromuscular disorder may present
with cavovarus foot— a condition in which the heel flexes, the arch is very high and the toes curl up. Foot deformities may be treated with casting,
bracing or with surgery.
Plantar fasciitis is inflammation caused by excessive stretching of the tissue (plantar fascia) that runs along the bottom of the foot. This
excessive stretching can result from flat feet, high-arched feet, obesity, a sudden increase in physical activity or improperly
fitting shoes. Symptoms of plantar fasciitis include pain on the bottom of your foot, near the inside where your heel and
arch meet. Treatments can include wearing properly fitting shoes and using orthotic inserts, doing stretching exercises and
losing weight.
Rheumatoid arthritis is a form of arthritis in which excessive inflammation wears away the protective tissue between joints.
Rotator cuff injuries are the most common cause of shoulder pain in adults over 30. The rotator cuff is a set of four ligaments that brace the
shoulder, where the top of the upper arm bone (humerus) and the shoulder blade (scapula) meet. A typical experience is that
of a patient in middle age who has tendonitis or bursitis, then lifts a load or suffers an injury that tears the rotator cuff.
Because rotator cuff tendons have a very low blood supply, they do not repair themselves quickly and are very vulnerable to
degeneration as we age. Degeneration can be sped up by repeating the same types of shoulder movements again and again.
Ruptured disc is another way to describe a herniated disc.
Sciatica is pain that radiates from your lower back down through your legs when your sciatic nerve becomes compressed, inflamed or
irritated. This nerve exits the spinal cord at the end of the lumbar spine.
Scoliosis is an abnormal curvature of the spine. Scoliosis can be related to a problem with the formation of vertebrae, or fused ribs
or can occur due to diseases that cause poor muscle control, such as polio or muscular dystrophy. Scoliosis can appear in
previously straight spines, and may have no known cause. This type of scoliosis (idiopathic) mostly affects teenaged girls.
Shin splints is an overuse injury that frequently affects athletes such as runners and figure skaters. It’s characterized by pain and
tenderness in the front of the lower legs during or after exercise. Shin splints can occur as a result of wearing improper
footwear during exercise or exercising on hard surfaces. Treatments can include ice, anti-inflammatory medicine, reducing
intensity of exercise temporarily, stretching exercises, orthotic devices and physical therapy.
Shoulder instability is a condition in which the shoulder joint is too loose and can slide around too much in the socket. Most of the time, an
injury causes the shoulder to become unstable. In some cases, the unstable shoulder can actually slip out of the socket. If
the shoulder slips completely out of the socket, it has become dislocated. If not treated, instability can lead to arthritis
of the shoulder joint.
Slipped disc is another term for degenerative spondylolisthesis.
Soft tissue and bone tumors in the feet are not very common. Most are non-cancerous, and can include bone cysts, plantar fibromatosis (tumor on the fascia,
a band of tissue that runs from the bottom of your heel to your toes), and fat-cell tumors. Malignant tumors may arise from
a bone cancer or may occur as a result of cancer spreading from elsewhere in the body.
Spasticity is involuntary, jerky movement of muscles that remain abnormally contracted (shortened or flexed) for long periods of time.
It is a common aftereffect of neurological disease and brain or spinal cord injury. Symptoms of spasticity can range from
slight muscle stiffness to deformity and permanent muscle shortening ( contracture). Clonus (rapid, repetitive muscle spasm) is also possible. Spasticity can be painful, especially if it pulls joints into
abnormal positions or prevents normal range of motion. Spasticity can interfere with your ability to dress, eat and do many
of the activities of daily living. Treatments may include physical therapy, muscle-relaxing medications, splinting or surgery.
Spinal stenosis is a narrowing of the spinal canal that causes pressure on the spinal nerves, commonly caused by osteoarthritis. This condition occurs as our bodies age and is seen mostly in patients over the age of 50. Some people have congenital spinal
stenosis, that is, they are born with a narrow spinal canal that becomes progressively worse. Symptoms of spinal stenosis
can include leg pain that worsens with walking and back pain.
Sprains/strains are two different injuries, although both are the result of forcing a joint past its normal range of motion. Sprains occur
when ligaments that connect bone to bone are overstretched, resulting in swelling, pain and even bruising. Jammed fingers,
twisted knees, and twisted ankles are common examples of sprains. Strains, also called muscle pulls, refer to an overstretching
of a muscle or tendon that causes the muscle to actually tear. Strains usually occur when a muscle is stretched too fast.
Stress fractures are an overuse injury. These occur when muscles are too tired to absorb any more shock, so the stress transfers to the bone
and creates a tiny crack. Stress fractures can often result from increasing the amount or intensity of an activity too quickly.
Most stress fractures occur in the lower legs and the foot.
Tendonitis is inflammation or irritation of a tendon. Tendons are the thick fibrous cords that attach muscles to bones. They transmit
the power generated by a muscle contraction to move bones. Tendonitis is usually temporary and occurs mainly as result of
overuse.
Tennis elbow is inflammation of the muscles of the forearm, or of forearm tendons. Commonly experienced by tennis players, it can be caused
by overuse or a constant pull of the lower arm muscles.
Thoracic outlet syndrome is a rare condition that occurs when vessels or nerves in your collarbone are compressed, sometimes by an extra rib. This
condition causes pain the neck or shoulder, numbness or tingling in the fingers and weakened grip.
Trigger finger is a condition in which the sheath surrounding tendons in your finger become swollen. Symptoms include pain, swelling, popping
and a catching feeling in the finger or thumb. The finger sometimes becomes locked in one position and is difficult to bend
or straighten. Trigger finger can be associated with rheumatoid arthritis, gout and diabetes.
Tumors of the spinal cord don’t occur frequently (about 0.5 to one percent of all tumors) and nearly 85 percent of them are benign. The other 15 percent
of spinal cord tumors are cancerous, however, they are most frequently seen in cancer patients whose disease has spread. Spinal
cord tumors can compress nerves, disrupt vertebrae and cause intense pain.
