What is sciatica?

A herniated disc in your spinal column that is pressing on the nerve roots in the lumbar spine may cause a condition called sciatica. Sciatica causes sudden low back pain or hip pain, and radiates to your buttock, thigh and leg.

Symptoms

Sciatica can cause sharp, burning or “pins and needles” sensations that radiates down your legs. This feeling can last for weeks before it goes away. Sometimes the pain worsens when you move, sneeze, or cough. This condition can be acute or recurring.

Causes and risk factors

Sciatica is most commonly caused by a herniated disc. Generally affecting people between 30 and 50 years of age, sciatica may occur as a result of osteoarthritis or the general wear and tear of aging.

Treatment

Symptoms range from mild to severe and can sometimes go away on their own. Treatment may include rest, applying hot or cold packs, stretching, walking, anti-inflammatory medication, epidural injection and/or physical therapy. Surgery may be recommended for extreme cases in which the compressed nerve results in disabling leg pain that is not resolved with nonsurgical treatments.

What is a herniated disc?

A herniated or “slipped” disc is a common injury that can affect any part of the spine. It can cause severe back pain and other problems in the arms or legs. According to the American Academy of Orthopedic Surgeons, approximately one in every fifty people will experience a slipped disc at some point in their life. Of these, 10% to 25% have symptoms that last more than six weeks.

Vertebral discs are flexible, rubbery cushions that support the vertebral bones. Each disc has a jelly-like center (nucleus) that is surrounded by a tough outer ring (annulus). A disc herniates when its nucleus pushes against the outer ring and puts pressure on the sensitive spinal nerves, causing back pain. Because a herniated disc in the low back often puts pressure on the nerve root leading to the leg and foot, pain often occurs in the buttock and down the leg. This is called sciatica.

Symptoms

Some herniated discs cause no symptoms, and a person may not realize the disc is damaged. But a herniated disc can also cause severe back pain, numbness or tingling, and weakness. Most herniated discs occur in the lower back, where they can cause symptoms in the buttocks, legs, and feet. Herniated discs also occur in the neck, where they can cause symptoms in the shoulders, arms, and hands.

Causes and risk factors

A herniated disc often occurs with lifting, pulling, bending, or twisting movements. They can also result from age-related weakening of the spinal discs. This is called disc degeneration, and it can occur gradually over many years as a result of normal wear and tear on the spine.

Treatment

This condition may first be treated with pain-relieving medications, muscle relaxers, corticosteroid injections, or physical therapy. Your neurosurgeon may recommend lumbar microdiscectomy, one of the most common surgeries to alleviate back pain from ruptured, slipped, or bulging disks, if other treatment methods have been tried and failed.

What is a compression fracture?

Fractures caused by osteoporosis most often occur in the spine and are called vertebral compression fractures. These fractures commonly occur in the lower thoracic and upper lumbar regions. According to the American Academy of Orthopedic Surgeons, they occur in nearly 700,000 patients each year. They are almost twice as common as other fractures typically linked to osteoporosis, such as broken hips and wrists.

Symptoms

A vertebral compression fracture causes back pain, typically near where the break occurs. They most commonly occur near the waistline. The back pain often gets worse with standing or sitting for a period of time. As osteoporosis progresses, another symptom can be a forward curving of the spine (“dowagers hump”) that results in a hunched appearance and the loss of height. Symptoms may also include a loss of range of motion and reduction of sensation in the extremities.

Causes and risk factors

Most compression fractures develop because of osteoporosis, which is a loss of bone density that causes your bones to become weak and brittle. If you have osteoporosis, routine daily activities such as bending down or coughing can gradually damage your vertebrae. Compression fractures can also caused by traumatic injury or by cancer of the spine.

Treatment

Treatment options may include rest, pain medication, and physical therapy. If your doctor has also diagnosed osteoporosis, you are at an increased risk for additional vertebral compression fractures and other fractures, such as to the hip and wrist. Your doctor will address treatments for bone density loss during this time. If you have severe back pain and these options are not successful, procedures such as vertebroplasty or kyphoplasty may be used to stabilize the fracture and prevent further collapse of the bone.

What is a cervical radiculopathy?

Cervical radiculopathy, also known as a pinched nerve, is a condition caused by an irritation or compression of nerve roots in the cervical spine. Because these nerves travel to the shoulders, arms, and hands, it can cause numbness, tingling, or weakness in these areas.

Causes and risk factors

• Degenerative disc disease
• Osteoarthritis
• Herniated disc
• Spinal stenosis

Symptoms

• Numbness, tingling, or weakness in the hand or fingers
• Weakness in the arm, shoulder, or hand muscles
• Loss of sensation
• Pain decreases when hands placed on top of head

Diagnosis and treatment

Cervical radiculopathy typically responds well to nonsurgical treatment. After a physical exam, your physician may use imaging such as x-ray or MRI to help diagnose the condition. An EMG or Nerve Conduction Study will help confirm if your symptoms are caused by too much pressure on the nerve. Physical therapy and nonsteroidal anti-inflammatories are often the initial treatment for cervical radiculopathy. Steroid injections can help alleviate swelling and relieve your neck pain to allow the nerve to recover. If this does not relieve the symptoms, your doctor may recommend surgery.

Osteochondritis dissecans (OCD) is a condition that develops in joints, most often in children and adolescents. It occurs when a small segment of bone begins to separate from its surrounding region due to a lack of blood supply. As a result, the small piece of bone and the cartilage covering it begin to crack and loosen.

Causes and risk factors

Repetitive high stress forces on the joint can result in a series of minor injuries on the elbow that can eventually lead to bony fragmentation and ultimately detachment of the bony fragment from the bone. Commonly seen in the adolescent sporting population; who partake in repetitive throwing or overhead activities such as baseball and gymnastics. More frequently seen in males (ages 10-14) than females and often affecting the dominant arm.

Symptoms

• Lateral Pain over the joint
• Stiffness
• Feeling of instability
• Stiffness after resting
• Locking
• Giving way
• Popping/clicking

Treatment

In most cases, OCD lesions in children and young teens will heal on their own, especially when the body still has a great deal of growing to do. Resting and avoiding vigorous sports until symptoms resolve will often relieve pain and swelling. There are different surgical techniques for treating OCD, depending upon the individual case.

Mallet finger is an injury to the thin tendon that straightens the end joint of a finger or thumb.

Causes and risk factors

Although it is also known as “baseball finger,” this injury can happen to anyone when an unyielding object (like a ball) strikes the tip of a finger or thumb and forces it to bend further than it is intended to go. As a result, you are not able to straighten the tip of your finger or thumb on your own.

Symptoms

The finger is usually painful, swollen, and bruised. The fingertip will droop noticeably and will straighten only if you push it up with your other hand.

Diagnosis and treatment

A mallet finger injury requires medical treatment to ensure the finger regains as much function as possible. Most doctors recommend seeking treatment within a week of injury. However, there have been cases in which treatment was delayed for as long as a month after injury and full healing was still achieved.

Arthritis in the hand is extremely common. In most cases, this is due to osteoarthritis, but may also be related to previous injury, rheumatoid arthritis, and/or other systemic illness. There are many factors that can affect your symptoms and function. Treatment for arthritis is patient-specific, your doctor can help develop a plan tailored to your goals.

Causes and risk factors

• Age
• Obesity
• Females are more susceptible than men
• Prior injury
• Repetitive stress
• Genetics
• Diabetes Mellitus
• Auto-immune disease such as Rheumatoid Arthritis or Lupus

Symptoms

• Burning pain
• Sharp pain with use
• Stiffness
• Swelling
• Bone spurs

Diagnosis and treatment

In most cases, the diagnosis can be made based on a physical exam and obtaining x-rays. Treatment for osteoarthritis varies depending on a patient’s goals. The following nonsurgical treatment options can be effective.

• Activity modification
• Massage
• Over the counter anti-inflammatory medications (ibuprofen, naproxen)
• Anti-inflammatory herbs such as turmeric or ginger
• Topical pain relief creams/gels
• Occupational/Physical Therapy
• Corticosteroid injections
• Prescription anti-inflammatory medications

If these treatments do not work, surgery may provide pain relief and/or improved function. On rare occasions, and/or if the arthritis is related to an auto-immune disease than evaluation by a rheumatologist can be warranted.

Dupuytren’s Contracture develops when the fibrous tissue layer underneath the palm and fingers begins to thicken. Small bumps form under the skin and may lead to the fingers contracting and curling in.

Causes and risk factors

• Common in people of Northern European or Scandinavian ancestry
• Frequently runs in the family
• May be associated with drinking alcohol
• May be associated with certain medical conditions such as diabetes and seizures
• Increases with age

Symptoms

• Initially, small sensitive lumps form in the palm. Usually with time, the pain subsides and goes away
• Nodules may thicken and contract creating tough bands of tissue under the skin inside the fingers and in the palm
• Most commonly the ring and little finger are affected, curling in towards the palm
• Becomes hard to straighten the bent fingers

Diagnosis and treatment

Your orthopedic surgeon will examine your hand and test the feeling in your thumb and fingers. The specified hand’s grip and pinch strength may also be evaluated. Your doctor will be able to use these recorded measurements to determine if the disease is systematic. There are multiple types of treatment for this disease, although there is no cure. In many cases, Dupuytren’s can be treated with a minimally invasive procedure performed in the office.

Carpal Tunnel Syndrome is a common condition that causes pain, numbness and tingling in the hand and wrist. This is caused when the tunnel becomes narrow or when the tissues surrounding the flexor tendons become inflamed and swell causing pressure on the median nerve.

Causes and risk factors

• Heredity
• Repetitive hand use
• Doing activities with extreme flexion or extension of the hand and wrist
• Pregnancy or other conditions that cause your body to hold onto fluid
• Diabetes
• Rheumatoid arthritis
• Wrist injuries

Symptoms

• Tingling and numbness in fingers – primarily in the thumb, index, middle, and ring fingers.
• Pain or tingling that travels up the arm toward the shoulder.
• Lack of strength in grip and finger coordination – this may make it difficult to participate in normal activities such as buttoning your shirt.
• Dropping things due to weakness or numbness
• Nighttime symptoms are very common and may awaken you from sleep.

Moving or shaking your hands can sometimes help to relieve symptoms.

Diagnosis

Most people that have carpal tunnel will notice that their symptoms gradually worsen over time. It is important to be evaluated in the early stages to slow or stop the progression of carpal tunnel syndrome. An orthopedic surgeon will examine your hand and wrist and test for nerve damage. An EMG or Nerve Conduction Study will help confirm if there is too much pressure on the nerve. Sometimes an ultrasound, x-ray or MRI will also be ordered. These tests help your doctor determine the severity of your carpal tunnel syndrome.

Treatment

Nonsurgical treatments include rest, ice, wrist splints, nonsteroidal anti-inflammatory drugs (NSAIDS), or steroid injections. Other options may include modifying your activity to reduce symptoms and slow the progression of the disease.

If conservative treatment options do not relieve your pain, your orthopedic surgeon may recommend surgery. A carpal tunnel release surgery increases the size of the carpal tunnel and decreases pressure on the nerve. This procedure can either be performed using endoscopic surgery or with traditional open surgery. There are risks and benefits to both and your doctor will discuss both with you. Some patients who choose endoscopic carpal tunnel release may be eligible to utilize wide-awake local anesthesia rather than general anesthesia.

Recovery

After surgery you may be encouraged to do the following:

• Elevate your hand above your heart and move your fingers to reduce swelling and prevent stiffness.
• Ice the surgical site for a given amount of time, a few times a day.
• You may need to wear a splint or wrist brace for several weeks.
• Follow your doctor’s specific instructions on when it’s okay to return to work and whether you will have any restrictions on your work activities.
• If you experience increased pain and weakness for more than two months following surgery, you may be referred to a hand therapist to help improve your recovery.

It is likely that surgery will improve your previous symptoms, but recovery can be gradual, and in some cases, can take up to one full year. Other factors that can contribute to longer recovery times are preexisting conditions, such as arthritis or tendonitis, which could also be contributing to pain and stiffness.

Carpal tunnel surgery aftercare and milestones you can expect to meet with carpal tunnel release can vary. Click here for one example of how your recovery could progress.

Train Your Brain is presented to third grade classrooms across Central Oregon. Prompted by an alarming increase of preventable head injuries in young people, The Center Foundation pioneered Train Your Brain as part of the Brain Trust initiative.

This elementary school outreach provides innovative, research-based curriculum on the importance of helmet use and brain and spinal cord injury prevention. The program reaches more than 2,000 students each year and distributes more than 1,000 helmets annually to those in need. These helmets should always be worn when participating in any non-motorized wheeled sport, including bicycling, skateboarding, roller blading and scooter riding.

Please help kids stay safe and healthy by encouraging them to be active and take all possible precautions to prevent injury – like wearing a helmet. 

Helmet Safety Tips

If you would like more information, or know of a child in need of a helmet, please call Stuart Schmidt at 541-322-2323 or email [email protected]. 

2025 Presentation Schedule

Train Your Brain is brought to you with the help of our generous sponsors! Thank you! 

 

How Train Your Brain got started

Years ago, a young Bend boy was struck by a car while riding his bike without a helmet. He was rushed to the ER where one of The Center Foundation’s board members, a neurosurgeon, was on call. Tragically, and in spite of our board member’s best effort, the boy did not survive.

As a result, and with the intention of preventing further tragedies, The Center Foundation adopted programs to educate our grade school kids on the importance of protecting their brain and spinal cord by learning and using good safety skills.

Today, St. Charles continues what The Center Foundation started by offering educational presentations to youth organizations in Central Oregon, including: elementary schools, boy scouts, pre-schools, summer camps, and English as a second language class. The presentations include age-appropriate discussions of brain and spinal cord anatomy and injury prevention techniques such as street, car, and bike safety. These active and fun sessions conclude with a melon drop helmet demonstration.

Students are asked to bring their helmets for a fit and function assessment. If a child’s helmet is ill fitting or damaged, or if they do not have a helmet, a new helmet will be properly fit and provided by our team of helmet experts at no cost.