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When knee pain is worse after meniscus surgery

Marc Darrow, MD Many people that we see  in our examination rooms have had a meniscus surgery. They are seeking our help in relieving the knee pain that they continue to have following the surgery. For some the pain started immediately after surgery, for others the pain became progressively worse and as the months and years went by significant pain set in. How did this happen? For many people, it happened because they had a belief that the surgery will help them. Typically, someone who considers surgery and decides to have the meniscus procedure, do so because they believe that

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Alternatives to Cervical Epidural Steroid Injection for Cervical Radiculopathy

Many people find relief from neck pain through various non-surgical treatments. Among these conservative neck care treatments are neck epidural corticosteroids injections. These steroid injections can provide temporary relief in situations of chronic neck pain and in cervical radiculopathy where inflammation is causing compression the cervical nerves and pain and numbness into the arms, hands and fingers. However, long-term results can be less successful. An October 2021 study (1) investigated the effect of preoperative epidural steroid injection on future outcomes  in patients undergoing surgery for cervical degenerative disease. In this large study: 97,117 patients underwent cervical degenerative surgery, of which

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Non-Surgical and Conservative Care for neck pain and cervical spine disorders

Chronic neck pain is one of the more frequent problems we see in our new patients because of its complexity and difficulty in finding the true cause of pain. Patients may present themselves with numbness or pain radiating from the neck into the arm due to nerve compression. They may be diagnosed with cervical radiculopathy which is caused by  herniated disc, or spondyliotic foraminal stenosis. When many doctors think there is a radiculopathy, a surgery will be recommended. Chronic neck pain usually centers around the nerves. Chronic neck pain usually centers around the nerves. A disc in the neck can

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Do Painkillers Cause Lower Testosterone Levels?

Marc Darrow, MD, JD. I see a number of patients who have advancing osteoarthritis but who are too young for joint replacement and are being managed for their joint pain until they are old enough for joint replacement. At the same time, they are losing hormones, gaining weight, and losing mobility. Typically, they have lower levels of activity, chronic pain, are becoming obese, and are on pain medications. They are, clearly, in a poor healing milieu.  In our office we have seen many men who had a long history of opioid usage and display signs of low testosterone levels including,

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Which surgery first? Spinal fusion or hip replacement?

Many people email us about their hip and back pain. Some have been recommended to a hip replacement, some have been recommended to a spinal surgery. Some have been recommended to both surgeries and they are in the process of choosing between one or the other and exploring options to help them avoid one or the other surgery, even both. Some at this point are not even deciding which to get first, they may simply take the first one that is available. The question that comes in to us is about stem cell therapy as an option and “which would

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Management of Glenohumeral osteoarthritis and shoulder replacement options

Marc Darrow, MD. Glenohumeral osteoarthritis is the degenerative breakdown of the ball and socket of the shoulder.  If you went to the doctor with shoulder pain, and you had a shoulder MRI, and that MRI revealed shoulder osteoarthritis, the next discussion you will probably have with your doctor is what can you do about it? That answer is not clear cut. What treatments you take can be influenced by the amount of pain and function that you have. The shoulder examination A physical examination should include screening for physical abnormalities—swelling, deformity, muscle weakness, and tender areas—and observing the range of

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