Joint and Extremity Conditions


Ankle and Foot Pain

Ankle pain is a common symptom that can be caused by several different factors, ranging from ill-fitting shoes to bone fractures or ligamentous tears.

Most common conditions causing foot and ankle pain is plantar fascitis and achilles tendonitis. It is characterized by pain on the sole of the foot, heel or behind the heel. It is caused by prolonged walking and/or standing, improper or worn out shoe wear, and anatomical structure of feet such as flat feet predisposing it to such injuries.

Other common ankle and foot conditions are caused by direct or indirect trauma to the region. They may include achilles tendon rupture or ankle sprain. The pain may vary from mild to severe, localized bruising and swelling may occur, and you may experience difficulty walking or putting weight on the involved foot. The first thing you should do is RICE: rest, ice, compress, elevate, and see a medical doctor to rule out severe injury.

Additional examples of ankle and foot pathologies are the following: heel spurs, arthritis of the ankle and toes, bunions and collapsed arches. The pain is characterized by dull and aching pain in the ankle or toes and worsens with walking, standing and or running.

Whether you experience a slow and gradual onset of pain or whether it happens suddenly during an activity, you should seek help. At Comprehensive Medical care we will examine your foot carefully and if necessary, we may refer you out for any necessary diagnostics such as x-rays or MRI’s. Physical therapy treats ankle and foot conditions with heat, ice, ultrasound, cold light laser therapy and electrical stimulation to control pain and inflammation.  Manual techniques such as soft tissue mobilization, massage and joint mobilizations are used to increase range of motion, decrease pain and fasten healing. We may also implement a specialized exercise program to strengthen the muscles of the ankle and foot and prevent pain from reoccurring.

Arthritis

Arthritis is a group of conditions that cause pain and damage to the joints of the human body. The main type of arthritis is Osteoarthritis (OA) which is also known as Degenerative Joint Disease (DJD). OA targets the cartilage that protects the joints and is a chronic condition. As a result, bone rubs on bone and the joint space decreases. Key symptoms commonly associated with OA are pain, joint stiffness, morning stiffness, decreased range of motion and difficulty performing daily tasks.

Nearly one in three adults suffer from swollen, stiff and painful joints as a result of arthritis, and it is the most common chronic ailment among the elderly.

At Comprehensive Medical Care we will perform a thorough evaluation and create a customized treatment plan to help get you back on the road to recovery.

Treatment of arthritis typically involves a combination of physical therapy, assistive devices to unload stress on the joint (canes, crutches or splints), daily exercise, weight loss for overweight patients, and possibly even participation in an exercise program. In the event that conservative treatment isn’t enough, we will refer you to our on staff Pain Management physician for further evaluation to see if you are a candidate for cortisone or viscosupplementation (Synvisc-One) injections.

If arthritis is left untreated the cartilage surrounding the joint will continue to breakdown and symptoms will continue to exacerbate. It is imperative that people suffering from OA be proactive and attack the disease promptly in order to achieve maximum results and prevent joint replacements.

Back Pain

Back pain is a common symptom that can be triggered by several different causes, including injury, accidents or degenerative conditions such as arthritis, disc disease or a herniated disc. This pain may be chronic or acute, depending on the cause, and can range in intensity from a dull ache to intense, throbbing pain.

Approximately 80% of the population will experience some form of back pain in their lifetime. Proper treatment starts with proper diagnosis. The quicker you get evaluated by a skilled staff the quicker you start the road to recovery.

At Comprehensive Medical Care, we would first start with a thorough physical exam to identify the cause of pain. There are four primary pain generating tissues in the spine. Through patient history and physical examination we would try and determine which tissue was causing the pain.  We would then try and determine which factors are contributing to a patient’s ongoing pain experience which typically has to do with poor muscular control.

Once we make a determination that you are a candidate for the conservative treatment that we offer, we will create a customized treatment plan to get you back on the road to recovery!

Bone Spurs

Bone spurs, also known as osteophytes, are bony calcium growths that develop on the end of bones and may cause pain and irritation as they rub against nerves and other bones.

Bone spurs can form on nearly any bone in the body, and are most common in the joints. The symptoms of bone spurs vary depending on the location. Bone spurs in the spine may be particularly painful, but many others do not cause any symptoms. In fact, many patients do not know that they have bone spurs for many years.

When in the spine, bone spurs can lead to Spinal Stenosis which can lead to radiating pain in the arms or legs dependent upon the source (neck or back.)

Click here for more information on Spinal Stenosis

Carpal Tunnel Syndrome

Carpal tunnel syndrome is a condition in which the median nerve becomes pinched or squeezed as it passes through the wrist. It can also arise as the result of a nerve injury following a motor vehicle collision or due to repetitive stress, such as prolonged keyboard usage or hand held telephone usage.

The typical symptoms that a patient will feel if suffering from carpal tunnel syndrome can include numbness, tingling or pain into the hand and fingers. In addition, the patient can also experience weakness in the hands that might make it difficult to grasp or hold on to certain objects. The symptoms are usually worse upon arising in the morning.

Physical therapy and chiropractic treatment can help reduce the symptoms caused by carpal tunnel syndrome by loosening up the wrist bones that surround the median nerve and increase the strength of the hand and arm muscles affected by the condition. In addition, nerve stretching and techniques directed to the neck can also vastly improve a patient’s condition. In order to reduce the severity of the symptoms in the morning, a carpal tunnel splint is also a very highly effective option.

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Disc Disorders

The intervertebral discs between the bones of the vertebrae help maintain proper joint spacing. It also acts as a shock absorber for the joint complex allowing for smooth, painless movement. These discs are composed of collagen and start out very soft, but gradually harden as we age. When the discs become damaged or misplaced, symptoms may arise, causing localized neck, mid or low back pain, often accompanied with radiating pain or numbness in the arms or legs.

Discs may become damaged as a result of:

  • Injury
  • Herniation
  • Degeneration
  • Tumors
  • Bone spurs
  • Repetitive flexion such as long period of sitting and improper bending strategies

At Comprehensive Medical Care, we have multiple solutions for disc pain. After a thorough physical exam a personalized treatment plan is constructed. The majority of disc pain is managed conservatively with exercises, modalities and manual treatments by our physical therapists and/or chiropractors. Dependent upon the severity of the condition, pain management techniques or non-surgical spinal decompression may be necessary.

Click here for more information on Pain Management.

Click here for more information on DRX9000(C) (Non-Surgical Spinal Decompression).

Elbow Pain

Two of the most common causes of elbow pain seen are overuse and trauma. Pain can occur on the inside or outside of the elbow joint and may be acute or chronic.  Elbow pain can also be commonly accompanied by numbness/tingling and burning sensations.  You may also experience weakness in the hand/forearm region as a result. Some of the most common types of elbow pain include tendonitis (tennis elbow and golfer’s elbow), bursitis, nerve entrapment, and fractures.

When you come to Comprehensive Medical Care, you will get a thorough evaluation and examination by any one of our many excellent medical professionals on staff. Depending on the findings, you may be required to get additional diagnostic work ups such as MRIs and/or X-rays.  It is important to us as your provider, and for you to cover every aspect of your health and know exactly what is going on with your condition.

Treatment can include conservative care with physical therapy and/or different types of injections depending on the condition.

Shoulder Pain

Shoulder pain is a common ailment that affects thousands of people in the US each year.  In some cases, shoulder pain can be commonly mistaken for pain that is being referred from your neck.  It is important to distinguish the difference between the signs and symptoms.  Some of the most common causes of shoulder pain include:

  • Trauma
  • Overuse
  • Lifting/carrying
  • Overhead movements
  • Degeneration
  • Tears

Some common symptoms to look out for are:

  • Pain
  • "Clicking" or "Popping"
  • Stiffness
  • Numbness/tingling
  • Weakness

There are several different components and structures that make up the shoulder joint.  It is important to distinguish which one of these structures is causing your pain so that you may receive the appropriate treatment to achieve the fastest and best results.

When you come to Comprehensive Medical Care, you will get a thorough evaluation and examination by any one of our many excellent medical professionals on staff. Depending on the findings, you may be required to get additional diagnostic work ups such as MRIs and/or X-rays.  It is important to us as your provider, and for you to cover every aspect of your health and know exactly what is going on with your condition.

Treatment can include conservative care with physical therapy such as joint mobilizations, stretching and postural exercises. Treatment can also include different types of injections depending on the condition.  Physical therapy has been proven to be just as effective, if not more than surgery alone, depending on the severity of the condition.

Fibromyalgia

Fibromyalgia is a complex condition where the nervous system amplifies the pain signal which can lead to pain throughout the muscles, ligaments and tendons, as well as fatigue, headaches and other symptoms.

Fibromyalgia is often hard to diagnose and may only be tested after several other conditions have been ruled out. Treatment for fibromyalgia focuses on relieving the symptoms of this chronic condition.

At Comprehensive Medical Care we would create a custom made treatment plan which would include gradually reintroducing exercises with the goal of desensitizing the nervous system.

Hamstring Muscle Injuries

The hamstring muscle group is made up of three muscles located at the back of the thigh. They function to flex the knee and extend the hip. As the hamstrings are used daily and physical activities they are prone to injuries such as strains and contusions.

A muscle strain, also called a "pull", occurs when the muscle fibers tear. With the hamstring muscles this typically occurs because of a sudden acceleration, or an excessive stretch.

A contusion, or bruise, can also happen to the hamstring muscles as a result of a direct blow or falling on the back of the thigh.

Symptoms of a hamstring strain or contusion are similar and include:

  • Bruising
  • Swelling
  • Spasm
  • Pain while stretching the muscle
  • Difficulty contracting the muscle

Treatment of a hamstring strain depends on the severity of the injury. Physical therapy treatment options commonly include:

  • Management of swelling and pain through rest, ice, compression and elevation
  • Strengthening
  • Special stretching techniques
  • Massage

At Comprehensive Medical Care, proper treatment begins with the proper diagnosis. When you come to our offices, you will get a thorough evaluation and examination by one of our many excellent medical professionals on staff. Depending on the findings, you may be required to get additional diagnostic work ups such as MRI’s, X-Rays and even Doppler Studies.

The hamstring is a group of muscles located on the back of the thigh that help extend the hip joint and flex the knee. As it is commonly used during physical and daily activities, the hamstring is prone to injuries such as a contusion or muscle strain. When these injuries occur, patients may experience bruising, swelling, muscle spasms and difficulty contracting the muscle.

Treatment for a hamstring injury depends on the severity of the condition, but may include rest, using crutches, icing the area, physical therapy and massage therapy.

Headaches and Migraines

A headache is a common symptom that involves aching or pain in one or more areas of the head or face. While there are many different types of headaches, one of the most common and most severe are migraines, which cause throbbing pain and may also lead to nausea, vomiting, depression and sleep disruption.

Chiropractic care has been proven effective for the treatment of migraine headaches, tension headaches, cluster and cervicogenic headaches. Proper treatment of headaches begins with a proper diagnosis of the type of headache it is and which factors are contributing to the patient’s individual condition.

Rarely headaches are caused by more serious conditions such as temporal arteritis, vertebral artery dissection, less commonly internal carotid dissection, and tumors.

At Comprehensive Medical Care our skilled team of physicians will do a thorough evaluation including patient history and physical examination and will order appropriate imaging if deemed necessary.

Check out Duke University's Study on Headaches and Chiropractic - Click HERE

Heel Pain

Heel pain is one of the most common forms of foot pain and may be caused by wearing shoes that do not fit properly, injury, or conditions such as achilles tendonitis, heel bursitis and plantar fascitis. This pain is often most severe in the morning or after prolonged activity. Patients may also experience swelling, redness and heat. In serious cases, if heel pain goes untreated, bone spurs may develop causing more severe pain.

At Comprehensive Medical Care, we will provide you with a thorough physical examination and evaluation by one of our many excellent medical professionals on staff. Treatment can include conservative care with physical therapy and/or different types of injections depending on the condition. Physical Therapy has been proven to be just as effective, if not more than surgery alone, depending on the severity of the condition.

Hip Pain

Hip Pain is a condition that affects many people either as they age or those who are on their feet for many hours per day. Hip pain can be caused by arthritis, bursitis, ligament tears and can even be referred from the low back or sacroiliac joint.

When a person feels pain deep in their groin region it could be a sign of a problem with the actual hip joint, as it resides in the inner thigh. Hip arthritis, labrum tears, and even the low back can cause pain deep in the groin.

Bursitis is usually felt on the outside of the hip.  A person with bursitis will usually complain of a lot of tenderness at the hip bone and will feel increased pain with prolonged walking and standing.

The low back and sacroiliac joint can refer pain due to the fact that some of the nerves at these areas run into the hip region. As a result, it is very important to get a proper physical exam, in order to properly diagnose the condition. Once the condition is diagnosed, proper treatment could include techniques to loosen up the appropriate joint, strengthen and stretch the muscles around the joint and work on functional gains. In addition, cortisone injections are a possibility, as is mechanical traction if the problem is emanating from the lower back.

Jaw Pain & TMJ

Jaw and facial pains are common conditions that can arise from joints and muscles in the neck and face.  Both the joints in the cervical spine, known as facet joints, as well as the temporomandibular joint (TMJ), the joint where the jaw hinges, can be responsible for facial and jaw pain.  Typical symptoms can range from pain in the neck and shoulders, in front of the ear, pain in the neck, trouble opening the mouth, clicking, snapping, and grinding of the “jaw joint.”

Other common symptoms that can include the temporomandibular joint and cervical spine include toothaches, headaches, neckaches, dizziness, earaches, hearing problems, upper shoulder pain, and ringing in the ears.  With so many potential causes of both facial and jaw pain, a detailed history and clinical exam is warranted to figure out the root of your problem.  Ruling out more serious or invasive conditions is conducted through examination.  More often than not, a less invasive route is all that is needed to address your condition.  At Comprehensive Medical Care proper treatment begins with the proper diagnosis.

Joint Disorders

All joints in the body are made up of bones and soft tissues that connect them, such as tendons ligaments and cartilage. There are several types of joint dysfunctions, each with different causes. Most often, muscle imbalances and inactivity lead to changes in the bones and/or soft tissues. In other cases, too much movement can create joint laxity and lead to instability.

Common sites for joint dysfunctions are the facets of the spine that move when a person bends forward or backwards. If the bone surfaces do not line up or if there is a restriction in movement caused by soft tissues, a person may feel pain, stiffness and experience inflammation that can affect their daily life.

The sacroiliac (SI) joints are formed between the triangular-shaped bone at the base of the spine and the back side of the pelvis. Unlike the facets, these joints are not designed to allow for much movement. If the sacrum becomes tilted or rotated towards one side, it will not line up correctly with the pelvis and can cause significant discomfort in a person’s low back or hips. Or, if one side of the pelvis is higher or lower than the other, it can lead to misalignment of the sacrum that can also cause pain and impact the way a person moves and performs daily activities.

Other common sites for joint dysfunctions are the temporomandibular joints of the mouth (also known as TMJ), the glenohumeral joint/shoulder joint, and the patellofemoral joint of the knee.

Physical Therapy and chiropractic care can help alleviate pain and other symptoms caused by joint dysfunctions. A combination of movement, stretching, strengthening, and/or joint mobilization can help correct the imbalances in the joints and greatly improve the symptoms of joint dysfunction and help people return to performing their daily activities with significantly less pain.

Knee Pain

Knee pain is a common ailment that affects thousands of people in the US each year. There are several different structures in the knee, each of which can be damaged by several different causes. Some of the most common causes of knee pain include:

  • Trauma
  • Overuse
  • Sudden turning movements
  • Awkward landings from falls
  • Infection
  • Degeneration
  • Osteoarthiritis

Some common symptoms to look out for are:

  • Pain
  • "Clicking" or "Popping"
  • Stiffness
  • Numbness/tingling
  • Weakness
  • Buckling or instability

When you come to Comprehensive Medical Care, you will get a thorough evaluation and examination by any one of our many excellent medical professionals on staff. Depending on the findings, you may be required to get additional diagnostic work ups such as MRI's and/or X-rays.  It is important to us as your provider, and for you to cover every aspect of your health and know exactly what is going on with your condition.

Treatment can include conservative care with physical therapy and/or different types of injections depending on the condition.  Physical therapy has been proven to be just as effective, if not more than surgery alone, depending on the severity of the condition.

Leg Pain

Pain in the legs can have many different causes.  From sharp shooting pain, typically referred to as sciatica, to a dull and achy heaviness, symptoms can vary greatly.  Possible causes of leg pain include herniated or bulging discs in the back, narrowing of the spinal canal or intervertebral foramen, peripheral nerve entrapments, occluded blood vessels, bursitis of the hip, and other conditions affecting the nervous and/or endocrine system.

Symptoms to address include foot or leg weakness, pins/needles or tingling in any portion of the leg, decreased sensation of one or both feet, and sharp or dull pains in the back or front of the thighs.  Because there are a variety of conditions that can cause one or more of these symptoms, it is imperative to be properly examined.  A detailed health history, followed by a comprehensive examination by a skilled practitioner can help identify the problem accurately.  Not all cases require advanced imaging procedures or lab tests but if the need should arise, one of our providers will ensure proper care.  Leg pain can be managed conservatively with a combination of physical therapy and chiropractic.  The option for injection and minor surgery is valid in certain cases and will be discussed fully between the patient and practitioner, should the situation arise.  We implore patients to feel empowered with knowledge and options when it comes to their health. At Comprehensive Medical Care, proper treatment begins with the proper diagnosis.

If you're in pain, click here to contact us now. You can also call us for an immediate appointment at 732-352-3555.

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