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    • Medicina del dolor, la columna vertebral y el deporte
    • Manejo del dolor
    • Medicina deportiva
    • Consejos de expertos

    Cómo manejar el dolor con Renown Spine, Sports & Pain Management

    Chances are you or someone you know will deal with chronic pain at some point in life. In fact, in the U.S. alone, one in five adults have experienced chronic pain in recent years, according to the Centers for Disease Control and Prevention (CDC). The road to relief is a frequently traveled one that can be filled with twists and turns, so it’s important for patients to have a trusted provider by their side navigating that journey.  We interviewed Dr. Sharlene Su, a pain management physician with Renown Medical Group, who told us what patients can expect when seeking care with Renown Spine, Sports & Pain Management (RSSPM) and all about the variety of pain relief options available to patients.  What pain management treatment options are available outside of painkillers? This depends on someone’s root cause of pain. For example, for pain from arthritis of the spine or major joints, radiofrequency ablation can relieve most of the pain for six months to two years, which can be life changing. If someone is suffering from a pinched nerve in the neck or back, an epidural can be useful. Nerve stimulators can also be a great option to relieve pain for years. One of the advantages of the procedures we perform at RSSPM is that they reduce the need for painkillers, which are notorious for having side effects of their own. Physical therapy can also be a very helpful tool to treat pain.  It is an exciting time in the field of pain medicine right now because new advances are -constantly being made. At Renown, we pride ourselves on staying current with the most cutting-edge treatments to ensure our patients always have the best available to them.  What are some at-home tips and tricks that patients experiencing pain can do on their own for some relief? If pain is related to posture or physical activity, consider doing stretching and strengthening exercises. YouTube can be a great (and free) resource for this. In terms of medications, over the counter topical pain creams can be great. Tylenol is one of the safest pain medications for those without preexisting liver conditions. On a short-term basis, anti-inflammatory medications can often be used safely depending on one’s overall health. Ice and heat can both be useful for treating muscle pain.  Can you tell us more about the services Renown Spine, Sports & Pain Management offers? Our team specializes in identifying the root cause of each patient’s pain and partnering with them to develop a custom plan tailored to their individual needs, which can involve injections, physical therapy and medications. We treat patients ranging from top-level athletes, to weekend warriors, to grandparents who’d like to be able to keep up with their grandkids. Once we relieve a patient’s pain, our role then transforms into a coach, educating and guiding our patients on how to prevent their pain from coming back.  At RSSPM, you’ll see the same doctor every time, which means that your provider will get to know you very well, and you’ll receive the same high-quality consistent care whenever you come for a visit.  Renown has a unique pain management team called “Special Procedures” that not many people may realize is a great option for care. How does this team treat pain? Our Special Procedures team is crucial to the high-quality pain management care that we provide. We have an amazing staff that assists with X-ray guided procedures including epidurals, radiofrequency ablations, joint injections and nerve stimulators. Dr. Casey Keating, our division chief, and I work with this team to ensure that every procedure is done with the same precision, attention to detail and quality. The Special Procedures team regularly receives feedback from patients on how well taken care of they felt during their procedure.  If someone is experiencing pain from an injury or even an unknown reason, what should they do to get care for their concerns? Contact your primary care provider for a referral to have an evaluation with us! RSSPM accepts most insurance plans and are proud that our wait times are averaging less than one week to be seen as a new patient. Two more doctors will be joining us in the next few months, which should reduce our wait times even more.  There are so many targeted and effective ways to treat pain nowadays, and it is worth addressing to live the life you want to live.

    Read More About Navigating Pain with Renown Spine, Sports & Pain Management

    • Atención del cáncer
    • Empleados
    • Proveedores

    Departamento destacado: Oncología médica

    The month of September recognizes several cancer-related health observances. Join us in celebrating our Medical Oncology team at Renown!  No person ever wants to hear the words, “You have cancer.” Those three short yet impactful words immediately change the course of someone’s life. As these patients Fight the Good Fight against cancer, there are a lot of intimidating unknowns that can take over their minds. What happens next? What will my treatment be like? What is my prognosis? How will I be able to handle this physically and emotionally? What will it take for me to beat this?  Who is better to be by their side than the devoted team members at the William N. Pennington Cancer Institute at Renown Health? From helping patients manage the process of complex paperwork and referrals to delivering personalized oncology and hematology treatment options tailored to each individual diagnosis, those fighting virtually any type of cancer are never alone, thanks to this team. The William N. Pennington Cancer Institute always lives up to that promise, guiding patients through the daunting journey of cancer treatment ahead, one step at a time.  Courageous Against Cancer Our exceptional Medical Oncology department inherently understands that each moment in life is precious, especially for patients battling cancer. This team is dedicated to orchestrating the most comprehensive plan for each patient, seamlessly weaving together diagnoses and treatments, oral chemotherapy, medication management, clinical trials, radiation oncology and more.   With the many patients they impact, there’s no question that there is never a dull moment in the day of the life of a healing hero like those in this department.  “No day is the same in Medical Oncology,” said Hollyann Dehm, Registered Nurse. “As a nurse, we wear many hats in the clinic. Our role is to educate patients on their treatment plans and specific drugs they are receiving, triage symptom calls from patients, refill medications and implement our oral chemotherapy program.  We help provide direct patient care by accessing ports, drawing labs and giving IV hydration when needed.  We also help fill out family and medical leave (FMLA)/disability paperwork, help with physician orders, help obtain prior authorizations for prescribed medications and treatments.”  “We do our best to let our patients know that they will not be going through this alone,” added Danielle Say, Physician Scheduling Coordinator. "We will be here for them every step of the way, guiding them and making sure their treatment is as smooth as possible and making ourselves available to them as much as we can. We end up getting to know many of our patients on a very close, personal level, and this helps to build that trust.”  “Our day-to-day activities include seeing patients and helping to manage their therapies as well as their toxicities,” added Dr. Harry Menon, DO, Oncology Physician. “We work closely with our infusion room staff and have a robust team to help us deal with these complex patients. We also work very closely with our surgical and radiation oncology colleagues in a multidisciplinary fashion to provide comprehensive care for our patients.”  The Medical Oncology team excels not only in providing cutting-edge cancer care but also in their compassionate approach to helping patients reduce the anxieties they understandably feel. Recognizing that a cancer diagnosis can be an emotionally overwhelming experience, this dedicated team combines medical expertise with unwavering support to create a healing environment.  “When patients are referred to our department, a lot of them have many fears and questions,” said Heather Cortez, Medical Assistant. “A majority of what our team does is focused on the mental support that our patients require to help them have the most successful outcomes. One thing I have learned about cancer care is that positivity in the face of adversity is everything. Just being there to listen to our patient’s concerns can make all the difference. Helping them to navigate their many appointments and taking the time to explain things in a patient and compassionate way, is part of how our team serves this vulnerable population.”  “The uncertainty is one of my patients' biggest fears: How far has my cancer progressed? How long will I have left? Is treatment even an option?” added Mary Wilson, Senior Medical Assistant. “The best advice that I can give my patients is that they are not alone. While this battle is going to be one of the hardest parts of their lives, they are surrounded by constant support to try and help with any burdens they may be facing. I also tell my patients that we have to take the little wins no matter how small they may be, because while cancer treatment is a physical battle, it is also a large mental battle."  “While we don’t have answers to all the questions patients and their family members may have, we do our best to listen to their questions and concerns regarding their cancer diagnosis and treatment and guide them through their cancer journey," added Hollyann Dehm. “We provide emotional support and education on their type of cancer, managing their pain and side effects of their treatment.  We also connect them to nurse navigators and our social worker who also help identify barriers to care and provide the patient with resources.”  Whether it's explaining treatment options in understandable terms or offering emotional support through difficult moments, this department is committed to empowering patients on their journey toward healing. Their holistic approach not only treats the disease but also nurtures the spirit, all while being a strong advocate on each patient’s behalf.  “Getting a cancer diagnosis can be the worst news that a person can hear; what we try to do is focus on improving quality life and focus on goals that help to promote quality of life,” said Dr. Harry Menon. “If the option for a cure is on the table, we try and focus on that goal in concert with promoting quality life. I try and have our patients focus on what they can control, with the understanding that even if some things are out of our control, the way we approach and manage those things, including our mindset, is still within our control.”  “In our clinic, we truly value our patients and how they are cared for,” added Mary Wilson. “The amount of compassion our team shows is incredible. Patients constantly commend our team on how much they feel like the provider's care. Our providers and staff are not afraid to advocate for patients and that truly is an accomplishment in and of itself.”  “We know patients are only hearing a small amount of the immense volume of information we provide them, so we encourage them to ask questions until it makes sense because the timeframe is different for every patient,” said Lillian Morton, APRN of Medical Oncology. “Cancer is an anxiety inducing lack of control whirlwind – if we can help by being responsive to patient calls and messages, we do so.”  With their harmonious and integrated approach, each patient’s treatment journey progresses uninterrupted, bringing them closer to a brighter and healthier future.

    Read More About Department Spotlight: Medical Oncology

    • Medicina del dolor, la columna vertebral y el deporte
    • Consejos de expertos
    • Medicina deportiva

    Guía para la cicatrización de lesiones: ¿Calor o hielo?

    Heat and ice are two of the most common treatments used to relieve pain and reduce swelling in injuries. However, each one is better suited for certain types of injuries Dr. Luis Palacio, MD explores the differences between the two.  When it comes to treating aches and pains, the debate between heat and ice has been ongoing for quite some time. Both have their benefits making it crucial to understand which option is better suited for your specific needs.   Determining which method is better depends on various factors such as the type of injury or pain you are experiencing. For instance, if you have recently sprained your ankle or pulled a muscle during exercise, applying ice within the first 48 hours can help minimize swelling and alleviate discomfort.   It's worth noting that some individuals find alternating between heat and ice therapy beneficial as well. This approach combines the benefits of both methods by using heat to increase blood flow followed by ice to reduce inflammation.  Cold Therapy  Cold therapy can help to reduce inflammation after an injury, heat can have the opposite effect. Therefore, heat therapy should be reserved for those who have chronic pain issues and are not dealing with an acute injury. Cold therapy is often recommended immediately after an injury or during the initial stages of inflammation.  Cold therapy such as ice packs are especially effective in treating: Sprains  Strains Any injury that involves swelling Heat Therapy  Heat therapy is known for its ability to relax muscles, increase blood flow and soothe pain. It is often used for chronic conditions or injuries that are not inflamed. Applying heat can help alleviate stiffness, promote healing and provide a comforting sensation. This increased circulation can bring more nutrients and oxygen to the area, helping it to heal faster.  Heat therapy such as heating packs are especially effective in treating:  Stiffness with associated pain   Injuries that are not inflamed  Muscle pain

    Read More About Guide to Injury Healing: Heat or Ice?

    • Medicina deportiva
    • Medicina del dolor, la columna vertebral y el deporte
    • Salud infantil

    Por qué su atleta adolescente debe consultar a un médico especialista en medicina deportiva

    Seeking specialized care for your teen from a sports medicine doctor is essential. Like a coach fine-tunes a player's skills, our experts fine-tune your teen's health, ensuring they stay at the top of their game. Luis Palacio, MD, a sports medicine physician with Renown Health, shares information to help young athletes safely push their boundaries and achieve their personal best. The Role of Sports Medicine Sports medicine is a specialized branch of healthcare that focuses on preventing, diagnosing and treating injuries related to physical activity and sports. Renown's Sports Medicine team consists of skilled professionals passionate about keeping young athletes performing at their peak while minimizing the risk of injury. With a comprehensive approach to care, our sports medicine doctors provide tailored guidance and solutions to help your teen reach their full potential. Injury Prevention and Education Prevention is the key to maintaining a long and successful athletic journey. Our sports medicine doctors collaborate with young athletes to educate them about proper warm-up techniques, body mechanics, and techniques to prevent overuse injuries. From understanding the importance of rest days to practicing correct form, our experts empower teen athletes with the knowledge they need to stay in the game.

    Read More About Why Your Teen Athlete Should See a Sports Medicine Doctor

    • Medicina deportiva
    • Buen estado físico
    • Manejo del dolor

    Cómo tratar un esguince o una torcedura

    Injuries happen to everyone. They are caused by participating in sports, recreational activities like hiking, and even by accidentally stepping off a curb wrong. If you experience a sprain or strain, the first few days are often the most painful. Renown Sports Medicine physicians Luis Palacio, MD and Brandon Hockenberry, MD walked us through what to do after an injury.  Listen to Your Body See a medical professional right away if: You know or suspect that a bone is broken You are having difficulties putting full weight on a joint of the leg Pain or swelling is severe There is a sign of an infection, such as redness and warmth in the joint  The First 24-72 Hours Joint sprains tend to swell more than muscle strains. You can use ice as needed for comfort and to relieve any pain, but do not use ice for more than 15-20 minutes at a time. Ice and NSAIDs (such as ibuprofen) can help prevent excessive swelling and mask the pain, but they do not speed recovery. Some research shows that overuse of ice actually delays recovery.    During the first 24-72 hours, your injury will go through an inflammation phase. Inflammation is your body’s natural way to dispose of dead tissue cells, build new healthy structures, and hopefully heal even stronger than before.

    Read More About How to Treat a Sprain or Strain

    • Buen estado físico
    • Medicina deportiva
    • Manejo del dolor

    Cómo manejar y prevenir la tendinitis

    Tendonitis occurs when a tendon in your body is inflamed or irritated. This painful condition can impact your day-to-day activities, but can be managed and prevented. Luis Palacio, MD, shared some insights into how to manage tendonitis. Overuse and Repetitive Motion Tendons are complex tissues in our body that connect muscles to bones, allowing us to move. Unfortunately, sometimes these tendons become inflamed, worn down or injured, a condition called tendonitis. Symptoms of tendonitis include pain or dull ache, tenderness and mild swelling at the site. While tendonitis can be caused by a sudden injury, it is more commonly seen in frequent motions, including: Repetitive motions in exercise, work or other physical activities. Awkward positions in a movement, including poor posture. Forced movements that strain your body. Sudden increase in frequency of movement or level of difficulty, including little to no recover time between new activity. Shoes without proper support or hard surfaces, such as concrete floors. Evaluation is Key If you suspect that you have tendonitis and it does not resolve on its own after a few days, you should get it evaluated by a primary care or sports medicine doctor. They can make recommendations to aid your recovery and refer you to the right sub-specialist if needed. With some intentional actions, you can help reduce the risk of tendonitis with the following suggestions: Add variety: Mixing up the type of exercise you do will help prevent repetitive motions that can result in overuse. Stretch and condition: Make sure the keep up with proper stretching and muscle strengthening to support your physical activities. Do it right: Make sure that the way you are completing exercise or work-related physical activities is correct. Seek out a professional for lessons or guidance if you are unsure.

    Read More About How to Manage and Prevent Tendonitis

    • Buen estado físico
    • Medicina deportiva

    Cómo detectar los signos de una conmoción cerebral

    Concussions are an unfortunate occurrence in youth sports and other physical activities. Learning the signs now will help you respond if you suspect that someone near you has suffered a concussion. A concussion is a mild type of traumatic brain injury (TBI) that can occur after any injury to the head/neck area. It’s important to seek the appropriate level of care if they occur. Brandon Hockenberry, MD with Renown Sports Medicine shares tips on concussion signs to look for and what to do next. Look for these Dangerous Signs First Call 911 or visit an ER right away if you notice one of the following in the person who suffered a blow to the head or body: One pupil is larger than the other Severe or worsening headaches Drowsiness or inability to wake up, including any period of unconsciousness Slurred speech, weakness, numbness or decreased coordination Multiple episodes of vomiting Convulsions, shaking or twitching Monitor for Concussion Signs and Symptoms If someone suffers a bump, blow or other jolt, it’s important to look out for changing symptoms. Symptoms can continue to evolve for up to 24 hours after the injury. Seek care from your primary care provider, an urgent care or a sports medicine provider if you notice any of the following: Cannot recall events prior to or after the incident Appears confused or disoriented Clumsy movements Slow reaction, including movements and speech Changes to normal behavior or mood You should also question the person about how they are feeling. If they report any of the following symptoms, seek care: Headache or feelings of pressure in their head Nausea or vomiting Dizziness or balance issues Problems with eyesight, such as blurriness or double vision Increase sensitivity to light or sound Sluggishness, or feelings described as “hazy” or “foggy” Struggles with remembering or concentration Just “not feeling right”

    Read More About How to Spot the Signs of a Concussion

    • Lactancia
    • Salud del bebé
    • Lactancia

    La lactancia no tiene por qué significar dolor en los pezones

    If you think sore nipples are just a normal part of breastfeeding, think again. Robin Hollen, APRN, and Breastfeeding Medicine Specialist, says that nursing can be an enjoyable experience for mom and baby without pain and discomfort. A top concern of nursing moms within the first week after delivery is how to prevent sore nipples. Even moms who’ve nursed before struggle with this common issue. While many women think it is a regular part of the nursing experience, it is actually a sign that something isn’t quite right. “Nursing your baby should be enjoyable,” says Robin Hollen, Breastfeeding Medicine Specialist with Renown Health. For over 30 years Robin has been supporting moms to breastfeed. Below she shares some valuable information and tips, helping you create a happy and healthy breastfeeding experience for you and your baby. What causes sore nipples? The most common cause of sore nipples involves incorrect latching. For a proper latch, a baby’s mouth takes in the entire nipple and some of the breast, so that the nipple rests at the back of the mouth where the palate is soft. With an improper latch, the mouth may slip down to the tip of the nipple while the baby nurses. This constant pressure on your sensitive skin may cause discomfort and pain. A board-certified lactation consultant can help assess if your baby is latched correctly and troubleshoot your breastfeeding concerns. Less common causes of sore nipples include: • Improper tongue placement of baby • Clenching • Incorrect breast pump use How can a mother prevent sore nipples from an improper latch? Breastfeeding is a learning experience for both mom and baby. Ask for help with the latch so your baby learns it correctly and maintains its depth. In the past, new mothers were surrounded by a community of women — their own mothers, grandmothers, or other family and friends — to provide assistance and guidance with every latch at the beginning of an infant’s life. In today’s culture, new moms can find themselves on their own with no extended family to lend their knowledge. Nurses, pediatricians and lactation consultants now fill that role; they are the eyes and hands along with the much-needed experience to guide new mothers. Our Breastfeeding Medicine experts assist nursing moms with latch every day. Even a single visit with a lactation consultant observing your breastfeeding baby can provide valuable insight on achieving, and maintaining, the proper latch - preventing future nipple soreness and discomfort. How to heal sore nipples from breastfeeding To heal sore nipples, you must first fix the cause, and correcting the latch prevents further damage. A lactation consultant can also help you address the pain. Below are some breast healing tips: • Your own expressed breast milk is excellent to rub into the nipple for anti-bacterial protection. • For those moms who need more lubricant or fat than breast milk offers, use a lanolin or a cream that is labeled safe for the baby. • Soothies are a gel pads providing comfort in between feedings, but should not be used with lanolin products. • Breast shells, not to be confused with shields, can guard the nipples from irritation or pressure in between feedings. If you have more questions about preventing and healing sore nipples or general breastfeeding concerns, talk to your pediatrician or a Renown Health Breastfeeding Medicine specialist at 775-982-6365.

    Read More About Breast Feeding Doesn't Have To Mean Sore Nipples

    • Lactancia
    • Salud del bebé
    • Lactancia

    4 Consejos sobre la lactancia para nuevas mamás

    While breastfeeding is natural, it's not always easy. We asked Certified Lactation Counselor Sarah Mitchell for some tips to help make the process easier for mom and baby. From increased infant immunity to improved maternal health and well-being, the benefits of breastfeeding are many. Still, only 60 percent of U.S. moms in the United States continue to breastfeed past their baby's first six months. There are for many reasons for why moms stop, including the mother's their need to return to work. We reached out spoke to Sarah Mitchell, a certified lactation counselor at The Lactation Connection at Renown, for some expert advice. Tip 1 At first, it's normal to expect obstacles. Even in cultures where close to 100 percent of moms breastfeed, they can experience issues, including getting the baby to "latch on," sore nipples, and milk production. In addition, it sometimes can take several weeks for mom and baby to get comfortable. Tip 2 Line up a coach, even before the baby is born. This can be a professional lactation coach, family member, or friend who is experienced and encouraging. While online videos can be helpful, most new moms need the one-on-one guidance that a coach can provide. Renown offers outstanding resources in its Lactation Connection center, including expert consultants, products, and support. Tip 3 Well ahead of the due date, set up a support network of friends, family members, or community groups such as La Leche League. Women historically have relied on extended support systems to help them with raising children, and breastfeeding is one of those areas that, while natural, still needs encouragement from the women who’ve been there. Tip 4 Don’t get discouraged if you need to supplement at times with formula. This, too, as it turns out, is not uncommon in other cultures. In other parts of the world, babies are given beverages and foods such as tea, broth, soup, juice, mashed bananas, and papaya. The American Academy of Pediatrics recommends supplementation only with approved formula -- but the point is, it’s ok to supplement if you need to. Finally, don’t forget the importance of breastfeeding for connecting with your baby. It’s essential to maintain breastfeeding over the weekends, preferably “on-demand,.” and will keep that special bond strong after you have returned to your job.

    Read More About 4 Breastfeeding Tips for New Moms

    • Lactancia
    • Salud del bebé
    • Lactancia

    Cómo almacenar la leche materna de manera segura

    Breast milk. It's often referred to as liquid gold. And fortunately, it can be safely refrigerated or frozen for later use, which can allow you to be a bit more flexible in your new routine with baby. Whether you're getting ready to return to work, planning for the chance date night out or just exclusively pumping, it's crucial to understand the guidelines for proper breast milk storage. Storing Breast Milk Use clean bottles with screw caps, hard plastic cups that have tight caps or nursing bags (pre-sterilized bags meant for breast milk). Be sure to label each container with the date the milk was pumped and your baby's name if the milk is going to childcare providers. You can add fresh, cooled milk to milk that is already frozen, but add no more than is already in the container. For example, if you have two ounces of frozen milk, then you can add up to two more ounces of cooled milk. For healthy full-term infants, milk can be stored as follows: Room temperature - six to eight hours (no warmer than 77°F, or 25°C). Refrigerator - up to five days at 32°-39°F (0°-3.9°C). Freezer– Varies depending on freezer type. Up to two weeks in a freezer compartment located within the refrigerator. Three to six months in a freezer that is self-contained (standard kitchen fridge/freezer combination) and kept at 0°F (-18°C). Breast milk should be stored in the back of the freezer and not in the door. Six to 12 months in a deep freezer that is kept at -4°F (-20°C). Be sure to leave about an inch of space at the top of the container or bottle to allow for expansion of the milk when it freezes. Thawing Breast Milk Place frozen breast milk in the refrigerator to thaw (about 24 hours) then warm by running warm water over the bag or bottle of milk and use it within the next 24 hours. If you need it immediately, remove it from the freezer and run warm water over it until it's at room temperature. Never microwave breast milk and do not refreeze it. Once your baby has started to drink from the bottle, you should use it within one hour. You may find that different resources provide different recommendations about the amount of time you can store breast milk at room temperature, in the refrigerator and in the freezer. Talk to your doctor or lactation consultant if you have any concerns or questions.

    Read More About How to Safely Store Breast Milk

    • Atención pediátrica
    • Salud de los niños pequeños

    Pregunte al experto: ¿Qué es la escoliosis?

    Posture is important, but for those children diagnosed with scoliosis (spinal curvature) it can be a difficult issue. The Washoe County School District Student Health Services Department screens 7th grade students for scoliosis as growth spurts often reveal the condition and, if diagnosed early, scoliosis can stop progressing. We asked Michael Elliott, MD, head of the Department of Pediatric Orthopedics and Scoliosis to answer some frequently asked questions about scoliosis. What is scoliosis? There are many types of scoliosis: early onset (occurs before age 10), congenital scoliosis is when the bones of the spine do not form correctly, neuromuscular scoliosis which is due to children’s neurologic and muscle disease, and the most common is Adolescent Idiopathic Scoliosis. The term “idiopathic “ means the exact cause is unknown, although we do know it runs in families. This type of scoliosis occurs in 2-3 percent of adolescents and is mainly seen during their growth spurt. This is why middle school screenings are recommended. Both genders get scoliosis but girls are 8 times more likely to have their curves progress and become larger. What are the signs that my child may have scoliosis? A few signs for parents to watch for are: One shoulder might be higher than the other. One leg may seem longer. A hip may be higher or look more prominent. The waist may not look the same from side to side (asymmetry). The trunk or rib cage may be more prominent on one side or shifted. When they bend forward they may have a bump on their back. How is scoliosis diagnosed? It can be noticed by a pediatrician at a physical, school screening nurse, PE teacher or parents. Once the curve is suspected the child is usually referred to a pediatric orthopedic surgeon scoliosis expertise. At the initial visit the doctor will perform a thorough physical including a complete neurologic exam to assess the amount of curvature. Once the exam is completed the physician will determine if a spinal x-ray is needed. The curve on the x-ray is measured utilizing the cobb angle (a measurement in degrees) which helps guide the treatment. What are common treatments for scoliosis? The treatment depends on the size of the spinal curve and the amount of growth the child has remaining. An x-ray of the child’s hand is used to determine the amount of growth remaining. This allows the determination of the child’s bone age, and based on the hands growth plates it can determined if the child is in their rapid phase of growth. Treatments include: Observation - For curves less than 20-25 degrees. This entails visits every 6-9 months with a repeat scoliosis x-ray. Since scoliosis curves increase only 1-2 degrees per month, and variations in measurements can be 3-5 degrees, an x-ray is not recommended before 6 months. If the curve remains less than 25 degrees the child is followed until their growth is completed (usually age 16-18). Progressing Curve - If growth is finished and the curve is less than 40 degrees, the risk of more curvature into adulthood is small. If growth is completed and the curve is over 45 degrees, the child is followed for several years as these curves can progress into adulthood. If the patient is still growing and the curve has progressed greater than 25 degrees but still in the non-operative range (less than 45-50 degrees) bracing is used to stop the progression of the curve. Bracing - Indicated for curves over 25 degrees but less than 45 degrees. If a brace is required you will be referred to an orthotist (bracing specialist). The orthotist assesses your child, reviews the x-ray and then fits the brace. (Having a brace made usually takes 2-3 weeks.) Once the brace is fit, your child will visit the scoliosis specialist for an x-ray in the brace to ensure it fits correctly. The primary goal of bracing is to halt progression of the curve and prevent the need for surgery. The brace must be worn for about 16 hours per day to be effective. In a recent bracing study 72% of the patients who wore their braces as prescribed prevented the need for surgery compared to the group who did not wear their brace. Surgery: When a curve reaches 45-50 degrees, and a child is still growing, surgery is usually recommended because the curve is likely to continue progress. If a curve is over 50 degrees and the child is done growing surgery also may be recommended. This is because when curves are over 50 degrees they tend to increase 1-2 degrees per year for the rest of your life. As curves get larger the amount of lung function tends to decrease which could cause breathing problems later in life. The goals of surgery are to stop the progression of the curve and safely correct any misalignment. This is accomplished by attaching implants (rods, screws, hooks and bands) to the spine. Bone graft is then placed around the implants to encourage the spine to fuse (grow together). This then forms a solid column of bone with metal rods in place, preventing the curve from changing. Most patients are back to their regular sports and activities six months post surgery.

    Read More About Ask the Expert: What is Scoliosis?

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