Senior Care and Orthopedic care

Welcome to W are killed and welcome to the whole -- what was our. I'm doctor Alon -- medical director Woolsey primitive medicine they have a great program like that you today. We are looking forward to talking with such -- good quality. Representing the Muslims of the associates. That's a -- as a senior partner. At this group this is a physician owned group of skilled board certified orthopedic surgeons. Since 1970. Their goal has been to provide exemplary care to their orthopedic patients. They're committed to a long term program of state of the yards orthopedic services defined by excellence in patient care. Highly qualified medical staff employee dedication and strong community relations. But first an interesting topic with the home instead senior -- unit there what are the most trusted networks of home terror worldwide. An innovator and soldiers killed since 1984. Instead seeing it -- is dedicated exclusively. To helping seniors stay in their homes as they age. Home instead senior care staff. Have a passion for improving the quality of life for seniors and families in their communities. In your community they offer reins of non medical services -- can be customized to your needs -- exactly to help you need. This kid it was our area residents were kind compassionate and they truly enjoy working with seniors. They are professionals extensively trained and elder care and they're all screens. Insured and -- Your junior about how open will loosen our grip doctor -- later on -- Everything big W Morgan. This is doctor -- -- medical director -- primary care medicine. And He was incidental to this. And my first guest is done well. Instead He insults. Donna thanks for joining us today thank you very much for having me. You can get to places I want to tell listeners. If you -- Well you have assembling. This next thirty minutes maybe one of the best spent thirty minutes but you've had for the whole year of 2011. Thought at first told me what what is home instead. On the home instead senior care is any international. Home care agency which is all over the world. My office is actually located in Chelmsford Massachusetts. I'm one of sixteen offices in Massachusetts. And we provide home care assistance for album only. In their homes. Donna in my office practice I finds personally one of the main challenges. Will be getting all the siblings on board. And helping their family member whether it's a -- remember who's already in a nursing home whose deteriorating. At home. Where there's a question of the best living situation. For their patients. And it's challenging because a lot of times the burden falls on one sibling. It's so common. That. This that we will be in my office. Analysts say that actually is there this is all on me my brother's two towns over. He wants it involves licences on the West Coast we email occasionally. And I'm feeling this pressure. And I love to be able to tell her tell her in that situation. There is. An organization that can help you can help your siblings. Can make this process much easier if I -- currently that's Romans that is all about. Yes that's correct. We do run across this often. More often in week we. Care to but. We have an informational. Block that helps. Siblings in situations like this. We we call -- the 5050 rule and what that means is generally when a sibling is around the fifty age mark. That means at their parent is probably in their late seventies early eighties in that area. And there are multiple siblings that's at. Times and generally it is one person that you know I find it -- on one person's shoulders sometimes too. Where they do have siblings that live in other parts of the country or they test. Don't want to. Get involved for whatever the reason may be com. This booklet helps. And the reasoning aimed at that 5050. Is because. Of the age Ian also that the response and responsibility of taking care parent falls also. Evenly amongst the siblings as well in this book helps. The children deal with the other siblings in the family. To come up with a good plan. For their parents that I think sometimes -- children lose sight that this isn't about them that this is about their parent. And this helps and has some real true stories in here from of people in certain situations in this book covers everything. And -- weekend. By all means if they were interested in getting a copy they could call our office. And by calling your offices Aldana in new border for any of our listeners today who this situation may be getting very close to home. And may be very imminent or they may be going through this actively right now. So for someone calls your office tomorrow morning and who they're the primary caregiver. For their mom. Who's failing at home. They have two siblings what what's the next step to they're gonna tape with your institution. Well it should only the cause it commend our office. We have Al will we have the folks in my office -- take the -- to what we call it care consultation. And what that means his book will get general information. From the sibling. And what they feel their parent needs are where they think that things are failing whether it be. There's food the refrigerator that's expired. Their hygiene is becoming questionable. Their own housekeeping. -- noticing a change. And what we do is we make make it an appointment to allowed him visit them at the home. And what we do is do I care plan we will come up with what we feel. Is the safest. In the best plan for the parent to stay home. We may make other recommendations where we feel that maybe home care is not. The best alternative for them. We have. A lot of -- resource is such as adult day programs. Senior centers all of all of this so we we tried to keep. Home instead. -- also a resource for people. As the end -- company that does do in home care but we are considered a resource company as well for people. Children that don't know -- ago are don't know what the first office. This is doctor island les and you're listening to the health Melissa our. On AM succeed WRKO. And we're speaking with -- -- the owner of home instead. And if you have any questions for dial up please call 617. 7793486. Please leave a message at the end of the -- -- will be getting back TO. All right with respect to the adult daycare and senior senators. In assistance with meals. -- gave the impression. That it it's almost like home instead we'll just be a general. Almost like a broker. But Horry -- information center that will help the simple all the children. And his siblings were together rather than the men go on their own and find each individual way to help their parent so for example. You know they wanna bring them to the senior center are. They don't know which seniors -- is appropriate for their family member. It's gonna be based on their needs. Their abilities. Their limitations. There may be a deep program that home instead it's going to say to this child. I know the exact right place for your family member. Based on our meeting and even assistance with meals. Or stay home health -- person is needed to -- -- correctly. Yes. What we have several clients now that. Because of financial restraints. They're not able to get eight hours a day seven days a week in the home with their parents. So what will make several recommendations such as your point about the adult day. Care. They can go there we actually do transportation. Week will go there in the morning. Make sure they take their medications. Give them breakfast a system with getting dressed. And then drive and the two adult today. And then when that day is over we can we do the same thing -- you know we pick them up bring them home. And you know maybe give them a light snack or you know assist them in the bathroom if they need to be. And then and we generally wait you know till the sibling comes home because a lot of the parent it's now. On that these type situations live with the parent. So but we can help bridge that gap for the sibling that does have some are born with -- today. When -- respect the siblings. Home instead seems like it's going to be a huge help to protect -- relationships among the siblings. The siblings have many years of history together. Ends. Hopefully a nice long standing relationships but it would seem natural that at a time of stress. With a parent deteriorating or parent or needs more help. It could be a source of conflict and not because of one -- not caring. But more because they need the guidance. They mean I'll be properly educated on the next steps. Fans -- me be disagreeing. Without even realizing their disagreeing. Cannes in May be in deep down to have the exact same goals. And same thoughts and wishes. But having trouble putting that together and communicating in a -- that's going to help but that. Yes absolutely. In the past what we've done when we've had several siblings that again live perhaps. All over the country. What we've done in the past is when we've come up with our care plan. And then we have like one point of contact but what we've done in the past is we've email through email or. You know phone conversations. Will be in touch with all the siblings so if there is an issue week we see some things. In the home -- the parent seems to. -- deteriorating a little bit more or. Just simple things like you know we noticed that. You know they need -- groceries or are something as simple as that or picking up the medications or. Even going to the doctors you know -- -- has the change in their medical. Status. You know we'll communicate that to all the siblings so there isn't a miscommunication. Between. Home its its senior care. The primary. Caregiver and then all the other siblings and they can just communicate directly with cops. This is doctor Glaser a guinier listening to the -- -- -- sour on AM succeed every RKO. And -- -- with on a plumber and home instead. And again if you have any questions for -- please call 6177793486. Leave a message Donna. Would be more than happy to get back to. And idea persistent settlements that would also be happy to assist you. -- -- I -- to at this time. See -- you could share with us some some real great success stories of course we're gonna. Leave out names out in the interest of if I spent generally get kicked off the automakers they Armenia and -- radio so what are what are some of the best success stories so far. You know I've been in business now for over eleven years and I have. Multiple stories that I could share I give beautiful cards from opium -- all the time. But I do have one story that. Kind of sticks in my brain and has whenever I first started my business. My first year. I got a call from a son. His mom. Who lived in Wilmington. Massachusetts. And He lived in the answer He was to over two hours away. She He spent the summits with her and then the fall winter she wanted to go home. And she had first stages of alzheimer's. Still very mobile very. Funny. And I had it she has special place in my hide that. I would pick her up on weekends and she would go with -- did to my errands. And I took her on her ninetieth birthday I took her to her first baseball game. And she. Called her son and told him and -- her son couldn't believe it and I said. And He said well Donna it laughing He said we'll see if mom remembers this three days from now by you made her happy that day and I civil that's important thing. It's it's just that point in time when she was happy that one day. She. Passed away a couple of years ago and the sun liberal mean this letter that says that it felt wasn't. For home instead senior care He said my mom. Last year's would not have and as wonderful as they were that her quality of life was probably the best. That. It could be. And you know I hate her birthday was on July 4 and I used to caller -- fire -- So that's you know she easily use a laugh about that but she ash is a wonderful woman she taught me a lot. About the you'll stories her husband was in the Warren. You just learn so much from these people it's just actually incredible. -- -- of I think you have Sabrina historian I and I know you you have probably hundreds of other stories that you could tell us and many lives that you've that you've touched. I was wondering about when the appropriate appropriate time would be for someone to first contact home instead a lot of older patients. And when George sold -- long term care insurance. And they get that well in advance of when they're going to needed of course. When's the -- earliest time someone should contact home instead. Well honestly. There's different things that I tell people. And again I think I addresses a little bit earlier but. And when they see things starting to change. Moms hygiene or dad tied gene. In the becoming more isolated. They're forgetting to take their medications. Their driving isn't. You know the bass there having accidents. You know there's a little signs. It's never really too soon to call. It's best to prepare yourself for -- days ahead then to be reactive. To -- crises and generally. I would say more than half the times it's it's a reactive situation where all of a sudden something happens and then like -- known now when a -- do. And they'd just start PM making so He it's always good to be proactive. Into playing -- ahead. To Steven get information and plain and for the future and I mean I think we all do it in a sense. And not waiting you know till we get older. But you know plan out certain things like -- financial. Information year you know. Get -- away and you know just all of the all of that has to be in place in -- that's not too soon to do that that to be done immediately. This is doctor -- Lee is an annual listening to the hopeful moments our on am succeeding WRKO. And listen Teradata plumber. Owner of home instead and all of the ways that we can help protect our. Are -- situation and really maintaining his relationships that we have looking out for parents as their agent and protect human relations -- our siblings. It again if you have any questions for Donna. Please call -- at 6177793486. Leave a message -- -- get right back TO. Donna with respect -- money in inheritance issues. And what guidance can you can give us on that and what role -- home instead playing that if any. Well in my experience when you talk of -- money and inheritance. That's always a touchy situation. I think what you the first thing that needs to be done is. You have you'd have to sit down and talk to your parents. Or parent. About the financial situation. Find no. You know do they have long term care insurance. To date have I -- are or what if financial situation it is. Because that's -- it's really gonna help them. In planning for their care in the long run. It's Paris inheritance. A lot of times if CME's. Contend with the lack of funds to help this family. But. There are. You know some state services out there -- that to help with with Ian he's an hour and income. -- You know a lot of resource is out there that we could help them with. You know a lot of times as far as inheritance. Goes. You may have a sibling. Talent to save the money another way Tom disbanded. -- -- into. Again a situation with the siblings but. Again that the book that we have will help address that so within the main kick ever on the head person will know how to. Address the situation. Donna thank you I I wish I had. Called you about three to four years ago for help with my wife's mom but she was starting to deteriorate you would've been a huge help. My wife and her two siblings everything turned out okay with the situation but He sure made it -- much easier for for all of us and for anyone listening. I hope you take that advice that you can't call. -- too early. She's at home instead. She won't help you with. Maintaining relationships of you when you're siblings when you're helping your. Parents who is in need of help in -- it's a great -- nuke to get started. Again this is doctor -- blazing you've been listening to their hopeful moments our and succeeding WRKO. I wondered if they are after all over time. For coming on the air -- doesn't educating us about. Home instead in how we can help our failings in in times of need again if you would like to reach -- at home instead. And receive your free information packet on senior care. Call 617. 7793486. And daughter will be happy about -- Please remember the stakes are high sibling relationships and the quality of their parents -- risk. But -- newer approaches any focus on building better after and we relationships. To giving to me feeling stronger than ever. -- I think -- Well -- timeless moments that it if you'd like to be stunned at home instead they receive a free information -- -- here please call 617. 7793486. Again at 617. 7793486. That they do -- on your time thank you very much. Rescues the health and wellness are we doctor Alan blazers. I'm doctor -- -- medical director at -- primary care medicine as a doctor no matter where I go people are always asking me questions about medical conditions so every Sunday afternoon at five I'll be sitting here behind -- medical microphone during the WRKO help them on this hour -- -- in this week for home instead discussing all things senior care in Newton Wellesley orthopedic associates discussing technological advances in orthopedics join me this and every Sunday at five it only -- an hour and -- -- -- a bit. Don't miss your weekly doctor's appointment -- AM 680 WRKO. Tomorrow or five. -- -- limit our boat for four more years of what appears to be. -- to ask. Formally here's a disaster or some Republican I'm not sure about. Which way would you. Yeah obviously I should -- QB he'll be on pins and needles make his decision. It's a tough ball isn't running the fuel us live. -- -- -- -- Doubled your portfolio. 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WR -- -- whose gonna help them will -- so when doctor Alan blazers. Welcome back. I'm doctor Alon -- medical Clinton will determine who medicine and listen to the whole football this hour on eight succeeding. WRKO. Inevitable conducted and quality. Senior partner and we'll see what that -- -- associates plus podium I going to be speaking about that connect. Pain in the reasonable people chose this topic isn't this -- Texas 80% of the population. And it's very important that you seek medical care. At the onset of symptoms. -- do polity could you just give us a little synopsis of back pain and would it be -- develops symptoms. What they should be looking for what are our red flags. When He should be calling you at the outset. Absolutely the back issue. As one where as we age the discs will degenerate. So if you're in your twenties. The disk has about 70% of water content in it and as you age Georgia seven -- that -- contents. Gets less and it goes down to about 20%. So the discs become more brittle and what happens in that fifty year time span. Is that the -- move differently. They created formations. And subsequently when the information touched the nerve roots with a spinal cord you're going to get pain. So when a patient comes to the office. Stands. They've had an an acute onset and by Cuba's -- onset of back pain in the coming this year primary care physician. And they say or not is that back pain started. A few days ago. It started. Kind of suddenly. And yet I feel it moving down -- -- some numbness and tingling. Going down going down my leg. -- be so the first steps they're going to take. Well the when you have symptoms like that any type of pain that radiates into the leg or into the arms indicates that there is pressure around the nerve roots. So this may be due to a disk which is ruptured. -- disk which is herniated or a disk which is -- And that will cause a specific pain pattern down the leg you may also get numbness and tingling down the public. You may lose a reflex but that's for this position to. Check out. The important thing. Two recognizes. There are certain red flags at all physicians. Will be concerned about it. If you have night pain pain it's continually. Continually awakening you at night. That's something that needs an evaluation and you may need some blood studies. If it came on because you were lifting. Fifty pound bag of cement. Then it could be due to a muscle sprain or muscle strain it could be due to a disk injury. And it could be due to a -- creation which puts pressure on the nerve. So we always wanna take a careful history. And find out how that began. Did it come slowly. Did it come quickly and then we have a better idea as to which tests may be necessary or what to value. Many patients who developed back pain. And come into the office. Have a shared concern. In the all one MRI's. Very often. What's your best advice regarding an MRI in in when that's indicated because obviously we know for back pain. A lot of times the back will slowly improve on its own. Sometimes he'll be -- measures. -- use I is still use heat but again the inflammatory medicine over the counter of course with the guidance of your position. In a lot of times it'll improve. So when -- when you say that we should be asking for that memorize a position or as a patient. Mounted it's an interesting point is that this new studies. Are all over the place as to whether or memorize indicated are not many people on one end of the spectrum will say. You only get an MRI if you're gonna operate. That could be a long time now and also. I just wanna make the point that. Is He said in the beginning well over one's lifetime 80% of us will have a major episode of back pain. Within three months 96%. Of those episodes. Will get better on their own generally width conservative care. And then some number of surgeries that are done on all back pain patients. There's really only in the ten or 15% range so surgery isn't really indicated. Initially. EU wanna do a careful. History. If there's an indication that there's some bladder dysfunction or bowel dysfunction. Or severe reading -- Which doesn't follow. Any recognize patterns and sometimes you do need to get memorize early on. However most of the time the treatment is conservative with the medications. With a stretching program. X rays -- then. Aren't usually necessary in the initial few weeks because most of the changes on X ray are going to be. Secondary to Wear and -- degeneration. And as you age you get more levels of Wear and tear degeneration. -- drilling loser and you listen to the health of -- sour on am succeeding. WR TL and I'm speaking with doctor Kenneth polity senior partner at Newton Wellesley what competed associates. That -- -- repeated associates has been around since 1970. They provide exemplary care to the orthopedic patients. And withdraw their doctor polity on as a guest today. To -- Were in the month of September we're going to be getting into the fall season. We're going to be getting into. A lot of certain sports injuries and we're gonna be getting into the winter when people start having injuries because of the weather. Could you comment a little bit on how your practice. You know the experience and it'll see this time of year in any guidance and of the patients with his upcoming season's coming. Absolutely generally. Back injuries though occurred anytime of the year -- various sports and various activities. Now they were getting into the fall season there's going to be a lot of breaking going on. And lifting. And you always have to be careful cleaning those gutters getting up final latter so that you don't fall that. Will cause other orthopedic injuries as well. But you also wanna do a basic core strengthening program -- abdomen. Mostly if here and get out of the line and your back muscles get weak you tend arch your back. That squeezes a nerve roots and causes of back pain pressure in the lower back down into the Baltic region. And when you're standing for instance doing dishes or re -- and pulling and twisting that's gonna aggravate all these activities. So it's always good to strengthen the abdomen is so is good to keep the knees bent. I have one strayed one band step it up on some things and watch who lifting always. Bend and lift don't. Bend over at the waste time and try to -- something up heavy. That's. Going to make it worse reveal it's if you make it increased incidence of injury you wanna bend your knees and went from there and always get help. If the bags are too -- or if whatever -- lifting is to have. I like that last statement from my myself with the back pain obviously. Lifting with the knees and lifting properly when I find this in order for myself person he's even better is -- I -- my wife to the heavy lifting and I. My back never bothers me what she brings in the groceries. That's -- cheer on full time dish duty to absolutely. Thanks -- with respect seemed physical therapy. And the role that that hasn't treating back connecting could you elaborate on that force. Absolutely the who once you do. Develop back pain. It. What happens is at the muscles will go into spasm and they will all to your body mechanics. So. The role at the physical therapist has. Again -- -- to loosen the muscles to strengthen the abdominal muscles to stretch the lower back muscles. And to eliminate the spasm. And they can do this in a number of ways. Sometimes -- -- Massage sometimes it's with electrical stimulation with -- The little electrical leads that simulate the muscles. In order of to loosen them. And sometimes. -- do ultrasound. Which heats up the muscles deep and then they can do is stretching and strengthening program. But most of it is to try and reduce the inflammation that's there. And for that you'll need anti inflammatory is -- bill or over the -- or other over the counter over the counter medications. Com and good walking in strengthening program. -- respect to the anti inflammatory is just as a reminder it's all of our listeners. That these medications. Can be concerning when you took large amounts that to -- concerning. When you're taking them prolonged duration of time is showing it to you dosing of inflammatory as with a full stomach and -- -- by patients that you need to deserve -- -- And give any risk of possible Carter indication. Torn his medications check with your doctor if there's a bleeding history that you have or and also history. They just -- issues is so they -- speak with someone before taking those medications. Doctor -- -- we've been speaking about a little about physical therapy as far as traction. And the role of that in preventing back pain and especially in someone who's had a history of back pain. How important is the stretching before the exercise and also how important is -- after the exercise. It's extremely important. I'm sure everyone's getting out of bed in the morning with some significant stiffness. In the lower back. And that basically happens because at night you're lying in one position you don't feel any pain. And the muscles get stiff with the muscles get shortened and they can go into spasm. And then when you get up it's hard to get out of bed it's hard to lean over the sink to brushing teeth. And so when you get up in the morning line your back bring your knees up to your chest. And just do two or three minutes is stretching. Then when you get out of bed you can twist side to side. You can bend forward a little bit loosened things up. Hot shower is always helpful once you exercise you always want a cooldown and stretch because once the muscles. Have been exercised in heated up. They can then contract and go into spasms so you wanna do you're stretching after the exercise program as well. And that should help. I'm doctor -- laser and -- listen to the -- the moment sour on idioms succeeding dumber are kill. And my guess -- -- polity and I are speaking about that connecting. If you wanted to -- doctor polity or any of his other orthopedic associates. The number to call is 617779. 3486. To clarify that's the phone number to call here to leave a message for doctor polity. They'll be sure to get back -- then within the next day but you know phone numbers 617779. 3486. The phone number to -- topologies office -- -- miles north of Phoenix. Is 6179640024. Was speaking about back in that pain and a little while ago we were starting to speak about physical therapy and how it has a clear role in treating back pain. I know a common question that I get asked by patience. Where elaborate exacerbation of their back pain that mean happy quite -- of severe. To get to your group for assistance. And it won't be such a severe case. Of any of the red flags we spoke about. But won't know that physical therapy is going to be hopeful for them. Is there a time when physical therapy. Should be delayed or is there a time when physical therapy is too early to advises -- better way -- -- -- But aides say if it's if you were insignificant -- spasm. It is sometimes difficult for the therapist to help you because part of their role is to do the stretching in the strengthening. So it's it's a fine balance I mean it's certainly. Reasonable to try a little therapy first but at some point if it doesn't seem to be helping you after a few weeks then you should be seen. It's nice to self diagnose but it's always better to get. Better expert opinion. That's hubby when I have already spoken about the treatment involving the anti inflammatory. Medications these are known as I'm not destroy real anti inflammatory drugs. And we we should. Tell our of our listeners there's clearly a difference between over the counter. In a prescription strength one of the differences is that the over the -- are. For the admiral in the Motrin. These are 200 milligram dose a lot of times the prescription doses will be 600 milligrams. -- 800 milligrams and it's also not just matching up and counting -- well I'll take. Three of those 200 send that to be the same track quite the same as metabolize a little differently. And this clearly different cost -- quality what are your thoughts on this. Let's it's an excellent point the over the counter medications. Are coated said that they dissolve in the stomach. And that's why you have to be careful when you take them because. When they dissolve in the stomach they can cause acid. Build up and stomach pain. The prescription drugs are coated differently. The prescription drugs will not dissolve in the stomach with the -- but will travel through the stomach and then. I have uptake in the other areas of the intestines. So good for. Taking four over the counter 200 milligram. Ibuprofen is not the same as taking 1800. Milligram Ibuprofen because you'll get. More than twice the level of the drug effectiveness. In the prescription strength. So that's why I think it's important. It's -- to take the smaller tablets initially but if this is something that you -- going to need more regularly because you've got. And it's interesting to note that the equivalent. Dosage in the prescription strength is. Less expensive -- the over the counter. The other nice thing about the prescriptions that if you of back pain that's so severe that you need a very high dose of the back pain is persistent. It should really be managed by -- health care professional. And then we'll help you make that decision jointly on. Aren't the treatment modality. And when you gonna get a medication you only getting the right dose. There will be able to guide you -- that. That's -- public with respect to. Athletes verses. The weekend warrior. What is sedentary patient and back pain. Are the treatments that we've already spoken about essentially the same or they focused a little different in the Anthony vs them on Anthony. Well in the in the athlete the professional athlete let's face it their. Higher paid. Individuals. Some who are extremely motivated to return to their sport as soon as possible. And what we see is when. A very high profile athlete is injured. They're pretty much gonna get an MRI scan right away in order to I'm determined. If they can come back quickly or not and what the treatment should be. And there's just a difference. There. Most this is time. In the Weekend Warriors. You were able to discern what the issue is and if it's not getting better. In a week or two weeks. Then the imaging studies could come into play but clearly we treat our professional athletes. A little bit different than the rest of us and we all wanna win and that's why we do it quickly. With. We've been hearing about back pain in how to treat this in those first few weeks. And I know as He spoke earlier. -- on the back and we'll be persistent. Let's get to the scenario where the back pain is persistent when a patient is are you tried physical therapy. They tried their different modalities. They've been on and not destroy real anti inflammatory medications. At the proper dose. They've been to your office already defense in my office -- eight. And now worry several weeks into. Going into a couple of months of unrelenting back pain. Let's get the scenario that it's also keeping them up at night the policy for a little while -- turn and the wake up when this persistent pain. What are we going to be looking for. Well it at that point presumably we've done the routine X rays that we do and which will tell us if there's arthritis. On the plane films where the regular X rays. At some point we would obtain an MRI scan. Now the MRI scan. I'd like to point out is electrons. It is not X ray radiation so. It used to be fifteen years ago. That we would get cat scans in the cat scans still have a lot of radiation but those have fallen out of favor. In the most -- in the most for the most part with regards to the spine and now we get MRI scans the MRI scans are good and it's showing soft tissue. A little bit. Less for showing -- issues. But when we see the disk is soft tissue the nerve roots are soft tissue. The joints to set joints these are moving joints in the lower backers. Can show inflammation soft tissue. We go to the samurai and then we see what is it that we think is causing the pain. That is this basically. A few structures the the disk as we've said before a controlled zone touched a nerve root if it does you'll get pain down the leg. There are joints in the back -- called the set joints. And as we age they get arthritic and they fill up with fluid and they can touch a nerve root as well. The set joints caused the morning stiff mistake caused pain when you mean backwards. They cost payment side to side motions and the disk. Intrusions are bulges. Or variations cause -- paint. So at that point ones who made a determination as to where the pain may be coming from we have other options which include. Injections. With the court so. Now. If we think that it's a disk problem. We can perform what's called an epidural steroid injections. Which. Is an injection generally performed under -- -- appear X ray where we place in the -- specifically. Near the nerve root and inject some cortisone. To reduce the inflammation. Around the disk in the nerve root and if that helps in the -- pain goes away they're about 50% effective sometimes they have to be done. Three times two or three times in order to get relief but it just helps to Alter the pain pattern to make you better. I'm -- drilling whizzer and you listening to the health and Melissa are on AM 680 WRKO. Back -- can't follow me and I are speaking about back pain and for all of our listeners if you have a question for doctor polity. Please call 6177793486. Leave a message of this number. In doctor polity will be sure you back to you. That's probably with respect to the injections we as we were just referring to you elaborate a little further on the definition of flu -- compete for all of our listeners. Well for -- escapee is an -- trade -- -- in what we call real time it's it's moved its emotions so. We take a shot and we can see this fine actually moving. If you are moving and so the -- scope. The -- -- unit. Basically we can put the needle in. We can localize our position and then we can get a more exact placement of the steroids. When do we get to the point we start seriously have a discussion about surgery. Well I like to tell my patients than. You. Call me. If you want surgery. Basically. Unfortunately nothing is guaranteed. -- back pain or in life and no one can tell you. That there's a 100% guarantee. That once you. Have surgery that your going to be a 100% better. In fact. Although we can eliminate your leg pain by taking herniated disk out once you put a scar on someone's back. You're creating scar tissue and a different. Type of back pain. And so you sometimes a substitute. -- general Leo lesser type of pain but one pain for another one so. Usually. Most of the back pains as I said before we'll go away and six to eight weeks however if you've continued to have severe. Radiating pain it's shooting down the laying and you can't sleep and you can't work and you can't move. Then you may be a surgical candidate and we have to think about -- doing surgery in order to alleviate the pain. And due to a -- with repeated associates. For patients coming in from back pain but there are few specific positions that they're going to be seeing or is -- anybody in the group that is your practice work that. Lou we've developed over the years who are now two thirteen. With the Phoenix surgeons and we have sub specialty interest. In just about all. Various. Of the -- various orthopedic. Specialties. Basically. You will probably be seen by one of the spying trained physicians or perhaps one of our specialists physicians assistants. But. Although everyone can see back pain. We try and get you to the right person. With the respect someone who develops. Sudden. Pain. After hours. And they're trying to decide. Am I going to the emergency room or my it is going to try to make it through the evening until I can get help in the morning. With respect to the need to go to the emergency rooms -- some medical emergencies. Such as loss of control of valor Blatter. That's some medical emergency in the setting of back pain. What are some of the other emergencies. Where the patient should just head right on over night and we told the morning. I would say if David they're noticing significant weakness. In from a -- a leg or an arm. Perhaps. Changing. Numbness or tingling. Which is president. Any thing some severe pain. Probably should be evaluated as well. You can try a some over the counter medication if you want you can try some heat you can try some IAC can alternate them. But if the teen becomes unmanageable then you may have to go to the emergency. I'm doctor -- Glazer and you're listening to the whole thing -- sour on AM succeeding WRKO. My guess doctor Kenneth polity and I have been speaking about back pain. Again if you have questions would you like to call in please call 617. 7793486. And doctor polity will be sure to get back TO. I'd -- to shift our discussion. Moving up the body to the neck -- -- respect to neck and back pain we know that 80% of the population. Will be affected. Neck injuries. Often have a little bit of a different story behind them back penis that would you find -- -- polity or there's a lot of overlap. Well then then the neck injuries. Jenna who will evolve from a lifting event could come. Over time the the disk it C 56 cervical 56. Generally begins to degenerate and everyone starting at the age -- 25. In this time progresses you can get further degeneration in this disc and others. So at some point you can you may wake up with a stiff neck you may have a problem looking overhead you may have a problem looking down you may be uncomfortable sleeping. The neck. Generally. Is more of aware and care phenomenon. And all so. When you get pain in the arm it's generally secondary to lifting. Incident. When patients come into the office and they tell us they have arthritis. Or their wondering. If any of the new generation there was speaking about. How they're released to -- arthritis is of the same what's the exact definition for our listeners. When did the definition is that. Degenerative arthritis. Wearing tariffs -- their all of the the same thing I mean this is to be contrasts it to. A mother or and on to has rheumatoid arthritis sets a whole separate. Type of arthritis. And that doesn't play a role. Most of the time it's degenerative arthritis which is wearing here and that's just due to as we age as they said before the disk. Will lose their water contents they've become more -- they're more susceptible. To. Cracks. Bill degenerate. Bill forms spurs built touched a nerve roots and then you get paint. I want this thing doctor Kenneth polity. For all this time but to have polity is in Newton Wellesley orthopedic associates. Their phone number is 617964. 0024. There are very impressive web site that's polity of -- the web sodium plays if you had it. Www. NW OK dot com. And again if you wanted to leave a message here productive Pahlavi for questions. 617779. 3486. You've been listening to the -- the moment sour on am succeeding WRKO. I'm doctor -- laser medical director -- primary care medicine I hope you enjoyed listening to this last hour. Of our health tips for you and I enjoyed good -- myself from our best. And I'm looking forward to utility into us next Sunday at 5 PM. And AM succeeding WRKO. Stay healthy stay well. There we'll see you next week. A health and wellness soured -- doctor Alan blazers.