By Becky Wiese
Central Illinois Orthopedic Surgery (CIOS) has long been a boon to Central Illinois patients. For more than 30 years, those who have experienced pain in various body joints — knees, hips, and shoulders, to name a few — have been able to get relief to the highest degree possible. Doctors Larry Nord and Brett Keller are orthopedic surgeons who continue to provide cutting-edge care by offering state-of-the-art procedures, and utilizing the latest in diagnostic and surgical techniques and technology.
“We are constantly updating and improving our services and technology to better meet the needs of our patients,” says Dr. Aaron Rossi, who acts as COO for the practice, and assistant surgeon in the operating room.
One simple way they can meet more patients’ needs is to simply go where the patients need them. They operate several satellite offices, including Morton, Hopedale, and Champaign. The Champaign office, which opened in July, along with the other satellite offices, enables patients who live both west and east of Bloomington-Normal to see their physician closer to home. More comfortable and more convenient — two factors that are extremely important to patients.
Updates and improvements continue to take place in the “home” office, located in the Eastland Medical Plaza near OSF St. Joseph Hospital. In June 2014, CIOS installed a state-of-the-art digital x-ray machine that has been a significant time saver and convenience for both doctors and patients. “We have the only one in the area,” says Dr. Rossi. “Images can be shot and captured in five seconds, then immediately viewed on the computers in each of our exam rooms.”
The Viztec U-Arm DR+ machine provides spectacular image quality, enabling the physicians to see clearly and make a diagnosis quickly. This ability reduces patient wait times in the office while increasing efficiency on the medical side of the equation. “With this machine, we can get three views of a knee or shoulder in less than one minute,” says Dr. Keller. This is a huge improvement, especially compared to traditional x-rays, which involves shooting the picture using film, developing the film, and then reading the images. “The digital images go straight to the computer, so there is literally no wait for a patient.”
Another benefit of this particular machine is that the U arm allows optimal flexibility for obtaining the views necessary, without causing discomfort to the patient. In fact, patients can be standing, sitting, or lying down, and the machine will accommodate and provide the images of both soft tissue and bones needed to make an accurate diagnosis. The patient can be x-rayed, and the physician can read the digital image immediately on the computer, make a diagnosis, and develop a treatment plan — all during the same office visit.
Shoulder Pain — Common Complaints
The shoulder is an amazing piece of the body’s architecture. It is a ball and socket joint that allows movement in just about any direction, making the shoulder the most moveable joint in the body. Consider all the directions a typical arm can move — up, down, to the side, across the body, over the head, even behind the back — all because of the way the shoulder is designed.
The downside to all of this potential motion is that a lot of things can happen to cause the joint to become unstable, and thus painful. Common problems include sprains, strains, dislocation, tendinitis, arthritis, frozen shoulder, and rotator cuff injuries.
In addition, because of its constant use, shoulder injuries can and do happen at any age — sports injuries, trauma from falling or other accidental injury, repetitive motion, and just the natural aging process can all cause shoulder pain.
We often take our shoulders’ abilities and range of motion for granted until pain is present; then we notice just how involved our shoulders are in daily activities. Getting dressed, fastening a seatbelt, raising and lowering your arm, even sleeping comfortably are just a few of the things we do on a daily basis that can be more difficult if shoulder pain is involved.
“The four main causes of shoulder pain include arthritis, rotator cuff tendonitis due to overuse resulting in inflammation of the tendon, rotator cuff tear, and shoulder impingement — caused by a bone spur that limits movement,” says Dr. Keller. Regardless of the cause, making the pain go away, and restoring as much mobility as possible, is the goal.
Finding Relief — General Diagnosis and Treatment
Initially, a physical exam takes place, which helps the doctor determine weakness and range-of-motion limitations caused by pain. An x-ray will show fractures, dislocations, and arthritis, while an MRI shows more of the soft tissue problems, such as rotator cuff tears.
Generally speaking, once the problem has been diagnosed, regardless of the cause, the first course of action is typically a conservative approach: resting the shoulder, using anti-inflammatory medications (NSAIDS), and applying consistent ice or heat therapy. Other treatments may be added, such as physical therapy, electrical stimulation of muscles and nerves, ultrasound treatment, and/or cortisone injections.
If none of those options seems to be helping, the problem might require surgery. “We do a lot of arthroscopic surgery,” explains Dr. Keller. “With technology now, the surgery is minimally invasive, making only three to four small incisions, and utilizing a camera and scope to make the repair.” Another benefit to arthroscopic surgery is that there is less pain, faster recovery, and decreased chance for infection.
Rotator Cuff Injuries — A More Specific Example
A torn rotator cuff provides a more specific example of how the process works. Rotator cuff tendons can become inflamed, strained, or torn through a variety of activities. Overuse, aging, breaking a fall with an outstretched arm, repetitive overhead motions, and heavy lifting can all cause weakness and degeneration of the four tendons that make up the rotator cuff. Over time, the muscles and tendons can completely tear. Although it is possible for these tears to not cause pain or disability, especially if they are due to the aging process, some people develop very significant pain, and will require treatment.
“Because these tendons are responsible for the movement of the arm upward, at shoulder level, or at 90 degrees, a patient usually complains of weakness and pain — especially when trying to lift the arm into a horizontal position,” explains Dr. Keller.
An MRI is used to accurately diagnose a rotator cuff tear. Once a tear is confirmed, similar treatment options apply as for general shoulder problems. “Conservative treatment involves a cortisone injection, along with possible physical therapy,” says Dr. Keller. “Patients with chronic tears won’t benefit as much from surgery because the quality of the tendon has been compromised over time. Patients who have an acute tear are more likely to benefit from arthroscopic surgery.”
Recovery from shoulder surgery takes time, although having an arthroscopic repair is extremely helpful in decreasing recovery time (mostly due to the small incisions). A patient will also undergo physical therapy, typically three times a week for six weeks, as well as being advised to use pain medication and the RICE therapy (rest, ice, compression, elevation) immediately after surgery for pain and swelling. “Patients are usually back to their pre-rotator cuff tear condition at about six months,” Dr. Keller says.
CIOS also offers patients a convenient place to receive their physical therapy. The Neuro/Ortho Rehab Center (NORC) is a 7000 square foot facility featuring state-of-the-art equipment staffed by physical therapists and athletic trainers specifically trained in orthopedic rehabilitation. “It’s a great benefit because we can work closely together to make the best treatment and recovery decisions for our patients,” says Dr. Keller.
Although shoulder pain is not uncommon, it’s definitely treatable in most cases. “Don’t assume all shoulder pain is a rotator cuff injury needing surgery,” advises Dr. Keller. “Conservative treatment options are the best way to start, and if surgery is necessary, we can help with that, as well.”
If shoulder pain is affecting your quality of life, the physicians, staff, and therapists at Central Illinois Orthopedic Specialists would be happy to help you find a solution very quickly.
Central Illinois Orthopedic Surgery is located at 1505 Eastland Drive, Suite 220, in Bloomington. Contact them for more information at 309-662-2278 or www.ciosortho.com.
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