All 15 disc herniations were classified as extrusions, six of which were sequestrations. All were uncontained as there was no surrounding annulus. After having numerous operations in the past due to RA, I knew that I had to have the operation to maintain my quality of life. I knew that due to my age I needed to proceed now while I am fully able to cope with the recovery. What was the experience of the surgery and recovery ?

Most herniated lumbar discs resolve spontaneously. 1 – 8 Although smaller herniations may be safely treated non-operatively, massive extrusions and sequestrations are sometimes treated by operation for fear of cauda equina compression. We present the clinical and radiological outcome of 15 patients who were treated conservatively having presented with leg pain and a massive lumbar disc herniation. Patients and Methods During the appointment, your provider will ask many questions to figure out what may be the cause of your pain. You should be ready to answer questions about: Your provider will perform an examination of the affected joint to see if there’s pain or limited motion. They’ll also look for signs of injury to your surrounding muscles, tendons and ligaments. I then had 4 weeks at home where I was allowed to take short breaks, but 70 % of the day I had to have my foot elevated ie on a chair / stool.

Can The Problem Get Worse?

Typical appearance of a wound post surgery. This patient adhered to the strict post-operative instructions. Step 4: First, fold in half your rolling paper, forming a slight V shape. This way, you will place the pieces of ground-up weed easily, and you should grab it in the middle correctly without accidents happening. Start putting the product inside to increase the amount upwards, so you form a cone shaped joint up to the center. Remember to leave room for the filter tip. NSAIDs are medications that can reduce swelling around joints and nerve endings to give pain relief. They are particularly useful North Lanarkshire Leisure’s Active Health Programme in partnership with NHS Lanarkshire provides a range of supported programmes to help individuals realise the benefits of becoming more physically active whilst also assisting those who are recovering from minor or even more serious illness.

We injected indigo carmine into the ganglion to arthroscopically identify the ganglion stalk and cyst. Indigo carmine enables an easier visualization of ganglion stalks and cysts under arthroscopic view. Indigo carmine is generally believed to be a safe, biologically inert substance, and is often used during cystoscopy when evaluating for lower urinary tract integrity after gynecologic surgery. 7 , 21 In the field of orthopedic surgery, there have been reports of its use in Baker cysts and ganglia of the hand and foot. 23 , 24 , 32 To our knowledge, this is the first report of surgery using indigo carmine for AC joint ganglion cysts. It has been reported that indigo carmine can potentially cause hypotension and bradycardia when intravenously administered. 7 , 21 However, when injecting indigo carmine into an AC joint ganglion cyst, the dye is injected directly above the AC joint ganglion cyst and does not enter the blood vessel; thus, the dye can be used safely and effectively. We carry out almost all injections under a short general anaesthetic (1 minute) as injecting into a painful joint can be quite sore. While you are asleep and lying still a small needle is inserted into the joint and the position is confirmed using an x-ray in theatre. A small amount of dye is injected first to make sure the needle is in the correct spot and then a mixture of steroid and long lasting local anaesthetic is injected. Undertaking the injection in this manner ensures a pain free experience for the patient and the best outcome clinically as there is no doubt about the placement of the injection. The surgery was very straightforward. A day case, so home the same day. And my recovery has been good, the swelling has gone down, and I only took pain relief for a few days and although I had a couple of early days when it was sore, it is a pretty bearable experience. But I did underestimate how much care I would need to take in the early days post op. I had thought that I’d be able to get into work (with my 90 min commute) maybe 2 or 3 weeks post op. That 4/6 weeks mainly off your foot, really is off your foot. And that to get the best outcome you need to really listen and follow the instructions of Mr Malik. It’s an investment to try and protect the joint and although it’s been frustrating watching people go out for long walks and grab that blue sky and sunshine whilst I sit at home with the foot elevated, the surgery would be a waste of time if I didn’t take the after care seriously. And after waiting all this time to have the operation, I’m going to do everything I can to ensure it’s a success. So 2.5 weeks post op, all good so far. What advice would you give to future patients with a similar problem?

Steroids, often given by injection into your joint, to provide short-term relief of pain and swelling. Goodkin R, Laska LL. Vascular and visceral injuries associated with lumbar disc surgery: medicolegal implications. Surg Neurol 1998; 49: 358–72. Physical or occupational therapy, along with a balanced fitness program, to gradually help ease pain and improve flexibility.

A follow up review will usually be carried out by the orthopaedic surgeon 10-14 days after surgery. Collin P, Matsumura N, Lädermann A, Denard P, Walch G. Relationship Between Massive Chronic Rotator Cuff Tear Pattern and Loss of Active Shoulder Range of Motion. J Shoulder Elbow Surg. 2014;23(8):1195-202. doi:10.1016/j.jse.2013.11.019 - Pubmed Surgery may be an option if your joint pain is long-lasting and doesn’t lessen with drugs, physical therapy or exercise. Apply crushed ice/frozen peas wrapped in a damp towel for 10-20 minutes, 2-3 times per day for the first 5-7 days post injury/ flare up of pain.Patients with constant pain and mid range pain require a 1st MTP joint fusion or a hemiarthroplasty. Injection technique is a modifiable risk. The risk of SIRVA can be mitigated by adopting measures such as adequate exposure, optimal patient positioning, accurate landmarking and usage of needles of appropriate lengths. Localized soreness and pain following intramuscular vaccinations to the shoulder are common, typically mild and self-limiting. [1] Shoulder injury related to vaccine administration (SIRVA), is a more severe and rare complication, and results in onset of shoulder pain and limited range of motion that persists after the vaccination. [2], [3] It is thought to occur due to inadvertent administration of vaccine into the shoulder joint or subdeltoid bursa, leading to an inflammatory cascade damaging the surrounding structures including bursa, tendons and ligaments. [4] SIRVA encompasses conditions including adhesive capsulitis, subacromial bursitis, rotator cuff tendonitis or tears, and subcortical bone osteitis. [4] It has been reported more with influenza vaccinations due to its widespread usage and has also been observed after vaccinations for tetanus, pneumococcus and papillomavirus [4], [5]. The first case of SIRVA following COVID-19 vaccination was reported by Tatiane et. al in April 2021, in which the patient was reported to suffer from subdeltoid bursitis and rotator cuff tendinopathy following the vaccination. [6] The exact incidence of SIRVA is unknown, but is increasingly diagnosed in recent times. Based on the American federal Vaccine Injury Compensation Program statistics, it is the number one complication which patients seek compensation from the no-fault Vaccine Injury Compensation Program. [7]. The surgery was done as a day patient, I was treated excellently from the moment I arrived, I was put at ease by all staff concerned.

Weight Reduction – People who are overweight tend to have more prolonged pain and poorer tissue healing due to increased levels of inflammation in the body. Reducing your weight can generally help improve the healing process. At this stage if the swelling has subsided sufficiently you will be advised to keep your foot in an elevated horizontal position (50-75% of the time). You will require to wear the special post operative shoe for another 4 weeks. Short trips can be made outside, within limits of pain and swelling. Disuse osteopenia – when bone is not loaded normally it starts to weaken (similar to wasting of muscle when it is not used) this is only temporary as the bone will return to normal density once it begins normal use again Bozzao et al 7 had eight patients in their series of 69 with disc herniations which occupied more than 50% of the canal. Six of these had reduced in size by more than 70% on follow-up axial MR scans. The wound is not usually painful, but you'll be given painkillers to take if you feel any discomfort after the operation.Dr Redfern possesses, to say the least, quite the impressive medical cirriculum to-date. One of the most notable aspects of his medical work thus far in his remarkable career has been inventing the MICA technique (Minimally Invasive Chevron Akin) as an incredibly effective minimally invasive treatment option for correcting bunions through the use of keyhole surgery. Currently 1st MTP joint fusion and hemiarthroplasty are more predictable than a 1st MTP total joint replacement for alleviating symptoms and restoring function in patients with severe arthritis of the 1st MTP joint. Complications are also greater than with a 1st MTP joint fusion or a hemiarthroplasty.