You can reference this one video for reminders of all of the top 10.
Archive for March, 2009
The Recap!
Tuesday, March 31st, 2009FINALLY! 9 & 10, also Viewer Question
Wednesday, March 25th, 2009Wow- with losing my computer, then my voice- it took forever to get here!. Finally, the last 2 of the top 10 list. Stay tuned for the recap, and an interview with Debra Rasansky, acclaimed physical therapist.
Keep those cards & letters coming!
Steroids- not all bad.
Thursday, March 19th, 2009Hey- a couple of weeks ago, I posted a short video about epidurals. In the video, I related that the injections often contain steroids, and I received comments from 3 concerned viewers who had received epidural injections, and were not aware that steroids could be part of the medication, and had worries about steroids in general.
Unfortunately, steroids get a pretty bad rap due to all of the news- this athlete or that athlete have been accused of using steroids. While steroids are a serious class of medication, there are a two main categories commonly in use, and a little clarification is in order.
The two broad categories of steroids are anabolic steroids and corticosteroids.
The steroids you hear about on the news are of the anabolic variety, and carry with them all sorts of side effects, including muscle growth, rage, psychosis, sexual dysfunction, as well a others.
The steroids included in therapeutic injections are corticosteroids, and are used as an anti-inflammatory agent. They carry with them some potentially serious side effects when inappropriately taken or prescribed, but have many great uses when dealing with various types of pain & inflammation. These drugs should be considered largely safe for short term use when appropriately prescribed.
Oral steroids in the form of Prednisone, or the commonly prescribed Medrol Dose Pack- can be used for nerve root irritation and other nerve mediated pain syndromes. Injectable steroids can be used when more aggressive therapy is needed. These injections can be superficial, in the case of trigger pint injections. Deeper injections are often placed with flouroscopic (live x-ray) guidance, to ensure they are directed to the most accurate location.
I hope this clears things up. The steroids present in epidural injections are safe and effective, and should not give you concern.
Look for the final 2 postings on the top 10 list, as well as a recap next week.
Also check back for our first guest interview with extraordinary physical therapist, Debra Rasansky, coming Thursday.
Be Well!!
My triumphant return after recovering from the Mother of all Colds, and Number 8!
Monday, March 16th, 20098
Sorry for the delay here- a really bad cold knocked my voice out for nearly a week. It’s remarkable how bad a cold can make you feel- I haven’t had one like this in years, so am am particularly grateful for being back on my feet.
Stay tuned this week for some responses to some great viewer questions. On Friday I will provide a recap of the whole top 10 for those joining in the middle. Thanks for visiting!
The REAL number 7.
Wednesday, March 4th, 2009Here is the real number seven. Sorry for the numerical mixup.
Also, please submit any questions you may have for our local physical therapist, and physical medicine and rehab specialists, as their guest segments are coming up soon.
-Andy
Andrew Kirschner: Good physician, bad at counting…
Tuesday, March 3rd, 2009OOPS!! Somehow or another I managed to post number 7 before adding number 6 on the Double Secret Top 10 list. I will give you 6 later this week.
Hit me with your best shot- Epidurals, a primer.
Tuesday, March 3rd, 2009This is just a brief intro to epidural injections. Many patients can benefit from the pain relief afforded by an epidural, but there are too many people under the misconception that they are only a band-aid, providing temporary relief. I wanted to provide you with a short intro & explanation for why that is not the case. Stay tuned for a discussion with a physical medicine and rehabilitation specialist for more information on how epidurals work and how they can be beneficial under the right circumstances.
Number 7 on the Double Secret Top 10 List.
Monday, March 2nd, 2009So here is number 7 on the top 10 list.
Tomorrow, please join me for a brief talk about epidural injections and their usefulness in treating back pain.
Philadelphia will miss Brian Dawkins
Sunday, March 1st, 2009
Me with Brian Dawkins, and another player they rewarded with being let go after a Pro Bowl season, Bobby Taylor.
OK- First let me say I am beside myself with disappointment.
I have been fortunate enough to work with many of my favorite athletes over the past decade or so, and of all of the folks I have worked with, Brian Dawkins is one of the best.
Always a gentleman, and always a warrior- Brian has given Philadelphia an incredible amount of excitement for the past 13 seasons. This past season when many of the sports ‘experts’ had written him off due to his age Brian stepped up his game and gave another Pro Bowl performance.
Yesterday, when he signed with the Denver Broncos, I don’t think I am overstating things when I tell you, my heart broke a little.
The Eagles organization has a long history of rewarding mediocrity, and punishing those players who really gave the team their all. Most of us in Philadelphia believed that Brian transcended this type of treatment, and would be justly rewarded by being provided incentive to finish his career here in Philly. Sadly I set my expectations too high.
Brian- you are an exceptional player, and human being. I wish you and your family the best in your move. Now I have an excuse to travel to Denver.
As for the Eagles front office- when are you folks going to get some class? It is criminal that #20 should finish out his career anywhere other than Philadelphia. You continue to earn your ‘also-ran’ status.
Anti-Inflammatory Meds (NSAIDs): Let’s get something straight.
Sunday, March 1st, 2009I received two questions from viewers this AM regarding NSAID- or non-steroidal anti inflammatory medications (drugs in the same family as Motrin, Advil, etc…) treatment for back pain. Specifically, both of these viewers had seen the same post on another blog.
In this post, the blogger- NOT a therapist or physician- told his readers that NSAIDs did nothing to heal back pain, and should be avoided as they mask pain.
This is ridiculous. While NSAIDs are not appropriate for all types of injuries and all types of patients (particularly those with kidney disease, for eample) they are very useful for helping to heal acute injuries. WIth an acute injury, inflammation can occur, causing local swelling and inhibiting local blood flow, and limiting the delivery of oxygen and nutrition to the injured tissue. NSAIDs can be used to reduce the swelling due to inflammation and help with healing. They have the added benefit of being an analgesic, and reducing pain. That being said, they should not be used chronically, and if pain from the injury persists you should certainly be seen by a physician.
When I read posts like the one cited above, I get nervous because the advice from an untrained individual could undermine the work performed by a qualified physician or therapist, and delay recovery or worsen a patients condition.
Be well,
-Andy
