How Corticosteroids Help with Inflammation and Pain

At Pinehurst Surgical, Dr. Moore sees patients with joint pain every day. While his expertise and training as a board-certified orthopaedic surgeon make a difference for his patients when they need knee or hip replacement, surgery is typically only pursued after conservative treatments have been exhausted. One of these treatments is the injection of corticosteroids. Often this is the next step when the patient has not responded to other treatments such as physical therapy or oral anti-inflammatory medications.

Here’s some more information about corticosteroids.

What are corticosteroids?

Although often confused with the steroids we hear about from professional athletes or bodybuilders, corticosteroids are different. The steroids for bulking up are anabolic steroids, not corticosteroids. Corticosteroids are synthetic drugs that closely resemble cortisol, a hormone produced by the body. Triamcinolone, cortisone, prednisone, and methylprednisolone are all examples of corticosteroids.

What do corticosteroids do?

For our patients at Pinehurst Surgical, we typically use corticosteroid injections to reduce inflammation. They can also be used to reduce the activity of the immune system, which can cause inflammation as the body is working against its own tissues, such as in rheumatoid arthritis.

Dr. Moore uses corticosteroids to provide relief from pain and stiffness. For instance, we inject them directly into joints and into inflamed bursa. We also inject them around tendons that have been strained due to repetitive movements, such as in patients with tennis elbow.

Why are corticosteroids injected?

Taking steroids orally can produce numerous side effects — everything from high blood pressure to insomnia to muscle weakness. Plus, corticosteroids taken by mouth or through an IV aren’t assured of reaching the problem area. Injections, on the other hand, guarantee the inflamed joint or area is directly targeted.

How are these injections used in treatment?

For our patients who are otherwise healthy, but maybe have joint pain from early osteoarthritis, we may use only corticosteroids for treatment. This may be sufficient to calm the inflammation and end the pain.

In other patients with more involved conditions, we may use corticosteroid injections as part of an overall treatment regimen that includes physical therapy, possible occupational therapy, supportive devices such as braces, and possible other anti-inflammatory pain medications. This, obviously, depends on the unique situation of the patient.

If you have joint pain, call us at Pinehurst Surgical Orthopaedic & Joint Replacement Center, (910) 295-0224, and let’s see how we can help.

Protect Your Joints through the Holidays

The holiday season is fast approaching and while it will look different this year depending on where you are and how serious the pandemic is, there are steps you can take to make sure that your holiday habits don’t impact your joint health.

Holiday Eating

We all indulge a bit over the holidays, and that’s not a problem, as long as you strive for balance. If you just have to have the gravy, be sure to add in an extra walk that week. If you choose to splurge on Grandma’s homemade pumpkin pie (and you should), try to have a smaller slice or increase your strength training. And instead of a nap after your turkey dinner, enlist your family in a game of basketball or touch football and get moving. The biggest risk to your joint health is sodium intake, because that causes you to retain water, puts extra pressure on your joints, and can increase the amount of pain you are experiencing.

Keep Moving

Our routines tend to get disrupted over the holidays, but if there is any way to maintain your exercise routine – even if you’re doing different activities – it can be good for your joints. Alternatively, if you’re supposed to be staying off your feet as part of your therapy, don’t let holidays be the excuse you use to not take care of yourself. All it may take is one more wrong twist and knee replacement surgery will be how you greet the New Year.

Keep Arthritis Pain at Bay

Being mindful about what you eat, striving for balance, and getting some exercise can all be good for managing your arthritis pain, too. In addition, be sure to stay hydrated and don’t go overboard on the alcohol. You can enjoy the holidays and have a little fun without overdoing it to such an extent that you suffer more.

If your arthritis or joint pain is no longer responding to traditional therapies, you should make an appointment to see Dr. Moore. For More information about, contact our Pinehurst, NC office, call us at (910) 295-0224, or check out our orthopaedic surgery blog.

Alternatives to Knee Replacement Surgery

Whether you’re trying to put off your knee replacement surgery until you meet your deductible, or you simply can’t take the time off, are there alternatives to knee replacement surgery? While the damage to your knee may something you can live with for some time, eventually, knee replacement surgery will become necessary to prevent you from losing too much mobility in your leg. Until then, we can help you manage the pain and discomfort until you are ready for surgery.

Preventing Aggravation to Your Knee

One of the best ways to minimize your knee pain is to stay off your knee as much as possible. You’ll need to avoid the activities that stress your knee the most, whether it’s racquetball or biking. You can replace your activity with something more congenial to your knee joints, like swimming, because it is still going to be important that you exercise and maintain your health.

Managing Pain

We can help you manage your pain in a variety of ways. Icing and heating the knee can help reduce swelling and stiffness. NSAIDs like ibuprofen can also help to keep your pain and swelling to a minimum to reduce the level of discomfort you experience. If those therapies don’t work, we can give you a steroid injection. You may also benefit from visco-supplementation (a series of injections to the knee joint). Between treating the pain and preventing aggravation to your knee that further exacerbates the old damage, we can extend the time you have left before you are forced to have knee replacement surgery.

When Is It Time for Knee Replacement Surgery?

For many of our patients, the final determinant of when to have knee replacement surgery is a decision based on how much pain you are in and how much you can tolerate. It also depends on your mobility. When your quality of life is more impacted by not having surgery, it’s time to have the surgery.

For More information about Knee Replacement Surgery with Dr. Moore, contact our Pinehurst, NC office, call us at (910) 295-0224, or check out our orthopaedic surgery blog.

How to Avoid Knee Replacement Surgery

The knee is a joint that takes a lot of brutal punishment over the course of a person’s life. It doesn’t matter what activity you’re doing – walking, running, biking, tennis, football, soccer, weightlifting – they all depend on your knees. So how do you avoid damaging your knees enough that you require knee replacement surgery?

What Is Total Knee Replacement Surgery?

Knee replacement surgery is a surgical procedure performed to relieve the knee pain caused by injury, age, or arthritis in the knee.  Here at our Pinehurst, NC surgical center, Dr. John Moore uses a metal-on-plastic artificial knee joint to replace the hinged joint of the knee. While you may not be able to prevent age-related deterioration of the cartilage or arthritis, you may be able to prevent knee replacement surgery from athletic injury and prolong the life of your knee joints through practicing good joint health.

The Key to Healthy Joints Is Exercise

It may seem counterintuitive, but the more you move, the better it is for your joints. Exercise not only keeps you flexible and keeps the tendons and muscles that support your joints in shape, but it helps to keep your weight at a healthy level. Carrying extra pounds makes your knee joints work that much harder.

Protect Your Joints with the Right Gear

Knee pads and knee braces should be worn when needed, whether they’re part of your sports gear or just a precaution. Biking, inline skating, and other activities may not require the gear, but a single accident can injure your knee sufficiently to require knee replacement surgery.

Stretch and Strengthen

Stretching is important, but if you do it at the wrong time, you put your joints at risk. Warm up first and loosen up your muscles with a walk or a 10-minute jog – then stretch. Work on strengthening your core, your leg muscles, and increasing your range of motion.

You may not be able to prevent the need for knee replacement surgery, but you can give your knees their best chance by incorporating these healthy joint habits. For More information about Knee Replacement Surgery with Dr. Moore, contact our Pinehurst, NC office, call us at (910) 295-0224, or check out our orthopaedic surgery blog.

Benefits of Outpatient Joint Replacement Surgery

There are many benefits to choosing outpatient joint replacement surgery at our facility over traditional outpatient surgery at the hospital. Not only do you get to recover primarily from your own home, but there are a number of additional benefits to choosing our outpatient surgery center instead of a hospital.

Patient Experience

You’ll spend one night in our outpatient facility after your joint replacement surgery. That night you will be cared for by our skilled nursing team with a concierge setting. We provide a 2:1 ratio of nurses to patients, so you are more closely monitored and cared for than the standard 1:8 ratio in the hospital.

Reduced Infection Rate

Because you’re not exposed to a hospital setting, you reduce your risk of exposure to everything from staph to COVID-19. Our facility only takes in healthy patients having outpatient surgery and nothing else. Dr. Moore has successfully completed over 100 outpatient joint replacements in the past four years with ZERO hospital re-admissions after outpatient surgery. The Surgery Center at Pinehurst has six operating rooms, two pain management rooms, and provides outpatient surgeries for joint replacement, plastic surgery, ENT, gynecology, and more.

Improved Recovery Times

Because outpatient joint replacement surgeries performed in the centers like the one at Pinehurst require smaller incisions, the risk of infection is reduced, and recovery time is accelerated. Accompanied by our more intimate, concierge-like post-surgical care, detailed communication, and support for both the patient and the family the overall experience and satisfaction of patients is higher, too.

Who Qualifies for Outpatient Joint Replacement Surgery?

Most private insurances will cover the cost of outpatient joint replacement surgery. The facility is limited to healthy, privately insured patients. Unfortunately, Medicare will not cover the outpatient center for this reason.

The Surgery Center of Pinehurst is located across the street from our practice and provides easy access to the facility for patients and their families. Dr. Moore’s team has created a structured guideline and protocol for impeccable preoperative and post-operative care to all of our patients. For more information about Outpatient Joint Replacement Surgery with Dr. Moore, contact our Pinehurst, NC office, call us at (910) 295-0224.

Avoid Injury This Summer

With the warmer weather and we all start spending a little more time outside, it’s a good time to be mindful of the injuries we can sustain after a long, inactive winter. To avoid injury as you resume summer activities, sports, and exercise, heed this advice.

Ease Back into Your Training

Whether you’re an athlete getting ready for a new season of baseball, track, or soccer or a jogger ready to get off the treadmill and back out in the fresh air, there are precautions you should take to avoid an injury that would keep you inactive for weeks or longer.  Be sure to warm up and stretch your muscles before your activity. Listen to your body – if you feel pain or discomfort, moderate the activity or stop.

Wear the Right Shoes

One of the most important ways to prevent injury is to wear the right gear. While that means wearing the proper equipment for your chosen sport (including proper visibility), nothing is more important than the shoes you wear – the right size, the right type of shoe, and the right support structure.

Don’t Overexert Your Body

Unless you’ve been conditioning in preparation for resuming your activities, it’s important to ease into the activity slowly and build up your stamina and strengthen the muscles that support your joints. Early season injuries can be serious – serious enough to require significant downtime or even knee or hip replacement surgery.

Don’t Just Get Physical – Get a Physical

Summer is a great time of year to schedule an annual physical, so that you can clear up any medical issues and make sure you’re in good shape to handle the uptick in exercise you’re planning.

There’s no reason you can’t spend your summer doing things that you love in the outdoors. Just be sure you’re taking steps to take care of your joints along the way so that you don’t get injured. If you are suffering from a knee or hip injury, contact us at our Pinehurst office today or call us at 910-295-0224.

Managing Hip Bursitis without Narcotics

The pain from hip bursitis can limit your mobility, reduce your ability to exercise and stay active, and impact your quality of life. In the past decade, it’s become more common for narcotics to be prescribed to alleviate the pain of hip bursitis.  You don’t need to turn to narcotics to manage your bursitis – there are several other steps you can take to keep the pain under control. Any initial treatment for hip bursitis at Pinehurst Surgical Orthopaedic & Joint Replacement Center is nonsurgical. Certain lifestyle changes can calm the inflammation and relieve the pain.

Switch Up Your Exercise Routine

If you typically jog or play tennis or other impactive sports for exercise, consider switching to a form of exercise that isn’t so hard on the joints – just until the inflammation is under control. Since extra weight can exacerbate hip pain, continuing to exercise is important. Try swimming or cycling.

Ice and Heat Can Improve Hip Bursitis Pain

When symptoms first occur, ice can help reduce pain and swelling, and moist heat is very beneficial during a bursitis flareup. You can soak in a tub or hot tub or use a moist heat heating pad.

Physical Therapy

Physical therapy can help improve hip bursitis. There are a number of exercises and stretches that can improve your mobility and alleviate hip pain.

Ibuprofen Can Help Reduce Inflammation

Ibuprofen is very effective for reducing inflammation. Ibuprofen is not addictive, but care must still be used when taking it. You should not drink alcohol or take more than the recommended dosage, as it can harm your liver.

Cortisone Shots

Pinehurst Surgical Orthopaedic & Joint Replacement Center can provide injections of a corticosteroid along with local anesthetic to relieve your pain. Cortisone injections can provide months of relief or even permanent relief, but this treatment can only be used on a limited basis because it can damage surrounding tissues.

If nonsurgical treatment doesn’t relieve your symptoms of hip bursitis, Dr. Moore may opt for surgery. With hip bursitis, surgery is rarely needed, but in some cases the bursa remains inflamed and painful despite physical therapy and other treatment. Surgery involves removing the bursa. This doesn’t affect the function of the hip and it doesn’t damage the hip.

Dr. Moore prefers to perform this surgery arthroscopically, if possible. He makes a small incision over the hip and a small camera, an arthroscope, is inserted. This provides guidance for miniature surgical instruments to be inserted through a second small incision to cut out the bursa.

For more information about Hip Replacement Surgery with Dr. Moore to reduce your joint pain or improve its function, call our office in Pinehurst, NC at (910) 295-0224.

How to Prepare for Knee Replacement Surgery

Knee replacement surgery is a common joint replacement surgery that can increase your ability to remain active and improve your quality of life. If you’ve been living with knee pain or have needed knee replacement surgery but have been nervous to proceed, you can stop living in pain. Orthopaedic surgeon Dr. John R. Moore and his staff offer relief from the pain with total knee replacement surgery at their surgical center in Pinehurst, NC.

How Is Knee Replacement Surgery Performed?

During your knee replacement surgery, Dr. John Moore will replace the hinged joint of the knee with an artificial knee joint. The surgery will only last about an hour. Recovery time, including physical therapy to build up strength in the leg and range of motion, usually takes about three months.

Before Your Surgery

Before your surgery, you will need to see your primary care physical to review your medical state and ensure you are healthy enough to undergo anesthesia. You may be asked to stop taking medications and supplements up to a week before the surgery, especially supplements like fish oil, vitamins, iron tablets, and calcium supplements as well as anti-inflammatory medications and NSAIDs. You will be asked to attend a patient information class a few days before your surgery to help you prepare.

The Day of Your Knee Replacement Surgery

Most knee replacement surgeries are outpatient procedures, so you will go home after you are sufficiently recovered. This means you do need someone to come with you for the surgical procedure who can drive you home. While the surgery itself only lasts about an hour, you will be in the operating room, pre-op, and recovery room for several hours. Your doctor will work with you to develop a pain management plan that limits or avoids the use of opioids.

After Surgery

In the days after your total knee replacement surgery, you will see a physical therapist the day of your surgery or the next morning in order to develop a therapy plan to regain your mobility and flexibility as quickly as possible. Complying with the therapists recommended exercises is vital. It won’t be long until you are up and moving again and back to your regular activities.

For More information about Knee Replacement Surgery with Dr. Moore, contact our Pinehurst, NC office, call us at (910) 295-0224, or check out our orthopaedic surgery blog.

Joint Replacement Surgery Pinehurst NC

Thanksgiving Foods that Feed Your Joints

The holidays are just around the corner, and with them, tempting foods that will have you testing your self-discipline. One way to encourage your healthy eating habits through the holidays is to remind yourself how THANKFUL you will be to avoid the joint pain that bad habits can cause.

T – Turkey is a lean meat filled with protein that can help you feel full and have enough energy to get through the day of festivities. Just don’t overdo it – a 3-ounce portion (about as much as you could fit in your fist) is all you need.

H – Hazelnuts and other nuts like walnuts are also a great source of protein and polyunsaturated fats, making them good (in small quantities) for your joints and your heart. Studies show that all nuts reduce inflammation.

A – Appetizers can be a great way to keep you from overeating at the Thanksgiving meal. Focus on veggie and fruit trays, which will deliver healthy vitamins and minerals and fiber to fill you up.

N – Navy beans, lentils, and other beans can be added to soups and salads for additional fiber. They are also an excellent source of Vitamin B.

K – Kale and other dark leafy green vegetables should be a staple in your diet if you are trying to keep your joints healthy. Kale a great source of calcium, too, for healthier, stronger bones.

F – Figs are unique in their ability to alleviate joint pain, containing a singularly beneficial flavonoid called luteolin, which is known for its effectiveness as an anti-inflammatory.

U – Unagi, Japanese eel often found in sushi restaurants, is an exceptional source of vitamins. It is also high in Omega-3, essential in the prevention of arthritis.

L – Lemon, whether added to your drinking water or used in other recipes, can help reduce the acid in your joints that can cause pain, especially in people suffering from gouty arthritis.

Your diet is an essential component in joint health and can be instrumental in alleviating joint pain. As Thanksgiving approaches, being mindful about your diet can help you avoid the pain that keeps you from enjoying the day with your family.

It can be hard to know exactly what you should and shouldn’t eat for your joint health. Use the tips in this article to ease swelling and discomfort this Thanksgiving. To learn more, schedule an appointment with us at our Pinehurst office today and call us at 910.295.0224.

Women and Osteoarthritis

A Look Into Risks and Prevention

Osteoarthritis (OA) is the clinical name for “wear and tear” on joints occurring most frequently in knees, hips, and hands. Osteoarthritis impacts millions of Americans but is slightly more prevalent in women. It is estimated that one in five adults has osteoarthritis, 24 million women and 17 million men according to the Arthritis Foundation. Two main factors come into play: gender and genetics.

Gender

Research has shown that female hormones affect the cartilage between bones and joints providing cushioning so the joints can move smoothly. When menopause occurs, estrogen levels drop meaning they lose that extra protection. This has been shown to still be true even in cases where women are receiving hormone-replacement therapy after menopause. A lack of testosterone may also put women at risk. Testosterone is key in building strong muscles which leads to healthier joints.

The amount of full-term childbirths a woman has had also plays a part in the chances of developing knee or hip arthritis. A study of more than 1600 women aged 50 to 79 who had given birth to 5 to 12 children was 2.6 times more likely to have a knee replacement than a woman who gave birth to only one child.

Genetics

If a family member has OA, you are more likely to have it. This has also been shown to be more true with women. If your mother was diagnosed with OA, you will likely experience issues in the same joints around the same age she was. This is especially true in cases of hand and knee osteoarthritis.

So what can I do to avoid OA?

  • Maintain a healthy weight
    • Being overweight or obese adds extra weight on your joints. Losing weight lessens the pressure on those weight-bearing joints and increases your mobility
  • Be active
    • Exercise is an incredible tool for OA, it can increase flexibility, boost your mood, strengthen your muscles and heart, and increase blood flow. If you already have joint issues, try lower-impact exercises such as swimming or yoga to stay active and in shape.
  • Speak up
    • If you are experiencing a lot of pain or interference in your everyday activities, even something as simple as walking down the stairs, let your doctor know

Though it may seem difficult to avoid Osteoarthritis, there are treatment options available to you. If you have any questions or concerns about OA don’t hesitate to get in touch with us at 910.295.0224.