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If you need back surgery, here are some things to consider.

Thanks to minimally invasive techniques, back surgery is easier and less painful than ever before. But surgery still presents patients with challenges as they recover, especially for more involved spinal procedures, such as removing bone spurs or fusing two bones. Here's what to expect if you or a loved one will be undergoing back surgery.

Pain Management

For any back surgery, you can expect pain for several days or more. If your surgery was to relieve pressure on nerves, you might still feel pain, numbness, or weakness along the affected nerves. In the hospital, you’ll most likely receive intravenous pain medication. When you go home, your doctor will give you a prescription for medication you'll take orally.

Wound Care

The site of the surgery will be sutured for up to two weeks. You should check the wound to see if it:

  • Begins to open
  • Feels warm
  • Looks red or swollen

In rare cases, the wound may get infected. Signs of infection include:

  • High temperature
  • Chills
  • Redness or swelling around the wound

Contact your doctor if you have symptoms associated with an infection.

Physical Activity

Depending on the type of surgery, activity might be limited for several weeks to several months. Some considerations include:

  • If you’re given a back brace or support, be sure to use it.
  • Don't ride in a car, even as a passenger, for two weeks.
  • Bend at the knees, not the waist.
  • Don’t lift or carry anything over ten pounds.
  • Limit walks and the use of stairs in the first two weeks after surgery.

Physical Therapy

Your doctor will give you exercises to strengthen your muscles, and in some cases he might recommend seeing a physical therapist.

When to Call the Doctor

Call your doctor if you develop an infection. Symptoms might include:

  • A wound oozing green or yellow fluid
  • Losing feeling in your limbs
  • Chest pain or shortness of breath
  • Worsening pain

At North Hills Hospital, we’re proud to offer a state-of-the-art Orthopedic Surgery Center with skilled spinal surgery staff. If you’d like a physician referral for any kind of orthopedic care, call 1-855-5NHILLS.

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Surgical Options for Back Pain


Depending on the cause of your pain, both treatments could be necessary.

You reach overhead for something, and pain shoots through your shoulder. Or maybe even when your sitting still, you feel an ache. What we call the shoulder is made up of three bones and many tendons and muscles, and problems with any of them can lead to shoulder pain.

In 90 percent of shoulder injuries, patients respond to non-surgical treatments. Other times, surgery is necessary. Here’s a look at some common shoulder problems and how they’re treated.

Arthritis in the shoulder is commonly treated with one or more of these:

  • Changes in physical activity to reduce pain
  • Physical therapy exercise
  • Injections of corticosteroids
  • Application of ice and/or moist heat
  • For rheumatoid arthritis, prescription medication

In some cases, doctors perform arthroscopic surgery to clean out the joint. In extreme cases, a doctor might recommend a shoulder joint replacement.

Inflammation and Tears
In the shoulder, tendons and sacs of fluid called bursas can become inflamed. Shoulder tendonitis and bursitis are usually treated the same way as arthritis.

The muscles and tendons around the shoulder form the rotator cuff. When a tear occurs in the cuff, half of patients use the non-surgical treatments described above to reduce pain. Surgery is most often recommended if:

  • The tear is a result of an acute injury
  • The tear increases in size
  • Pain lasts more than six months
  • There is major loss of use of the shoulder

With a one-time dislocation, a doctor pops the upper arm bone back into the shoulder joint. Afterward, physical therapy helps reduce risk of recurrence. But if dislocations become frequent, surgery is often recommended.

Surgery, including the insertion of pins or plates, can be an option, depending on the type of break. In some cases, simply wearing a sling is enough to let the bone heal. In either case, exercises to strengthen muscles are the norm.

Whatever is causing your shoulder paint, the Orthopedic Surgery Center at North Hills Hospital is ready to help. Our staff includes surgeons, physical therapists, and occupational therapists. Give us a call at (855)-5NHILLS for a physician referral.

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Learn how to protect your back and prevent serious injury.

Serious back injury can lead to long-lasting pain and disability. Regardless of your age or health status, it's important to adjust your lifestyle and habits to prevent back injury since many injuries are preventable. Take time to learn how to move and lift safely.

Promote ergonomics at work
Many jobs involve strain to the back and risk of back injury. Whether you work on an assembly line, at a computer or you spend all day lifting heavy kids, consider ways to avoid getting hurt. If applicable, talk to your workplace about promoting ergonomics. The best way to avoid back injury at work is to modify the work environment and work tasks to reduce the hazards of lifting. This can be done in many ways, but a large component involves educating workers on how to lift properly.

Learn to lift
Even if your job doesn’t generally consist of lifting heavy objects, you’ll probably be confronted with bending and lifting at some point. Carefully check an object before you lift it. How heavy is it? Can you get a good grip? As you lift, ensure the following actions:

  • Don’t twist while lifting.
  • Try to carry the object between your waist and shoulders.
  • Warm up and cool down with stretches.
  • Take breaks if you’re lifting for an extended period of time.

Stay fit
To prevent back injury, keep the muscles of your back and core strong. Strength training is an important part of any adult’s fitness routine. Lifting weights can help improve back pain as well as other issues like weight management and sleep. If you don’t know how to lift weights, get help at your local gym or consider taking a group fitness class that involves weight lifting.

Dealing with back pain or injury? North Hills Hospital offers patients minimally invasive technology for spine surgery. Learn more about your options here. To request a physician referral, please give us a call at 1-855-5NHILLS.

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Surgical Options for Back Pain

Find out if joint replacement surgery can help you recover from pain and immobility.

Arthritis is a common ailment in the United States, causing millions of people pain. According to the Centers for Disease Control and Prevention, one in five adults report having been diagnosed with arthritis. For some people, conservative treatments aren’t enough to relieve pain and improve quality of life. In those cases, joint replacement surgery may be the best option.

Here are some reasons why you may be a candidate:

  • You’ve tried conservative methods such as pain medication, physical therapy, light exercise, losing weight and massage. These methods aren’t enough to help.
  • Your pain is in your hip or knee. These are common areas of the body for joint replacement procedures.
  • Your pain is severe. Because of chronic pain, you have difficulty walking, taking stairs, lifting things or getting out of chairs. You’re uncomfortable even when at rest.
  • You have a joint deformity. If the structure of your joint itself has a problem, surgery may be the only way to repair it.
  • You’re reasonably healthy. Joint replacement is major surgery and isn’t right for everyone. Those with diabetes and other conditions may not be ideal candidates.
  • You’re ready to do the work. After joint replacement surgery, you become your best treatment option. You must adapt to using a cane or walker while you heal. You must participate in physical therapy to get your new joint in working order.

At North Hills Hospital, the Joint Replacement Program offers pre-operative education sessions to help you prepare for surgery. To learn more, call the North Hills Hospital joint replacement resource line at (817) 255-1691. If you would like to request a physician referral, please call 1-855-5NHILLS.

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From a Patient’s Perspective: Knee Joint Replacement

Dr. Jeffrey Phelps, the Medical Director for North Hills Hospital’s Spine Program, understands just how common and debilitating back pain can be. In fact, the large majority of most adults will experience some type of back pain in their lifetime. While the causes of this type of pain can vary, Dr. Phelps shares some important insight on our blog today about back pain treatment.

What are the common causes of back pain?
Dr. Phelps explains that the majority of back pain cases are usually due to arthritis or muscle strain and sprain. Both of these causes are typically inoperable but do respond to specialized physical therapy exercises and medication. Back pain that results from a pinched nerve may not be relieved without surgery, however. Be sure to get your back pain evaluated by a specialist to find out the cause and to determine an appropriate treatment plan.

When is back surgery necessary?
If physical therapy and medication do not resolve the condition, more invasive procedures may be considered. Dr. Phelps recommends getting an immediate evaluation for surgery if a patient experiences the following:

  • Pain that does not improve over time
  • Pain that worsens over time
  • Muscle weakness
  • Difficulty walking
  • Numbness in the feet or legs
  • Bowel or bladder difficulties

What is minimally invasive back surgery?
According to Dr. Phelps, there have been significant medical advances in back surgery during the past 5 to 10 years. Minimally invasive procedures offer patients the following benefits:

  • Shorter recovery periods
  • Immediate treatment as opposed to extended treatment periods
  • Lower risk of infection
  • Smaller incision sites and less scarring

For those who can't tolerate traditional surgery or extensive anesthesia, minimally invasive surgery offers these patients a chance at back pain relief, also.

What can patients expect from recovery?
Along with a shorter recovery period, patients who have had surgery to relieve a compressed nerve will feel 90% better within one day. Dr. Phelps explains that nerves do need time to heal from extended compression. But newer surgical techniques now allow patients to resume normal daily activities within days to weeks.

Who are the back pain experts?
Dr. Phelps advises patients with back pain to do their research and seek out medical care from qualified, fellow-trained spine surgeons only. Beware of gimmick offers that promise back pain relief.

North Hills Hospital specializes in non-invasive techniques for back pain relief and minimally invasive spine surgery. Our physicians will review each patient's unique condition and offer conservative treatment options before considering surgery. If you would like to meet with Dr. Phelps, please call 1-855-NHILLS for a physician referral.

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When Do You Need to See an Orthopedic Specialist?

Learn how to prepare your teen for anterior cruciate ligament reconstruction.

Any kind of surgery can be scary for kids–and surgery resulting from a sports injury is no exception. Unfortunately, an ACL tear is a common sports injury and female athletes are 4-6 times more likely to experience one. ACL surgery requires follow up with physical therapy and the use of crutches, so it’s especially important for parents and doctors to appropriately counsel a teen on what to expect.

Go over the procedure in detail
Ask your teen’s doctors for pamphlets and handouts to help explain ACL surgery. Teens are old enough to be informed in detail, including risks. Explain that the anterior cruciate ligament (ACL) is found in the knee and is one of the major ligaments connecting the thigh bone to the shin bone. Be sure to share that surgery is the only way to keep the knee stable again. It’s important to establish trust with your child by being upfront and clear about aspects of ACL surgery that may be painful, such as the initial recovery. Ask your teen’s doctor if photos or video of the procedure will be available to share after the surgery. Talk about aftercare, including time spent on crutches and physical therapy.

Soothe your teen’s fears
The risks of surgery may give your teen feelings of anxiety. Talk to her about stress management techniques like light exercise, stretching and meditation. Let your teen know that her doctor has performed ACL surgery many, many times in the past. While it’s a serious surgery, it’s very common and has been well-researched and documented. Remind your teen how much better she’ll feel after recovery.

Focus on your teen’s responsibilities
According to Medline Plus, therapy after ACL surgery can last 2-6 months. Most patients should not expect to return to sports for 6-9 months. It may be challenging for a teen to meet PT appointments and follow up with the appropriate exercises and aftercare at home. Remind your teen frequently about two very important points:

  1. Physical therapy is critical for preventing reinjury and restoring the knee's function.
  2. The more dedicated your teen is to physical therapy, the better and faster the injury will heal.

It is important that your teen focuses on obtainable goals set throughout recovery in order to see her progress and commit to the long-term benefits.

At North Hills Hospital, we have therapists on staff designated as Orthopedic Certified Specialists; only 3% of Texas therapists have achieved this designation. In fact, one of our therapists has completed specialty training in ACL injury prevention and rehabilitation. Find out more about our experienced staff of therapists, surgeons and the services we provide here. For a physician referral, please call 1-855-5NHILLS.

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Find out whether therapy or surgery is a better option for your back pain.

Chronic back pain is extraordinarily debilitating and can abruptly put an end to everyday tasks that many of us take for granted. No one should have to live with back pain like this. But can you find relief with less aggressive methods for pain management, such as medication and therapy? Or is surgery your only hope? Here are some points to consider:

Every person's back pain is unique.
It is important to remember that the cause of your back pain and how it physically affects you is unique. Even if it is a common condition, some people experience or cope with pain differently than others. Common causes for back pain include:

  • Bone fracture
  • Herniated disc
  • Spinal stenosis
  • Sciatica
  • Spondylosis
  • Arthritis
  • Strain

Try less aggressive methods first.
Before surgery is ever considered, many physicians aim to treat back pain with less invasive methods. These methods include:

  • Rest. A patient may be encouraged to rest the back for a short period of time so that any muscle damage has time to heal.
  • Medication. A course of treatment may aim to relieve pain or reduce muscle spasms.
  • Physical therapy. Patients are taught to use specific exercises that are designed to build muscle strength around the spine and reduce strain on the problem area.
  • Education. It is important that patients understand which activities or movements may increase back pain or worsen a specific condition.
  • Psychological therapy. Patients are taught ways to relax the body or decrease any causes for anxiety that may affect muscle pain or spasms.

When to consider surgery.
There are many types of surgical treatments used to relieve back pain, and some are more invasive than others. Your physician may recommend some type of back surgery if:

  • Back pain causes incontinence or leg weakness. These are signs of an emergency condition and usually require immediate surgery.
  • Less aggressive methods are not providing any relief.
  • Back pain is worsening, even after trying less aggressive methods for pain relief.
  • Back pain significantly interrupts daily activities over a long period of time.

North Hills Hospital can offer you relief.
Here at North Hills hospital, our spine surgery program carefully diagnoses and treats your specific condition. Our Therapy Services can help reduce your back pain by offering the least invasive methods of treatment first. For patients who do require surgery, we offer a number of microscopic and minimally invasive spine procedures to bring our patients relief.

Would you like to meet with a back specialist to determine the best course of action for you? Call 1-855-5NHILLS for a physician referral.

Has this happened to you? You began a new exercise regimen or joined a weekend sports league with the best intentions of becoming more physically active. But instead of getting fit, you got hurt. Maybe you twisted a joint suddenly, over-exerted yourself or fell wrong – but now you’re in pain and there’s a lot of swelling to go along with it. What do you do? We interviewed Dr. Scott Wenger, an orthopedic surgeon here at North Hills Hospital, and asked him when it’s time to seek out an orthopedic specialist after a patient experiences a sports-related injury.

Know Your Body

Stresses and strains are par for the course during physical activity and dependent on each individual’s fitness and flexibility. You know the difference between normal body aches and a potential injury better than anyone. If you do experience an injury, Dr. Wenger suggests that you do the following:

  • Stop all activity immediately and do not “play through” any pain.
  • Follow the “R.I.C.E.” method: rest the injury, ice it, use compression with an elastic or ACE bandage and then elevate it.
  • If the injury does not improve in a day or two, see a physician.

The Warning Signs

Once you meet with a physician, you may discover that a specialist is recommended. Dr. Wenger explained that there are some specific warning signs that may indicate the need for immediate specialized care. These include:

  • Persistent joint swelling
  • A decreased range of motion
  • An obvious deformity
  • Joint instability
  • Failed improvement

Your primary care physician will likely order an x-ray to determine the extent of the damage. If your injury does need the attention of a specialist, you will receive a referral.

Avoiding Injury

Dr. Wenger offered some important suggestions to avoid serious injury in the future. Be sure to:

  • Warm up and stretch before all physical activity, and then cool down and stretch again afterward.
  • When beginning a new workout routine, start slowly and acclimate your body to increased activity over time.
  • Engage in cross conditioning and core stability workouts to build muscle strength in joints and increase stability. Total body conditioning will allow for more mobility and flexibility during strenuous activity, which may lessen the possibility of injury.
  • Remember that age and physical fitness do affect your risk of injury. Weekend warriors who suddenly exert themselves like they did 20 years prior could put themselves at great risk for injury.

Do you have questions about how to prevent sports injuries? Would you like to schedule an appointment with a physician who specializes in orthopedics or sports medicine? Please contact North Hills Hospital at (817) 255-1000. To request an appointment with Dr. Wenger, please call (817) 616-0700 or visit his website.

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Injury prevention for that little soccer star in your family

Larry Weiss, a retired postmaster, knew something had to be done when the pain in his first knee got as bad as it did.

“The pain was severe; I knew it was bone on bone.”

Larry found Dr. Thomas Carrell through friend recommendations, and his fears were confirmed. An x-ray and consultation verified that he needed a knee joint replacement and he scheduled his first procedure with Dr. Carrell in Killeen, Texas.

When Larry’s second knee started to show the familiar and painful signs of joint deterioration just like his first, he didn’t want to put it off any longer than necessary and knew Dr. Carrell was the answer. This time, Larry followed him up to North Hills Hospital for his procedure, where he now works as an orthopedic surgeon.

We asked Larry about his second knee replacement and his experience at North Hills.

How did you feel before the surgery? Did you have any concerns about the procedure?
I really had a great experience. I knew Dr. Carrell from my first procedure and I consider him a friend now, so I trusted him and knew how it would go. But the folks at North Hills still explained everything and told me what to expect from my surgery. They assigned me a very nice person who took me through the entire experience. They answered all of my questions and I really felt very comfortable going into surgery.

How did the procedure go?
My procedure wasn’t very long, about 3 hours or so. By that evening, I was eating and drinking and really didn’t need much pain medication at all. They also set me up with a machine that slowly flexed and moved my knee. I had great results and I think it helped my recovery a lot. I’ve had friends who didn’t get to use one after surgery and they didn’t recover as quickly as I did. The day after surgery, they had me up and walking with a walker. They let me go as far as I could walk and let me do as much as I was comfortable doing.

How was your recovery from surgery?
After two days in the hospital, I went home and then used a walker for about another week. But Dr. Carrell set me up with a therapist who could either come to my home or see me at the hospital. So, for three weeks, a therapist came to my home and helped me recover use in my knee. But once those three weeks were over, I was all set to do anything I wanted to do.

How do you stay active?
I’m a retired postmaster and now live on a 150-acre ranch where I restore antique cars and keep them in barns that I maintain. I also have an insurance agency that I run with my son. I’ve got plenty to do, but my knees don’t slow me down anymore.

We are so glad to hear that Larry is back up to speed and staying busy on what seems like a small slice of heaven in his part of Texas. If you have any questions about knee joint replacement, our Orthopedic Surgery Center, or our dedicated staff of physicians, surgeons, nurses and therapists, please call (817) 255-1000 or visit our website here.

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Donna has always been active, and it takes a lot to slow her down. Running was her exercise of choice for a long while, and she taught aerobics classes for 13 years. But about three years ago, she began to experience incredible pain.

When she was in her teens, Donna was in a car accident that dislocated her left hip. Back then, rehab was not a common option, so she healed just by using crutches. As time went by, this injury continued to haunt her, causing her hip to periodically lock up.

Her hip pain grew worse, and she began to lose her range of motion. She could barely get dressed, and she couldn’t put on her shoes or lean down. She found herself walking with a limp and soon she was hunched over. Being in this condition was frustrating for her. “I couldn’t do things with my kids and grandkids. Even going to the mall was impossible,” Donna explains. “I hurt so much that it affected my relationship with my husband, too.”

One day, Donna’s husband saw an ad for a joint pain seminar at North Hills Hospital, and she decided to attend. There she met Dr. Thomas Carrell, an orthopedic surgeon, and she began to learn about joint replacement surgery.

Next, she made an appointment with Dr. Carrell, and after he took x-rays, he explained how her hip had been damaged. There was little cartilage left at all, so her joint was basically bone on bone, which accounted for the pain she was experiencing. “I can’t live like this anymore,” Donna said to herself. She agreed to have hip replacement surgery in April 2010.

Right after having the surgery, Donna remembers that her left leg felt so heavy, “like it weighed two hundred pounds.” But she was determined to follow the recovery instructions to the letter. She even stood and shuffled a few steps the evening after the surgery. From there, she used a walker for two weeks, and then transitioned to a cane. She faithfully performed all the exercises she had been taught, so she could build up her strength and regain her range of motion.

She had been advised that her recovery would take about six weeks, but she returned to work after three. And after four weeks, she was feeling much better.

These days, Donna is back to working out four times a week. She doesn’t run anymore, but she uses the elliptical machine and the treadmill, and she cycles. She also enjoys “water walking” in the pool and lifting weights.

As for other people considering joint replacement, Donna advises that they learn as much as they can before the procedure. She attended a “joint camp,” where Dr. Carrell and his staff walked patients through the process and helped them understand what to expect. “Learning everything that you can beforehand is key,” she says. “And write down your questions so you don’t forget.”

Now more than a year after the surgery, Donna says, “The doctors, nurses, and other staff at North Hills were just terrific. If I could give them a score above 100, I would! Without this surgery, I think I’d have been in a wheelchair by now. But I know that I if I take care of myself, this new hip will outlast me. I’m so glad I had it done. I feel wonderful.”


Interview with patient

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