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Medication isn’t the only way to relieve pain.

After an injury or accident, or while experiencing chronic pain, you might try over-the-counter pain relievers or get a prescription for more powerful drugs. Both kinds of pain relievers, however, can have side effects. If you’re going through rehabilitation and dealing with pain, you might want to consider alternative pain relief methods.

Relaxation Techniques

Methods of relaxing the body can reduce pain, especially chronic pain. Some of the specific techniques for achieving relief include:

  • Mindfulness meditation – This calls for focusing only on the current moment, and not judging any thoughts, feelings, or sensations in the body—such as pain.
  • Breathing exercise – This focused breathing is meant to relieve pain. It requires paying close attention to each inhale and exhale, which should be as deep as possible. During breathing exercises, practitioners are encouraged to keep their shoulders and stomach relaxed.
  • Progressive relaxation – Starting at either the top of the head or the toes, patients tighten and then relax the muscles in each major region of the body.
  • Hypnosis – Done either with a trained practitioner or alone, a sequence of steps leads a patient into deep relaxation.


Acupuncture has been used in China for several thousand years to reduce pain. A doctor places thin metal needles into points on the surface of the skin that correspond to the part of the body experiencing pain. Acupuncture has been to shown to help with:

  • Lower-back pain
  • Neck pain
  • Certain headaches


A number of supplements are thought to help pain, especially the pain of osteoarthritis. Some of these include:

  • Capsaicin, the chemical in hot peppers that gives them their heat
  • SAM-e, an amino acid
  • Fish oil, which helps reduce inflammation
  • Glucosamine and chondroitin, which, when taken together, are especially helpful with severe knee arthritis.

Cognitive Therapy

This form of therapy, initially developed to treat various psychological conditions, has also been shown to help patients cope with chronic pain.

When you need rehabilitation to ease pain and restore mobility, Therapy Services at North Hills Hospital are ready to help. For more information about both inpatient and outpatient services, call (817) 255-1672.

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How to Prevent Serious Back Injury

Five Tips for Reducing Joint Pain


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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How to Prevent Serious Back Injury

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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Hear from Alison Parnell, a physical therapist at North Hills Hospital, about ways to improve your posture.

Good posture means that the three natural curves in our spine are in a neutral position. In other words, your spine should not be too rounded or arched. This is important in our everyday activities because the neutral position places the least amount of stress on the body’s tissues. The neutral position also optimizes breathing, circulation and overall function by reducing strain or overuse. Faulty posture can lead to abnormal wear of joints and pain since muscles and ligaments are not working in their optimal position. Muscles and ligaments tend to fatigue more quickly, too.

What Causes Faulty Posture?
Contributors to a faulty posture include a sedentary lifestyle and osteoporosis. Although osteoporosis causes decreased bone density, supplements, diet and exercise can decrease the impact of this disease. For those with a sedentary lifestyle and those with osteoporosis, posture can be improved by strengthening core muscles and increasing flexibility.

How Can Posture Be Improved?
One of the easiest ways to start working on your posture is to sit tall and straight, as if a string is pulling your head toward the ceiling. However, it is important to ensure that you're not overarching your spine when you do this.

To find your neutral spine in sitting, first slouch as much as you can, bringing your shoulders towards your hips, then arch your back as far as you can. Now find the middle of both positions — that is your neutral spine. To help you maintain this position, it is important that your core muscles are able to hold you there for extended periods of time.

One of the most effective exercises to achieve a neutral spine is an abdominal brace. Think of pulling your belly button in toward your spine, without allowing your chest to move. Also be sure to breathe throughout the exercise, as it is easy to forget when holding your stomach in. Hold this for 5 seconds and do 10 at a time. Repeat 2-3 times a day.

For those of you who must sit most of the day, it is important to get up and move around about every 30 minutes. While sitting, you will need a chair with a good lumbar support. Your feet should be flat on the floor or on a stool if unable to reach the floor. Your weight needs to be distributed evenly between your hips. Be sure to keep your shoulders in a relaxed and back position.

Would you like to learn more about Therapy Services at North Hills Hospital? Be sure to visit us online or call 1-855-5NHILLS for a physician referral.

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Knee Injury Prevention Tips from the Experts

This post is part of our series meant to encourage women in various stages of their lives to tune out the noise of society’s demands and find a balance that works for them, which in turn makes their whole families much healthier.

Meet Jennifer – single mom of two, full time physical therapist and community volunteer.

Hi Jennifer! Tell us a little about your family:
I am a physical therapist full time at North Hills Hospital and single parent to two daughters, ages 14 and 11.  I regularly volunteer at River Legacy Living Science Center and Mission Arlington.

What tips do you have for managing your time in the midst of so many responsibilities?
I make lists and keep a detailed calendar.  The list will show what needs to be done today and what can wait.

What are your best tips (or tricks) to get your family to eat healthy?
My daughters help with meal planning and grocery shopping.  When we go to the store, they each get to choose one item.  Last time the older one chose asparagus and the younger daughter cauliflower.  I encourage them to try different things and we find new recipes to try.

How has being a mom made you view sleep/rest differently?
I still make time to get plenty of rest so I can take care of what tomorrow will bring.  This might mean that something may not get done that day, but I will feel better the next day. Rest helps me to stay healthy and avoid illness.

What does a balanced life for you look like?
Having enough time for family, exercise, work and volunteering. 

What advice do you have for fellow women?
Make sure and make time for yourself to do the things you want.  Find out what is important to you.  This will help keep the balance and maintain your sanity.

In honor of organized women like Jennifer, we wanted to give you a free meal planning and grocery list download. Just click on the image to download your very own! This is only intended for personal use – not for resale.

What about you? What other tools do you use to stay organized while running a busy house? We’d love for you to share in the comments, or linke to your own blog post with some good tips.

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 various ways you can manage chronic pain.

Living with pain can change a person's life. Even the simplest, everyday activity can take longer or seem impossible due to the resulting pain and discomfort. Individuals suffering from chronic pain often avoid many favorite activities and social situations since pain can limit most actions. Pain that affects a person's life this way can result in deep depression and a significantly reduced quality of life.

What can a chronic pain sufferer do to manage the condition? Here are some important tips:

1. Seek medical help. You should not have to live with chronic pain. Be sure to seek advice and assistance from medical professionals. Your physician will help find the root cause of your pain. Once the source of the pain is determined, then a plan to reduce or end that pain can be created. A combination of techniques may or may not work best depending on your particular diagnosis.

2. Discuss medications with your physician. While pain medication will not cure the cause of the pain, it can ease pain in your daily routine while you and your physician work to find a way to treat the cause. Over the counter (OTC) medications may be all that you need, or your physician could prescribe a medication. Whether it is an OTC or prescription drug, be sure to follow dosage instructions carefully.

3. Discuss the benefits of physical therapy. You may think that moving more would cause your body more pain. However, many causes of pain can be significantly relieved under the careful guidance of a physical therapist. There are therapies for a number of medical conditions, some of which may surprise you, so be sure to discuss this option with your physician.

4. Consider other non-medicated pain relief options. Relaxation techniques, biofeedback, acupuncture, meditation and other specialized therapies may be very successful ways to manage your pain.

Would you like to read more about our suggestions for pain management? Visit our online Health Library here. If you would like to meet with a North Hills Hospital physician or physical therapist, we recommend that you call us for a referral today at 1-855-5NHILLS. No one should have to live with chronic pain and we are here to help you find immediate relief.

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.

Learn more about the benefits and importance of hand therapy

Chances are you used your hands to click open this blog post. In fact, your hands have probably been hard at work all day accessing information on the computer, tackling daily chores and assisting with almost every single thing that you do. We know the importance of caring for hands, and here at North Hills Hospital, we offer hand therapy for a number of debilitating conditions.

In honor of Healthy Hands Week, Heidi Hutchings, an occupational therapist and certified hand therapist at North Hills Hospital, has shared five interesting facts about hand therapy.

Did you know …

1. Hand therapy treats upper extremity disorders including:

  • Carpal tunnel syndrome
  • Fractures of the upper extremity
  • DeQuervain's
  • Trigger fingers
  • Trauma to tendons
  • Burns
  • Dupuytren's contracture
  • Dislocations
  • Boutonniere deformity
  • Fibromyalgia
  • Infections
  • Nerve compression syndromes (tennis elbow, golfers elbow, cubital tunnel, carpal tunnel syndrome)
  • Amputations and replantations
  • Birth defects
  • Rotator cuff disorders
  • Bursitis
  • Tendonitis
  • Thoracic outlet syndrome

2. A CHT is a certified hand therapist, and each therapist must have 4,000 hours of experience with treating upper extremity (shoulder, elbow, wrist and hand) diagnosis. Therapists must also pass an extensive examination process.

3. There are only 5400 CHTs in the world.

4. Hand surgeons refer patients to CHTs because they have specialized knowledge about the complex nature of the anatomy in the hand and upper extremities. They also know which repeated therapies and exercises can effectively treat various conditions.

5. Along with hand therapy, North Hills Hospital offers patients physical therapy, occupational therapy, speech / swallowing therapy and wound care. As a result, a comprehensive plan for hand care and recovery can be created for each patient's individual condition.

For more information about our inpatient and outpatient hand therapy services, contact us at (817) 255-1672. For a physician referral at North Hills Hospital, please call 1-855-5NHILLS.

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Knee Injury Prevention Tips from the Experts
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Whether you're an athlete recovering from a sports incident or a patient recovering from an unfortunate fall, knee injuries can be extremely debilitating and painful. Mobility and daily activities become limited due to pain and internal damage in the knee. To prevent these types of injuries from happening, we would like to offer some important insight about knee injuries and how you can prevent them. We spoke to Rebecca Thomann, North Hills Hospital's Joint Replacement Program Coordinator and a physical therapist, to find out more about knee injury diagnosis, treatment and care.

What are the most common knee injuries?
They include:

  • Strains of various ligaments around the knee including Anterior cruciate ligament (ACL), Posterior Cruciate Ligament (PCL), Lateral Collateral (LCL), Medical Collateral (MCL).
  • Tears of various ligaments around the knee including ACL, PCL, LCL, MCL
  • Meniscus tears (lateral and/or medial) or torn cartilage in the knee
  • Patellar (knee cap) dislocations
  • Fractures
  • Patella femoral syndrome (pain on the inside of the knee and below the kneecap)
  • IT band friction syndrome (pain on the outside of the knee)

Who experiences the most common knee injuries?
Knee injuries occur at all ages. Generally, osteoarthritis type knee injuries occur most often in older populations. High school and College aged females are most likely to sustain an ACL tear (ligament in the knee). Eighty percent of knee injuries result from torn ACLs (which is a tear in a ligament found in the knee). One in 3,000 people will face an ACL tear in their lifetime. Those who play sports that include cutting and other fast changes in direction have an increased risk for knee injuries. These sports include soccer, basketball, volleyball, and tennis.  Also sports with high levels of contact such as football increase the risk of knee injury.

When do you know your knee injury is serious?
If your knee isn't functioning as it should, be sure to seek medical treatment. Serious knee damage is likely when people:

  • Can't put weight on the knee
  • Struggle with their knees giving out or locking
  • Can't climb stairs without experiencing pain
  • Do not have a full knee range of motion

How do you treat knee injuries?
Injured knees need to be rested to reduce swelling, along with the following:

  • Protection
  • Rest
  • Ice
  • Compression
  • Elevation
  • Modalities
  • Medicine
  • Support

Other treatment options include prescribed medication, physical therapy and surgery. For those struggling with osteoarthritis, some alternate knee treatment options would include:

  • Physical therapy (often including aquatics)
  • Injections from a physician
  • Minimally invasive arthroscopic knee surgery
  • Total knee replacement (followed by several weeks of physical therapy)

When is surgery needed to treat a knee injury?
Knee injuries must be considered on a case-by-case basis to determine whether they should be treated with physical therapy, surgery or a combination of both. Surgery is always the last resort and may not be the best treatment for the specific injury. Physical therapy can help the knee build more strength, which takes pressure off injured ligaments, cartilage, or bone. Therapy can also help retrain muscles to ensure proper firing of the muscles and aid in the symmetry of muscle forces allowing decreased strain to the tendons and ligaments.

Ligament tears are considered for surgery more often in younger patients but, even then, may only be considered if physical therapy has not improved their condition.

Cartilage tears are often treated with arthroscopic surgery to clear away floating debris or help improve the knee's function. Physical therapy typically follows to help rebuild muscles around the knee for maximized support.

Breaks may require surgery if pins are needed to keep bones in place during the healing process. Otherwise, using the self-treatments above, followed by physical therapy, is beneficial.

Older patients with knee conditions due to osteoarthritis may be good candidates for arthroscopy or joint replacement surgery. These are considered on a case-by-case basis and only if all other treatment options have been exhausted.

How can I prevent knee injury?
Our expert suggests the following tips to avoid unnecessary pain and damage from knee injury:

  • Train for the activity you plan to do.
  • Cross train, which includes strength training, stretching, core training, and proprioception activities. IF participating in cutting sports, you should include plyometrics in your cross training routine.
  • When training, watch your alignment carefully. Your feet, knees, hips and shoulders should line up.
  • If you are a long-distance runner, watch how fast you increase your mileage. It should increase no more than 10% a week.
  • If you have pain, stop what you are doing.
  • Stay active and make physical fitness a priority.
  • Ask for advice! North Hills Hospital's physical therapists can train you in injury prevention or help you get started on an exercise program that is right for you.
  • If you are in a high-risk sport for ACL tears, such as soccer, basketball, volleyball, or football, we have a therapist certified in an ACL tear prevention program that is backed by research (Sportsmetics).
  • We are a certified Joint Replacement Hospital by JACHO.

North Hills Hospital provides the Northeast Tarrant County community top-notch therapy services to assist patients on an inpatient and outpatient basis. We offer physical therapy, occupational therapy, speech / swallowing therapy, and wound care. To find out more about patient therapy options, please visit us online or call 1-855-5NHILLS for a physician referral.

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