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Dr. Daniel C. Eby

Orthopedic Surgery & Sports Medicine

What are NSAIDs and how do they work?

Written by Daniel C. Eby, DO on . Posted in Treatments.

NSAID is an abbreviation for non-steroidal anti-inflammatory drugs. Most often these medications can be found over-the-counter at your local pharmacy. There are higher strength options available from the provider by prescription, such as meloxicam.

This group of medications works by decreasing the general inflammation throughout your body. NSAIDs can be helpful in treating muscle aches and pains, as well as symptoms from arthritis. 

NSAIDs not only relieve pain, but also help to decrease inflammation, prevent blood clots, and reduce fevers. They work by decreasing an enzyme in our body called cyclooxygenase or COX for short. COX-2 is produced by our bodies to help heal injured or inflamed joints.

When too much inflammation is in a joint, you may experience pain. NSAIDs work to decrease inflammation and pain. 

While very helpful in many diseases, most NSAIDs also decrease COX-1. COX-1 works to protect our stomach and maintain our kidney function. By decreasing COX-1 as well as COX-2, there can be unwanted side effects.

Common Side Effects

  • Throat, stomach and intestinal upset, and ulcers. 
  • Kidney dysfunction
  • Increased bruising

Common NSAIDs

You may recognize them by their generic names:

  • meloxicam
  • ibuprofen
  • naproxen
  • diclofenac
  • celecoxib
  • indomethacin
  • aspirin in high doses

Or you may recognize these medications by their brand name:

  • Mobic
  • Motrin or Advil
  • Aleve
  • Voltaren
  • Celebrex
  • Indocin

Should I apply ice or heat to an injury?

Written by Daniel C. Eby, DO on . Posted in Treatments.

Ice should be used in the acute stage of an injury (within the first 24-48 hours), or whenever there is swelling. Ice helps to reduce inflammation by decreasing blood flow to the area in which cold is applied.

Heat increases blood flow and may promote pain relief after swelling subsides. Heat may also be used to warm up muscles prior to exercise or physical therapy.

What is an epidural?

Written by Daniel C. Eby, DO on . Posted in Treatments.

An epidural is a potent steroid injection that helps decrease the inflammation of compressed spinal nerves to relieve pain in the back, neck, arms or legs. Cortisone is injected directly into the spinal canal for pain relief from conditions such as herniated discs, spinal stenosis, or radiculopathy. Some patients may need only one injection, but it usually takes two or three injections, given two weeks apart, to provide significant pain relief.

What is arthroscopic surgery?

Written by Daniel C. Eby, DO on . Posted in Surgery.

Arthroscopic surgery is one of the most common orthopaedic procedures performed today. Through the use of small instruments and cameras, an orthoapedic surgeon can visualize, diagnose, and treat problems within the joints.

One or more small incisions are made around the joint to be viewed. The surgeon inserts an instrument called an arthroscope into the joint. The arthroscope contains a fiber optic light source and a small television camera that allows the surgeon to view the joint on a television monitor and diagnose the problem, determine the extent of injury, and make any necessary repairs.

Other instruments may be inserted to help view or repair the tissues inside the joint.

What is joint replacement surgery?

Written by Daniel C. Eby, DO on . Posted in Surgery.

Joint replacement surgery is performed to replace an arthritic or damaged joint with a new, artificial joint called a prosthesis. The knee and hip are the most commonly replaced joints, although shoulders, elbows and ankles can also be replaced.

Joints contain cartilage, a rubbery material that cushions the ends of bones and facilitates movement. Over time, or if the joint has been injured, the cartilage wears away and the bones of the joint start rubbing together. As bones rub together, bone spurs may form and the joint becomes stiff and painful.

Most people have joint replacement surgery when they can no longer control the pain in their hip or knee with medication and other treatments, and the pain is significantly interfering with their lives.

How long do artificial joints last?

Written by Daniel C. Eby, DO on . Posted in Surgery.

On average, artificial joints have a lifespan of 10 to 20 years. If you are in your 40s or 50s when you have joint replacement surgery, especially if you are very active, you are likely to need another joint replacement surgery later in life.

What happens during rotator cuff surgery?

Written by Daniel C. Eby, DO on . Posted in Surgery.

Shoulder surgery for rotator cuff problems usually involves one or more of the following procedures: debridement, subacromial decompression, rotator cuff repair.

Debridement clears damaged tissue out of the shoulder joint.

Subacromial decompression involves shaving bone or removing spurs underneath the tip of the shoulder blade (acromion). This creates more room in the space between the end of the shoulder blade and the upper arm bone so that the rotator cuff tendon is not pinched and can glide smoothly.

If the rotator cuff tendon is torn, it is sewn together and reattached to the top of the upper arm bone.

What is an ACL reconstruction?

Written by Daniel C. Eby, DO on . Posted in Surgery.

ACL reconstruction is a surgical procedure that repairs a torn anterior cruciate ligament (ACL), one of the four ligaments that help stabilize the knee. The ligament is reconstructed using a tendon that is passed through the inside of the knee joint and secured to the upper leg bone (femur) and one of the two lower leg bones (tibia).

The tendon used for reconstruction is called a graft and can come from different sources. It is usually taken from the patient’s own patella, hamstring, or quadriceps, or it can come from a cadaver. ACL reconstruction is most often performed through arthroscopic surgery.

What’s the difference between x-rays, MRI and CT scans?

Written by Daniel C. Eby, DO on . Posted in Q and A.

X-rays are a type of radiation, and when they pass through the body, dense objects such as bone block the radiation and appear white on the x-ray film, while less dense tissues appear gray and are difficult to see. X-rays are typically used to diagnose and assess bone degeneration or disease, fractures and dislocations, infections, or tumors.

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