Herniated Disc Symptoms vs. Spinal Tumor: Symptom Comparison
“Both herniated disc and tumors can present with symptoms that are consistent with the nerve compression,” says Charles Park, MD, Director of The Minimally Invasive Brain and Spine Center at Mercy Medical Center in Baltimore.
“However, the pain from herniated disc gets better with rest, but the pain from tumor may get worse at night, laying down,” adds Dr. Park, a neurosurgeon.
Will the pain from a tumor subside, however, with daytime rest, as in resting in a recliner chair?
Dr. Park says, “Usually, pain from tumor does not get better with daytime rest.”
However, he adds that heat, ice, ultrasound and massage will yield temporary relief of pain.
What symptom description might a patient tell a neurosurgeon/spine surgeon that would make the surgeon suspect a tumor vs. a herniated disk?
“The most important is the pain that doesn’t get better with rest at night.” says Dr. Park.
Resting at night in bed relieves the area of the forces of gravity.
When a Doctor Suspects Cancer
When doctors are presented with a patient complaining of pain that seems to be from a herniated disc, the doctor doesn’t automatically suspect cancer unless the patient reports that it does not respond to rest and gets worse at night.
“The spinal tumor is much less frequent than the disc problems,” says Dr. Park.
Tumors in the spine account for about 10-15% of all central nervous system tumors.
Primary spinal cord tumors, which originate in the spine itself, are even rarer, with an estimated incidence of two to 10 cases per 100,000 people annually.
These can occur in the spinal cord, nerve roots or surrounding structures.
Interestingly, most spinal tumors are the result of a primary cancer elsewhere in the body that hahs spread.
However, primary spinal tumors are often benign — but can still cause serious symptoms due to their location.
Because they are rare, diagnosis may be delayed, especially in early stages when symptoms, such as back pain, can mimic more common conditions — such as a herniated disc.
“But when we order MRI for disc problems, the tumor will be visible as well, if present,” says Dr. Park.
Dr. Park specializes in minimally invasive surgical techniques for treatment of conditions affecting the brain and spine. He’s skilled in advanced procedures and techniques that utilize innovative computer technology and image-guided surgery systems.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
Migraine Headache vs. Chronic Subdural Hematoma
A neurosurgeon says there is one distinguishing feature between a migraine headache and chronic subdural hematoma head pain.
Chances are, if you have a chronic subdural hematoma, you might remember in your recent history getting hit on the head or bumping your head hard on something.
But some patients with cSDH are unable to report the head trauma that caused it.
This is because sometimes, the “trauma” seemed insignificant at the time, such as a run-of-the-mill bonking the head on the car door frame when getting into the car. It’s noticed at the moment, but is quickly forgotten.
Five weeks later when the headache from the chronic subdural hematoma arises, the patient does not link it to the little mishap with the car door frame.
And all it takes is this seemingly minor trauma to induce a cSDH in an elderly person.
But a person over age 60 may also have migraines, and people younger than 60 can get a chronic subdural hematoma.
“One distinguishing feature is that the headache from cSDH is worse in the mornings,” says
Charles Park, MD, Director of The Minimally Invasive Brain and Spine Center at Mercy Medical Center in Baltimore.
He is a neurosurgeon and continues, “Migraine headaches are severe, and associated with light, sound, etc., and usually unilateral.” That means one-sided.
“At night, when we lay flat, there is an increase in venous blood return to the heart and increase in venous pressure. so, the soft structures, such as discs and nerves and brain, get swollen or get larger, which causes a bit more pressure on the brain and this causes worsening headache.”
What about onset of migraine?
Is it always gradual? Or can it be sudden?
“Depends on the type of migraine headaches, but usually the onset of migraine headache is much faster than chronic subdural hematoma, which develops over days,” says Dr. Park.
There are exceptions to the rule of developing over days, however.
My mother was diagnosed with a cSDH six weeks after she fell and hit her head.
She awakened one morning with a horrible headache.
The day prior, going all the way back six weeks, she had not had any headaches.
Even when she got into bed the night prior, she felt perfectly fine.
Sometimes, the brain does not act in ways that we think it should.
Like that old saying goes, “If the human brain were simple enough for us to understand, we’d be too simple to understand it.”
Dr. Park specializes in minimally invasive surgical techniques for treatment of conditions affecting the brain and spine. He’s skilled in advanced procedures and techniques that utilize innovative computer technology and image-guided surgery systems.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/Prostock-studio
Risk of Chronic Subdural Hematoma in Elderly Who Exercise
A chronic subdural hematoma is a gradual brain bleed that’s common in the elderly.
Can exercise bring this on, being that sometimes exercise involves jarring or erratic movements?
Perhaps you know that a whiplash-type movement of an elderly person’s head can actually cause a very slow bleeding in the brain: the chronic subdural hematoma.
The bleeding does not occur immediately, as would be the case of the far more life-threatening acute subdural hematoma.
A whiplash can result from a fender bender or even a fall in which the person’s head doesn’t even strike anything, but it gets jerked enough to tear a tiny blood vessel in the brain.
Although whiplash is commonly associated with neck pain and stiffness, the impact on the brain can also cause invisible injuries such as a headache, and of course, a gradual bleed in the brain.
So maybe this has you thinking that you’re at risk for a chronic subdural hematoma if your older age is combined with some kind of physical activity that jars the body (and therefore head) around:
- Horseback riding
- Mini-trampolining
- Dancing
- Jumping (rope, jacks, box)
- Running, jogging, skiing
- Step aerobics class
Good News for Aging Exercisers
“I have not seen a chronic subdural hematoma on an elderly patient due to exercise,” says Charles Park, MD, neurosurgeon, and Director of The Minimally Invasive Brain and Spine Center at Mercy Medical Center in Baltimore. “It’s usually due to a fall or head bumps.”
Dr. Park says it is okay for people in the senior citizen age bracket to take aerobics classes, do jumping drills and the like.
A person age 60-plus is more likely to suffer a head injury falling off the horse than from the movement of sitting on one.
Senior age men and women should just be aware of the surface they are walking on (at stores, parking lots, slick floors at bowling centers) to prevent a slip/trip-and-fall — which could cause a head injury such as a subdural hematoma.
These surfaces can become hazardous, especially if they are wet, uneven or poorly maintained.
To minimize the risk of falls, seniors should avoid walking on slippery or uneven surfaces whenever possible and use handrails or other supports in potentially hazardous areas.
Meanwhile, they can exercise, jump and run to their heart’s content.
Dr. Park also points out, “Roller coaster with sudden change in direction is not recommended.”
The G forces involved here do not compare to those involved in exercise, including jumping on a mini-trampoline.
That sudden and fast change of direction can simulate a whiplash — leading to a slow brain bleed.
Dr. Park specializes in minimally invasive surgical techniques for treatment of conditions affecting the brain and spine. He’s skilled in advanced procedures and techniques that utilize innovative computer technology and image-guided surgery systems.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/Mladen Zivkovic
Traumatic Chronic Subdural Hematoma in Young Adults
Can young adults get a chronic subdural hematoma from head trauma?
“It’s possible but not likely,” says neurosurgeon Charles Park, MD, Director of The Minimally Invasive Brain and Spine Center at Mercy Medical Center in Baltimore. “Chronic subdural hematoma is usually for older people who have a lot of brain atrophy,” he adds.
This article refers strictly to chronic subdural hematoma that results from some kind of trauma, as opposed to a spontaneous bleed – which has actually been documented in medical literature to occur in young people, but it’s rare.
In general, brains shrink with age: age-related atrophy. This means more space between the brain and the skull.
It doesn’t take much trauma to tear the blood vessels in an elderly person’s brain.
If the tear is very small, blood will begin leaking, but at a very slow rate.
The space between the atrophied brain and the skull allows this blood to collect, and it can take two, even three, months for symptoms to begin first appearing.
The space allows the blood (and cerebrospinal fluid) to collect, and the symptoms of this chronic subdural hematoma may be a severe headache, altered mentation, weakness, paralysis and other symptoms that mimic that of a stroke.
In a young person, the same force of trauma to the head, that caused the chronic subdural hematoma in an elderly person, may tear the blood vessels, but due to a bigger brain (no age-related atrophy), there’s very little space, or to put it another way, there’s very tight space, between the brain and the skull.
Any bleeding will not build up and collect; it will just be reabsorbed by the body: no symptoms, no problem.
The same trauma may also not even tear the younger, stronger blood vessels.
Do not confuse chronic subdural hematoma with acute subdural hematoma.
In a young person — even a strong, very fit one — significant head trauma can result in an acute SDH – which is a life-threatening situation due to the rapid bleeding in the brain.
Dr. Park specializes in minimally invasive surgical techniques for treatment of conditions affecting the brain and spine. He’s skilled in advanced procedures and techniques that utilize innovative computer technology and image-guided surgery systems.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/9nong
Sources: ncbi.nlm.nih.gov/pubmed/19546844; ncbi.nlm.nih.gov/pubmed/16028774
Why Can Young Athletes Get a Herniated Disc?
Even young athletes can suffer from a herniated disc; it’s not just for older couch potatoes.
Charles Park, MD, neurosurgeon, Director of The Minimally Invasive Brain and Spine Center at Mercy Medical Center in Baltimore, says that the “Disc is composed of two parts: inner soft nucleus pulposus and outer tough annulus.
“Because of the tremendous amount of pressure that young athletes put on their bodies, the pressure may be overwhelming and may tear the outer layer, and some of the inner material can herniate out and put pressure on the nerve.”
Being that most young athletes don’t develop this, what predisposing factors are present that would put the young athlete at higher risk of a herniated disc?
BruceBlaus/CreativeCommons
Dr. Park explains, “A lot depends on genetics, which we can’t do anything about. Some are born with weak annulus, which is more predisposed to rupturing.
“But also, doing a lot of heavy axial-loading kind of activities, such as squatting, will put a lot of pressure on the annulus.”
What kind of exercises can help reduce the risk of a young athlete developing a herniated disc?
Dr. Park says that “core strengthening exercises will lower the risk.”
What are some very effective exercises for strengthening the core?
The core is the group of muscles in the abdominal and lower back regions that act as stabilizers to the spine.
A thousand sit-ups a day is not the path to a strong core. Spending an hour a day on the floor doing leg lifts, leg swings, crunches, etc., is not the answer.
The best core strengthening exercises include but are not limited to:
- pushup
- pushup dumbbell row
- deadlift and back squat
- chin-up
- pull-up
- lat pull-down
- bent-over barbell row
- bent-over dumbbell row.
Planking, too, will strengthen the core. Freepik.com
Pushup dumbbell row
To help protect your spine from developing a herniated disc, young or old, you should do these exercises, and your primary consideration should be perfect form.
Dr. Park specializes in minimally invasive surgical techniques for treatment of conditions affecting the brain and spine. He’s skilled in advanced procedures and techniques that utilize innovative computer technology and image-guided surgery systems.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
Sitting a Lot Every Day Raises Breast Cancer Risk
Breast cancer is linked to prolonged periods of sitting done most days of the week.
For this study, other variables were adjusted for like physical activity and body mass index, and the results still came out as follows:
A higher risk of breast cancer the more a woman spends time sitting.
Alpa Patel, PhD, headed the study that looked at the leisure sitting time in 77,462 women and 69,260 men who did not have cancer. The time spanned 1992 to 2009.
The full report appears in Cancer Epidemiology Biomarkers & Prevention, 2015.
How can a woman reduce her daily sitting time?
ANY sitting time that’s reduced counts towards a lower risk of disease including cancer.
So if a woman sits all day at work, what can she do?
Get a Treadmill Desk
If you spend a good amount of time at home on a computer, a treadmill desk will reduce significant sitting time.
Or, if it’s placed before the TV, you can reduce sitting time while watching your favorite shows.
Even if you spend only small amounts of time at home on a computer or watching TV, walking during that time will go towards reducing your chances of getting the “sitting disease.” It will lower your risk of breast cancer.
You may also want to explore the possibility of using a treadmill desk at your workplace.
I’ve been using a treadmill desk for many years now for home computer use, and believe me, it really does make a difference. You’ll get used to it faster than you think.
No Treadmill Desk?
If that’s not an option, then just simply get up every 45 minutes from the computer and stay on your feet for five minutes.
- Do yoga
- Throw some kicks
- Do mountain climbers or squats
- March in place
- Play with the dog
- Water the plants
- Stand while going through the snail mail
Perhaps you can combine workplace duties with these on-your-feet breaks.
If you can’t get a treadmill desk for home use, then pace as you watch TV: forward and back, side to side, or do some Zumba or standing yoga moves, jumping in place, squats, lunges — whatever goes.
Excessive sitting, for whatever reason, has been associated with breast cancer. That’s enough to get moving more.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/catch-my-eye
Source: sciencedaily.com/releases/2015/07/150713131429.htm
Bench Pressing with a Thoracic Aortic Aneurysm?
The guidelines for bench pressing with a thoracic aortic aneurysm are not encouraging.
If you found this article, you’ve probably been diagnosed, or know someone who has, with a thoracic aortic aneurysm—and know exactly what this is.
And you probably lift weights or were planning on taking this up, including the bench press.
“Once someone is diagnosed with a thoracic aortic aneurysm, a common question is whether or not they can exercise,” begins Jack Wolfson, DO, FACC, a practicing cardiologist in Arizona, author of The Paleo Cardiologist: The Natural Way to Heart Health.
“The concern, of course, is to avoid an event that could cause the affected blood vessel to rupture.
“There are many reports in the literature and small studies which document heavy exertion as a precipitating factor.”
CAN a person with a thoracic aortic aneurysm bench press in a safe manner?
Well, the motion of bench pressing isn’t the issue. It’s the weight of the barbell.
Lifting weights increases blood pressure during the movement (though weightlifting will lower resting blood pressure as the individual becomes more trained).
A person with a thoracic aortic aneurysm must avoid activities that raise blood pressure, because forceful pressure within the bulging portion of the aorta can cause it to dissect.
Dr. Wolfson says, “Activities to be avoided include anything which involves strenuous lifting. I tell most people that 25 pounds is probably the upper limit.”
This is where it gets tricky. A 50-year-old woman who has never trained with weights should be strong enough to bench press 25 pounds for a number of repetitions.
As a fitness expert, I know for a fact that novice women, even middle aged, can often start out with the 45 pound unloaded Olympic bar for the bench press.
As a former personal trainer, I never started my novice female clients at 25 pounds for the bench press—this is way too light.
You can imagine how light this would be to a man—especially if he’s been working out for a while.
So the restriction of lifting no more than 25 pounds, in someone with a thoracic aortic aneurysm, would seemingly more apply to lifts that recruit only a small amount of muscle and involve a non-efficient body position.
For example, hoisting eight, 25 pound sacks into a truck is more strenuous than bench pressing this same amount of weight for eight repetitions.
Suppose a man, who regularly bench presses 225 for reps, learns he has a thoracic aortic aneurysm (e.g., a chest X-ray for suspected pneumonia reveals it).
Does this mean to drop his bench press down to 25 pounds, even though 100 pounds would be a walk in the park for him?
How about a compromise of 50 pounds, since the bench press motion is done while lying down and recruits many more muscle fibers than, say, lifting a 25 pound kettlebell straight out in front of yourself?
No data this refined exists to answer these questions, but on the other hand, because this data does not exist (and maybe one day it will), such an individual should give up bench pressing altogether to avoid the temptation to return to a more strenuous level.
“Check with your doctor to devise an exercise plan that is appropriate for you,” says Dr. Wolfson.
“Make sure to ask questions about specific activities you may be considering.
“Your doctor may want to perform an exercise stress test to determine your blood pressure response to activity.”
Wolfson Integrative Cardiology specializes in functional medicine and provides treatment plans for out-of-town patients.
Lorra Garrick is a former personal trainer certified through the American Council on Exercise. At Bally Total Fitness she trained women and men of all ages for fat loss, muscle building, fitness and improved health.
How Painful Is Pronator Teres Syndrome?
Just how painful can pronator teres syndrome be?
This condition is much under-publicized, and its symptoms can mimic carpal tunnel syndrome (CTS).
Any condition that involves a nerve can cause pain.
Pronator teres syndrome involves pressure on the same nerve that’s involved with CTS: the median nerve, a major nerve running down the arm.
“There are varying degrees of pain and paresthesias with pronator syndrome,” says Jonathan Oheb, MD, North Valley Orthopedic Institute, Chief of Orthopedic Hand and Upper Extremity Surgery.
And what is a paresthesia?
Paresthesia is a sensation of tingling, numbness, burning or prickling on the skin, often described as “pins and needles.”
It commonly occurs in the hands, arms, legs or feet and can be temporary from pressure on nerves, or chronic due to underlying conditions like nerve damage or circulatory issues.
Dr. Oheb continues, “With pain localized over the proximal forearm and paresthesias distally in the thumb, index, middle and half of the ring finger.”
Those finger locations are the same as with carpal tunnel syndrome. This is why sometimes initially, the physician will suspect CTS first.
The reason that the pain or discomfort of either pronator or carpal tunnel syndrome does not affect the entire ring finger or any part of the pinky is due to the distribution of the nerves branching out.
The branching distribution does not reach the muscles and nerves in those areas; thus, they are not part of the pain with these neuromuscular conditions.
Pronator syndrome is less common than CTS, but it can definitely cause pain.
CTS affects about 3-6% of adults, while pronator syndrome is relatively rare, though exact prevalence is unknown.
Estimates suggest pronator syndrome occurs at a rate 10 to 100 times less frequently than does carpal tunnel syndrome due to anatomical differences in nerve compression sites and more prominent symptoms.
“Pronator syndrome usually presents with pain localized in the proximal forearm which is made worse with repetitive prono-supination of the forearm,” says Dr. Oheb.
The pain can be bad enough to prevent strength training or household duties that activates that region.
The proximal area refers to that closer to the center of the body.
In this case it would mean near the elbow and inner portion of the forearm if you were standing with your arm hanging straight at your side.
Prono-supination refers to rotating the forearm from that of a palm-down position to a palm-up position.
In addition to hand, elbow and shoulder care, Dr. Oheb provides comprehensive surgical and nonsurgical treatment for all orthopedic conditions of the hip, knee and ankle, including broken bones and injuries. jonathanohebmd.com
Lorra Garrick is a former personal trainer certified through the American Council on Exercise. At Bally Total Fitness she trained women and men of all ages for fat loss, muscle building, fitness and improved health.
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Top image: Shutterstock/Kristiana Gankevych
Carpal Tunnel vs. Pronator Syndrome: Symptom Comparison
Jonathan Oheb, MD, compares the symptoms of carpal tunnel syndrome with pronator teres syndrome.
“Whereas carpal tunnel syndrome is compression of the median nerve at the wrist, pronator syndrome is median nerve compression at the elbow,” says Jonathan Oheb, MD, North Valley Orthopedic Institute, Chief of Orthopedic Hand and Upper Extremity Surgery.
Symptom Comparison
“Symptoms similar to carpal tunnel syndrome include numbness, pain, tingling, burning in the thumb, index, middle and half of the ring finger.
“Differences unique to pronator syndrome include aching pain localized to the forearm, lack of night symptoms (seen in CTS), worsening with repetitive prono-supination, loss of sensation to the palm of the hand (due to a branch of the median nerve that comes off before the carpal tunnel).”
How a Doctor Can Tell Which One You Have
Doctors look at where the pain and numbness show up and what movements trigger them.
Simple exams and nerve tests help tell them apart.
Physicians use physical tests such as tapping over the median nerve, wrist-bending maneuvers and forearm resistance checks, along with nerve conduction studies (EMG), to see where the median nerve is being compressed.
In addition to hand, elbow and shoulder care, Dr. Oheb provides comprehensive surgical and nonsurgical treatment for all orthopedic conditions of the hip, knee and ankle, including broken bones and injuries. jonathanohebmd.com
Lorra Garrick is a former personal trainer certified through the American Council on Exercise. At Bally Total Fitness she trained women and men of all ages for fat loss, muscle building, fitness and improved health.
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Top image: Shutterstock/Alexonline
Pronator Teres Syndrome Pain: Solutions
Dr. Jonathan Oheb provides solutions for when the pain of pronator teres syndrome strikes.
Pronator teres syndrome is characterized by compression of the median nerve as it travels through the forearm, typically at the level of the pronator teres muscle.
Though this condition hardly gets any media attention when compared to carpal tunnel syndrome, it sure can hurt at times.
Patients often experience pain, numbness or tingling in the forearm and hand, particularly in the areas served by the median nerve: thumb, index finger, middle finger and half of the ring finger.
There Are Several Options for Relief from Pronator Teres Pain
There are several options, according to Jonathan Oheb, MD, North Valley Orthopedic Institute, Chief of Orthopedic Hand and Upper Extremity Surgery.
“Resting the forearm muscles, splinting to prevent forearm prono-supination, and nonsteroidal anti-inflammatories are the mainstay of conservative treatment for pronator teres syndrome,” says Dr. Oheb.
“This is continued for a minimum of three to six months before any surgery is considered.”
Prono-supination refers to rotating the forearm from palm-down to palm-up.
As your treating physician about splinting. A splint should still allow elbow movement.
But pain will be mostly prevented if the movement that causes it is stopped — with a splint.
Otherwise, consciously trying to remember to avoid rotating the forearm will prove difficult in day to day life.
For fast pain relief, the NSAIDs may begin working within 45 minutes, but don’t let this give you a false sense of security that you can then rotate the arm as freely as the other one.
The structure still needs rest from its function, which is where the splinting comes in.
For immediate relief of the pain, apply ice.
Sometimes the pain is in the form of a very annoying ache.
There may also be tenderness when the area is pressed with fingertips.
So when the pain of pronator teres syndrome is really dampening your day, remember the following five approaches for fighting off the discomfort:
- Rest
- Splinting
- NSAIDS
- Ice
- Physical therapy. Stick to your physical therapy assignments.
How well do pain pills work for the discomfort of pronator teres syndrome?
“Nonsteroidal anti-inflammatories help with pain as well as with decreasing inflammation and the secondary damage that inflammation causes to the nerve,” says Dr. Oheb.
NSAIDs include Ibuprofen, Naproxen and Meloxicam.
You need to be patient — yet dedicated with your conservative management of PTS.
Surgery for correcting the pain of pronator teres syndrome should be an option when all conservative approaches have failed.
The surgical procedure usually involves making an incision in the forearm to access and release the median nerve from the compressive structures.
In addition to hand, elbow and shoulder care, Dr. Oheb provides comprehensive surgical and nonsurgical treatment for all orthopedic conditions of the hip, knee and ankle, including broken bones and injuries. jonathanohebmd.com
Lorra Garrick is a former personal trainer certified through the American Council on Exercise. At Bally Total Fitness she trained women and men of all ages for fat loss, muscle building, fitness and improved health.
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