Dr Rupal Patel talking about common orthopedic related problems

1. Manage bone and joints
problems during COVID-19
Dr. Rupal Patel
Orthopedic surgeon, VCU health
Date

2. Contact info
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Rupal Patel, MD
- VCU health orthopedic surgeon
- Seeing patients in downtown,
Colonial heights, Chester and Short
pump area
- Affiliated hospitals: MCV,
Chippenham, Southside regional
medical center and John Randolph
hospital.

3. Shoulder: pain and injury
• Common causes – injury/sprain, frozen shoulder, impingement
syndrome/bursitis
• Symptoms – pain with movement, pain at night, radiating to arm, limitation of
range of motion
• Signs – pain with raising the arm above the head, unable to raise the arm.
Difficult to reach back (putting belt in hooks for men and tying bra in female)
• Treatment:
- Apply ice or heat
- Take OTC meds – Aleve, Ibuprofen (Motrin), Tylenol
- Exercises
- Injection
- See the doctor: x-rays, MRI (Rotator cuff tear), surgery

4. Shoulder exercises

5. Knee pain
• Common causes: osteoarthritis after age 40, sprain, meniscus tear, gout
• Symptoms: pain in front of the knee, pain in inner side of the knee, giving
away (instability), popping or cracking in the knee
• Activities: going up & down stairs, in and out of car, raising from the chair,
walking uneven surface
• Signs – crepitus on the knee, pain with twisting of the knee
• Treatment:
- Apply ice or heat
- Take OTC meds – Aleve, Ibuprofen (Motrin), Tylenol
- Exercises
- Injection
- Doctor’s visit: x-rays, MRI

6. Knee exercises

7. Back Pain
• Common causes: degenerative changes, bulging disc, pinch nerve, muscle
sprain/strain, rarely infection
• Symptoms: localized to the back, radiating to hip and legs, tingling or
numbness, weakness, urinary incontinence
• Sciatica
• Treatment:
- Apply heating pad
- Exercise, exercise and exercises
- Tylenol, Aleve, Motrin
- Prednisone, muscle relaxer (need prescription)
- Physical therapy
- See the doctor: x-rays, MRI, injection

8. Back exercises

9. Neck Pain
• Common causes: degenerative changes, bulging disc,
pinch nerve, muscle sprain/strain, rarely infection
• Symptoms: localized to the neck, radiating to shoulder
and arm up to fingers, tingling or numbness, weakness,
unsteady gait
• Signs – numbness distribution, spurling sign
• Treatment:
- Apply heating pad
- Exercises
- Apply neck pillow
- Tylenol, Aleve, Motrin
- Prednisone, muscle relaxer (need prescription)
- Physical therapy
- See the doctor: x-rays, MRI, injection

10. Neck collar Neck exercises

11. Wrist and Hand problems
Wrist sprain
• use brace, activity modification, NSAIDs,
Ice
Carpal tunnel syndrome:
• Pinch nerve at wrist
• tingling and numbness of three and half
fingers, wakes up at night
• Compression test
• Brace, Injection, surgery

12. Wrist and Hand problems
De Quervain’s tenosynovitis (tendinitis at wrist and
thumb)
• Pain on dorsal radial side
• Finkelstein’s test
• Ice, NSAIDs, Brace, injection, surgery
Basal joint arthritis of Thumb
• Pain at the base of the thumb
• Heat, limit use, brace, injection
Trigger finger
• Locking of finger
• Massage, ice, NSAIDs, Injection, surgery

13. Foot and ankle problems
Ankle sprain
• pain on outer side of the ankle, mild
swelling, no deformity
• Rest, Ice, elevation, NSAIDs, ankle
support brace, CAM boot
Foot sprain, fractures, toes fracture:
• Pain and swelling
• Ice, elevation, NSAIDs, rest, buddy
taping and hard sole shoe

14. Foot and ankle problems
Achilles tendinitis
• pain in back of the heel
• Ice, stretching exercises, NSAIDs
Plantar fasciitis (heel spur):
• Pain at heel
• Worse in morning, after prolonged
standing or walking
• Roll the foot on frozen bottle,
stretching exercises, gel pad, NSAIDs,