Ankle Pain


 

ANKLE PAIN


The ankles support the body and are susceptible to daily wear and tear and to injuries that can cause discomfort and pain affecting your daily quality of life. At the Center for Integrated Pain Management, conditions are diagnosed and treatment plans are tailored for the patient’s optimal health and pain relief. Below is a list of ankle conditions treated at the Center.


  • Tarsal Tunnel Syndrome
  • Achilles Tendonitis
  • Ankle Sprains, Strains and Tears
  • Ankle Instability
  • Muscle Spasms
  • Nerve Entrapment/Radiculopathy


A diagnosis will be made once Dr. Kulick reviews your family history, completes a thorough physical examination and conducts an in-office ultrasound. If necessary,  Dr. Kulick may request that you obtain an MRI, a CT Scan or additional X-rays in order to determine the diagnosis and treatment plan.


To learn more about the treatment and relief of ankle conditions please contact our office at  212-867-1777.




Tarsal Tunnel Syndrome


What is Tarsal Tunnel Syndrome?

Tarsal Tunnel Syndrome is a disorder caused by the compression of the tibial nerve that runs through the tarsal tunnel located under the bony protrusion on the inner ankle.  A sprained ankle, flat feet, diabetes or arthritis may cause the condition.


Seek Treatment for these Symptoms:

  • Numbness or tingling in ankle or foot
  • Shooting pain along the inner ankle
  • Pain radiating to foot


Next Steps

Consult the Center for a diagnosis and for treatment options.  These may include anti-inflammatory medication, ultrasound-guided corticosteroid injections, steroid-free hydrodissection in order to free the nerve or an ultrasound-guided nerve block injection.


To learn more about the treatment and pain relief of Tarsal Tunnel Syndrome please call us at 212-867-1777.

Achilles Tendonitis


What is Achilles Tendonitis?

Achilles Tendonitis causes pain in the heel and the back of the lower calf. The Achilles tendon, the largest in the body, connects calf muscles to the heel bone and it is used daily to walk, run, jump, and climb anything from stairs to mountains. Tendonitis is the inflammation of a tendon, the tissue that connects muscle to bone.  While middle aged weekend warriors and dedicated runners are often at high risk for developing this condition, anyone who suddenly initiates an aggressive exercise regime, or who does not first warm up and stretch the calf muscles before beginning to run, exercise, or play sports like tennis or basketball, may be at risk. Bone spurs on the heel bone may also aggravate this condition.


Seek Treatment for these Symptoms:

  • Pain or tenderness along the back of the heel
  • Heel pain increases after exercise
  • Stiffness or swelling behind the heel along the tendon
  • Limited range of motion
  • If there is a popping sound at the time of injury, seek immediate treatment, since the Achilles tendon may have ruptured


Next Steps

Consult the Center for a diagnosis and for treatment options. These include rest, ultrasound-guided corticosteroid injections and physical therapy. Additional highly specialized and cutting edge options include ultrasound-guided tenotomy injections that destroy damaged tissue, followed by ultrasound-guided prolotherapy injections or ultrasound-guided injection of platelet rich plasma therapy (PRP) to accelerate the growth of healthy replacement tissue.


To learn more about the treatment and relief of Achilles Tendonitis please call us at 212-867-1777.




Ankle Sprains and Strains and Tears


What are Ankle Sprains, Strains and Tears?

The ankle is susceptible to sprains and strains.  In fact, it is the most common location for a sprain. A sprain is the stretching or tearing of ligaments, the tissue that connects bones to bones.  It occurs when the foot turns inwards stretching the ligaments on the outer ankle.


A strain is the stretching or tearing of the tendons, tissue that connects muscles to bone, or muscles. Sprains and strains may be caused by a fall or twisting the ankle in an unnatural position.  Often, these occur during sports activities, but can also result from a misstep while walking. Both sprains and strains can result in a partial or complete tear of the soft issue.


Seek Treatment for these Ankle Sprain Symptoms:


  • Sharp ankle pain particularly when moving or walking
  • Severe pain if engaged in weight-bearing activities
  • Swelling or bruising at the ankle
  • Limited range of ankle motion
  • Popping sound when injured
  • Sudden and acute pain at time of injury


Seek Treatment for these Ankle Strain Symptoms:


  • Pain
  • Swelling or redness
  • Muscle spasms or weakness in ankle
  • Limited range of motion.


Next Steps:

Consult the Center for a diagnosis and for treatment options. These include rest, ice, compression, and elevating the ankle. Ultrasound-guided corticosteroid injections and physical therapy may help. Additional highly specialized and cutting edge options for strains, if tendinosis is indicated, are ultrasound-guided tenotomy injections that destroy damaged damaged tissue, followed by ultrasound-guided injections of platelet rich plasma therapy (PRP) to accelerate the growth of healthy replacement tissue.


To learn more about the treatment and relief of Ankle Sprains, Strains and Tears please call us at 212-867-1777.

Ankle Instability


What is Ankle Instability?


Chronic Ankle Instability can result from suffering multiple ankle sprains.  The ligaments may grow back too loosely and eventually the ankle may start to twist more easily and frequently give way. This in turn may lead to additional sprains and chronic pain.


Seek treatment for these symptoms:


  • Recurring ankle sprains or strains
  • Recurring ankle pain
  • Ankle feels off balance


Next Steps:


Consult the Center for a diagnosis and for treatment options. These include rest, ice, compression, and elevating the ankle. Ultrasound-guided corticosteroid injections and physical therapy may help. Additional highly specialized and cutting edge options for strains, if tendinosis is indicated, are ultrasound-guided tenotomy injections that destroy damaged damaged tissue, followed by ultrasound-guided injections of platelet rich plasma therapy (PRP) to accelerate the growth of healthy replacement tissue.


To learn more about the treatment and relief of Ankle Instability please call us at 212-867-1777.


Muscle Spasms

 

What Are Muscle Spasms?

Muscle spasms are very common and can happen without warning. Perhaps you stand on your toes to reach for an item or even sleep in an awkward position. This suddenly triggers a muscle spasm in your ankle and you cannot straighten or move it without pain. Muscle spasms are the involuntary contraction or tensing of one or more muscles. They may occur in the wrist, forearm, hand, neck, upper or lower back, hips and legs.  Muscle spasms may be caused by heavy lifting, muscle overuse, weak muscles, nerve compression, spinal conditions such as degenerative disc disease or a herniated disc, and many sports injuries. Some sports including golf, football, weightlifting and basketball that require the constant twisting of the spine may lead to back spasms. Spasms may seem to appear out of nowhere however, typically small tears in the muscle may have developed over time. These tears may lead to swelling that compresses the nerves surrounding the muscle. This in turn sparks a muscle spasm that can cause pain, cramping or twitching.


Seek Treatment for these Symptoms:

  • Muscle pain that does not dissipate on its own
  • Constant muscle cramps
  • Difficulty moving
  • Muscle appears hard or distorted


Next Steps

If the muscle spasm does not resolve by itself after a few days of rest, icing the area for short periods of 10 to 20 minutes every two hours or using a heated pad, and taking non-steroidal anti-inflammatory medication, then seek treatment. Consult the Center for a diagnosis and for options.  The spasm may be the result of an underlying condition that can be treated. Once identified, treatment options may include ultrasound-guided corticosteroid injections, trigger point therapy, ultrasound guided prolotherapy injections or anti-inflammatory or muscle relaxant medication. Ultrasound guided injections of platelet rich plasma (PRP), or stem cell therapy may be advised. If nerve entrapment is indicated then a steroid-free hydrodissection to release the nerve or ultrasound-guided nerve block injections will be recommended.

To learn more about the treatment and relief of Muscle Spasms please call our office at 212-867-1777.


Nerve Entrapment/Radculopathy


What Is Radiculopathy?

Radiculopathy is a group of conditions affecting one or more nerves in the spine. These nerves may become pinched or compressed, causing pain, numbness or tingling in the arms or legs. The sciatic nerve, the large nerve that runs down the lower back, hip, buttocks, and back of leg to the foot may be compressed in the lower back as a result of a herniated disc or other spinal damage.

Radiculopathy commonly occurs in the cervical spine (neck), the thoracic spine (mid back)or the lumbar spine (lower back).

Cervical, thoracic, and lumbar radiculopathy are often caused by herniated discs in the vertebrae (bones of the spine) and spinal stenosis, a narrowing of the hole in the vertebrae through which spinal nerves exit.  This places pressure on the nerves as they branch out from the spine. The compression may also be caused by an injury, overuse of muscles and tendons, poor posture, bone spurs, and arthritis.


Seek Treatment for these Symptoms:

  • Pain that radiates outward from the injured nerve
  • Numbness, tingling, burning sensation
  • Muscle weakness
  • Cervical radiculopathy affects the neck, upper back, shoulder, chest, arm,or hand.
  • Thoracic radiculopathy affects the chest, ribs, shoulders, mid back or stomach area
  • Lumbar radiculopathy causes sciatica which is an irritation of the large sciatic nerve located in the lower back.  This causes pain to radiate down the back of the leg to the calf or foot called sciatica
  • Pain may be aggravated by activities such as walking, climbing stairs or sitting


Next Steps

Consult the Center for a diagnosis and for treatment choices.  Depending on the diagnosis, treatment options may include ultrasound-guided corticosteroid injections, ultrasound -guided injections of platelet rich plasma (PRP), ultrasound-guided prolotherapy injections, physical therapy and anti-inflammatory medication. If nerve entrapment is indicated then a steroid-free hydrodissection to release the nerve and ultrasound-guided nerve block injections will be recommended.


To learn more about cervical radiculopathy and its treatment please call our office at 212-867-1777.

Location
Alexander Kulick, MD
112 East 61st Street
Upper East Side

New York, NY 10065
Phone: 917-810-4139
Fax: (646) 585-0042
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917-810-4139