Friday, May 27, 2011

Texting may be Hazardous to your Health

Text messaging has become a preferred method of communication for a large number of Americans, particularly teens and young adults. According to market research performed by the Nielsen Company in 2010, the average teenager sends more than 3,000 texts per month! Amazingly, this number appears to be on the rise, especially among teenagers age 13 to 17. The second highest frequency of texting occurs in young adults, age 18 to 24. This group exchanged approximately 1,630 texts per month, an average of 3Multitask Mantexts per hour. Along with its popularity, however, have come a number of health hazards. Foremost of these are repetitive stress injuries, motor vehicle accidents, and walking-while-texting injuries.

Texting tendonitis: Also called "Blackberry thumb" and "teen texting tendonitis", this is a repetitive stress injury affecting the tendons of the thumbs, since texting relies almost exclusively on the use of the thumbs for typing. Features of this condition include aching and throbbing pain in the thumb or sometimes other fingers and wrist. As with other repetitive stress injuries, such as carpal tunnel syndrome, treatment usually involves avoidance of the aggravating activity, splinting, application of ice, and anti-inflammatory medications.

Motor vehicle accidents: As if talking on a cell phone while driving wasn't bad enough, the impact of texting while driving appears to be even worse. In a study presented to the Pediatric Academic Societies last year, 21 teens using a driving simulator drove erratically and in some cases even ran over pedestrians while texting or operating a MP3 player. In a similar simulation, researchers from the University of Utah found that texting on a cell phone while driving is six times more dangerous than talking on a cell phone. A poll performed by PEMCO Insurance Company found that 31% of respondents admitted to texting while driving their cars. The actual number of texting-related automobile accidents may never be known since it would be unlikely that the perpetrator of the accident would admit that they were texting while driving.

open manholeWalking-while-texting injuries: There appears to be a growing trend of injuries and even deaths occurring when people are texting while walking. Distracted walking often results in facial or eye injuries from falling or walking into a signpost or parked car. A study performed at Ohio State University identified over 1,000 emergency rooms visits from pedestrians who tripped, fell, or ran into something after becoming distracted while using a cell phone to talk or text. If repeated today, this 2008 study would almost certainly find a larger number of emergency room visits related to cell phone use while walking. Distracted walking has also resulted in injuries to others through collisions with other pedestrians, bicyclists, or people on rollerblades.

Avoiding texting injuries: The following are suggestions to help prevent injuries related to texting:
  1. Vary the hand or digits used to text. Don't text for more than an few minuteswithout a break.

  2. Stop texting if it produces pain or tingling in your thumbs or hands. You mayneed to make changes in your work, play, or texting habits.

  3. Never text while driving or operating machinery.

  4. Be alert when walking, particularly in cities. People have been injured or killed by walking into traffic while texting or talking on a cell phone.

  5. Don't text while engaging in physical activities such as bicycling, rollerblading, or running.

  6. Be careful if texting in settings where attention to your surrounding is required, such as waiting for a bus or sitting alone at night.
If you have any questions about texting related injuries, please log into your account and send us your question. We are here to help.

Thursday, May 19, 2011

New osteoporosis screening guidelines

Osteoporosis is a condition associated with low bone mineral density (BMD) resulting in increased risk for fractures. According to the National Osteoporosis Foundation, as many as 10 million people in the U.S. have osteoporosis and almost 34 million are at risk. When detected by screening measures, treatment of osteoporosis has been shown to decrease the risk of developing an osteoporosis-related fracture.

The US Preventive Services Task Force (USPSTF) is a respected panel of health care experts who review the current medical literatureMower to develop scientifically based screening guidelines for a variety of medical conditions. One of the conditions for which it has issued screening guidelines is osteoporosis, the last time being in 2002. At that time, they recommended bone density screening for women 65 years or older and for women aged 60 to 64 years at increased risk for osteoporotic fractures. In that report, there were no recommendations regarding screening postmenopausal women younger than 60 years or women aged 60 to 64 years who did not have an increased risk for fractures.

As is the case with many diseases, screening guidelines can change based on new scientific evidence. Following a review of osteoporosis-related research published since 2002, the USPSTF released new screening guidelines, which updated their previous recommendations. Here are several important points drawn from their most recent report:
  1. Starting at age 65, all women should undergo screening for osteoporosis. This applies to women of all racial and ethnic groups. The USPSTF did not define a specific upper age limit for screening in women because the risk for fractures continues to increase with age.

  2. In women between ages 50 and 64, the need for testing is based on their risk of breaking a bone due to osteoporosis over the next ten years. Screening is recommended if this risk equals that of a 65-year-old white woman who has no additional risk factors. Those risk factors include a family history of osteoporosis, low body weight, and alcohol abuse.

  3. The USPSTF recommends the use of the FRAX formula to estimate a woman’s 10-year risk of sustaining an osteoporosis fracture. This tool uses clinical information, such as age, body mass index (BMI), parental fracture history, and tobacco and alcohol use to determine the risk of fracture. Bone density screening is recommended in women aged 50 to 64 years with a 9.3% or greater 10-year fracture risk.

  4. The most common methods of screening for osteoporosis are dual-energy x-ray absorptiometry (DXA scan) of the hip and lumbar spine and quantitative ultrasonography of the calcaneus. While both methods can predict fractures accurately, the DXA has become the gold standard for the diagnosis of osteoporosis and for guiding decisions about which patients to treat.

  5. The optimal time interval for performing screening tests has not yet been determined. It appears, however, that at least 2 years between screenings is necessary to reliably measure a change in bone mineral density (BMD), and even longMowerer intervals may be necessary to improve fracture risk prediction.

  6. According to the USPSTF, there is not enough current evidence to recommend screening for osteoporosis in men. This is in contrast to the National Osteoporosis Foundation’s recommendation that BMD testing should be done in all men at 70 years of age or in the 50-69 year age group if they areat high risk for a fracture.
It has been estimated that by the year 2012, approximately 12 million Americans over the age of 50 will have osteoporosis. Detecting low bone mineral density through screening provides an opportunity to prevent osteoporosis-related fractures. The USPSTF found convincing evidence that treatment of osteoporosis can reduce subsequent fracture rates in postmenopausal women. In addition to adequate calcium and vitamin D intake and weight-bearing exercise, several medications are approved by the U.S. Food and Drug Administration to reduce fractures, including bisphosphonates, parathyroid hormone, raloxifene, and estrogen.

Friday, May 13, 2011

Does knuckle cracking lead to arthritis?

CrackUrban legend would indicate that knuckle cracking leads to arthritis of the joints of the hand. It would be a gross overstatement, however, to say that the medical literature has thoroughly explored this connection. This is one of those quasi-medical issues that is scarcely mentioned in medical school curricula.

What causes the knuckles to pop? People primarily tend to crack two groups of hand joints. These are the joints between the bones of the fingers (interphalangeal joints) and the joints formed where the bones of the hand meet the fingers (metacarpophalangeal joints). By manipulating these joints, either through extreme flexion, extension, or sideways bending, pressure in the joint space decreases, and a gas bubble forms in the joint fluid. This results in rapid movement of joint fluid toward the bubble causing it to burst which leads to the characteristic cracking sound.

Why do people crack their knuckles? For some people, knuckle cracking is a habit or something that they do out of boredom. Others say that it helps relieve joint discomfort and improves the range of motion of the hand joints.

CrackWhat type of arthritis is thought to be associated with knuckle cracking? Knuckle crackers allegedly are at risk of developing osteoarthritis, a degenerative disease affecting the joint cartilage. The additional "wear and tear" of the joints due to knuckle cracking is thought to be the culprit in the development of arthritis. Osteoarthritis is a potentially debilitating disease that affects a majority of individuals over the age of 65. If a definite link between something as simple as knuckle cracking and the development of osteoarthritis was confirmed, modifying one's behavior could reduce the risk of developing the disease.

What is the existing evidence? The first study exploring the connection was published in 1975. Twenty-eight nursing home residents were polled and asked if they cracked their knuckles currently, or if they had in the past. These responses were compared to x-rays taken of the hand joints. Interestingly, the number of subjects who had evidence of osteoarthritis was lower among the knuckle crackers than in a comparison group who indicated that they had not cracked their knuckles. While the authors did not go as far as saying that knuckle cracking provided a protective effect, they dismissed the notion that knuckle cracking leads to the development of osteoarthritis.

A second study evaluated 300 subjects over the age of 45 for the presence of habitual knuckle cracking and hand arthritis or dysfunction. An increased prevalence of osteoarthritis was not found in the group that habitually cracked their knuckles. This group, however, was more likely to have hand swelling and lower grip strength. The authors concluded that habitual knuckle cracking could cause functional hand impairment but not in the development of osteoarthritis.

The most recently published study took a more scientific approach than the previously performed studies. Hand x-rays were used to confirm the presence of osteoarthritis in the 135 subjects included in the study. A control group of 80 subjects was also identified who did not have osteoarthritis. Questionnaires were given to both groups to gather information about knuckle cracking, as well to learn about their risk factors for the development of osteoarthritis. This study even calculated "crack-years," to quantify the length of time that subjects cracked their knuckles in order to explore the possibility of a "dose response" relationship between knuckle cracking and the development of osteoarthritis. The study found that those who had osteoarthritis were no more likely to have cracked their knuckles than the subjects in the control group who did not have osteoarthritis.

Although it may not make the practice any less annoying, the evidence available today indicates that cracking your knuckles will not cause you to develop arthritis.

If you have any questions about joint pain or osteoarthritis, please log into your account and send us your question. We are glad to help.

Thursday, May 5, 2011

Lawnmower safety

MowerAccording to the Insurance Information Institute, lawnmower injuries send approximately 75,000 people to the Emergency Department each year. Of this number, around 16,000 are under 19 years of age, with 600 of these young people sustaining amputations. Sadly, relatively few of these injuries are due to mechanical problems with the lawnmower---most are the result of human error.

How do lawnmower injuries occur? One of the most common mechanisms involved in lawnmower injuries is attempting to unclog the cutting blade with the hand or foot. Other injuries occur because of improper mowing technique, such as pulling the mower backwards. Wearing improper clothing, like open toed sandals, or not wearing eye protection, are other common reasons for injuries sustained while mowing.

What are some of the most common types of injuries? Lawn mower injuries include deep cuts, loss of fingers and toes, broken bones, burns, and eye damage. Approximately one-fourth of lawnmower injuries involve the wrist, hand or finger and a slightly smaller percentage affect the foot, ankle, or toes. Eye damage from flying debris is a less common, but potentially sight-threatening, lawnmower-related injury. Injuries can occur not only to the lawnmower operator, but also to nearby individuals.

How can mowing be made safer? By taking special precautions, the great majority of lawnmower injuries can be prevented. The Consumer Product Safety Commission offers these suggestions for safer use of power lawnmowers:
  • Read the owner's manual to become familiar with the workings of the machine. Keep the manual in a safe place so it will be handy the next time you need it.

  • Fill the fuel tank before starting the engine to cut the lawn. Never refuel the mower when it is running or while the engine is hot.

  • Check the lawn for debris (twigs, rocks and other objects) before mowing the lawn. Objects have been struck by the mower blade and thrown out from under the mower, resulting in severe injuries and deaths. Wearing eye protection is advised.

  • Don't cut the grass when it's wet. Wet clippings can clog the discharge chute, jamming the rotary blade and causing the engine to shut down. When you need to remove clippings from the chute, the motor must be stopped.

  • Wear sturdy shoes with sure-grip soles when using the mower, never sneakers, sandals or with bare feet. Slacks rather than shorts offer better protection for the legs.

  • If the lawn slopes, mow across the slope with the walk-behind rotary mower, never up and down. With a riding mower, drive up and down the slope, not across it.

  • Don't remove any safety devices on the mower. Remember that the safety features were installed to help protect you against injury. Check safety features often and repair or replace if needed.

  • With an electric mower, organize your work so you first cut the area nearest the electrical outlet, then gradually move away. This will minimize chances of your running over the power cord and being electrocuted.
In addition to the above suggestions, the American Academy of Pediatrics advises that children younger than 16 years should not be allowed to use ride-on mowers and children younger than 12 years should not use walk-behind mowers. Additionally, children should never be allowed to ride as passengers on riding mowers. Prior to mowing, make sure that children are indoors or at a safe distance away from the area to be mowed.

Obviously, the main source of danger with lawnmowers is the blade. Never insert hands or feet into the mower to remove grass or debris. With the motor off (and some suggest disconnecting the spark plug wire) use a stick or broom handle to remove any obstruction. It is highly recommended to use only those lawnmowers that have an automatic brake. This feature, required on all new mowers, stops the blade in three seconds when the operator releases his/her grip on the handle-mounted control bar.

If you have any questions about lawnmower safety, please log into your account and send us your question. We are glad to help.