Back Pain



For more information about Back Pain or to make an appointment with Dr. Kartik Shenoy, please call (760) 552-8585


Have you ever had lower back pain? If not, chances are you know someone who has. Low back pain is a very common diagnosis.

The low back is comprised of the vertebrae, or the bones, and in between each vertebra is a disc that acts as a cushion, and in the further back part of the spine are small joints – all of which can wear down with time and cause back pain. The condition also can be caused by surrounding muscles, tendons and ligaments getting injured, often when playing sports or lifting something that’s too heavy.

Lower back pain can be episodic or persist for long periods, and a spine specialist can recommend effective treatments to improve quality of life.

Starting simple is the recommended course of action; pain often can be relieved by taking over-the-counter medications like Tylenol, Aleve or an anti-inflammatory like Advil. Rest and placing ice or heat on the affected area also can help.

When pain continues, it’s recommended to see your regular doctor, who can explain treatment options, including injections, and refer you to a physical therapist or spine specialist who can perform an assessment with X-Rays or CT scan.

When pain persists, particularly when it radiates from the back to the legs, is when surgery can play a pivotal role to make people better.

The best outcomes for spine surgery are when there’s either nerve root compression or spinal cord compression. A procedure called decompression can be performed to take pressure off the nerve roots.

It’s also recommended to see an orthopedic surgeon or specialist after an acute injury, perhaps suffered in a fall or car accident. Orthopedic surgeons tend to cover the extremities and the spine; people often have orthopedic surgery for broken bones after going to the emergency room. And orthopedic specialists can continue to provide treatment during the post-surgical process.

Another common condition to see an orthopedic surgeon for is arthritis. If a patient has knee arthritis or hip arthritis, an orthopedic surgeon can perform a knee or hip replacement. Orthopedic institutes can address the full spectrum of extremities, from shoulders down to the fingertips, from hips down to the toes.

The primary goal is always to improve a patient’s quality of life.

For more information about lower back pain and orthopedic treatments, or to make an appointment with Dr. Kartik Shenoy, or call the office at (760) 552-8585.


Carpal Tunnel



For more information about Carpal Tunnel or to make an appointment with Dr. Nayyar, please call (760)552-8585


Do you spend a lot of time sitting at the computer and typing all day? Many people

these days who work on a computer for long periods of time may be at risk for developing carpal tunnel syndrome, a condition that can cause pain, numbness and tingling in the hand and arm.

Also known as median nerve compression syndrome, carpal tunnel often occurs when individuals perform the same routine movement over a significant length of time. Even repetitive movements like cell phone use can pose a risk because it involves flexing the wrist repeatedly.

Carpal tunnel is caused by a compressed nerve in the wrist, which results in the symptoms of tingling sensation, pain, and weakness. Repetitive hand movements can add extra pressure on a nerve, aggravating the area further.

Although it is impossible to fully predict who is more prone to developing carpal tunnel, there are a few factors that heighten your risk. Carpal tunnel can commonly run in families, since genetics plays a role in the bone structure of the wrist. Women may also be more prone to developing carpal tunnel because the carpal canal is relatively smaller in women than in men. Individuals with diabetes or thyroid conditions are more likely to develop carpal tunnel as well. Additionally, pregnant women can also be more prone to carpal tunnel syndrome, particularly during the postpartum period.

Carpal tunnel syndrome continues to appear in younger individuals more and more often these days with the increased use of cell phones and computers. It can also be very related to the type of work you perform daily, especially if it involves flexing your wrist. At this time, there are no proven methods to prevent carpal tunnel from developing, aside from reducing activity. If you feel you may be at risk, wearing a wrist brace while performing the repetitive activity can help. Doctors also recommend taking frequent breaks in the workday and reducing the force behind your grip.

If you are experiencing regular symptoms on a daily basis, we recommend starting treatment sooner rather than later. Getting treated early can help slow down the progression of carpal tunnel. In addition to using a wrist brace, anti- inflammatory medications can also help decrease the swelling around the nerve. A steroid injection into the canal can decrease the inflammation as well. However, if these treatments do not result in much improvement for the patient, surgery is often the final recommended option to alleviate symptoms.

Since it can be very challenging to avoid using your wrist or hands in daily life, often many patients find that surgery is very effective. Many patients experience no symptoms two to four weeks after surgery. Although about 10% of patients can see carpal tunnel syndrome reoccur after surgery, the majority of patients come to a successful recovery.

At times, post-operative therapy may be recommended depending on if the patient has experienced any signs of motor loss or strength deficit. Therapy may take up to six weeks.

For more information about carpal tunnel syndrome or to make an appointment with
Dr. Nayyar, visit or call his office at (760) 552-8585.


Rotator Cuff Injury



For more information about rotator cuff surgery or to make an appointment with Dr. Kalra,

visit or call (760) 244-7777 ext. 224


What is a rotator cuff injury? This is a very If pain or loss of motion continues, your doctor common injury that many of us may be unfamiliar with. The rotator cuff is composed of four muscles and tendons around the shoulder joint that helps your shoulder move. The shoulder joint is a very mobile joint, just like your knee or elbow joint. The muscles of the rotator cuff are very important for many functions, including bending forwards, backwards, rotating around, and getting your arm above your head.

A rotator cuff injury usually involves a tear in the tendons rather than the muscle. Most of the injuries in patients happen because of normal wear and tear of the human body over time. Many people can even have a rotator cuff injury and not even realize it. Not all rotator cuff tears are symptomatic or painful.

However, in younger individuals, many times a rotator cuff injury can be painful if it occurs due to heavy lifting or another physical activity. In older individuals, a tear may be moderately painful but not intensely noticeable. If a tear is ignored, it can often get worse over time. A tear can grow larger in size and muscles begin to lose their strength when fat grows in its place, an occurrence called fatty infiltration. This contributes to weakness, although it may not be painful.

Often, many patients may describe a rotator cuff injury feeling like a “catch” in the shoulder. It can also feel like a dull ache. The injury does not heal on its own and needs treatment. However, sometimes other muscles take over and compensate for the tear.

Treatment is approached on a case-by-case basis. Most patients do not need surgery. Usually, corticosteroid injections are given first along with physical therapy. Injections help with pain and contribute to reducing inflammation.

will typically order an MRI to take a closer look at the tear. Depending on the results, your doctor will either recommend observing for more time or suggest surgery to repair the tear, particularly in younger individuals. The ultimate goal is to help patients

get back up to speed, so they can continue regular activities as soon as possible.

For patients who need physical therapy, treatment usually involves heat or cold therapy, massage, resting, and guidance through a range of motion exercises. The goal is to build strength in the surrounding muscles while bringing pain under control and preventing stiffness of the shoulder joint. Typically, physical therapy takes six to eight weeks to complete, twice a week.

Full recovery time can vary depending on each patient. Some cases can be more complex, often involving a combination of a rotator cuff injury and arthritis. Treatment can involve a reverse shoulder replacement surgery. Although rare, these cases do occur.

At our office, we also offer complex rotator cuff repairs involving biological patch augmentation. If a patient has poor quality tissue, they may need an allograft. We also offer our patients amniotic stem cell therapy, applied during surgery, which helps regenerate the tendon during healing. These specialized treatment options are available at our practice along with standard treatment for rotator cuff injuries.

If you are experiencing pain or stiffness in your shoulders or if you suspect you may have a rotator cuff injury, be sure to visit your doctor to make sure it does not worsen over time.


Knee Osteoarthritis



For more information about Knee Osteoarthritis or to make an appointment with Dr. Nayyar, please call (760)552-8585


Are you familiar with the joint disease known tennis or jogging to lower-impact activities like as knee osteoarthritis? If you’re not, it’s a good time to brush up on this common condition that typically affects men and women later in life. Knee osteoarthritis is a result of wear and tear on the joint over time.

Osteoarthritis affects 27 million Americans, which breaks down to one in four adults experiencing symptoms of osteoarthritis by age 65. Although any joint in the body can be affected by osteoarthritis, it’s most common in the knee.

There are many factors which contribute to osteoarthritis of the knee. First, it is a condition which can be genetically passed down through family members. Secondly, physical trauma to the knee over time can also be a major contributing factor, along with a patient’s weight. Lastly, inflammatory conditions such as rheumatoid arthritis can also cause this type of disability.

Pain in the knee is a key indicator that it’s time to see your doctor. If you are doing simple activities like walking and experiencing pain or swelling during or after your activity, it could be a sign of knee osteoarthritis. Experiencing difficulty bending or straightening your knee is a sign you may have an underlying problem.

Your doctor will determine a diagnosis of your condition after a thorough examination. He or she will also rule out any other potential issues that could be causing your pain. A medical professional can take a look at your range of motion and if you have trouble walking. Testing can also be done on the muscles and ligaments within the knee.

Surprisingly, only about half of individuals will recognize how severe their arthritis is. When you begin to feel early symptoms, it’s important to see a doctor so you can learn how to implement preventative care. Addressing knee osteoarthritis early can help stop the condition from progressively getting worse.

Switching from high-impact activities like playing tennis or jogging to lower-impact activities like swimming, walking or cycling can help prevent knee osteoarthritis from getting worse. This way, you can still remain active while also supporting your knee. Weight loss can also help slow the progression.

If lifestyle changes are implemented and you are still experiencing pain, generally, physical therapy is recommended as a next step. Strengthening the muscles outside of the knee joint can often help reduce symptoms. Assistive devices like using a cane, a walker, or shock-absorbing shoes or inserts may also be suggested. Using a heat or ice compress or adding on pain-relieving ointments or creams can also help.

Treatment can also involve anti-inflammatory medications, like ibuprofen, and/or cortisone injections, which help reduce inflammation. Another type of injection is commonly called a rooster comb injection, which is a gel-type of substance that helps lubricate the knee joint to also decrease the inflammation within the knee. More recently, there’s also been a big push for biologic injections, or what’s commonly called the stem cell injections. These involve harvesting a patient’s own blood and cells for use in an injection. For early to moderate arthritis, stem cell injections have been shown to significantly reduce the pain.

Lastly, surgery can be an option for treating knee osteoarthritis. Knee arthroscopy, involving a small incision, can be performed for early arthritis.
If the condition is severe, however, a full knee replacement may be recommended.

Overall, there are many treatment options for knee osteoarthritis. Talk to your doctor about your options. Results after treatment for knee osteoarthritis are generally positive. Be sure to seek the help you need to keep on thriving every day.

For more information about knee osteoarthritis or to make an appointment with Dr. Nayyar, visit or call his office at (760) 552-8585.