If you suffer from persistent backaches and neck pain, you may be diagnosed with spondylitis. Spondylitis refers to degenerative changes of the spine, such as the formation of bone spurs and degeneration of spinal discs. This condition can affect the neck, upper or mid back and lower back. Of these, spondylitis of the neck- cervical spondylitis and lower back- lumbar spondylitis are most common.

Spondylitis is considered to be triggered by age. As a person grows older, the wear and tear of the bones and ligaments of the spinal column can lead to the development of bone spurs and osteoarthritis. Age can also cause the discs between vertebrae to weaken and degenerate leading to bulging discs and herniating spinal discs. Most people experience the first symptoms of spondylitis between the age of 20 and 50. A family history of spondylitis and being prone to injuries also increases a person s risk of suffering from spondylitis.

Since spondylitis is a degenerative disease, there is no cure for this condition. However, the pain associated with it can be managed. Thus, treatment for spondylitis is very similar to treatment for neck or back pain. This treatment can be in the form of pain medication, exercise, physical therapy and minimally invasive surgery. Depending on the extent of spinal damage the doctor may prescribe steroids that need to be injected directly into the intervertebral spaces. This is also known as epidural injections.

Spondylitis patients are often advised to follow their normal schedule and refrain from bed rest as this can prolong recovery. However, at the same time, you should not undertake any activity that puts additional pressure or stress on the spinal column. Alternating between warm and cold compresses can help relieve the pain associated with spondylitis. Additionally, try sleeping with a pillow between your legs to relieve low back pain. 

Special pillows that offer cervical support can help relieve spondylitis of the neck.

Surgery may be considered in cases where this condition causes or worsens nerve damage. Spinal decompression surgery involves relieving pressure on the nerves in the spinal column that may be caused by a herniated disc, spinal stenosis or foraminal stenosis. This surgery can be performed through a laminectomy, discectomy or foraminotomy. Bone spurs in the spinal column or a vertebral disc can also be removed surgically. However, these surgeries are rarely performed as most patients respond well to non-surgical treatments.

Causes of Spondylitis - How Can it Be Treated?

Muscle sprains and ligament tears are one of the most common injuries that medical practitioners encounter on a regular basis. These injuries are painful and can also limit one s movement, needless to say. However, there are simple things that can be done as soon as the injury happens so that the impact of the injury can be reduced, the symptoms minimised, and recovery improved.

A sprain is a tear of the ligament. The ligament is responsible for connecting the tissue strands that connect the bone to the muscle. When this sprain affects the muscle or even the tendon, it is known as a strain.
Sprains are very common and can occur due to a fall, twist, or impact. Most commonly affected areas are the ankles and wrists. Sprains happen when there is a pull or a twist of the ankle or the joint. This is very common in athletes and can be caused by repetitive motions in the knees, wrists, elbows, etc.

The most common symptom is pain, swelling, limited movement, and sometimes bruising. The degree of these injuries depends on its severity. The most common ways to treat such injuries are as follows.

RICE therapy: RICE is an acronym for rest, ice, compress, and elevate. Rest the affected area immediately by stopping any further activity. Ice the area using an ice wrap, with the ice cubes wrapped in a towel or a cotton cloth. Repeat this exercise if possible for every 20 minutes. This will reduce the swelling and pain. Compress the area using a sling or a wrap. This will help in reducing the swelling. Elevate the affected area if possible above the heart. This will help control the blood flow and thereby reduce the swelling and pain.
Pain control: If there is pain that needs medication, go for the non-steroidal drugs like ibuprofen or acetaminophen. If it is a child that is injured, it is advisable to give non-aspirin ones.
Seek professional help: Most sprains can be self-limiting over a couple of days. However, it is advisable to seek medical help if there is significant pain, swelling, or numbness, open wounds or bruises, or inability to move the joint.
The doctor may decide to do the following.

Scanning or imaging to rule out any internal hard/soft tissue injury like fracture or tear
Immobilise the joint with a splint or a cast
Start physical therapy if there is severe pain and immobility
Surgical repair if there is a ligament injury
A word of caution to athletes or people who are very active physically is to go easy on the joint. In an eagerness to quickly get back to their routine, more and severe damage may be caused. This can be avoided by allowing time for complete healing.

Muscle & Ligament Sprain - Tips To Help You Deal With It!

Shoulder pain can be a persistent dull and nagging sensation in the upper arm or shoulder area. It can be easily differentiated from neck pain as it is related to the movement of shoulders i.e. it will increase and decrease with shoulder movements, especially overhead activities. The other signs to identify shoulder pain is if your shoulder movements are reduced.

If you find it difficult to scratch / wash your back, comb your hair or reach your back pocket, it clearly shows you are suffering from shoulder pain. Shoulder pain can happen due to various reasons, it varies from person to person depending on the activities he/she is involved in, for e.g. sports, manual job etc. It can be a single major injury or multiple small injuries due to repetitive usage patterns. Also, degenerative changes in various parts of the shoulder can lead to shoulder pain.

In case of middle to old age, injuries that can cause shoulder pain are:

    Biceps Tendonitis
    Acromio-clavicular Joint arthritis
    Scapular Dyskinesia
    Trapezitis
    Suprascapular nerve entrapment In young age, injury due to sports or gym activity can cause shoulder pain
    Superior labral anterior/posterior (SLAP tear)lesion

Also, traumatic or repeated dislocations of shoulder can cause shoulder pain due to:

    Bankart lesion

Diagnose Shoulder Pain

Shoulder pain can be diagnosed only after thorough history taking and clinical examination. However, some imaging studies can be very helpful like:

    X-rays: Through an x-ray one can view the shoulder in many different views.
    Ultrasound: With an ultrasound, you can also check the damaged caused to the tendons and muscles of the shoulder but the quality of reporting depends upon the expertise of the doctor.
    MRI: MRI gives a clear picture of the shoulder as it shows everything related to a shoulder joint that is joints, vessels, tendons and muscles that too from different angles.
    Diagnostic Arthroscopy: A surgical procedure often used by orthopaedic surgeons to diagnose and treat issues inside a joint. Arthroscopy has the big advantage that one can use it to diagnose as well as treat at the same time.

Treatment for Various Types of Shoulder Pain

    For Shoulder Impingement or Rotator Cuff tear: Give rest to the shoulder for a few days only Dedicated Physiotherapy Protocol Bursal injections If these fail then, (Surgery)Arthroscopic sub-acromial decompression If Cuff tear is found, then one can go for Arthroscopic/Mini-open repair
    Labral Lesions: For anterior Labral lesions (Bankart's) following anterior shoulder dislocation then surgery in the form of Arthroscopic Bankart's repair is the only option to reduce risk of recurrence and degeneration.

SLAP Lesions

    Pain relief and physiotherapy as first step If this fails then following surgical options are available
    Arthroscopic debridement or repair of labrum
    Biceps tenotomy or tenodesis

Arthritis

In this case, the joint is already destroyed and has to be resurfaced for pain relief and to maintain ROM. If Rotator cuff muscles are working, then Shoulder resurfacing hemiarthroplasty (preferred in young people), that has a life of 10 to 15 years, Total shoulder replacement (preferred in middle aged to old people) has a life of 10 to 15 years. But, if rotator cuff muscle are not working then Reverse Geometry Shoulder replacement is recommended, that has a life of 10 years.

It is always advisable to get yourself diagnosed properly in case of shoulder pain as management changes depending on clinical situations. Neglecting shoulder conditions can lead to bigger problems later on.

Always remember 'a stitch in time saves nine'

Shoulder Pain: Causes, Diagnoses & Treatment

Physiotherapy plays a pivotal role in helping a person recover after a hip replacement surgery. It brings back the old flexibility and prevents blood clots in the area where the procedure has taken place. After the surgery team gives its green signal, a physiotherapist starts working with a patient for a full recovery. 

Here is a list of some common exercises that a physiotherapist suggests after a hip replacement surgery:

Walking: It is important to use the crutches for a time period of 4-5 weeks post the procedure. Until the surgeon or the physiotherapist advises against using the crutches, it makes sense to use it while walking. It makes sense to retain the normal walking posture by using the crutches rather than limping without it. A physiotherapist reviews the pressure exerted by the arm while holding a crutch, before advising the patient to get rid of the crutches.
Increasing hip flexibility: This is a basic form of exercise where an individual lies on one side of the body with knees and hips bent. A pillow is placed in between the knees. While doing this, it should be ensured that both the feet is kept together and the back muscle is not twisted. The top knee should be slowly raised like an opening of the calm shell. This position should be maintained for 4-5 seconds.
Strengthening the hips: The body should rest on the stomach. The buttocks should be tightened and one leg should be slowly lifted. This position should be maintained for a stretch of 3-5 seconds. The same should be repeated for both the legs.
Strengthening the hip and the stomach muscle: The body should rest on the back with a leg bent. The stomach muscle should be tightened and the bent leg should be lifted carefully while ensuring that the bend does not supersede more than 90 degrees. While keeping the stomach muscle tight, the lifted leg should slowly come down to touch the surface. This act should be repeated for 5-6 times.
Strengthening the thigh muscle: While sitting in a steady chair, an elastic loop should be wrapped around the ankles. The elastic loop should be stretched with one leg while keeping the other foot firmly rooted to the ground. The lifted foot should slowly come down to the normal position. The same act should be repeated for 4-5 times.
Improving balance: An elastic loop should be tied to one leg of a table and the other end of the loop should be tied to one ankle. The table should be held on for maintaining balance. Maintaining an erect position, the tied up ankle should be stretched sideways. The position should be maintained for 3-5 seconds to return back to normal standing position.

How Physiotherapy Can Improve Recovery After Hip Replacement Surgery?

Fractures are simply a break in a bone. They can be caused due to injury, (traumatic fractures) or a pre-existing condition like osteoporosis that causes weakening of bones (pathologic fractures). There are many ways to classify fractures. All fractures fall into the major categories of simple and compound fractures. Simple fractures are fractures where bones remain inside the skin and don t jut out. They are also called closed fractures.

Compound fractures, also called open fractures, are broken bones that penetrate through the skin. These types expose the bone and deep tissues to the environment. Compound fractures are more serious of the two. The healing here may be affected due to deep infections for which antibiotics need to be used. There are many different sub types of fractures and we re only going to skim through them here.

Comminuted fractures: Severe fractures in which a bone breaks into several smaller pieces.
Avulsion fractures: A small piece of bone is completely torn off from the main bone due to fierce pulling off a part of the body.
Other types of fractures are characterised by the many different angles the bone breaks into like transverse, oblique and spiral fractures.

Diagnosis
When a bone is broken there are symptoms like swelling that doesn t subside on its own and pain. In such a case it s imperative that one goes to a doctor for a diagnosis. Doctors can usually recognise most fractures by examining the injury and taking an X-ray. The X-ray also provides a clear idea about the type of fracture and the degree of displacement of the bone. And, it s important that the patient doesn t wait too long before approaching a doctor. This is because bones begin to heal very quickly after a fracture and the bone tissue will heal using any tissue available. This can lead to a misalignment of broken pieces of bone and cause disability and loss of function.

There are cases when X-ray may not show a fracture. This is especially common in fractures in the hip and wrist in older people. For diagnosing these, doctors will get some other tests done such as a computed tomography (CT) scan, magnetic resonance imaging (MRI), or a bone scan.

Treatments
Fractures have to be treated by doctors. The doctors set the fractured bones in their proper place and hold them there so that they can heal. Setting a bone is called "reduction." Reduction without surgery is called "closed reduction." But if the fracture is serious, it s going to require surgery with bone repositioning, called open reduction.

In extreme cases, pins, plates, screws, rods, or glue are used to hold the fractured bones in place, inside the body. Once the bone abutment has been treated, the bone is immobilised to allow the broken pieces to heal. In most cases, the fractured part is set in a rigid cast. The fractured ends of the bone can be fixed into place using metal pins connected to an external frame. This is removed after the bone has healed.

Fractures - How To Diagnose Them?

Not all people who suffer from Tennis Elbow have swung their racquets, and those who have never been affected by the problem will not be able to understand how severe the pain and discomfort can be. It is a debilitating condition that affects one s normal lifestyle in both minor and major ways.

Platelet-rich plasma therapy is nowadays considered a promising treatment for consistent and chronic tendon problems including Tennis Elbow and Golfer s Elbow. It is often conjugated with autologous blood injection which is a quick and minimally invasive process using the cells of the patients without any use of any drugs.

What is Tennis Elbow?
The human elbow is a joint comprising of three bones: humerus in the upper arm, ulna, and radius in the lower arm. Each part of the bone is covered with cartilage that facilitates free movements of the bones. Tennis elbow occurs at times when the epicondyle layer on the elbow joint become inflamed or torn.

Understanding platelet-rich plasma therapy
PRP is a non-surgical, in-office treatment which starts withdrawing a little amount of blood. The blood is then spun in a centrifuge for concentrating the platelets in the place. This process also segregates the red and white blood cells. Then the platelets together with some amount of plasma are injected into the body in the affected region which has some injury and is not able to heal properly.

When a person is affected with Tennis Elbow, the platelet-rich plasma is injected into the Flexor Origin present on the medial side of the wrist extensor tendon origin at the lateral epicondyle. The doctor may need to jab the needle in different places.

Why is PRP suitable for Tennis Elbow?
The primary objective of using platelet-rich plasma therapy is utilizing the cells and protein of the body along with specific healing factors that can stimulate and jumpstart the process of healing in the tendons. To begin the healing process that has either stalled or could not be completed or has never started, the PRP is the best means. The first step of beginning the healing process is dealing with the inflammation. Experts are fascinated at the way in which the platelet rich plasma can replace the conventional anti-inflammatory medical treatments of Tennis Elbow.

The arrival of platelet-rich plasma has caused the corticosteroid shots to lose their popularity. Because, though they can relieve acute pain for a short span of time, they do not promote healing and may also cause further breakdown of the affected area.

PRP therapy is known for improving the natural healing process of the body. It has ignorable side effects, and the best part is that it is minimally invasive. Since Tennis Elbow is becoming more common these days, it needs to be treated in ways that would be able to complement one's situation and restore normal functionality. 

Consider Platelet- Rich Plasma Treatment For Effective Treatment Of Tennis Elbow

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