The carpal tunnel is the passageway for the median nerve to pass through on the inner side of your hand, when your palms are facing down. For example, while typing, there is a lot of movement of the fingers and this puts a lot of pressure on this tunnel. In fact, people who are involved in a lot of typing are one of the most prone people for carpal tunnel syndrome (CTS). Other causes would include trauma, fractures, etc., where the tunnel is injured.

Conventional measures to treat CTS included a combination of exercise and pain killers in mild to moderate cases. In moderate (sometimes) to severe cases, surgery was also done. However, with advancements in medical technology, endoscopic surgical procedure is gaining popularity.

What is done?
In endoscopic surgery, a small incision is made in the wrist or one each in the palm and the wrist. Through this, a flexible tube with a camera and minute cutting tools are inserted into the wrist. Another ligament known as transverse carpal ligament is cut. This reduces the pressure on the median nerve, which provides relief from the CTS symptoms.

What to expect as benefits?
The intention behind the surgery remains the same in both traditional and endoscopic procedures. The pressure on the median nerve is released, restoring movement and reducing pain in the joints. In addition, the endoscopic procedure has the following benefits.

Less invasive: Needless to say, there are only one or two small incisions done for this procedure, so less surrounding tissue is damaged.
Same day surgery: No hospitalization is required, and unless required, the patient can return home on the same day of surgery.
Reduced recovery time: The recovery period is usually substantially less compared to the traditional surgical approach.
Back to work: Depending on which is your dominant hand, you would be able to return to your regular work earlier than with regular surgery. If your non-dominant hand is involved, a day or two of rest is required. If your dominant hand was involved, give it up to four weeks for complete recovery.
Reduced chances of nerve injury: The area of operation has many nerves and blood vessels, and endoscopic surgery reduces the chances of damaging adjacent nerves.
Anesthesia: This is done under local anesthesia. Therefore, complications arising out of general anesthesia are completely avoided.
Indications
While these sound promising, your doctor will decide if you are a candidate for endoscopic procedure depending on the following:

Nonsurgical treatment including exercise and pain killers have not provided relief, even after several months.
Severe symptoms including those of nerve damage, like loss of sensation, altered coordination, etc., is affecting your normal daily routine.
Person requiring bilateral surgery like severe trauma, wheelchair dependent, etc.

Carpal Tunnel - How Endoscopic Surgery is Beneficial?

Fibromyalgia is a condition characterised by extreme muscle pain that is followed by weakness, fatigue and issue with the state of mind. It is believed that fibromyalgia causes painful sensations by affecting the way your mind forms pain signals.

Indications now and then start after a physical injury, surgery, disease or critical mental anxiety. In different cases, side effects progressively show after some time with no single occasion that triggers it.

Here are some coping methods you can use to help yourself live well with fibromyalgia:

Minimize stress and tension in your life. Stress may play an essential part in activating fibromyalgia side effects and its symptoms. Many individuals with fibromyalgia tend to feel on the edge, anxious, and inactive around the time when the side effects fibromyalgia flare up.

Exclude yourself from unpleasant circumstances. People tend to amplify issues, making them appear to be far more prominent than they are. When you think of something to be a last chance situation, despite the fact that in reality, it is not, your body responds as though you are at risk. Work at treating your feelings as problems come by.

Make worksite adjustments. To continue working full-time, you should stay rationally and physically ready to handle your employment obligations. To keep away from stress and tension, you may need to give additional time during the day to complete your personal needs and sort out your problems. Converse with your manager and work out a timetable that allows you to manage your time.

Coordination. Coordination is important with an unending condition like fibromyalgia. Transparent conversations diminish the problems amongst you and your companion, family, friends and colleagues.

Figure out how to say no. Failing to say no to excessively numerous requests will make you overburdened. That will add to your anxiety level. To help yourself say  no  to a convincing companion, consider the circumstance before you reply and also think about the time you will be saving.

Keep a diary. Writing in a diary consistently can turn into a great channel for analyzing yourself and your situation. A few people can also figure out when their fibromyalgia symptoms started. That can help them see how and when the symptoms began.

Take a hot shower. Take a hot shower, a hot tub bath, or a steam bath. To begin with, it will help you to unwind the muscles that are tense. It will also decrease the pain and make your muscles more flexible and effortless to move.

Exercise frequently. As per physiotherapists, exercising routinely is vital to get rid of fibromyalgia. In light of the pain, delicate muscles, continuous weakness, and stiffness felt by individuals with fibromyalgia, many have turned out to be physically unfit. Hence, all of the above-mentioned treatments are very important in order to stay fit.

How To Deal With Fibromyalgia?

Also known as Median Nerve Compression, Carpal Tunnel Syndrome is characterized by a sensation of tingling and numbness in the hands or the arm caused due to a strained nerve of the wrist. This condition occurs due to stress which affects the functioning of the part of median nerve, situated along the wrist.

Various Causes of Carpal Tunnel Syndrome:
Constant movement of the hands in activities such as typing on the computer
Pregnancy
Arthritis

Various Symptoms of Carpal Tunnel Syndrome:
The symptoms of this syndrome start to show up when there is excessive pressure build up in the median nerve of the wrist. You may experience-

A sensation of numbness
A sensation akin to the pain experienced when needles are inserted into the skin
Pain (mostly at night)
The build- up of pressure can occur due to a number of reasons. They are-

Painful injury
Fracture
Tenosynovitis (a condition that affects the tendons along the sides of the thumb)
The compression of the nerve may develop anywhere, and not necessarily the wrist only.
Diagnosis of Carpal Tunnel Syndrome:
Doctors base their diagnosis of the condition on the symptoms and certain tests. These include-

Phalen s test (a test that is carried out to determine any pain or numbness in the fingers within one minute of this activity)
Wrist flexion/median nerve compression test
Tinel s test (a test that is used to diagnose irritated nerves)
Few nerve enlargements may be revealed by an ultrasound, X-Ray, MRI scan, CT scans etc. The doctor generally recommends any of the above tests to determine carpal tunnel syndrome.
Important measures that help treat the condition are

Getting ample rest
Educating yourself on the various symptoms
Knowing certain activities or movements that trigger symptoms
Attending physiotherapy sessions
Physiotherapy as an important form of treatment for Carpal tunnel syndrome
Extensibility of muscle as well as soft tissue
Strengthening the forearms and the ability to grip things and pinch too
Maintaining posture and performing hand agility exercises can improve the hand movement
Mobilization of the Carpal bone and stretching of the flexor retinaculum (a fibrous band near one s wrist) so as to widen the carpal tunnel
Gliding training for nerves/ tendons for unrestricted motion
Endurance training for strengthening the upper limb as well as the wrist

Carpal Tunnel Syndrome - Measures That Can Help Treat It!


A fracture separates a single solid object into two or more pieces due to pressure. In medical terms, a fracture refers to a broken bone due to some kind of external trauma. A crack in the bone, on the other hand, it does not cause a clean break in the bone, there is only a separation or discontinuity in the bone material.

A crack in the bone caused due to repeated stress is often called as 'hairline fracture'. Here are the basic differences between a crack and a fracture in the bone and how to treat them:

1. A crack or hairline fracture is rarely caused by a single injury. It is usually the result of bone fatigue, which may be caused due to repeated, concentrated stress over a long period of time and thus, it is also called as 'stress fracture'. Other bone fractures are almost always the result of sudden and severe force on the bones.

2. The skeletal system constantly remodels itself. The cells, known as 'osteoblasts' absorb calcium and secrete bone connective tissue. If a particular site is exposed to recurrent bouts of force (which are individually not impactful enough to cause a crack), over time the osteoblasts in that region malfunction and the crack appears.

Muscular exhaustion can also cause cracks in the bone. Fractures are caused due to sudden external single force trauma to the bone. Nutritional problems like deficiencies of Calcium, Phosphorus, vitamin D and excessive smoking decrease the bone mineral density and increase the chance of both cracks and fractures.

3. Symptoms of a crack are swelling, tenderness and sharp pain in the injured region and the symptoms worsen over time. A fracture has similar symptoms and might also exhibit an external physical distortion and makes it impossible to move that part of the body that where the bone is broken.

4. An MRI is often suggested for detecting the crack or crack-prone areas because an X-ray can only detect the crack after it widens somewhat or the bone starts paining because the rays cannot pass through the tiny gap in bone material. A fracture is easily detectable by an X-ray because the rays pass right through the break.

5. Complete rest for six to eight weeks is the most effective way of healing a crack. Using a walking boot in case of cracks in the leg bones in also helpful. Healing fractures require extensive medical intervention. Surgical techniques like bone grafting and the insertion of metal plates are used to reposition the broken bone.

Cracks VS Fractures

The knee is the largest joint in the human body and is a complex structure formed of bone, muscle and cartilage. Development of pain in the knees can be caused by numerous factors such as aging, injuries, diseases, dietary deficiencies, etc.

Arthritis is the most common cause of knee pain and usually affects the elderly and aged. It occurs due to an inflammation of the joint and causes pain, swelling, redness and inflexibility of the knees.

What are the factors that determine treatment method?

Diagnosis for knee pain varies from patient to patient as each case is different and must be approached differently. Some of the factors that determine the treatment method are as follows:

- Cause of the problem
- Nature and intensity of pain
- Age of the patient
- Medical history of the patient
- Diet and lifestyle of the patient

There are a number of different types of arthritis which can affect the knees in different ways and, consequently, require different types of treatment methods.

What are the various treatment methods for knee pain?

1. Conventional Remedies - These are used in case of conditions that are not too severe or chronic. It includes keeping on bed rest, using an ice pack, taking a painkiller and anti-inflammatory medicines, wearing knee braces, etc.

2. Physical Therapy - There are many stretching and strengthening exercise routines that help alleviate knee pain and treat the condition. Recovery is achieved by making the muscles around the knees stronger and increasing stability and flexibility.

3. Injections to the Knees - A number of anti-inflammatory substances and supplements, as well as lubricants, can be injected into the knee joint which helps reduce pain and makes the joint more supple.

4. Stem Cell Therapy - This involves drawing platelets from the patient's blood and injecting it into the knee joint for repairing damage caused to ligaments, tendons or cartilage.

5. Surgery - Surgical procedures for treating knee pain include partial or complete knee replacements.



What kind of treatment does your knee pain require?

A small piece of bone is known as a fragment and it is very common that an avulsion fracture also tends to damage the protrusions of bone to which the tendons attach. This basically means that the tendon or ligament will come away from the bone and it will take a small piece of bone with it. It is sometimes very hard to find out what type of injury you have and this is why knowing the causes and symptoms of an avulsion fracture are very helpful in determining exactly how severe the injury is. 

Here are the causes of an avulsion fracture:

Explosive landing: Athletes who tend to jump or land with great impact tend to get these most commonly. Therefore, it is crucial for your health that if you participate in such sports, you do follow the correct method of jumping.
Explosive extension: Similar to how an athlete landing ferociously can get an avulsion fracture, someone who is extending the legs very violently and explosively during an exercise can also get an avulsion fracture. This is because the bone getting extended could very well damage the protrusions to which the tendons are attached. 
Symptoms
These are the two main causes of an avulsion fracture. There are not many symptoms of an avulsion fracture. This is because an avulsion fracture can only be determined by an MRI or by an X-ray scan. Therefore it is nearly impossible to diagnose that you have an avulsion fracture without looking at the results of the tests performed on the part of your body. However, the way you got the fracture and especially the details of it are very good indications of whether you have an avulsion fracture or not.

Avulsion Fracture - Common Causes Behind it

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