In recent times, there has been an upsurge in the instances of leg pain. People from all age groups, irrespective of their gender, are being affected. Needless to say, this painful and uncomfortable condition throws life in jeopardy and adversely affects and interfers with a person's daily activities. While the pain can be in both the legs, many people also suffer from severe radiating pain in one leg.

What causes radiating pain in one leg?
More than often, this kind of pain is triggered by nerve problem or disorder. If you experience a shooting pain that originates in the lower back and gradually radiates down to one of the legs (from the buttocks to the back of the leg), chances are you are experiencing sciatica.

In sciatica, the nerve affected is the sciatic nerve. The sciatic nerves originate from the spinal nerves L4 to S3. From the lower back, the nerves (two sciatic nerves) extend downwards to the back of each leg. The sciatic nerves further divide into a tibial and peroneal nerve. These nerves are mostly responsible for the sensation and motor functions of the legs and the feet.

Sciatica can be an outcome of
The discs present between the vertebrae provides them with a much-needed cushion, preventing injury or damage. In case, of a degenerative disorder of the disc, the protective cushion gets affected resulting in the pain and associated symptoms.

Lumbar spinal stenosis: A medical condition where the spinal canal in the lumbar area narrows down, exerting pressure on the sciatic nerve.
Spondylolisthesis or a slip disc: The condition mostly affects the lumbar area (base of the spine) whereby there is slippage of one of the bones over the adjacent bone (the bone located just below it).
A muscle pull in the buttocks can also trigger sciatica and many times, a pregnant woman may also experience sciatica. The sciatic pain can be:

Chronic sciatic pain: As the name suggests, chronic sciatic pain is intense and more severe, with the symptoms persisting for a longer time (more than three months). Arthritis, severe nerve damage or scarring (tissues) are often responsible for chronic sciatic pain.
Acute sciatic pain: An injury to the nerves, muscles, spinal joints or discs can cause the pain. However, as instantly as the pain starts, the condition improves within days (at times weeks).
In addition to the radiating pain, there may be other symptoms associated with sciatica such as

Difficulting in leg or foot movement.
Weakness
Sciatica can also trigger a pain in the back of the leg which aggravates when a person is in a sitting position
Hip pain
Numbness, and often a tingling or burning sensation radiating down the leg
In some people, sciatica can cause a shooting pain (which worsens when a person tries to stand up)
The pain (in some cases) can extend to the foot and toes
There can be many underlying factors responsible for the pain radiating to one leg. Neglecting the condition will only worsen the situation further. 

Radiating Pain In One Leg - What Can Be The Reason Behind It?

At some point in life most people experience acute pain in their lower back which is extremely painful. Pain in the spine causes a lot of discomfort and disruption in the life of an individual and hence, it is always better to get it checked on time. There are patients who even wonder when they should consult a neurosurgeon or a spine surgeon for their back pain. It is advisable that a physical examination is done by a primary care physician for low back pain before consulting a spine surgeon.

Why consult a Physical care Physician First?
The main reason to consult a primary care physician at first is that he would prescribe medications for severe lower back pain. The medications could include non-narcotic pain medications such as Ultram or non-steroidal anti-inflammatory drugs such as Motrin. The physician can even refer you to a chiropractor or for physical therapy to get relief from the back pain. Mechanical means are made use of by a chiropractor mainly to alleviate the back pain of the patient.

If the patient feels better with the physical therapy or the medications prescribed by the family doctor and is able to resume normal activities, then there is no need to see a spine surgeon. It is often recommended to take good care of the back and to exercise. A combination of ergonomics, regular stretching and improved everyday posture is beneficial as it reduces the chance of causing pain in the lower back. Exercise plays a very important role and it provides the possibility of reducing the pain.

Conservative Care for Treating Lower back Pain
It is best for patients to consult a conservative care specialist if after consulting a chiropractor they do not find any reduction in their pain and they do not want to undergo spine surgery. The conservative care specialists are well-trained in rehabilitation of musculoskeletal disorders and specialize in spine care. The role of the conservative care specialist is similar to a cardiologist who specializes in treating neurological disorders.

The specialist for spine care works along with the surgeon in a spine center to treat the lower back pain. The specialist is trained in diagnostic techniques and is capable of making use of a combination of diagnostic tests as well as injection techniques such as epidural steroid injections to diagnose the source of the lower back pain in a patient. They can even advise patients whether it is appropriate to consult a spine surgeon for surgery. Surgery is done to correct the anatomical conditions and it is performed only when non-surgical treatments are not successful in alleviating the pain of the patient.

When Is The Right Time To See A Spine Surgeon?

Spondylitis includes swelling of the vertebra. It happens because of wear and tear of the ligament and bones found in your cervical spine, which is in your neck. While it is to a great extent because of age, it can be brought on by other reasons too. Side effects incorporate pain and stiffness starting from the neck to the lower back. The spine's bones (vertebrae) get fused, bringing about an unbending spine. These changes might be mellow or extreme, and may prompt a stooped-over posture. Some of the non-surgical methods to treat spondylitis are as follows-

Exercise based recovery/physiotherapy: Your specialist may send you to a physiotherapist for treatment. Non-intrusive treatment helps you extend your neck and shoulder muscles. This makes them more grounded and at last, relieves pain. You may neck traction, which includes using weights to build the space between the cervical joints and decreasing pressure on the cervical disc and nerve roots.
Medications: Your specialist may prescribe you certain medicines if over-the-counter medications do not work. These include:
Muscle relaxants, for example, cyclobenzaprine, to treat muscle fits
Opiates, for example, hydrocodone, for pain relief
Epileptic medications, for example, gabapentin, to ease pain created by nerve damage
Steroid infusions, for example, prednisone, to decrease tissue irritation and diminish pain
Home treatment: In case your condition is less severe, you can attempt a couple of things at home to treat it:
Take an over-the-counter pain reliever, for example, acetaminophen or a calming medication, for example, Advil or Aleve.
Use a warming cushion or an ice pack on your neck to give pain alleviation to sore muscles.
Exercise routinely to help you recover quickly.
Wear a delicate neck prop or neckline to get transitory help. In any case, you shouldn't wear a neck brace for temporary pain relief.
Acupuncture: Acupuncture is a highly effective treatment used to mitigate back and neck pain. Little needles, about the extent of a human hair, are embedded into particular points on the back. Every needle might be whirled electrically or warmed to improve the impact of the treatment. Acupuncture works by prompting the body to deliver chemicals that decrease pain.
Bed Rest: Severe instances of spondylitis may require bed rest for close to 1-3 days. Long-term bed rest is avoided as it puts the patient at danger for profound vein thrombosis (DVT, blood clots in the legs).
Support/brace use: Temporary bracing (1 week) may help get rid of the symptoms, however, long-term use is not encouraged. Supports worn for a long time weaken the spinal muscles and can increase pain if not continually worn. Exercise based recovery is more beneficial as it reinforces the muscles.
Lifestyle: Losing weight and eating nutritious food with consistent workouts can help. Quitting smoking is essential healthy habits to help the spine function properly at any age.

Spondylitis - Can Non Surgical Methods Help You?

Muscle contusion is a condition that is characterized by bruising in the muscles. It generally tends to occur in athletes who play a lot of contact sports. Repetitive blows in any part of the body may cause damage to the underlying muscle tissues. These blows may lead to internal bleeding, resulting in blood clot formation. The most common site where it occurs are the quadriceps.


The various causes of this condition are:
1. Direct repetitive blows to a part of the muscle in contact sports such as football
2. If you fall on a hard surface 
3. It may also occur if the muscle comes in contact real hard with sports equipments like soccer balls

The symptoms of a muscle contusion are:
1. You may experience swelling of the muscle
2. Excessive pain
3. Decrease in range of motion in the concerned body part
4. It may lead to leaking of blood vessels
5. You may also experience hematoma where a lump is formed over the affected spot
6. Symptoms of broken bones, dislocations and fractures may also occur

Complications
This disorder may also lead to various complications such as compartment syndrome, which leads to compression of blood vessels resulting in pain. 

Treatment
The basic treatment for this condition is the rice protocol which is rest, ice, compression and elevation. You should rest the muscle, then apply ice to the affected area to reduce the pain. You can also take nsaids (non steroidal anti-inflammatory drugs) to reduce the pain. In severe cases, the doctor may drain the lump surgically.


It is advisable to not return to your normal sports routine in order to allow the muscle to recover. If you carry on with your regular routine, it may result in further complications like the formation of scar tissue. You may undergo various stretching exercises to relieve the pain and make a gradual return to your normal sporting activities.


Causes and Symptoms of Muscle Contusion

Myths about Total Knee Replacement

Myth#1 - Knee replacement is a surgery for old people. “I’m too young for a knee replacement.”
Fact - Candidacy for a knee replacement is not based on age, but on the person’s level of pain and immobility. Living with a painful joint that prohibits you from working or participating in normal life activities is an outdated way of thinking. Age is not necessarily a limiting factor. Often times, a patient is actually fearful about the uncertainty of surgery. Once they are able to resume many of the activities they enjoyed before the surgery, with increased mobility and with less pain, they are very happy they had the surgery. The quality of life one achieves by living without knee pain is priceless.

Myth#2 - “I should wait as long as possible to undergo knee replacement surgery” 
Fact - You don't need to suffer by waiting until the pain is intolerable. The longer life of joint replacements enables people to consider surgery earlier and at a younger age. Osteoarthritis is a degenerative disease that continues to damage the joint and delaying surgery makes both surgery and return to activity more difficult. Delaying surgery lowers a patients’ quality of life not only before the operation, but even for up to two years following surgery.

Myth#3 - “I should continue with medications as long as possible”
Fact - Medicines including painkillers just give symptomatic relief for a temporary duration and prolonged usage is riddled with serious side effects such as renal failure, peptic ulceration  etc. All these medicines are NOT curable.

Myth#4 - Alternative therapies such as acupressure, ozone treatment, massage beds, oils, laser therapy, magnetic therapy; braces will cure my advanced arthritis and knee pain.
Fact - Till date there is NO cure for advanced knee arthritis and these alternate therapies are not backed by established scientific data. All these modalities give temporary pain relief in early to moderate arthritis for some duration only and are NOT curative. Often times, a patient who is actually fearful about the uncertainty of surgery lands up trying these in order to avoid surgery. 

Myth#5 - After a knee replacement, it takes months to recover.
Fact - Depending on the activity, most patients who undergo knee replacement are able to perform routine tasks within a few weeks. A return to rigorous activity takes only a few months. One becomes independent for himself before discharge from hospital. There’s no prolonged best rest required after the surgery.


Myth#6 - After knee replacement, I’ll have to give up some activities and sports.
Fact - You have a high probability of getting back to activities like brisk walking or cycling in 6 to 12 weeks. It will take a bit longer to return to more rigorous activities and contact sports. Squatting and sitting cross legged though possible but at best should be kept to minimal.

Myth#7 - Knee replacement surgery leaves a large scar that is noticeable.
Fact - Scarring is minimal compared to traditional surgery. In fact, the scar is typically only 3 to 5 inches long. As time passes, the scar will fade and become less noticeable.

Myth#8 - Knee replacement is a very painful surgery. There is lots of pain in post operative period.
Fact - With modern day pain management such as in a multimodal approach, ensures that the patient does not feel any pain in post op period and has a smooth recovery.

Myth#9 - Knee replacement is done one at a time.
Fact - Both the knees can be operated at the same time if the patient does not have significant co morbidities and is deemed fit to undergo the procedure by the doctor.

Myth#10 - The new knee lasts for 5-6 yrs. only.
Fact - With modern day precision including computer assisted knee replacement and advancement in biomaterials, the survivorship has increased considerably. Today's joint replacements last 25 years or longer and, for most people, will last a lifetime.

Myth#11 - Knee replacement cannot be done a second time.
Fact - Knee replacement can be done multiple times what is called as a revision joint replacement surgery with good survivorship.

Myth#12 - “I am obese, I cannot undergo Knee replacement surgery.”
Fact - Knee replacement can be successfully done in an obese patient though the recovery is somewhat prolonged and might require additional implants. However, patients who are morbidly obese and have restricted mobility primarily due to obesity are better off after a bariatric procedure.

Myth#13 “I have diabetes or hypertension or heart ailment, so  I cannot undergo Knee replacement surgery.”
Fact  - diabetes hypertension or heart.



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 13 Myths About Total Knee Replacement (TKR), Busted!

Bursitis is a disorder that is characterized by inflammation of a fluid filled sac called the bursa. Bursa is present in between various tissues such as muscles, tendons and bones where friction may occur. This sac cushions the tissues and prevents friction. The usual areas that are affected by this condition are hip, shoulder and the elbows.

The symptoms of bursitis are:
1. You will experience pain in the affected area
2. Tightness and stiffness in the area
3. Local swelling of the muscle
4. Redness of the area
5. Any physical contact with the area causes pain

Bursitis may also occur due to the following reasons:
1. Ageing results in loss of elasticity of the tendons, thus impairing their ability to tolerate any stressful activity
2. Sports such as baseball where you are required to throw the ball with force may lead to bursitis
3. If you do tasks that require kneeling down on a regular basis
4. Sitting on hard surfaces for extended periods of time
5. Abnormalities such as improperly placed joints
6. Inflammation from other conditions such as gout, thyroid disorders and rheumatoid arthritis may lead to bursitis

Treatment
The condition is treated by using a variety of methods such as exercise and medication. Antibiotics are used to treat any underlying infection causing bursitis. Injections may be administered to reduce inflammation in the affected area along with exercises to strengthen the affected muscle. In severe cases, the doctor may resort to surgery to treat this condition.

Prevention
You may use certain preventive measures to stay clear of bursitis. Some of them are
1. Lift with proper form: If you are lifting something heavy, then make sure you keep the spine straight and bend your knees slightly.
2. Take breaks: Don t remain in the same position for long duration, take small breaks and walk around to release the stress from your legs.
3. Exercise: Do strength building workouts to build strength in the joints. Include mobility and flexibility stretches in your routine to keep your joints healthy, thus increasing the range of motion.
4. Maintain optimal weight levels: If you are obese, then take steps to reduce your weight. Maintain a proper diet to check your waistline.

Bursitis - 4 Ways You Can Prevent it

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