There are various forms of Paralysis. Paralysis of the lower limbs is one of the most severe forms of Paralysis. It is also known as Paraplegia. People suffering from such Paralysis lose all sense below the waist. They cannot move their legs or hips, cannot void without help, and cannot have intercourse. They barely feel anything below their waist. However, the degree of inability may vary from one person to another.

In people suffering from such Paralysis, there is usually substantial impairment in movement. Though such inability is not necessarily permanent, rarely do people recover from such inability. Lower Limb Paralysis may put people at risk of deep Vein Thrombosis.

Causes of Lower Limbs Paralysis:

Paralysis of the lower limbs usually results from injury to the spinal cord or the brain. However, spinal cord injury is the most common cause of such Paralysis. Such injuries inhibit the ability of the brain to receive and send signals from lower limbs. Causes of such inability may include:

Infections in the spinal cord

Lesions of the spinal cord

Tumors in the brain

Infections in the brain  

Nerve damage at the hip or waist.

Oxygen deprivation in the brain or spinal cord due to choking, violence, or surgical accidents.

Stroke

Congenital spinal cord deformities such as Spina Bifida etc.

However, the most common cause of Lower Limb Paralysis is congenital spinal deformity, such as Spina Bifida. The degree of Paralysis depends on the location of the spinal lesion and the extent of spinal cord or nerve damage. Some people with spinal lesions may even walk independently if the lesion is lower down the spine. However, people with upper spinal lesions are usually not able to do that. They may require ortho shoes as well as walking aids in order to ambulate. If these don t work, they may need wheelchairs for mobility. Usually these people learn to ambulate with the aid of ankle foot orthoses.

Treatment of Lower Limbs Paralysis:

There is no treatment for Paralysis. However, in some cases, people suffering from Lower Limb Paralysis are able to regain some of their ability with the help of physical therapy. What physiotherapy does is that it retains the spinal cord and the brain to strengthen nerve connections and muscles so that patients can work around their limitations. If paralysis is due to some underlying cause, removal of the cause can treat the patient.

If an infant is found to be suffering from Spina Bifida, doctors can operate on his spinal cord and bring down the severity of the problem. Such children are less likely than others to use walking devices.

Bowel and Bladder Management:

This is a serious aspect of Lower Limb Paralysis. Patients need to undergo routine bladder and bowel evaluation and device management plans to reduce the risk of organ damage.

Conclusion:

There is hardly any treatment for Lower Limb Paralysis. However, physical therapy may solve some of the problems. If it does not, management of bowel and bladder and watching out for deep Vein Thrombosis should be done on a regular basis.

One can also use alternative methods like Acupuncture, Chiropractic, Massage, and other holistic treatments. However, it is always recommended to consult an orthopedic doctor before opting for any methods.

Paralysis Of Lower Limbs!

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!

When you think about a healthy diet, you wonder how much carbohydrate, protein, fats and minerals you need to stay fit. However, are you neglecting the importance of vitamins in your daily diet? Research suggests that vitamins play a crucial role in muscle building and bone health.

Here is a look at the different vitamins that will help you enhance your muscles and bones using vitamins.

1. Vitamin D-

You may have heard about the importance of calcium for proper bone health. However, only consuming calcium-rich foods will not help you develop stronger bones. If you do not have enough vitamin D in your body, you will not be able to use the excess calcium for bone health. Vitamin D helps your body utilize the calcium for bone growth and enhancement.

Apart from strengthening your bones, vitamin D also works wonders for your muscles. It helps the body absorb calcium and phosphorus, both of which are essential elements in the production of adenosine triphosphate or ATP. ATP is the only form of energy that your muscles can use during movements and activities.

Best sources for vitamin D are cheese, egg yolk, certain fatty fish, shrimp, mushrooms, soya milk, orange juice and cereals.

2. Vitamin K2-

Vitamin K2, also known as menaquinone, improves your cardiovascular health. Vitamin K2 is also a coenzyme that helps your bone use proteins. Additionally, a study performed in 2013 revealed that vitamin K2 improves bone metabolism in post-menopausal women. At such an age, women s bone health starts to deteriorate and osteoporosis sets in. Therefore, vitamin K2 becomes all the more important for women at such an age.

Best sources of vitamin K2 are butter, cheese, egg yolk, dark chicken meat, and fermented soy.

3. Vitamin C-

Vitamin C is a great choice if you work out regularly. A powerful antioxidant, it helps your body metabolise proteins in the body, leading to muscle growth. Additionally, vitamin C helps in the absorption of iron, which is an essential component of blood.

Best food sources for vitamin C are citrus fruits, such as oranges, lemons and more. Additionally, green capsicum, broccoli, and blackcurrants also provide ample amounts of vitamin C to your body.

Even though vitamins have a role to play in building stronger bones and muscles, the only diet will not be enough for a fit body. You need to start exercising along with eating a balanced diet if you want to stay healthy. Furthermore, exercising helps improve your musculoskeletal health.

Vital Vitamins For Musculoskeletal Health!

Radiology is a special branch of medical science that uses various techniques of imaging for the diagnosis and the treatment of several types of diseases in the body. The different types of imaging techniques used in radiology are X-rays, Computerised Tomographic scan (CT Scan), ultrasound, Magnetic Resonance Imaging (MRI) and nuclear medicine which includes Positron Emission Tomography(PET).

Role played in evaluating hip replacement
Hip replacement surgeries have become extremely common in the recent times, and radiological evaluation remains the mainstay of the overall hip replacement procedure. Thus, the role played by radiology is quite significant in such situations. All the specific anatomical landmarks and the measurements are used to make sure the placement is perfect during the hip replacement surgery. Radiological imaging helps in the assessment of the following conditions that are as discussed below.

The length of leg
The inequality in the length of the two legs is prevalent after a hip replacement surgery which can create a great deal of discomfort and inconvenience to the patients. A greater difference in the length of the two legs increases the chances of dislocation, and this is a situation where radiological evaluation plays a crucial role. With the help of radiological imaging, the length of the legs can be made almost equal.

The horizontal center of rotation
In this case, horizontal center of rotation helps in the assessment of the acetabular component of the prosthesis. This is calculated by the measurement of the distance between the center of the head of the femur and the acetabular teardrop. This distance should be bilaterally equal, and it is just not possible without the help of the imaging techniques of radiology.

Acetabular inclination
The acetabular inclination is the angle formed between the face of the cup and the transverse axis. If the angle is less, then it results in a stable hip, but the abduction is limited. On the other hand, if the angle increases then there are high chances of dislocation of the hip. Thus, with the help of radiological evaluation, proper and effective angular inclination is given which is optimum for the patient.

The stem positioning of the femur
The main aim of the stem positioning of the femur in a hip replacement surgery is placing the stem in a position which is neutral within the shaft. To get a proper idea of the positioning, the imaging techniques are of utmost importance which cannot be achieved perfectly without the imaging.

Thus, the crucial role the different techniques of radiological imaging plays during the overall procedure of a hip replacement surgery can be perceived. With the use of the different imaging techniques, the results obtained are closer to perfection.

How Radiological Evaluation Can Help In Case Of Hip Replacement?

Osteoporosis is a disease of the bones. It occurs when the mesh-like structures present inside the bones becomes thin. This is a condition in which the bones become extremely fragile and have a tendency of breaking easily. The broken bones cause extreme pain. There are artificial medicines available in the markets for treating this condition. However, treatment of osteoporosis can be best done by the naturally produced Parathyroid hormone (PTH). 

It is secreted by the parathyroid glands in our body. It is an 84-amino acid polypeptide. The most interesting thing about PTH treatment is that it actually builds new bones. Other medications for osteoporosis only reduce the rate of loss of bones. PTH helps in increasing the amount of calcium in body. It also prevents bone loss due to osteoporosis. It is often considered to be an anabolic agent. If an osteoporosis patient is given low doses of PTH, his or her bones get strengthened. It also helps in increasing the bone mass.

Why a doctor recommends PTH for osteoporosis? Is it better than other drugs?
Traditionally, bisphosphonates were used to treat osteoporosis. However, it has been observed in a number of cases that bisphosphonates only help in slowing down the loss of bone density. However, PTH increases bone mineral density. Therefore, it is a better option for the treatment of osteoporosis. It is usually given to patients who have extremely low bone mass. It has been found effective in cases where other medications failed to show results. Moreover, it also works for postmenopausal women. 

Doctors believe that it can also be used for treating men with osteoporosis who are at high risk for fracture. It improves the microarchitecture of the bone and can do wonders in altering the bone size. Moreover, it has lesser side-effects on the health of the patient. It is known to cause dizziness and nausea and no major discomfort. It has also been noticed that patients who are being treated with PTH develop less back pain. These are also cost-effective for the long term treatment of osteoporosis.

Parathyroid Hormones - Is It a Better Treatment For Osteoporosis?

Treatment of frozen shoulder varies depending on the stage it is at, and how severe is the pain and stiffness. There is no outright cure and the aim of treatment is to keep the joint as mobile as possible. The most effective treatment is that which maintains a good range of movement until the shoulder starts to heal. 

Treatment may Include the following:

1. Shoulder exercises: Regular, gentle exercise can help to keep the shoulder joint mobile. If your shoulder is very stiff, exercise may hurt, and it should only be carried out with the guidance of your doctor or physiotherapist. If you are able to, continue using your shoulder as normal saving' the shoulder can cause the muscle to waste and may make stiffness worse.
2. Painkillers: Over-the-counter painkillers such as paracetamol or prescription-only drugs such as codeine may be taken to ease pain and you should discuss this with your general physician or pharmacist.
3. Anti-inflammatory painkillers: Such as ibuprofen and diclofenac, are often prescribed to ease pain and inflammation. Any medication that you take should be discussed with your general physician or pharmacist.
4. Steroid injections into or near the shoulder joint may be effective at relieving pain and inflammation for a few weeks. However, injections are not a cure, and symptoms may return.


Treatment of frozen shoulder

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