The bones and joints orchestrate very well with each other for smooth movements of various joints and the spine. However, due to various reasons, some identified and others unknown, there could be inflammation of the areas where the bones join the muscles leading to impaired movement. The range of motion could be reduced or it could be painful, thereby, limiting movement. Spondyloarthritis includes a group of inflammatory diseases that involves the bones and joints and enthuses which are areas where the ligaments and tendons attach to the bones. This causes conditions like plantar fasciitis, ankylosing spondylitis, psoriatic arthritis and reactive arthritis. The term spondyloarthritis is a blanket term to describe any of the above-mentioned conditions.

Read on to know a little more in detail about it:

Causes: While the exact etiology is not identified for sure, most patients with spondyloarthritis have an autosomal dominant gene (HLA-B27). Chronic infections could trigger the onset of the disease too.

Symptoms:

1. In all forms of spondyloarthritis, there is always inflammation of the spine, joints and entheses. If the fingers or toes are involved, there could be swelling leading to what are typically known as 'sausage digits'.

2. There is sacroiliitis which is inflammation of the joint between the pelvis and the spine, and spondylitis which is inflammation of the joints between the spines. 3. Family history and autosomal dominant gene.

Diagnosis:

A detailed medical history and physical examination form the cornerstone of a confirmed diagnosis. In addition, radiographic examination and diagnostic blood tests also could be done to confirm the diagnosis. Radiographs, especially, of the spine and the low back show typical changes including sacroilitis in suspected cases of spondyloarthritis. If the spine does not show these changes, but there is a high likelihood of spondyloarthritis, then MRI (magnetic resonance imaging) can be used to confirm the diagnosis.

As a final step, a blood test for the HLA-B27 gene can also be confirmatory. However, it is not true that a person with the gene will definitely develop the disease.

Treatment:

The most important aspect of treatment is the use of pain medications and anti-inflammatory drugs (NSAIDs) which help manage pain and inflammation.
Corticosteroid injections may sometimes be given directly into the joint spaces or the membranes to provide quick relief of these symptoms.
ESWT / RSWT has a definite role to cure enthesopathy. Plantar fasciitis, and achillodynia can be cured with ESWT. Even small joints of hand and feet are amenable to treatment with RSWT. It is nonoperative and noninvasive treatment and has no side effects.
Very rarely, stronger drugs such as methotrexate or sulfasalazine may be used.
Another set of drugs known as TNF-blockers (tumor necrotizing factor blockers) are also shown to be highly effective in controlling the pain of the spine and joints.
In very severe cases, surgery may be required to correct joint damages or correct severe degenerative changes.
Exercise plays a very vital role in controlling the issue and improving range of motion.

What You Should Know About Spondyloarthritis?

Primary Total Hip Replacement Surgery is generally a successful procedure, allowing people to restore their active and painless lifestyle. It involves the replacement of a hip joint with a prosthesis or an implant made of different materials. But, over a period of time, this procedure might fail for a number of reasons. When such a failure happens, revision surgery is employed. The Revision Total Hip Replacement Surgery is hence the second operation that removes parts of the first prosthesis to replace them with a new set.

The ultimate goal of both the procedures, namely Total Hip Replacement Surgery and Revision Total Hip Replacement Surgery is the same that is to improve the quality of life by bettering the functionality and relieving pain. However, these two surgeries are different in their procedure and complexity. Revision Total Hip Replacement Surgery is more complex and takes much longer time. It requires good planning and use of specialized tools and implants for achieving good results. Use of specialized implants compensates for the damage to soft tissue and bone that makes it difficult for the surgeon to use standard Primary Hip Implants.

Revision Total Hip Replacement Surgery can manifest itself into two forms:

There might be the need to remove the entire prosthesis and its replacement. It might also involve rebuilding the bone around the hips with augments or bone graft.

In another case, there is a possibility that only some parts or components of the prosthesis need to be removed and replaced.

When to go for Revision Total Hip Replacement Surgery:

When there is wearing and loosening of Implant, it does not function properly. For proper functioning, the implants can be cemented into place or press- fit allowing the bone to grow onto them. If this does not happen, the components get loose leading to pain. Loosening of implants might be caused by excessive body weight, rigorous physical activity, and wearing of the plastic liner inserted between metal cup and ball. Also, younger patients might also have to go through a Revision Surgery when the implant completes its life expectancy.

If there is a bacterial infection in the Total Hip Replacement, Revision Surgery is employed. This is so because antibiotics cannot alone eliminate bacteria from joints. In such cases, two stages of the operations are required. But sometimes, a single stage operation is also employed. However, it has limited application.

When there is a recurrent hip location in the ball and socket joint, Revision Surgery is opted to properly align the joint and to insert the implant.

In case of a periprosthetic fracture (when bone around the implant breaks), Revision Surgery is required.

When metal used in implant breaks or degrades, it may cause damage to soft surrounding tissue and bone. This would require a corrective Revision Surgery.

Preparation for the Surgery:

The patient undergoes a thorough physical examination. It is to ensure that undergoing surgery would not be harmful in any possible way. X-Rays, MRIs, and CT scans are employed to fully understand the structure of the joint. Laboratory tests are conducted to ascertain the fitness of the patient to undergo the procedure. It should be noted that post- surgery, the patient is not able to function at all and requires help even to perform petty tasks for himself. Thus, suitable arrangements should be made accordingly in advance for the same.

Post-Operative Care:

Post-operative care involves pain management, preventing infection, physical therapy, wound care, and prevention of blood clot. It ensures a healthy recovery.

Primary & Revision Total Hip Replacement Surgeries!

Osteoporosis wreaks havoc in many senior citizens, especially women. This is a disorder that systematically weakens the bone and can fracture the spine and the hip. If not treated early, it poses a serious threat to mobility. While medicine is a prerequisite to treating this condition, exercise goes a long way in helping patients of osteoporosis. Regular exercise can improve balance and strengthen the muscle. This being said a doctor should be consulted for a fitness assessment and bone density test before going ahead with any exercise routine.

What is the right exercise for you?
Exercises are recommended depending on the degree of osteoporosis a person is suffering from. Some exercises may not be suitable for a person while some can greatly help. It is therefore suggested that a doctor or physiotherapist is consulted before starting any exercise. Here is a list of exercise that doctors often suggest:

    Strength training: Strength training aims at strengthening the spine and other muscles. It includes the usage of free weights and lifting own body weight. In case the exercise involves the usage of weight machines, utmost care should be taken to ensure that the spine does not get twisted. Resistance training, on the other hand, should be designed in such a way that it fits the tolerance and ability to cope up.
    Flexibility exercises: When the joints are allowed to go through the range of motion, it helps in muscle function. Stretching, for instance, should only be done when the muscle is warmed up. Care should be taken that stretching is done gently which is devoid of any bouncing. The spine should not be flexed. Any exercise that demands to bend towards the waist should also be avoided. An experienced physiotherapist should be able to suggest which stretching exercise is suitable for patients with osteoporosis.
    Aerobic training: Aerobic training necessarily means that the bone supports the body weight. This exercise helps the bone from mineral loss and is good for body balance strength and flexibility. Some aerobics that can be easily performed by patients with osteoporosis include dancing, stair climbing, cycling and walking. These exercises also help in blood circulation and cardiovascular diseases.
    Exercises you must avoid: High-impact body activity exercises such as jogging, jumping and running should be strictly avoided in order to avoid bone fracture and weaken muscle. Unlike exercises with controlled movements, these exercises can twist the spine and cause severe immobility in movement.
    Twisting: For patients with osteoporosis, an exercise that involves forward bending resulting the waist to come down should be avoided. Exercise such as this can cause compression fractures leading to restriction in physical movement for a temporary to longer duration. Any sort of bending and twisting, therefore, should be avoided. 

Suffering from Osteoporosis - Know Which Exercise is Right and Wrong for You?

A slipped disc is a condition which is characterized by a damaged disc in your spinal cord. The disc is a soft substance present in the spinal cord that cushions the vertebra in the spine. A slipped disc occurs when the soft substance in the disk pops out causing pain in the area. 

There are various preventive measures that you can adopt to prevent a slipped disc from occurring; they are

Keep a check on weight: Being overweight increases the risk of a slipped disc as the pressure on the lower back will be immense. In order to reduce the pressure, maintain optimal levels of bodyweight.
Exercise regularly: Do strength training exercises such as the plank and squats to strengthen the core muscles. This helps in strengthening your lower back strong and prevents slipped disc from occurring.
Maintain a good form while exercising or lifting anything heavy: If you are exercising or simply lifting something heavy, make sure to keep your lower back straight. Lifting heavy weights without proper form may lead to slipped disc as the spine may not be able to bear the stress.
Quit smoking: It is advised to quit smoking as smoking impairs the ability of the disc to absorb nutrients and thus, prevents it from remaining healthy. It may also cause the discs to become brittle and dry.
Maintain a good posture: Remember to keep an uptight posture while walking; keep the spine straight to prevent slouching. Maintain a proper neutral posture while sitting as well. Hunching over your desk while working with your computer may also cause problems in your spine.
Do not sit for prolonged periods: Sitting for extended periods of time may cause problems in your lower back and posture. It may weaken the lower back muscles and lead to complications such as a slipped disc.

Slipped Disc - Things You Must Do To Prevent It!

Muscle cramps often occur in the calf muscle of the back of the lower leg. It is often characterized by a momentary sharp pain along with a muscle lump beneath the skin. Just like its sudden appearance, muscle cramp disappears the same way without any botheration. However, a doctor should be consulted if you see any of the following symptoms:

    The pain keeps coming back
    The cramps result in weakening of the muscles
    It causes frequent discomfort
    It results in changed skin color, redness or swelling of the skin
    The condition doesn t improve with normal care
    Cramps are not associated with obvious causes such as playing, exercising and jogging

What causes muscle cramps?
Any strain on muscle, dehydration, muscle overuse or simply standing for a prolonged time can lead to muscle cramps. The exact cause of muscle cramps is not known in a lot of cases. There could be the following medical conditions that could lead to such muscle cramps:

    Blood supply: At times when the arteries narrow down resulting in an inadequate blood supply in the leg, a sharp pain can be felt followed by muscle cramps. This can happen while exercising or playing. It disappears as soon as one rests their legs.
    Mineral depletion: Shortage of magnesium, potassium and calcium in the body can lead to muscle cramps. Even medication for high blood pressure can lead to cramps in the legs.
    Nerve compression: Nerve compression of the spine can produce sharp pain on the leg muscles. The pain worsens with longer durations of walk. The symptoms, however, can be delayed a bit if the walking posture is changed, like the way one walks while carrying a shopping cart.

What are the risk factors associated to muscle cramps?

    Dehydration: Muscle cramps often happen among athletes when they get dehydrated and fatigued while performing in hot temperature.
    Age: People over the age of 60 often lose mass in the muscle. The remaining mass gets stressed out soon, resulting in muscle cramps.
    Pregnancy: Pregnant women face frequent muscle cramps due to the sudden increase of body weight and restricted movements in the pregnancy period.
    Medical conditions: Certain medical conditions such as nerve disorder, thyroid problems, liver failure, diabetes etc. greatly increase the chance of muscle cramps.

Some common ways to treat muscle cramps:

    A brisk walk followed by stretching relaxes the muscles and greatly helps in staying away from cramps.
    A diet consisting of magnesium on a regular basis gives relief from muscle cramps.
    A wet cloth soaked in hot water often shows magical results and gives instant relief from muscle cramps.
    Being hydrated throughout the day helps with muscle cramps. It is necessary to consume enough amount of electrolytes so that muscle contraction does not happen.

Why You Get Muscle Cramps?

Cervical spondylosis is an age related disorder affecting the discs and joints in your neck. The overuse of the bone and cartilage in the cervical spine of your neck leads to cervical spondylosis. While it is mostly caused by age, it can also be caused by other factors. Stiffness and severe, chronic pain are the most common problems with patients afflicted with cervical spondylosis. While in others, it might not cause problems and they can go about their daily activities.

Physiotherapy for Cervical Spondylosis
There is no cure for cervical spondylosis, but its symptoms can be treated with physiotherapy. If you have chronic pain in your neck, shoulder blades or arms, a physiotherapist can provide effective pain relief by strengthening your vertebrae and neck. This will improve your posture and prevent any relapse of the pain.

Firstly, the physiotherapist will evaluate your condition; check your reflexes and strength. Then, the physiotherapist will move on to the following treatments:

Stretching, strengthening and straightening exercises: Before beginning these exercises, your physiotherapist will first apply cold or heat to the affected area and then proceed with a deep tissue massage or electric stimulation. When your muscles are relaxed, the exercises will begin only then. These exercises are performed to strengthen the muscles in your neck. Through these, you will learn how to improve your range of movement and posture.
Neck traction: Pulling your head to stretch out your spine is called neck traction. This technique is used to improve movement and ease the pain. Traction is used to open the spaces between the vertebras gently in order to ease pressure on the distressed discs. Traction is done continuously or sporadically, with short periods of rest in between. If you cannot find the right physiotherapist to do this for you, there are devices to help you stretch your spine.
Cervical collars and pillows: Neck pillows or cervical pillows, are made to keep your neck steady while you sleep. Cervical collars are also called neck braces which are used to support the neck. While cervical collars have been proven to be quite beneficial, there isn t much evidence to support cervical pillows in treating cervical spondylosis. You can always consult your physiotherapist before purchasing a cervical pillow.

Cervical Spondylosis - How Physiotherapy Can Help Treat it?

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