While it may be obvious that no form of pain is welcome, it can be said that pain which is felt on account of being affected by sciatica is especially unwelcome. Taking that into due account, the good news is that physiotherapy can go a long way in helping by improving this sort of pain.

The longest nerve in the whole human body is the sciatic nerve, so it can be expected that when there is trouble with this nerve, the pain would be pretty significant. The leg pain which is caused to a person when this nerve happens to be getting pinched is known as sciatica.

There is a range of treatments when it comes to how something as painful as sciatica is to be solved. Now, while it is true that a solution such as making sure there is an amount of bed rest which is sufficient is very important, to say the very least, it is often the case that the person with sciatica would like his or her recovery to be hastened.

In order to make sure that this is the case, physiotherapy is quite useful. There are various forms of physiotherapy which can be made use of, and the decision as to which sort of physiotherapy a person would be best suited to would obviously be part of the subjective assessment of the person by a practitioner who is well qualified and experienced.

Some of the solutions when it comes to physiotherapy being used in order to treat sciatica are quite innovative, to say the very least. For example, there is physiotherapy instrument mobilisation, which is also known as PIM. What this entails is that a mechanical spring-loaded instrument is used in the process which serves the purpose of mobilising the spinal cord of a person along with his or her peripheral joints.

One form of physiotherapy oriented treatment which is used to address the issue of sciatica is real-time ultrasound physiotherapy. It can be said that this is not close to as cutting edge as physiotherapy instrument mobilisation is but it does serve as a rather dependable and useful way to battle sciatic pain. This form of physiotherapy makes use of ultrasound technology to analyse how the muscles function and then using that as a basis to create a list of physiotherapy exercises to be done by the person who is having sciatica. Rather than medicines, physiotherapy improves sciatica by getting a person to use oneself!

How Can Physiotherapy Help With Sciatica Pain?

Inflammation and resultant pain in the joints are usually the basic tenets of arthritis. This joint disorder can be painful and often, a debilitating one. It can also make the joints stiff. There are many ways of dealing with this problem, but with ayurveda, one can get to the root cause of the ailment and its presence. This helps in taking a well rounded holistic approach towards treating it with ancient know how that revolves around herbs and other natural substances which have great medicinal value, lifestyle changes, diet, exercise and yoga, oil massages, and other methods. Arthritis is known as sandhivata in ayurvedic jargon. Read on to find out how ayurveda can help in dealing with arthritis.

Herbs: one can make use of various herbs that contain linoleic acid to help in providing lubrication to the joints so as to prevent pain and stiffness. These herbs include borage seed oil which is extracted from borage seed, evening primrose oil, blackcurrant seed oil, capsaicin, curcumin, feverfew, flaxseed oil and a standard ayurvedic concoction that combines ashwagandha, gugulla, ginger, cumin and haldi or turmeric. These substances can help in treating the joints that are suffering from the pain of arthritis.

Diet: in ayurveda, to treat ailments like arthritis, it is usually recommended that a patient should start by flushing out the body toxins from within. Diet is one of the ways in which this can be done. A detoxification diet to clean the colon would be one of the foremost ways of doing a cleanse. Further, in one's daily diet, there should be a good dose of vegetables, fruits and other juices. Also, one must have plenty of herbs and spices, which can be used to season the food. Curd should generally be avoided and garlic should be used liberally. The various properties that help in an inside out cleanse that will help the system function in a better manner so that the treatment of ailments is also effectively supported.

Exercise: in ayurveda, a certain amount of daily exercise, which spans at least 45 minutes to one hour, is a must. A pattern of healthy eating, restful sleep and exercise is what usually helps in treating ailments like arthritis. For this ailment specifically, light exercise like walking is recommended. Various yoga asanas that involve sitting, standing, balancing and lying down poses as well as restful poses will also help in treating knee, shoulder and lower back pain specifically. Also, mustard oil massages can help in reducing the pain.
These are the few ways in which ayurveda can help arthritis patients live a more normal life with minimal pain.

Ayurveda For Arthritis

Injuries are very common, especially head injuries are one of the leading causes of death and disability in adults. As per surveys conducted, 1.7 million people suffer from head injuries every year and this estimation is increasing day by day.

There are several types of head injuries from mild as a cut, bruise, bump, contusion to severe ones caused due to a concussion, fractured skull bone, deep cut, internal bleeding, brain damage, etc.

A head injury is a comprehensive term which consists of an array of injuries that damage the skull, scalp, brain, and blood vessels and tissues in the head. It is generally referred to as a traumatic brain injury (TBI) and brain injury, depending upon the type and extent of trauma.

Causes of Head Injury-

A head injury can occur due to many reasons. Some common causes of these head injuries are:

Vehicle accidents

Domestic violence

Street fights

Fall from height

Child abuse

Subdural hematomas

Brain hemorrhages

Symptoms of Head Injury-

A head injury is followed by various symptoms depending upon the intensity of the injury. Here is a list of all the possible symptoms of brain injuries:

Nausea and vomiting.

Fatigue or sleepiness.

Extreme headache.

Confusion.

Loss of muscle control or paralysis in the part of the body controlled by the part of the brain that is affected.

Coma.

Dilation of the pupils and related visual problems; Blurred vision, photosensitivity, blindness, loss of muscle control in the eyes.

Cerebrospinal fluids might come out of the ears and nose, sometimes accompanied by blood.

Problem breathing.

Low pulse rate.

Increase in blood pressure.

Difficulty in swallowing.

Loss of hearing.

Problems in cognitive functions.

Numbness or tingling in the limbs.

Loss of bladder and bowel control due to loss of control over muscle functions.

Loss of consciousness.

Treatment of Head Injury-

Diagnosis of a brain injury has to be detailed and very quick at the same time. It always comes under emergency cases. Some of the steps involved are:

Cardiac and pulmonary function test.

Glasgow Coma Scale test.

Pupil dilation and corneal function test.

Brain stem reflex tests.

The most common way of diagnosis is the use of CT scans and MRI scans.

A severe head injury often needs surgery to reverse symptoms like chronic fatigue, bleeding, or loss of bodily function. Diagnosis involves finding out the type and severity of the injury and treatment involves removing the problem surgically.

Take Away-

Head injuries take time to heal, but medical treatment along with neurosurgery can aid the process of recovery and also help a person to lead a healthy life in the future. Most young patients recover fully, while some older patients or patients with preexisting neurological conditions live with a degree of disability.

All You Must Know About Head Injury & Its Treatment!

Rheumatoid arthritis is an auto-immune chronic disorder that might cause abnormal swelling in the joints when the joint tissues are attacked by the human immune system. The more frequently used body joints, such as the knees, fingers, shoulders, wrists, elbows and hips commonly get affected by the disease. Rheumatoid arthritis can also occur in the ligaments or tendons and might affect areas such as the kidney, bone marrow, eyes, lungs, and heart.

If rheumatoid arthritis is not diagnosed on time, it might lead to future complications, such as blood cancer in the lymph regions, osteoporosis (a medical condition resulting in the weakness of the bones), infections, stiffening of the arteries and dry mouth.

What exactly causes the disease is not known, but a significant damage to the immune system might cause the inflammation of the joints, resulting in this condition. Obesity, a family history of this condition and other lifestyle habits such as smoking tobacco put one at higher risks of this disorder.

The symptoms of rheumatoid arthritis might vary among people. The most common symptoms of rheumatoid arthritis are;
1. Severe pain in the morning
2. Episodes of mild fever with severe pain
3. Redness and inflammation of the joints which might cause intense pain
4. Stiffness in the joints
5. The pain might increase in low-temperature conditions
6. Acute lethargy and weight loss

Treatments
The treatment of rheumatoid arthritis includes a prescribed dosage (depending on the intensity of the condition) of non-steroidal anti-inflammatory drugs such as ibuprofen, anti-rheumatoid drugs such as methotrexate and steroid drugs such as prednisone to reduce the swelling and the subsequent pain. Performing regular exercises in order to retain the flexibility of the joints with appropriate consultation from the physiotherapist might cure rheumatoid arthritis. 

Persistent Stiffness in Joints - Can it be a Sign of Rheumatoid Arthritis

5 Ways to Stop Muscle Cramps

Muscle cramps are feared and loathed by all of us alike – they hurt, they slow us down and they just give us a helpless feeling! The most common cause of these cramps is premature fatigue which affects the reflex control of muscles. Here are 5 ways guaranteed to beat these troublesome muscle cramps:

1. Take rest
The most easy and sure-shot way to kill a muscle cramp is to take rest. Just rest your body, be at one place and the cramp will not last more than 3-4 minutes. Moving around will only cause the pain to be aggravated and eventually affect other areas as well.

2. Consume solutions rich in salt
Whenever you encounter a troublesome cramp, the first instinct is to reach for water. However, studies have shown that salt solutions are far more effective in countering cramps as compared to plain water. You can have pickle juice and similar drinks which have a high salt concentration.

3. Be physically active
The most common reason for muscle cramps is over-straining of the body. If you are planning to indulge in an extremely intensive physical activity, make sure to train well in advance. Also, keep the duration and intensity of the training at a similar level to that of the actual activity.

4. Keep your body hydrated
Dehydration is the root of a number of troublesome conditions, muscle cramps being one of them. Make sure to always carry a water bottle with you and drink a minimum of 7-8 glasses of water on a daily basis.

5. Indulge in light passive muscle stretching
When faced with a muscle cramp, in addition to resting, try and gently stretch the affected muscle. This continuous and light passive stretching lets the brain know that it can relax the muscle and help it return to normal.




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5 Winning Ways to Stop those Nasty Muscle Cramps

The intervertebral discs are made-up of two concentric layers, the inner gel-like Nucleus Pulposus and the outer fibrous Annulus fibrosus. As a result of advancing age, the nucleus loses fluid, volume and resiliency and the entire disc structure becomes more susceptible to trauma and compression. This condition is called as degeneration of the disc. The disc then is highly vulnerable to tears and as these occur, the inner nucleus pulposus protrudes through the fibrous layer, producing a bulge in the intervertebral disc. This condition is named as herniated disc. This can then cause compression to the spinal cord or the emerging nerve roots and lead to associated problems of Sciatica radiating pain from back to legs in the distribution of the nerve. Other symptoms could be a weakness, tingling or numbness in the areas corresponding to the affected nerve. Sometimes bladder compromise is also present, which is made evident for urine retention and this need to be taken care as an emergency.
Excessive weight, bad postures, undue movements, improper weight lifting and other kinds of traumas may weaken the intervertebral discs. When this occurs the pulpous nucleus will bulge against the annulus, or even be squeezed through it (extruded disc).

The first steps to deal with a herniated or prolapsed lumbar disc are conservative. These include rest, analgesic and anti-inflammatory medication and in some cases physical therapy. At this point, it is convenient to have some plain X-rays done, in search of some indirect evidence of the disc problem, as well as of degenerative changes on the spine.

If in a few days these measures have failed, the diagnosis has to be confirmed by means of examinations that give better detail over the troubled area, as the MRI, CT which will show the disc, the space behind it and in the first case, the nerves. In some instances, the EMG (electromyography) is also of great value, as this will show the functionality of the nerves and muscles.

Once the diagnosis has been confirmed, one of the best alternatives existing today is the Ozone Discolysis as the results obtained are excellent and practically has no complications. This novel treatment avoids the use of surgery in 80% of those who needed it. In most patients left with painkillers as the only treatment, the symptoms eventually disappear, only that this could take weeks to months. Ozone speeds up these developments, see the same result in a few weeks. The problem has to be seen and approached integrally and frequently the combination of therapies has to be used, most frequently physiotherapy. Also, it has to be known that those who had a herniated disc have 10 times more chances of having another herniation than the rest of the population.

If despite the ozone therapy the symptoms persist, Drill Discectomy/ Laser Discectomy are good alternatives before open surgery (Discectomy) which has to be contemplated in those true emergencies, as mentioned above, this is possibly the first choice.

Once the conservative treatment fails:

Early aggressive treatment plan of pain has to be implemented to prevent peripherally induced CNS changes that may intensify or prolong pain making it a complex pain syndrome. Only 5% of total LBP patients would need surgery & 20% of discal rupture or herniation would need surgery. Nonoperative treatment is sufficient in most of the patients, although patient selection is important even then.

Depending upon the diagnosis one can perform & combine properly selected percutaneous fluoroscopic guided procedures with time spacing depending upon pt`s pathology & response to treatment.

Using precision diagnostic & therapeutic blocks in chronic LBP, isolated facet joint pain in 40%, discogenic pain in 25% (95% in L4-5&L5S1), segmental dural or nerve root pain in 14% & sacroiliac joint pain in 15% of the patients. This article describes successful interventions of these common causes of LBP after conservative treatment has failed.

LESI: Lumbar Epidural Steroid Injection

Indicated in   Acute radicular pain due to irritation or inflammation.

Symptomatic herniated disc with failed conservative therapy
Acute exacerbation of discogenic pain or pain of spinal stenosis
Neoplastic infiltration of roots
Epidural fibrosis
Chronic LBP with acute radicular symptoms
Epidural- lumbar injection
ESI Treatment Plan

Compared to interlaminar approach better results are found with a transforaminal approach where drugs (steroid+ LA/saline +/- hyalase) are injected into anterior epidural space & neural foramen area where herniated disc or offending nociceptors are located. Whereas in interlaminar approach most of drug is deposited in posterior epidural space.Drugs are injected total 6-10 ml at lumbar, 3-6 ml at cervical & 20+ ml, if caudal approach is selected. Lumbar ESI is performed close to the level of radiculopathy, often using paramedian approach to target the lateral aspect of the epidural space on involved side. Cervical epidural is performed at C7-T1 level.

SNRB- Selective Nerve Root Block 

Fluoroscopically performed it is a good diagnostic & therapeutic procedure for radiculopathy pain if

There is minimal or no radiological finding.
Multilevel imaging abnormalities
Equivocal neurological examination finding or discrepancy between clinical & radiological signs
Postop patient with unexplainable or recurrent pain
Combined canal & lateral recess stenosis.
To find out the pathological dermatome for more invasive procedures, if needed
Intradiscal Procedures 

Provocative Discography - Coupled with CT

A diagnostic procedure & prognostic indicator for surgical outcome is necessary for the evaluation of patients with suspected discogenic pain, its ability to reproduce pain(even with normal radiological finding), to determine type of disc herniation /tear, finding surgical options & in assessing previously operated spines.

Percutaneous Disc Decompression (PDD)

After diagnosing the level of painful offending disc various percutaneous intradiscal procedures can be employed

Ozone Discolysis: Ozone Discectomy a revolutionary least invasive safe & effective alternative to spine surgery is the treatment of choice for prolapsed disc (PIVD) done under local anaesthesia in a daycare setting. This procedure is ideally suited for cervical & lumbar disc herniation with radiculopathy. The total cost of the procedure is much less than that of surgical discectomy. All these facts have made this procedure very popular at European countries. It is also gaining popularity in our country due to high success rate, less invasiveness, fewer chances of recurrences, remarkably fewer side effects meaning high safety profile, short hospital stay, no postoperative discomfort or morbidity and low cost.

Dekompressor: A mechanical percutaneous nucleosome cuts & drills out the disc material somewhat like morcirator debulking the disc reducing nerve compression.

Epidural Adhenolysis or Percutaneous Decompressive Neuroplasty for Epidural Fibrosis or Adhesions in Failed Back Surgery Syndrome (FBSS)

A catheter is inserted in epidural space via caudal/ interlaminar/ transforaminal approach. After epidurography testing volumetric irrigation with normal saline/ L.A./ hyalase/ steroids/ hypertonic saline in different combinations is then performed along with mechanical adenolysis with spring loaded or stellated catheters or under direct vision with epiduroscope.

Procedures That Can Help Treat Slip Disc & Sciatica!

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