Vertebroplasty means shaping the backbone i.e. vertebra for backbone and plasty is related to shape. This is an outpatient procedure done to treat compression fractures of the spinal cord. The backbone is made up of multiple small bones which are stacked one on top of the other with a filling material in between that is known as vertebrae. The stack of bones are held in place by the soft, elastic vertebral material. 

Vertebroplasty & similar procedure called kyphoplasty is a non-surgical procedure where collapsed vertebrae is brought back to shape by injecting medical bone cement under fluroscopy / image intensifier in OT, thereby relieving pressure on the spinal cord or spinal nerves with special canula directed to the core of vertebral body. Indicated in osteoporotic vertebrae, spinal fracture, metastatic tumour or primary tumour of spine. This technique has replaced major surgery done earlier to reshape & fix vertabrae.

Technique: Bone cement, in a semisolid state, is injected into the weakened or fractured bone space. Once this solidifies, it provides additional support to the spine, enabling normal movement. It also helps in reducing the pain significantly and improves the overall mobility.

Procedure:

In what takes about an hour, the following steps are done. Earlier, a few decades ago, this would be an open surgical procedure. However, with advance technology, now it is done using a small incision

Local anesthesia is given in the area that needs to be operated
A biopsy needle is inserted into the fractured space with the help of an X-ray
The acrylic bone cement is injected into the bone space with a needle to fill up the space, once it solidifies, it stabilizes the vertebral space
The needle is removed and the incision is covered with a bandage
Usually the patient is sent home in an hour s time unless the overall condition is really bad
There could be some soreness at the site where injection is given, but one can notice a significant reduction in pain from the day of the procedure
There is also improvement in mobility while doing daily chores
The pain relief can last up to 3 years after the procedure
Returning back to normal activities takes about 3 to 4 days after the procedure
When to use this procedure?

Vertebroplasty is usually done in case of non-radicular pain that is intractable. In most cases, they do not respond to traditional therapies including physiotherapy, pain medications and even surgery. The pain could be due to:

Osteoporosis
Cancer metastasis
Myeloma
Spinal hemangiomas
Traumatic fractures
Benefits of using vertebroplasty for managing pain 

Minimally invasive
Effective way to get relief
Improves mobility
Cost-effective
Reduces need for long-term use of painkillers
Stabilizes the spine and prevents further collapse

Vertebroplasty - How It Can Help Manage Pain?

Dysmenorrhea is a condition marked by severe menstrual cramps. This is caused due to contractions in the pelvic area during the menstrual cycle. While most women go through some degree of cramping, when the cramps become too serious and severe, it should be reported to a doctor to find out if there are any other related problems like Endometriosis, Fibroids, Adenomyosis or some infections.

Here are the ways in which this condition may be treated effectively:

Medication: One of the main ways of dealing with this condition includes taking pain relievers that must be prescribed by your doctor. Also, one can take over the counter drugs to relieve the pain. These include ibuprofen as well as aspirin and non-steroidal anti-inflammatory drugs. Acetaminophen can also help in most cases. Some women may need antibiotics to take care of pelvic infections that cause pain in the pelvic region.

Hormonal Birth Control: if your symptoms are too severe and debilitating, then the doctor can also put you on hormonal birth control treatment to bring down the pain and severity of the cramps. These are usually prescribed in the form of oral tablets which need to be consumed daily as advised by the Gynaecologist . Sometimes, some women may be unsuitable / unwilling for oral medications and in such cases, other routes for hormonal administration may be followed. This can be administered in the form of an injection. Also, you may wear the dose as a patch on the skin. A surgical procedure can also implant the same under your skin. This also comes as a flexible ring that the doctor can insert into your vagina with the help of an intrauterine device (IUD).

Surgery: In very extreme cases, the doctor may recommend surgery. This is usually conducted in case there is an underlying condition like endometriosis or fibroids, which can create severe complications for the patient as well. The doctor may also carry out surgical removal of the patient's uterus in case there are many complications.

Home remedies: One can exercise on a regular basis in a moderate manner so as to ensure that the cramps are not too severe. Also, you can use heat therapy in order to bring down the pain. This can be done by taking a hot bath and soaking in a tub of hot water. Also, you can use a heat compress so as to relieve the pain. Other dietary supplements can also be taken in order to reduce the cramps. For this purpose, one should regularly indulge in fish and flax seeds as well as other ingredients that are rich in omega three fatty acids. Also, vitamin B1 is an important ingredient that can be found in leafy green vegetables. Magnesium supplements can also be taken by the patient for such cramps.

Stress: one will need to take care of the stress levels by staying away from stressful situations and also cutting back on the consumption of alcohol. One should also avoid smoking completely. Meditation & Yoga have been known to help in relieving stress and you can practise a little bit of these on a daily basis. Also, devoting time to your hobbies and listening to good music can be a stress-buster when incorporated in your daily routine.

So eat right, exercise right, think right and have a positive attitude- That helps take care of most non-pathological cases of dysmenorrhoea.

Ways to Treat Dysmenorrhea Effectively

Avascular Necrosis, also termed as Ischemic Bone Necrosis or Osteonecrosis is a medical condition characterized by the bone death on being deprived of blood. The condition is known to occur in the shoulder, ankles, and knees. However, the part of the body most affected by Avascular Necrosis is the hip. In this article, we will describe the conditions that contribute towards Avascular Necrosis of the hip along with the associated symptoms.

Factors that lead to Avascular Necrosis of the hip
The supply of blood to the bones may be interrupted by a myriad of factors some of which include

1. Certain medical conditions and health disorders such as

Gaucher's disease: A genetic disorder resulting from glucocerebrosidase enzyme deficiency. As a result, glucocerebroside gets deposited in the cells of the macrophage-monocyte system.
Sickle cell anemia: A genetic disorder which results in the RBC's appearing like a sickle cell instead of being round shaped.
Both of these conditions bring about a significant reduction in the supply of blood to the bones resulting in Avascular Necrosis.

Certain inflammatory conditions that may damage the arteries and trigger Avascular Necrosis of the hip include autoimmune diseases, pancreatitis or HIV infection.

2. Extensive and prolonged use of corticosteroids: Often used as non-inflammatory drugs, corticosteroids can play a contributing role, resulting in Avascular Necrosis (non-traumatic). The fatty substances are usually broken down by the body. However, the use of corticosteroids may affect this breakdown as a result of which the fatty substances start piling up in the blood vessels, constricting their size. The constricted blood vessels, in turn, reduces the supply of blood to the bones to a great extent.

3. An injury or a fracture affecting the femur: A hip fracture or a dislocation that affects the upper half of the thigh bone or the femur acts as a potential threat, triggering a traumatic Avascular Necrosis (AVN) of the hip.

In some case, radiation therapy or chemotherapy for cancer can go a long way in interfering with the ability of the bone (weakens the bone) to receive blood, causing bone death.

People who are into heavy drinking stand a greater risk of suffering from AVN. An increased consumption of alcohol causing constriction and narrowing of the blood vessels interfering with the flow of blood to the bones.

Symptoms characteristic of AVN of the hip

Unfortunately, the initial stages of AVN are asymptomatic. However, as the condition progresses into later stages, a person may experience pain and discomfort, particularly while exerting pressure on the bone affected by the condition.
As the bone and the adjacent joints deteriorate and collapse further, a person may experience great difficulty in using the joint altogether.
In some cases, the condition may progress and affect both the hips (Avascular Necrosis Bilateral).

Causes and Symptoms of Avascular Necrosis of the Hip

Shoulder pain can be a persistent dull and nagging sensation in the upper arm or shoulder area. It can be easily differentiated from neck pain as it is related to the movement of shoulders i.e. it will increase and decrease with shoulder movements, especially overhead activities. The other signs to identify shoulder pain is if your shoulder movements are reduced.

If you find it difficult to scratch / wash your back, comb your hair or reach your back pocket, it clearly shows you are suffering from shoulder pain. Shoulder pain can happen due to various reasons, it varies from person to person depending on the activities he/she is involved in, for e.g. sports, manual job etc. It can be a single major injury or multiple small injuries due to repetitive usage patterns. Also, degenerative changes in various parts of the shoulder can lead to shoulder pain.

In case of middle to old age, injuries that can cause shoulder pain are:

    Biceps Tendonitis
    Acromio-clavicular Joint arthritis
    Scapular Dyskinesia
    Trapezitis
    Suprascapular nerve entrapment In young age, injury due to sports or gym activity can cause shoulder pain
    Superior labral anterior/posterior (SLAP tear)lesion

Also, traumatic or repeated dislocations of shoulder can cause shoulder pain due to:

    Bankart lesion

Diagnose Shoulder Pain

Shoulder pain can be diagnosed only after thorough history taking and clinical examination. However, some imaging studies can be very helpful like:

    X-rays: Through an x-ray one can view the shoulder in many different views.
    Ultrasound: With an ultrasound, you can also check the damaged caused to the tendons and muscles of the shoulder but the quality of reporting depends upon the expertise of the doctor.
    MRI: MRI gives a clear picture of the shoulder as it shows everything related to a shoulder joint that is joints, vessels, tendons and muscles that too from different angles.
    Diagnostic Arthroscopy: A surgical procedure often used by orthopaedic surgeons to diagnose and treat issues inside a joint. Arthroscopy has the big advantage that one can use it to diagnose as well as treat at the same time.

Treatment for Various Types of Shoulder Pain

    For Shoulder Impingement or Rotator Cuff tear: Give rest to the shoulder for a few days only Dedicated Physiotherapy Protocol Bursal injections If these fail then, (Surgery)Arthroscopic sub-acromial decompression If Cuff tear is found, then one can go for Arthroscopic/Mini-open repair
    Labral Lesions: For anterior Labral lesions (Bankart's) following anterior shoulder dislocation then surgery in the form of Arthroscopic Bankart's repair is the only option to reduce risk of recurrence and degeneration.

SLAP Lesions

    Pain relief and physiotherapy as first step If this fails then following surgical options are available
    Arthroscopic debridement or repair of labrum
    Biceps tenotomy or tenodesis

Arthritis

In this case, the joint is already destroyed and has to be resurfaced for pain relief and to maintain ROM. If Rotator cuff muscles are working, then Shoulder resurfacing hemiarthroplasty (preferred in young people), that has a life of 10 to 15 years, Total shoulder replacement (preferred in middle aged to old people) has a life of 10 to 15 years. But, if rotator cuff muscle are not working then Reverse Geometry Shoulder replacement is recommended, that has a life of 10 years.

It is always advisable to get yourself diagnosed properly in case of shoulder pain as management changes depending on clinical situations. Neglecting shoulder conditions can lead to bigger problems later on.

Always remember 'a stitch in time saves nine'

Shoulder Pain: Causes, Diagnoses & Treatment

Why does PAIN occur? Understand the Mechanism of Pain

Pain is an unpleasant and distressing physical sensation caused by disease or injury, which induces hurt and anxiety in those suffering from it.
There are many different manifestations of pain, ranging from short term (acute pain) to long term (chronic pain). Other classifications include pain in the internal organs (visceral pain), injured tissue (inflammatory pain), nerves (neuropathic pain), etc.

The reason for the occurrence of pain depends on the cause and kind of pain being experienced. In most cases, pain acts as a warning sign that the body has been afflicted by a disorder of some sort, which may have arisen due to internal sickness or external wounding. Acute pains are generally cured on their own through rest or simple medication. Chronic pains, on the other hand, are more complicated in nature and the treatment requires more elaborate diagnosis.

The mechanism of pain

Pain is an extremely personal and subjective experience and affects each individual to varying degrees. The pain signals, which can arise in any part of the body, travel through the spinal cord to the brain along thousands of specialized nerves and nerve fibres. In the brain, it is processed in the centres associated with anxiety, emotions, memory, appetite, etc. Signals and pain inputs are then returned from the brain to the spinal cord, which may heighten or diminish pain.

In some cases, pain may also be induced by damage to the brain and spinal cord, which happens after a stroke.
A constant barrage of pain signals may cause the cells at the end of nerve fibres to become over-sensitized. This is known as 'wind-up' and is one of the most common causes of chronic pain that occurs even though the root of the problem has been identified and treated.

The causes and effects of pain differ from case to case depending on the signals received by the brain and its interpretation. It affects the individual's day to day activities and if persistent, can also have a harmful impact on mental health and psychosis. Pain is always handled, diagnosed and treated differently in all patients by drawing out the best possible solution to the problem.





Why does PAIN occur? Understand the Mechanism of Pain

There are many ways to treat pain and this includes acupuncture, several natural remedies, technological procedures and surgery. Among the different approaches for treating pain, massage therapy is an effective method.

Massage therapy is one of the earliest therapeutic processes for relieving pain for a long time as it provides ideal relief and performs recovery functions as well. In the modern day, massage therapy is a popular pain relieving remedy, which is utilized by people all over the world.
Massage therapy involves manipulation of the tissues, which is performed by special therapists. There are various types of massage therapies, which incorporate different techniques and procedures.
Long-term massage therapy is not very expensive and has no side effects on the body. With the help of massaging, there is an increased lymph flow, improved blood circulation and several positive effects on the immune system. 
Conflicting views

The current studies on massage therapy are quite conflicting and there are negative views regarding the effects of massage therapy to provide pain relief. Massage therapies are successful in treating several cases of lower-back pain. However, many experts consider massage therapy to be a relaxation technique and not a proper treatment procedure.

They say that massage provides relief to pain, but physical therapy, exercise and medicines are far superior in providing pain relief than massage therapy. Massage provides relief to neck pain, shoulder pain, headaches and carpal tunnel syndrome. However, it is considered that this relief is only temporary and not consistent enough. A single session of massage therapy does not really provide a long-term relief from pain. For better and lasting results, massage therapy should be undertaken regularly.

Multidisciplinary treatment

Massage alone will never provide ideal relief from any kind of pain and a multidisciplinary approach should be taken for pain relief treatment, where massage therapy would be one of the elements. For ideal pain relief, you should practice other measures such as physical therapy, behavioral health care, acupuncture, regular exercise and use massage therapy as a complementary relief method.

Massage therapy can never be the main treatment procedure for treating pain and it is an accompanying treatment method which you should practice along with major treatment procedures. Massage therapy combined with other therapies will provide you effective pain relief.

Massage therapy for pain provides effective temporary relief from pain. It should be performed by a trained massage therapist and for good results must be performed every day. However, massage therapy is not a primary treatment measure and should be a part of a multidisciplinary approach for pain relief. In case you have a concern or query you can always consult an expert & get answers to your questions!

Massage Therapy for Pain - An In-Depth Analysis!

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