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?

Facial paralysis can happen due to many factors. Sometimes inflammation develops around the facial nerve as it passes through the skull from the brain. This presses on the nerve and makes it stop functioning. As the nerve stops functioning, so does the muscle it controls.


This is what happens in Bell s palsy, the most common cause of facial paralysis.


Bell s palsy can happen to anyone and its cause is, hold your breath, a viral infection. Herpes zoster, Varicella zoster and HIV viruses can cause Bell s palsy.


Bell's palsy is a common cause of a facial paralysis but there are many others too that affect or damage facial nerve. These include head injury, sarcoidosis, lyme disease, growths in the ear, tumours in the parotid gland, brain tumours and stroke.


The weakness of the face usually one-sided is a symptom of Bell s palsy. The face may droop to one side, chewing food is also tough, drooling, dry eyes and difficulty wrinkling forehead and speech are other symptoms of Bell s palsy, the most common reason for facial paralysis.


Treatment:
The type of therapy you receive for facial paralysis will depend on its cause. It will also develop on how long you ve suffered from facial paralysis and the extent of damage to the facial nerve.


Your physiotherapist can help and so can speech and language therapists to deal with the issue.


In physiotherapy, a treatment called 'facial retraining' with facial exercises helps with facial palsy. It is important that you seek help from a therapist who specialises in facial rehabilitation only.


This is what you can expect from facial rehabilitation therapy-
Exercises for eye care
Exercises for dry mouth management
Exercises to make drinking and eating easier
Speech therapy
Your physiotherapist will educate you on how the facial nerve works and how it recovers. This is important to make you recover. A home therapy programme plays an important role too. It includes massages to keep face muscles mobile and healthy, stretches to lengthen muscles, exercises to help re-learn balanced facial movements and relaxation of your facial nerve and muscles.


The physiotherapist will work on your facial movement to make muscles fit. The basic idea is to slowly rewire the brain-to-nerve-to-muscle pathway. The physiotherapist s first step is to retrain you to do correct movements voluntarily, while mentally focusing on the movement.


Physiotherapy may take months but keep at it to recover completely, especially the home exercises.


Injections of botulinum toxin or Botox also help especially if you suffer from spasms in facial muscles. Surgery is also an option for chronic cases.


Remember that exercises should be done gently as well as daily to reap benefits. Always do these exercises with the help of a therapist only. Doing exercises by yourself can be counter- productive.


Facial Paralysis - How Can Physiotherapy Help You Get Better?

Phimosis, Paraphimosis are the two major issues which occur in males In Phimosis, the foreskin is not easily pulled back from the tip position of the penis. Normally, this problem takes place in younger children and this is not a serious condition. With spontaneous erections and natural manipulations, more than 90% of foreskin becomes retractable by age 3 to 4 years. Few require Preputioplasty and Circucision is reserved for Balanitis Xerotica Obliterans. Paraphimosis, is quite a painful condition which needs to be treated urgently. Paraphimosis is the condition in which the foreskin is pulled back or get stuck in the same position. Due to this the retracted foreskin, as well as the penis part, becomes swollen. 

In this condition, the fluid will build up, and thus the foreskin cannot be returned to its original position. If anyone ignores it then it can lead to major issues. This can have an effect on blood flow to the tip of a penis. And, if not treated on time then the tip of the penis can get damaged.

The insect bite is a condition which can cause swelling of the phallus and prepuce. This can be easily treated by medicine. Differential diagnosis Penile edema, which is related to insect bites, allergic reactions, and trauma. 

Causes of Phimosis and Paraphimosis: 

Scar tissue: Any kind of infections can create the scratch marks on the foreskin. This can also affect the penis. Thus because of tough tissues, it is somewhat difficult to pull it back.    Pull and stretch: It is important that one should not forcefully move the foreskin. Pulling it or stretching the tip of penis vigorously can cause inflammation. 
Medical conditions: If anyone is suffering from diabetes, then there are chances of having a infection known as balanitis. This is typically an infection which takes place at the tip of the penis. 
Thus, in this case, it is necessary to discuss the problem with your doctor. Therefore, after going through your complete medical history, he can suggest you the best treatment which can manage the swelling of the penis. 

Why Paraphimosis happens? 

Mishandled foreskin 
Piercing 
Treatment and cure for Paraphimosis: 
The manual reduction is the first treatment which is suggested by your doctor. In this procedure, analgesic is given as a pain killer through the mouth. Other than this local anesthetic block is applied to your penis. Or applying anesthetic jelly in a local area is quite helpful during manual reduction. Injections of hyaluronidase are also effective to decrease the swelling.

How Surgery Can Help Manage Swelling Of Penis?

As life expectancy is increasing so is the incidence of vertebral body (VB) fractures now being the commonest fracture of the body. PVP is an established interventional technique in which bone cement is injected under local anaesthesia via a needle into a fractured VB with imaging guidance providing instant pain relief, increased bone strength, stability, decreasing analgesic medicines, increased mobility with improved quality of life and early return to work in days.

In this era of minimally access surgery replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression fracture spine.

Morbidity & consequences of spinal fracture:

Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly
Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory & GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
High risk of primary or consequential damage to neural, bony or disc element
Increased wedging, deformity & increase incidence of adjacent VB
Chronic pain of altered spine mechanics
Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.
Cost of surgery and hospital treatment
Cost of implants
Phobia of surgery
Prolonged recovery period & Extensive rehabilitation
Changed spinal mechanics & transition syndrome
Major surgery & anesthesia with its own complications
Results / Outcome

PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral.
Different studies show an immediate pain relief in (85   90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
PVP does augment height of VB but ideal would be kyphoplasty
Patient is either off medicine or on reduced doses.
Patient feels so well that he almost forgets if he had VB

Percutaneous Vertebroplasty (PVP) is an emerging interventional technique in which surgical polymethyl methacrylate bone cement is injected under local anaesthesia via a large bore needle into a vertebral body (VB) under imaging guidance providing increased bone strength, stability, pain relief, decreased analgesics, increased mobility with improved QOL and early return to work. Started in 1984 by Galibert PVP is done in host of indications.

Senile osteoporotic compression remains the commonest Indication. Other indications are Metastatic VB, Multiple myeloma VB, VB haemangioma, Vertebral osteonecrosis & for strengthening VB before major spinal surgery. The benefit has been extended to the traumatic stable uncomplicated VB compression (VCF) which is commoner in younger age group with active life profile and prime of their career where strict bed rest and acute or chronic pain are unacceptable and they are more demanding for proactive treatment approach so as to be back to work ASAP.

Discovering the fact that VB is the commonest of body, its incidence >the hip, it becomes imperative to take it more seriously. With increasing life-span there is more of aged osteoporotic population, more so due to sedentary indoor lifestyle and post menopausal osteoporosis. Diabetics, smokers & alcoholics are at higher risk of developing osteoporosis. I have seen such alcoholic patient developing six spine fractures in just three months time from a single fracture being on complete bed rest.

Quick fix of fracture spine makes patient walk back same day instead of bed rest of months together avoiding morbidity & mortality of prolonged bed rest, making bedridden patient walk, in a way bringing patient back to normal life.

In this era of MAS replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression.

Morbidity & consequenses of spinal 

Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly.
Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory &
GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
High risk of primary or consequential damage to neural, bony or disc elements.
Increased wedging, deformity & increase incidence of adjacent VB
Chronic pain of altered spine mechanics.
Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.
Morbidity and complication of spinal surgery 

Cost of surgery and hospital treatment
Cost of implants
Phobia of surgery
Prolonged recovery period & Extensive rehabilitation
Changed spinal mechanics & transition syndrome
Major surgery & anesthesia with its own complications
Preparation & Procedure:
X-ray spine in a/p & lat view. CT is more informative of bone & morphology. MRI is good for soft tissue injuries. Ask for pedicle size in all dimensions and construct a 3D image aiming needle placement and cement filling in scan room itself as rehearsal of PVP. This reduces operative time & gives better results. Conventionally PVP is done by hammering the vertebroplasty needle through the bone. Here we use light weight drill to bore through the vertebra. It is important to set the needle at exact entry site & side with right trajectory aiming the defects.

In lateral view needle should go through middle of the pedicle going up to anterior 1/3 of VB. In P/A view the needle can be in midline or paramedian depending upon & if uni/bipedicular approach is planned. Approach varies as per location of vertebra, anterolateral in cervical, costotransverse/parapedicular in thoracic & transpedicular in lumbar vertebra.

Do bone biopsy if there is any doubt about lession. Do dye test (vertebral venography). Make cement more radiopaque by adding barium /or tungsten. Inject cement with 1or2 ml luerlock syringes strictly under fluoroscope in lateral view & cross checking in P/A view. Stop injecting either there is adequate filling or at the first sight of ectopic cement leak. Keep sample cement to see for hardening. Remove needle with rotational movement before cement hardens.

Pain relief is by virtue of different mechanisms postulated :

Cementing of fragments.
Thermal neurolysis of VB nerve ending due to heat of polymerization.
Washing away of nociceptor chemicals.
Neurolytic action of liquid monomer.
By allowing early ambulation decreasing pains of immobility & bed rest.
Complications 

PVP is generally safe with low risk.
Ectopic cement leak is frequent but generally inconsequential.
Outcome 

PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral
Different studies show an immediate pain relief in (85   90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
PVP does augment height of VB but ideal would be kyphoplasty.
Patient is either off medicine or on reduced doses.
Patient feels so well that he almost forgets if he had VB

Vertebroplasty (PVP) / Kyphoplasty - Approach To Management Of Vertebral Body Fractures!

After a tough workout session or a strenuous day at the office, your muscles may feel floppy and exhausted until you have given them a chance to rest. However, persistent muscle weakness with no apparent cause or explanation can be a sign of an underlying medical problem.

What causes muscle weakness?
Voluntary muscle contractions and movement are generated when the brain sends a signal through your spinal cord and nerves to the particular muscle. If there are any hindrances in the connections between them, it can result in muscle weakness. However hard you try, the muscle is such cases becomes abnormal.

Here are some common causes of muscle weakness:

Lack of Use: One of the most common causes of muscle weakness, lack of muscle fitness may occur as a result of a sedentary lifestyle. If the muscles are not used, then the fibers are partially replaced with fat.
Ageing: As we age, our muscles tend to get weaker and lose strength. Muscles become bulky and recovery times during injury are greater. However, with physical activity, it is still possible to increase the muscle power. So stay active and instill strength in your muscles.
Infections: Infections and inflammation can cause temporary muscle fatigue. Even though recovery is quick, if the infection is severe the weakness can last for some time. Without proper care, it can lead to permanent damage.
Pregnancy: During and just after pregnancy, high levels of steroid in the blood and low levels of iron can cause muscle tiredness. Lower back pain is common during pregnancy and all your muscles may feel floppy.
Chronic Diseases: With conditions of diabetes, heart disease, kidney disease and anemia, it can lead to muscle weakness by thwarting the essential blood or nutrient supply to the muscles. Also, chronic pain related ailments cause weakness.
Injuries: Injury or trauma such as sporting injuries, pulls and sprains can deter the muscles. Along with localized pain, it can also lead to muscle weakness if not taken care of properly.
Sleep Disorders: With disturbed or reduced sleep there is a general sense of tiredness that leads to fatigue in the muscles. Insomnia, anxiety, depression and other mental disorders also affect the muscles a great deal.
Conditions affecting Nerves: Conditions like Myasthenia gravis or motor neuron disease affects the nerves and thereby fail to relay signals to the muscles, leading to weakness.
Genetic disorder affecting muscles: There are also certain inherited diseases which can affect the muscles like muscular dystrophy.
Spine-related disorders: Conditions like slip disc and other disorders affect the muscles served by the irritated or compressed nerves of the spinal cord.

Muscle Weakness - 10 Common Reasons Behind It!

Hereditary Angioedema is a rare skin related disorder and as the name suggests it is also a genetically inherited condition. This condition mainly afflicts the throat, abdomen and the limbs of the patient, with a certain kind of swelling. This swelling can become fatal if not treated on time. Here is everything you need to know about the condition and its treatment.

Causes: A rare genetic mutation of the SERPING1 gene can cause this condition. Usually, this gene is known to produce C1 esterase inhibitor, which is a kind of blood protein. This blood protein is an important element of one s immune system and is usually involved in the biochemical reactions that control the body s response to inflammation causing elements. This is done when the blood protein produces a hormone known as Bradykinin. If this blood protein does not function in a normal manner, then there is excessive production of this hormone, which leads to swelling and inflammation.

Type One: There are various types of Hereditary Angioedema that can affect various parts of the body. Type one is one of the most common kinds and can be found on the face, hands, abdomen, throat, as well as feet and genitals of the patient. The severity and frequency of attacks cannot really be predicted and the patient may suffer from attacks throughout his or her life. The best way to treat this type of Hereditary Angioedema is with the help of antihistamine drugs and prednisone which can fight allergic attacks.

Type Two: This kind of Hereditary Angioedema has the same symptoms as type one and is caused by a malfunction of the C1 inhibitor, rather than the Bradykinin hormone as one can see in type one. This condition can also be treated with anti-allergy drugs.

Type Three: This is very rare kind of Hereditary Angioedema. In fact, medical science is yet to find a conclusive body of knowledge that can point to the exact causes and symptoms of this condition. Coagulation is one of the main causes recognised so far. This condition is much more common in women than it is in men, and it usually shows up as facial swelling.

Timely Treatment: While there is no cure for this condition, one can prevent a flare up of the symptoms by taking C1 inhibitors and Bradykinin receptors as well as enzyme inhibitors. It is important to get early treatment for the symptoms and to have constant access to a hospital and its emergency unit. One should also keep track of attacks and symptoms and get regular check-ups done by a doctor to detect the earliest signs of the same to avoid fatalities.

What is Hereditary Angioedema and How Can it be Treated?

Don't wait any longer, manage your Hip Replacement online with a Lybrate doctor today

Consult for Hip Replacement - Online and Easy!

FilterClear All

COMMON SPECIALITIES

COMMON ISSUES