Muscle contusion is a condition that is characterized by bruising in the muscles. It generally tends to occur in athletes who play a lot of contact sports. Repetitive blows in any part of the body may cause damage to the underlying muscle tissues. These blows may lead to internal bleeding, resulting in blood clot formation. The most common site where it occurs are the quadriceps.


The various causes of this condition are:
1. Direct repetitive blows to a part of the muscle in contact sports such as football
2. If you fall on a hard surface 
3. It may also occur if the muscle comes in contact real hard with sports equipments like soccer balls

The symptoms of a muscle contusion are:
1. You may experience swelling of the muscle
2. Excessive pain
3. Decrease in range of motion in the concerned body part
4. It may lead to leaking of blood vessels
5. You may also experience hematoma where a lump is formed over the affected spot
6. Symptoms of broken bones, dislocations and fractures may also occur

Complications
This disorder may also lead to various complications such as compartment syndrome, which leads to compression of blood vessels resulting in pain. 

Treatment
The basic treatment for this condition is the rice protocol which is rest, ice, compression and elevation. You should rest the muscle, then apply ice to the affected area to reduce the pain. You can also take nsaids (non steroidal anti-inflammatory drugs) to reduce the pain. In severe cases, the doctor may drain the lump surgically.


It is advisable to not return to your normal sports routine in order to allow the muscle to recover. If you carry on with your regular routine, it may result in further complications like the formation of scar tissue. You may undergo various stretching exercises to relieve the pain and make a gradual return to your normal sporting activities.


Causes and Symptoms of Muscle Contusion

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!

A bone fracture occurs when a strong external force is applied on the bones causing it to break. It is an extremely painful condition that results in days of immobility and rest. There are several reasons which can result in bone fracture, some of them being:

1. Injuries caused in sports
Any sport requires and demands extreme physical exertion and participation. Being involved in any sport therefore automatically increases your risk of incurring injuries. Bone fractures therefore are mostly reported during sports.

2. Osteoporosis
Due to the deficiency of calcium, the bones of both men and women tend to get weak and more susceptible to fracture and breakage. It is one of the primary causes that lead to bone fracture.

3. Osteomalacia
This also refers to a condition wherein the bones become weak and brittle. Much like osteoporosis, osteomalacia too significantly contributes to instances of bone fractures.

4. Osteosarcoma
This is a rare form of bone cancer that most often develops either near the femur or near the shinbone. An instance of this form of bone cancer is most often found in children and weakens the bone, consequently leading to fractures.

Though there may be different causes of broken fractures, its symptoms remain similar. Some of them are-

1. Swelling
One of the most common symptoms of bone fracture is perceptible swelling. If any of your bone is fractured, that particular part will be visibly swollen.

2. Deformity
Bones give your body the shape it has, thereby, any fracture anywhere would inevitably manifest itself as a clear deformity of that particular part.

3. Extreme pain
It goes without saying that a bone fracture would entail excruciating and extreme pain. This pain sharply increases with mobility thereby necessitating complete rest.

4. Temporary loss of function
The part of the body where the bone is broken temporarily becomes dysfunctional. For instance, if the bone in your hand is broken, you will find it extremely difficult to move and do any work with it.

Causes and Symptoms of Bone Fracture

Osteoporosis is a disease that affects the bones of its sufferers. This is most commonly found in women, especially in those who are close to, or going through, menopause. Hormonal changes around this period in a woman's life usually lead to various changes in her body. One of these changes includes loss of bone tissue which can leave the patient with brittle and weak bones, a condition that is also known as osteoporosis. This condition literally imbibes the word porous, meaning hollow bones. It is born from an acute deficiency of calcium and vitamin d. The dexa scan or bone density test, also known as the dual energy x ray absorptiometry scan, is one of the most effective tests that can help you in detecting this kind of damage or thinning bones. Here's why.

- fractures: the dexa scan is an important one because it sends low energy beams to areas like your joints and tissues to show how susceptible you are to fractures. It does so by measuring the strength of the tissues as well as the bones to see how brittle they may be.&nbsp;

- other ailments: measuring the thinning of your bones can also point to the presence of other ailments that may have gone unnoticed or undetected, earlier. These can include kidney disease, hyperparathyroidism which happens due to overactive secretions of the said gland, as well as liver disease due a malfunctioning liver, intestinal disease and various disorders in the intestinal tract, and a serious vitamin d deficiency. With this scan, you can get an insight into the other parts of the body affected by the bone density, and whether or not they are functioning properly.&nbsp;

- estrogen: simply checking the estrogen levels cannot ascertain whether or not you have osteoporosis, as a high estrogen level can be credited to a particularly heavy period cycle. It does not show the bone health the way a dexa scan does.&nbsp;

- easy and standardised: this method of scanning usually happens with the help of a mounted x ray machine type, hand held gadget which can be extended to conduct the scan. This is an easy and standardised method that releases low levels of radiation which also makes it a healthier option.

- bone density scores: the t scores and z scores point towards the bone density and help in diagnosing the condition efficiently. With a systematic scoring system, it is a sure shot test for osteoporosis.

Osteoporosis is a serious condition. The first step in treating the same is to get a detailed scan like the dexa scan done, so as to test the extent of the bone thinning to ensure that proper and timely treatment takes place.&nbsp;


Why Is The DEXA Scan Important For Osteoporosis Patients

Osteoporosis is a medical condition marked by a decrease in bone density. It results in the brittleness of bones and their fracture. Osteoporosis does not display any signs or symptoms but manifests itself in advanced age.

Homeopathic remedies for Osteoporosis

Silica or Silicea-This remedy is for people who are often nervous, feel sweaty during the night, get easily tired and are a highly nervous lot. The injuries of such people take the time to heal/ are difficult to heal and their spine is weak. Generally, these patients have delicate or refined features.
Symphytum- Meant for those fractures that occur because of mild trauma, this remedy is useful in cases where pain persists in old but healed fractures and also when bones need to be strengthened.
Calcarea carbonica- This remedy is administered to people who are overwhelmed by a lot of work and stress, get tired easily after work and have a proclivity to stress a lot. Generally, these people are overweight and have a lot of body flab and easily get depressed by cold/chilly weather and dampness in the air. They have swollen joints, experience a recurring back pain and get a sweaty head in the night. An interesting characteristic of these people is also that they have a craving for eggs and sweet things.
Calcarea phosphorica- This remedy is meant for people who have a deep, uncontrollable and intense desire for travel. They want a change in their environment and have a general sense of dissatisfaction. People requiring this medication have pain in their neck, upper back and hips. Fractures, if any, are slow to heal and there maybe deposits of calcium in the bones. Post-exercise, these people feel greatly tired.
Phosphorus- Meant for people who experience a burning pain between their shoulder blades, phosphorus as an osteoporosis remedy is given to those people who have an intense desire for refreshing foods like ice cream, beverages, carbonated drinks etc. Such people are usually lanky and their faces often get flushed. They are sensitive, suggestible and susceptible to the imagination. They get easily tired after a round of exercise and work.
Homeopathy Dosage
Unless directed by a homeopathic physician, take doses of low potency like 6X, 6C, 12X, 12C, 30X or 30 C if you are going in for self-medication. Follow the instructions printed on the label.
If you are taking a single dose, ten wait for its response. If the medicine is working, then wait for its full effect to manifest. If there is little or no response, take another dose. If there is no response at all after taking the second dose then change the medicine.

Please note that dosage depends upon the individual and the intensity of his/her ailment,

Osteoporosis - How Homeopathic Remedies Can Help?

Your spine or backbone is composed of 26 bone discs, known as vertebrae. The vertebra shields your spinal cord and allows you to bend forwards and backwards, and stand. However, a number of problems, such as the following can change the structure or cause the vertebrae and its surrounding tissues to become damaged  

  Injuries
  Infections
  Tumours
  Changes in bone formation due to ageing   herniated disks, spinal stenosis
  Conditions like scoliosis and ankylosing spondylitis

Spinal disorders often lead to pain and discomfort when bony projections put pressure on the spinal nerves or cord. Over time, spinal disorders limit movement and reduce flexibility.
Treatment varies depending on the disease, ranging from medications and therapy to bracing and surgery.

Endoscopic Spine Surgery: what is it?

Contradictory to traditional open surgery, the new age endoscopic surgery is a minimally invasive procedure used to detect and treat a disorder. Unlike open surgery, minimally invasive endoscopic surgery does not require the patient to undergo general anaesthesia. The procedure is possible under local anaesthesia, considering the fact that it can be performed without cutting open the portion of the surgery site.

How does surgery work?

During the procedure, the surgeon first administers local anaesthesia to numb the site of the operation. You will be awake during the entire procedure but will not feel any pain. Then, he/she will make a small incision and insert a slender, tubular instrument   known as an endoscope   with a camera attached on one end through the soft tissues and skin, down to the spinal column. This allows the surgeon to get a clear view of the spinal tissues and understand where the problem exists. The endoscope holds the muscles open, allowing the surgeon to remove the damaged tissues or disk.

Endoscopic spine surgery preserves normal mobility, as the spine is not fused with rods and crews. When performed under an experienced surgeon, the procedure takes less than an hour.

Benefits of the Procedure

The advantages of going for an endoscopic surgery are the following  
  Local anaesthesia
  Surgery and discharge on the same day
  Microscopic incisions
  No removal of bone or muscles
  Zero or minimal blood loss
  Preserves spinal mobility
  Immediate recovery
  Reduced intake of pain medicines
  The high rate of success
  Improved quality of life

Minimally invasive endoscopic surgery has made it possible to rectify spinal problems and disorders without having to go under the knife. With less pain and quicker recovery, you can improve your spine health and get back to your usual activities in a day or two.

Consult a specialist and discuss the procedure in detail before opting for the same.


Endoscopic Spine Surgery Under Local Anaesthesia!

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