Like other knee injuries, the torn meniscus can be painful and debilitating. But unfortunately, it is quite common. In fact, a torn meniscus is one of the most frequently occurring cartilage injuries of the knee.

What is Meniscus? 

A meniscus is a C-shaped piece of cartilage present in the knee that acts as a cushion and stabilizes the joint. Its function is to protect the knee from wear and tear. Two menisci are present in each of the knee joints. They can get damaged or torn during activities, which puts pressure on the knee joint or may rotate it.

What causes a meniscus to tear? 

A quick stop or vigorous twist may force the femur to crumble into the top of the tibia. It may potentially tear out the cartilage of the meniscus. It may also occur while doing deep squats or kneeling, especially while lifting a heavyweight. Athletic activities often result in this knee injury, particularly in the sportspersons such as footballers and hockey players. Sports that involve sudden stopping and pivoting such as tennis and basketball may also result in the torn meniscus. Meniscus tears are a special risk in elder people as the cartilage weakens and wears thin over time. As the age progresses, worn tissues become more prone to tears. Just a clumsy twist while getting up from the bed or chair is sometimes enough to cause a tear in case of weakened menisci due to aging.

Symptoms of a meniscus tear: One may hear a popping sound around the knee joint when a meniscus tear occurs. Initially, the pain may not bad but once the inflammation sets in, the knee starts hurting quite a bit. The knee may get stiff or locked. It may become difficult to move the knee in a full range of motion.

Diagnosis of a Meniscus Tear: Diagnosis of a meniscus tear starts with the patient s history and a physical examination. The doctor inspects, palpates, and applies specific diagnostic maneuvers to diagnose a torn meniscus. The McMurray test is used to make the clinical diagnosis of a meniscus tear. The doctor flexes the knee, then straightens and rotates it to put tension on a torn meniscus. The movement will cause a clicking sound if a meniscus tear is present in the knee. A magnetic resonance imaging (MRI) scan is the preferred choice to diagnose the torn meniscus. This technique allows the doctor to evaluate the knee cartilage in a more detailed way.

Treatment of Torn Meniscus: The treatment of a torn meniscus depends on the severity and the location of the tear. If the size of the tear is small and the location is on the outer end of the meniscus, a surgical repair is usually not required. Give rest to your knee as much as possible. The doctor may advise using crutches to avoid putting weight on the legs. Icing the knee every three to four hours for 30 minutes is recommended for this injury. You may use compress bandage to reduce the inflammation. Try to keep the knee in an elevated position to reduce the swelling. NSAIDs may be prescribed to get relief from pain and inflammation. If the symptoms persist, the doctor may advise for an arthroscopic surgery.

Torn Meniscus - What Exactly Is It? 

Ankylosing spondylitis refers to a form of arthritis that affects the spinal column. This condition causes the bone vertebrae to fuse together leading to a rigid spine. Depending on the extent of the damage, this could result in mild changes or in a stooped posture. Although the cause of this disease is not known, it is said to be passed down from one generation to another through a gene called the HLA-B27. This gene is also linked to spondylitis.

Ankylosing spondylitis cannot be cured, but with treatment, the pain and stiffness associated with it can be managed. Along with medication, physical and occupational therapy is a must when treating this disease. In some cases where the disease has caused severe deformities, surgery may also be recommended. However, an early diagnosis can also help prevent significant deformity.

A physical exam and an X-ray are the key factors used to confirm a diagnosis of Ankylosing spondylitis. Some of the symptoms associated with this disorder are:

Pain and stiffness: Everyone complains of a backache at some point or the other but a persistent lower back ache could be a sign of something serious. Spondylitis often starts in the sacroiliac joints and hence the lower back, buttocks and hips are the first to be affected. Pain that lasts for more than three months should not be ignored as it could be a sign of Ankylosing spondylitis.
Bony fusion: This condition causes an abnormal growth of bones in the spinal column. This can lead to the fusing of bones in the spine. The bones of the neck, back and hips are most affected by this bone fusion. While this can affect a person s mobility it can also cause complications. For example, the fusing of the ribs to the spinal column or the breastbone can restrict the expansion of the chest while breathing.
Pain in ligaments and tendons: Apart from the bones, this condition also affects a person s tendons and ligaments attached to the bones. For example, pain in and around the heel may be caused by tendonitis.
Other symptoms: The symptoms of ankylosing spondylitis are not restricted only to the joints. Hence, it is also known as a systemic disease. Some of the other symptoms exhibited by people suffering from this condition are fever, fatigue, inflammation of the eyes and a loss of appetite. Some people may also complain of lung and heart problems. 

Ankylosing Spondylitis - How To Know You Are Suffering?

The core muscles, mainly concentrated around the abdomen, hips, lower back, trunk, and glutes, are indeed a powerhouse that gets you going. The stronger the core muscles, the fitter you stay. Without a proper core strength, a lot of the day to day activities including lifting or bending gets affected. Certain health conditions can weaken the core muscles. But how to know if the core muscles are weak? There are many signs and symptoms associated with weak core muscles. 

Mentioned below are some important signs that may be an indication of weak core muscles.

For your posture to be correct, the spine and pelvis need to be stable: The muscles of the lower back and the abdomen does exactly that, ensuring a steady and correct posture. However, when the core muscles weaken, they are unable to provide stability to the spine and the pelvis resulting in a poor posture. Left unattended, poor posture, in turn, can trigger a myriad of complications and discomfort.
The body loses its balance: As already mentioned, the core muscles go a long way in stabilizing the body and helping you to maintain the body balance. You can perform a small test to know if your balance is affected. Close your eyes and stand on one foot. Repeat the procedure with the other foot as well. If you have a developed core, you will be able to hold the position for at least 10 seconds, if not more (both the legs).
A pain concentrated to the lower back: Do not ignore a lower back pain. It could be an indication of your core muscles not being strong enough, especially the ones adjacent to the spine. The weak muscles fail to provide the necessary support to the discs and the vertebrae resulting in pain (mild to severe depending on the severity of the condition) and discomfort. Timely medical intervention may help improve the condition.
Weakness throughout the body: The strong core muscles are an indication of a healthy and fit body. When the muscles start to lose its strength, the entire body gets affected. A person finds it difficult to even lift things. Doing even a small and regular work leaves a person weak and tired.
You can also perform the Hollowing Test to check your core strength: Sit in a comfortable position. Starting breathing in and out. As you breathe out or exhale, try to pull your stomach inwards towards the spine for at least 10 seconds. Unable to pass this test (can't hold the position for 10 seconds) indicates weak core muscles.
You can also try the plank test: Get yourself in a push-up position with the entire body resting on your elbows, arms, and toes. The hip should be level and steady. Failing to stay in this position for 50 seconds is indicative of weak core muscles

Core Muscles - How To Know If They Are Strong Or Weak?

Why osteoporosis and osteopenia are fast turning into diseases of the young

Did you know that osteoporosis causes more than 8.9 million fractures worldwide every year? what is frightening is many of these fractures are now taking place among the youth due to deficit diet and poor lifestyle coupled with genetic predisposition. Both osteoporosis and osteopenia are two forms of bone loss conditions, with the latter being a precursor to the former. To distinguish between the two a bone mineral density test is usually performed.

What is the difference between osteoporosis and osteopenia?

A BMD (bone mineral density) t-score between -1 sd and -2.5 sd indicates osteopenia with a high chance of osteoporosis. On the other hand, a t-score of -2.5 sd and below stands for osteoporosis. A higher bone density (above -1sd) is usually indicative of stronger bones. Fragility index is more accurate way to assess the risk of fractures.

In osteoporosis the bone loss or weakening of bones take place over a long period of time, and results in unexpected fractures and severe bone problems. Disfigurement, fractures in the spine, loss of mobility and independence are usual characteristics of this bone disease once it progresses further.

Prevention is better than cure, always!

To keep bones strong and healthy, calcium and phosphate is continuously absorbed by the body. But after 30, the body?s ability to absorb calcium slows down and there?s a decrease in the production of new bones. In contrast, bone desorption (the process of transferring calcium from the bone to the blood) continues unabated.

When the body starts absorbing the store of calcium in the bones to meets its needs, it leads to calcium depletion and is one of the causes of the weakening of the bone.

At present, the age limit (50-60 years) for osteoporosis has seen a drop with many younger people increasingly suffering from the ailment. Factors like unhealthy lifestyle, late-night shifts, smoking and alcohol consumption have been found to be the culprits behind the rise in osteoporosis cases among the young. Recent studies have identified vitamin d deficiency as a major factor for poor bone health and bone mass density in the young.

How to keep your bones strong and healthy? and manage osteo - penia/porosis complications:

Bone loss can be prevented by adopting these very simple but effective ways:

- exercising can help in building strong bones and muscles, while preventing bone loss.

- maintaining a calcium intake of 1000 mg for pre-menopausal women and 1200 mg for women post menopause.

- staying out in the sun for 20 minutes to produce requisite amount of vitamin d for calcium absorption and using supplements of vitamin d.

- there are many safe medicines available to prevent and treat osteoporosis like alendronates, calcitonin, parathyroid, teriparatide preparation etc.

- in osteoporosis induced /associated fractures we have to to modify implants to negate weak purchase of implants in bone and improve mobility. We have been using these modifications in established osteopenia/porosis case in fractures treatment/joint replacement/ arthroscopic fixations and MIS spine fracture management.


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Are Osteoporosis and Osteopenia fast turning into diseases of the young?

The problem of morning back and neck pain may be due to the position of sleeping or it may be related to inflammatory arthritis which can be familial. Morning back pain is largely related to wrong sleeping posture and less commonly due to arthritic conditions like Ankylosing Spondylitis or Rheumatoid Arthritis. Whatever be the cause- this condition requires attention by an Orthopedic doctor as it may worsen in due course of time and should not be taken lightly.

Some common factors causing this are:

Mattress: Too soft or too hard a mattress might induce back ache after sleep. For people with waist and hips of equal proportion, a firmer mattress would do well. For those with narrower waist than their hips, a flexible and softer mattress that can move with the pelvic weight would be a perfect choice. Refrain from using old hardened mattresses.

Pillow: The pillow you use must be able to render support to your neck naturally. Instead of using excessively firm or soft pillow, try substituting it with memory foam pillows, refillable water pillows or cervical support pillows.

Posture: Not changing your position while sleeping or sleeping on the belly exerts strain on the back muscles, causing pain. On the other hand, sleeping on the back or on the sides causes comparatively less strain on the spine.

Other causes such as strenuous workouts or physical activities or sitting at a stretch during the day might cause pain while sleeping or after getting up from bed.

Remedies for Morning Back Pain:

Fortunately, there are some home remedies to cure the morning back pain.

Switching your mattress is a more expensive remedy for back pain, but may often be the ultimate cure. Most people sleep the best on medium-firm mattresses. Be sure to try out the mattress before you buy it.

For occasional back pain after sleeping, apply heat to your back to relax your muscles before you go to bed and when you get up in the morning.

Massage your back with pain relieving creams and apply heat on it with a heating pad for quick relief.

Specific spinal stretching exercises and Planks (a type of exercise) can greatly help in easing back pain, if done on a regular basis.

It is always recommended to CONSULT an Orthopaedic doctor if you suffer from morning back pain.



What Should You Know About Morning Back Pain And Neck Pain?

If you are experiencing joint stiffness in your hip along with pain and tenderness, you could be suffering from hip arthritis or osteoarthritis. Osteoarthritis accounts for being the most common form of arthritis. It is referred to as degenerative joint disease and old-age arthritis and usually, occurs because of age-related issues. The condition occurs when injury and inflammation of a joint lead to the breakdown of the cartilage tissue, causing pain, swelling, and deformity.

How hip arthritis affects the hip joint?
People who are affected by osteoarthritis of the hip may have difficulty in walking properly. Diagnosis in the early stage is difficult as pain may occur in various locations such as the thigh, groin, knee or buttocks.

The underlying causes
The factors responsible for osteoarthritis include increasing age, joint injury and excess body weight. Some other factors may also be responsible. They are as follows:

When the joints have formed improperly.
In case of inherited defects in the cartilage.
When a person puts excess stress on the hip joint because of being overweight or due to certain activities and motions.
How it can be detected?
The different symptoms of hip arthritis or osteoarthritis are as follows:

Joint stiffness, especially after waking up in the morning.
Joint stiffness after sitting for a long period.
Swelling, pain, and tenderness in the hip joint.
A crunching feeling or sound of bones rubbing against one another.
The inability to move the hip for carrying out daily activities.
Treatment
The aim of osteoarthritis treatment is to improve the patient s ability to move about so that his regular life is less affected. The function of the hip and pain management are other targets of treatment for this condition. The different treatment plans are as follows:

Proper joint care and rest
Using a cane while walking for taking weight off your hip
Losing excessive weight
Non-drug pain relief measures for controlling pain
Regular exercise
Several medicines, including NSAIDS and other prescribed pain medication
Surgery
Alternative therapies
Hip replacement surgery
This is a surgical procedure used for osteoarthritis treatment when all other treatment plans fail. The damaged ball of the hip joint is replaced with a metal ball in this surgical procedure. The hip socket is resurfaced by using a plastic liner and metal shell. Apart from the mentioned treatment procedures, hip resurfacing is another surgical option for osteoarthritis treatment, which helps in giving relief when a hip replacement surgery is delayed. In this procedure, the affected hip joint surfaces are surgically removed and are replaced with metal.

Arthritis - How it Impacts Your Hip Bone?

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