People have a common perception that most injuries, medical conditions only affect those who spend several hours working outdoors. But what if we tell you that people who stay indoors- such as homemakers - are also susceptible to numerous health problems?

There s a saying:  Home is where the heart is.  But for countless homemakers, home is the place where  hurt  is! Scores of Indian homemakers encounter various injuries every year while engaging in household chores like cleaning and washing. The most common ones are-

Sprain- if you re a neat freak, you wouldn t mind spending half of your day cleaning the entire house. Here s a small tip- go slow if your cleaning duties include shifting heavy appliances and furniture from one place to another. There s a high chance that you may end up with a sprain injury. Sprains occur when you accidentally twist your ligaments. Another major cause of sprain injuries is a sudden fall. If you re mopping the floor or cleaning the bathroom, there s a fair chance that you may slip or lose balance. One must be cautious when working with water.
Back injuries- These are the most common types of injuries at home. Bending, lifting a heavy bucket or an abrupt movement, can strain your back muscles or ligaments leading to back injury. Many times the injury can result in a persistent, sharp stabbing pain, and hinder your usual routine.
Joint compression- Homemakers spend a considerable amount of time standing in the kitchen. As tiring as it is, standing for prolonged periods puts pressure on your joints- knee joint, hip joint as well as those in the feet and the ankle. This leads to wear and tear of the synovial joints, eventually causing them to tear. In due course of time, you will find it difficult to move around and walk even a meagre distance.
Prevention-
Starting to get worked up? Don t be. These problems can easily be prevented if you follow these steps-

Avoid overstretching, bending and twisting
Avoid lifting heavy weights. If possible, use a waist belt to keep away from traumatic injuries.
Keep your body weight in check. Mild exercises can help you with that.
Maintain a healthy diet- calcium intake can help your bones get stronger.
Use muscle braces to keep your joints protected.
Treatment-
The most preferred and effective choice of treatment for curing muscle injuries and joint inflammation is physiotherapy. Physiotherapy uses manual therapy, mechanical force and exercise therapy to promote mobility.

The most common method of treating such injuries is the RICE technique.  RICE  stands for Rest, Ice, Compression and Elevation. Keep the injured part at rest. Put an ice bag on the injured portion. Compress the injured area. Elevate the wound/injury for faster relief.
Anti-inflammatory drugs like Ibuprofen and Aspirin are prescribed to reduce inflammation and swelling. Painkillers can offer you instant relief from pain.
Physiotherapy treatment can effectively cure you of such injuries, that too in a short span of time. If you follow the treatment guidelines, recovery will take about 2-4 weeks. 

Common Problems Faced By Homemakers Who Stay Indoors - How Physiotherapy Can Be Of Help?

The movement between bones and muscles is possible due to the fluid filled sacs that enable smooth gliding of the bones. When there is an inflammation of these sacs, condition known as bursitis results, leading to friction, reduced movement, painful movement, discomfort, and irritation.

Some of the common causes of bursitis include age, which brings along reduced elasticity of the tendons and ligaments.  Additionally, sudden injury to the bursa area, repetitive stress, overuse of the ligaments or tendons, incorrect posture, and improper exercise can all lead to bursitis.

The most commonly affected parts are the elbows, shoulders, hips, knees, and ankles. The dull, aching pain that ensues is accompanied by stiffness. Movement can worsen this pain.  The area can be red, hot, and swollen indicating infection. Whatever the area affected, some of the common ways to manage bursitis pain are listed below.

1. Rest - As soon as bursitis is identified, the area must be rested. As noted, in most cases, repetitive stress and injury is the most common cause, and resting the area really helps.

2. Ice only - If bursitis is happening for the first time, then an ice pack alone should help reduce the pain in 1 to 2 days.

3. Ice and moist heat - If it is happening repeatedly, then alternating moist heat and ice for 15 minutes each will help.  This can be done two to three times a day. 

4. Anti-inflammatories: In most cases, if rest and topical therapy are not working, then the regular anti-inflammatory agents may be given. 

5. Physical Therapy - In some cases, mild exercises can help reduce inflammation and pain. 

6. DMSO (dimethyl sulfoxide) - This clear, colorless, oily liquid is made from wood pulp and helps in reducing the inflammation caused by bursitis. A 70% DMSO mixture can be applied with cotton on the affected area 3 times a day for 3 days, then 2 times a day for the next 3 days, and then 1 time a day for the next 3 days.  If there is no improvement in the first 3 days, it needs to be discontinued.

7. Foods to remove calcium deposits - In a number of cases, bursitis that is present for months or years is worsened due to the calcium deposits. Foods like apple cider vinegar can help dissolve the calcium deposits that could have formed in the bursa.

8. Steroids: Local injections of corticosteroids may be necessary in some cases. Though inflammation can be curtailed with this, there is always the fear of hampered immunity and altered sugar levels.

9. Surgical drainage - In very rare cases, the bursa may need to be surgically drained.
Bursitis is a very common issue and can be managed easily as well. Consult your doctor and avoid medicating on your own.

Ways to Treat Bursitis

The spinal cord is indispensable to your body. It supports your head, keeps your posture erect, and helps you walk. Ailments of the spine are extremely painful to remedy and throw a lot of your other organs in trouble as well. Therefore, it follows that you should take the best care of your spine possible.

While there are a number of ways you can do that, some stand out from the rest. They are:

  Do your exercises properly: there are umpteen ways you can work out and get results that are harmful to your spine. You may easily lift something too heavy for your constitution, or the angle at which the object is placed may be too high for all your muscles to coordinate and work properly. Be aware, and avoid these mistakes. If you feel like the object is too heavy, refrain from lifting it. Even when lifting, make it such that the muscles of your lower body have to do the maximum work.

  Move on: Physical movement is the first commandment of having your spine fit and in a peak condition. This movement can be trivial and every day, like daily walks in the park or going to walk your pet. However, a sustained movement like that is very important, combined with stretching or aerobic exercises.

  Work smart: There are several ways you can avoid injuring your spine at the workplace. You should choose a chair that is adjusted according to your height and supports your lower back well. Your feet should be able to reach the floor properly and well. You should also avoid unhealthy conveniences like holding your phone between your ear and shoulders to keep your hands free.

  Go for daily checks: You should keep daily tabs on what is happening to your spine. Go for daily checks, and immediately check with your doctor if you experience symptoms like back pain without any evident disease, or if discomfort persists even after medication.

The spine is integral to the proper functioning of your whole body, and shouldn t be ignored even for a day. There are exercises you can do to keep it in good shape, and those that you can avoid. There are also triggers after which you should check with your doctor as well. Here s wishing you good spinal health.

The spine is an integral part!

Ways To Keep Your Spine Happy!

The carpal tunnel is the passageway for the median nerve to pass through on the inner side of your hand, when your palms are facing down. For example, while typing, there is a lot of movement of the fingers and this puts a lot of pressure on this tunnel. In fact, people who are involved in a lot of typing are one of the most prone people for carpal tunnel syndrome (CTS). Other causes would include trauma, fractures, etc., where the tunnel is injured.

Conventional measures to treat CTS included a combination of exercise and pain killers in mild to moderate cases. In moderate (sometimes) to severe cases, surgery was also done. However, with advancements in medical technology, endoscopic surgical procedure is gaining popularity.

What is done?
In endoscopic surgery, a small incision is made in the wrist or one each in the palm and the wrist. Through this, a flexible tube with a camera and minute cutting tools are inserted into the wrist. Another ligament known as transverse carpal ligament is cut. This reduces the pressure on the median nerve, which provides relief from the CTS symptoms.

What to expect as benefits?
The intention behind the surgery remains the same in both traditional and endoscopic procedures. The pressure on the median nerve is released, restoring movement and reducing pain in the joints. In addition, the endoscopic procedure has the following benefits.

Less invasive: Needless to say, there are only one or two small incisions done for this procedure, so less surrounding tissue is damaged.
Same day surgery: No hospitalization is required, and unless required, the patient can return home on the same day of surgery.
Reduced recovery time: The recovery period is usually substantially less compared to the traditional surgical approach.
Back to work: Depending on which is your dominant hand, you would be able to return to your regular work earlier than with regular surgery. If your non-dominant hand is involved, a day or two of rest is required. If your dominant hand was involved, give it up to four weeks for complete recovery.
Reduced chances of nerve injury: The area of operation has many nerves and blood vessels, and endoscopic surgery reduces the chances of damaging adjacent nerves.
Anesthesia: This is done under local anesthesia. Therefore, complications arising out of general anesthesia are completely avoided.
Indications
While these sound promising, your doctor will decide if you are a candidate for endoscopic procedure depending on the following:

Nonsurgical treatment including exercise and pain killers have not provided relief, even after several months.
Severe symptoms including those of nerve damage, like loss of sensation, altered coordination, etc., is affecting your normal daily routine.
Person requiring bilateral surgery like severe trauma, wheelchair dependent, etc.

Carpal Tunnel - How Endoscopic Surgery is Beneficial?

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!

Gout is a disease of the joints. It is a kind of arthritis, which is caused by the deposition of uric acid in the joints. The deposited uric acid causes inflammation of the joints. The disease occurs when our body fails to eliminate the excess uric acid in blood by excretion or the production of the acid is increased.

The level of uric acid in our bodies goes up when the amount of purines in our meals is increased. Purines are responsible for the production of uric acid. They are found in meats, alcohol, sea food and other food items. When digestion of these foods takes place inside the body, purine is released into the blood stream. Uric acid level is also increased by a sedentary lifestyle. Sometimes other factors like intake of insufficient water, consumption of medicines and obesity can also affect the uric acid level in the blood.

Symptoms of Gout

One will notice a redness and swelling around the affected joint. Gout commonly affects the big toe, ankles, hands and wrists. The patient has to deal with intense shooting pain in the joint. The patient also feels some itching in the affected region. Some patients develop nodules called tophi in the joints.

Homeopathy Treatment for Gout

In most cases, patients seeking allopathic treatment for gout take frequent pain killers to get rid of the pain. The pain killers will provide temporary relief. But the main problem persists. However, homeopathy treats the root cause of the problem and aims at eradicating the disease completely. In this article, three commonly used homeopathic medicines used for treating gout have been listed. However, these medicines may not suit all individuals with gout. The effectiveness of the medicines largely depends on the patient s lifestyle. These medicines are listed below:

    Colchicum: It is the primary medicine given to patients suffering from gout. It is good for the treatment of the chronic cases. It is given to patients who suffer from pain in the big toe. The pain is unbearable, when the affected area is touched. The region turns hot, red and swollen. In these patients, the pain starts from the left side usually. The patient feels feverish. Their problem will intensify in warm weather. Their joints get stiffer.

    Ledum Pal: It is for patients who suffer from gout pain travelling upwards. The pain is likely to start from the patient s feet and travel towards the knees. The patient will not be able to bear external warmth. The patient feels better with cold application.

    Benzoic Acid: This medicine is for patients who suffer from gout along with offensive urine. The odour of the urine is intolerable. The colour of the urine is unusual brown in colour sometimes. There is a cracking sound in the joints.

Homoeopathic medicines can be a big boon for all those who suffer from high uric acid. These medicines work by reducing the uric acids overproduction by the body and accelerating the removal of this waste product from through the kidneys.

Homoeopathy is known to control the uric acid diathesis and is also useful in acute attacks. Homeopathy helps in controlling the pain during the acute attack of gout as well as helps in preventing the recurrence of such episodes. It helps in reducing stiffness and improves the mobility of the joints.

One big advantage that homoeopathy offers in the treatment of high uric acid is that once treated the chances of relapse are very less, this is also subjected to the condition that diet and Alcohol and weight are well controlled.

With continued treatment from a specialised homeopath, the patient notices reduction in the frequency of attacks and intensity of pains with gradually leading to complete cure.

Suffering from Gout - Can Homeopathy Help in Treating it?

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