Mobility for a person is very important, and when you look through, the hip is a very important component to this. It connects the upper and lower parts of the body and helps in movement. It is a ball and socket joint, where the hip bone provides a socket, into which the upper part of the thighbone (femur) sits into, allowing for free movement.

Like any other human organ, the hip also is prone to damage. Be it natural ageing, infection, injury, or diseases, hip movement can be affected, leading to limited movement and increased pain and stiffness. For these people, being able to get back a hip which will allow them to be back on their feet is a boon for sure. It helps in relieving pain and improving mobility, almost giving people a second lease of life.

Reasons for hip replacement:

With natural ageing, the hip joint can lose its ability to move, due to normal wear and tear of the hip and thigh bones
Diseases of the hips (infectious or autoimmune) can also lead to hip replacement
Injury or trauma is another major cause that requires hip replacement
Joint problems, leading to repeated dislocations
Tumours of the relevant bones
Understanding the procedure in detail

The affected bones (whether diseases or worn out) are replaced with a prosthesis which is compatible with the normal body tissue.
While some materials fuse to the natural bone, others do not and are simply placed as a separate unit
This is a surgery which requires hospitalisation and stays for up to 5 days depending on patient s overall health condition
The entire procedure may take a couple of hours and is usually done under general anaesthesia
An incision is made through the side of the hip
Both the hip and the thigh joints are prepared, diseased tissue removed, re-shaped, etc. to make way for the prosthesis
The prosthesis is introduced through the same incision and positioned into place
As noted earlier, there are two types. The ones which fuse to the bone have pores in them into which normal bone eventually grows.
The other variety is the cemented version, and a glue is used to keep it in place
Most doctors now use a combination, that is cement a porous prosthesis, into which bone will grow, and the incisions are closed
The patient stays in the hospital for 1 to 4 days depending on overall health
Once discharged, infection and pain control are continued
Exercise and physiotherapy play a major role in restoring normal function
Weight management is also very important

Hip Replacement - Understanding The Procedure In Detail!

Endoscopy refers to inserting microscopic cameras into the body through tiny incisions which throw up pictures of the inside of the body onto a screen. Endoscopy has been used for diagnostic purposes since the 1970s. Endoscopy for surgery has become popular from the 1990s.

Endoscopic spine surgery is a state-of-the-art surgery technique which involves micro incisions and minute tubes that cause almost no damage to surrounding tissues and muscles. It is a minimally invasive surgery and it is also called a pinhole surgery.

What are the advantages of endoscopic pinhole spine surgery?

There are a lot of reasons why doctors opt for an endoscopic surgery-

  It is also called Minimally Invasive Spine Surgery (MISS) because it causes little blood loss
  Recovery is almost immediate. A person can resume everyday activities within a week
  Very little pain around the surgery region so minimum pain medication is needed.
  No muscle or bone is removed.
  Since screws and rods are not used, full mobility of the spine can be restored
  The wounds are minute and do not usually require stitches and thus no ugly scars are left after the wounds heal.

What are the characteristics of an endoscopic spine surgery?

  The surgery is performed under local anaesthesia
  The person is discharged within 24 hours of the surgery
  The incisions that are made are microscopic

What are the different types of endoscopic surgery?

Endoscopic discectomy:
It is the least invasive of all spinal surgeries. It is used for treating herniated discs. Endoscopy reveals images of the spine. Through the same tunnel, surgery tools are inserted and the bulging or herniated disc is pulled out with a grasper. The wound does not always require stitches to close it.

Endoscopic Laminotomy:
This a substitute for open laminotomy. The camera helps locate exactly where the target area is. Then an incision is made below and above the lamina to relieve the pressure compressing the nerve.

Endoscopic facet rhizotomy:
With microscopic cameras, the nerves causing pain are identified and then the laser is used to numb these nerves which relieve pain. This type of surgery can also remedy a previously botched spinal surgery, facet joint arthritis or facet joint pain

Endoscopic foraminotomy:
This type of surgery again uses microscopic surgical tools guided by a tiny camera to enlarge a narrowed neuro of spinal nerve root canal to give it more room to move about without being compressed.

Endoscopic Spine Surgery & Pinhole Technique!

Most of us suffer from lower back pain at some point in our lives; be it from a sedentary lifestyle, spending hours at the office desk or from strenuous physical exercises. In most cases, a little bit of rest does the trick. However, if the lower back pain persists for 3-6 weeks, physiotherapy is recommended.

How does physiotherapy help?

The main purpose behind physiotherapy is reducing lower back pain and increasing muscle and bone function, so that such instances are avoided in the future. Physiotherapy is the first line of defence against lower back pain. More drastic measures such as surgery are undertaken once physiotherapy fails to do is job.

Physiotherapy is often recommended when the back pain is caused due to lifestyle factors, a minor injury like a fall or other moderate factors. For more severe back injuries, doctors recommend surgery straight away when there is no scope of performing physiotherapy.

Low-intensity back pain can be cured using a combination of heat packs, ultrasound wave therapy and Iontophoresis (using a localized current source to introduce medical ionic compounds to the body).

A physical therapy program for back pain usually has two components:

Passive physical therapy to help reduce the patient's pain to a more manageable level

Active exercises

Passive Physical Therapy - Modalities

The physical therapist may focus on decreasing pain with passive physical therapy (modalities). These therapies are considered passive because they are done to the patient. Examples include:

Heat/ice packs

TENS units

Iontophoresis

Ultrasound

Active Physical Therapy - Back Pain Exercises

In addition to passive therapies, active physical therapy (exercise) is also necessary to rehabilitate the spine. Here are some of the common exercises for back pain:

Back Stretch: Put your hands underneath your head while lying back. Bend your knees but put your feet on the ground. Roll your legs to one side and hold them there for 10 seconds. Repeat three times for each side.

Deep Lunge: For this, you need to kneel on one knee with the other foot pointed towards the front. Lift the back knee up and hold it there for five seconds and then bring it down. Repeat this exercise three times for each side.

One Leg Stand: This is the simplest of exercises. Hold on to a wall for support while standing and face towards it. Then slowly hold one leg and bend it behind you. Hold in the same position for five seconds before bringing it down. Repeat the process three times for each leg in five second gaps.

Physiotherapy for Back Pain

Also known as Median Nerve Compression, Carpal Tunnel Syndrome is characterized by a sensation of tingling and numbness in the hands or the arm caused due to a strained nerve of the wrist. This condition occurs due to stress which affects the functioning of the part of median nerve, situated along the wrist.

Various Causes of Carpal Tunnel Syndrome:
Constant movement of the hands in activities such as typing on the computer
Pregnancy
Arthritis

Various Symptoms of Carpal Tunnel Syndrome:
The symptoms of this syndrome start to show up when there is excessive pressure build up in the median nerve of the wrist. You may experience-

A sensation of numbness
A sensation akin to the pain experienced when needles are inserted into the skin
Pain (mostly at night)
The build- up of pressure can occur due to a number of reasons. They are-

Painful injury
Fracture
Tenosynovitis (a condition that affects the tendons along the sides of the thumb)
The compression of the nerve may develop anywhere, and not necessarily the wrist only.
Diagnosis of Carpal Tunnel Syndrome:
Doctors base their diagnosis of the condition on the symptoms and certain tests. These include-

Phalen s test (a test that is carried out to determine any pain or numbness in the fingers within one minute of this activity)
Wrist flexion/median nerve compression test
Tinel s test (a test that is used to diagnose irritated nerves)
Few nerve enlargements may be revealed by an ultrasound, X-Ray, MRI scan, CT scans etc. The doctor generally recommends any of the above tests to determine carpal tunnel syndrome.
Important measures that help treat the condition are

Getting ample rest
Educating yourself on the various symptoms
Knowing certain activities or movements that trigger symptoms
Attending physiotherapy sessions
Physiotherapy as an important form of treatment for Carpal tunnel syndrome
Extensibility of muscle as well as soft tissue
Strengthening the forearms and the ability to grip things and pinch too
Maintaining posture and performing hand agility exercises can improve the hand movement
Mobilization of the Carpal bone and stretching of the flexor retinaculum (a fibrous band near one s wrist) so as to widen the carpal tunnel
Gliding training for nerves/ tendons for unrestricted motion
Endurance training for strengthening the upper limb as well as the wrist

Carpal Tunnel Syndrome - Measures That Can Help Treat It!

Did you know that in addition to your diet, exercise is one of the best ways to make sure that you never lie on a hospital bed with a surgeon treating you for a bone disorder? Medical expertise has constantly pointed out to the fact that regular exercise makes your bones less likely to suffer from wear and tear during old age.

As you exercise, your muscles become stronger, your bone density increases and your balance improves. Of course, it goes without saying that you need to follow certain precautions before you exercise to avoid certain injuries.

Before starting any exercise program, make sure that you prepare your body for exercise. A brief warm up helps you to get your muscles ready for exercise. It also makes sure that your chances of injury are drastically reduced.

Here are some tips to keep your bones healthy:

Weight lifting: Weight lifting is a type of exercise that, if done correctly, will be extremely beneficial for your bones. You can opt for simple bodyweight exercises such as pushups and squats, which build muscle as well as strength. Avoid using very heavy weights as it causes back-related problems such as slipped disk.

Yoga: Yoga is another method of exercise which is very beneficial for bones and joints. The premise of yoga is static strength building wherein you hold a pose or an exercise for a certain period of time; this helps in strengthening your muscles. Along with your muscles, your bones also become stronger as you get fitter. Yoga is repetitive stress which is good for flexibility and hence keeps your joints supple and muscles in good shape. There are certain asanas which are weight bearing and anti-gravity postures can strengthen your bones. 

Swimming: Swimming again is a good aerobic exercise and is good for back and over all fitness but doesn't strengthen bone per se. It is a way to keep you healthy. Swimming is a cardiovascular exercise, which is also known for its calorie burning capabilities. It is also very effective is incinerating fat and keeping your skeletal system healthy. Whereas walking and jogging and running certainly build your bones as they are weight bearing exercises.

Pilates: Pilates is a new form of exercise that has been gaining a lot of steam lately. It does not require much equipment, as you can get started with just a mat. It is very effective in working your spine and the hips, thus keeping your lower back strong. A weak lower back increases the chances of bone disorders drastically.

How Exercise Can Help In Keeping Your Bones Healthy?

Stress is sometimes good for you. When you stretch yourself beyond your capacity, your body accepts challenge and increase the capacity to cope up with challenge. To a certain extent, it is good for body. But when the stress crosses the limits, it starts hurting you. That's the bad stress for you. Moderate stress for too long a time also is bad for you. Most of the hormonal diseases like diabetes, thyroid etc. Occur because of long standing underlying moderate stress. 

Stress can be physical or mental. Physical stress is due to long and continuous physical activities like walking, jogging, travelling, cycling. Mental stress is mainly because of financial tension or relationship distress. Both types of stress cause similar damages to body. Stress is the main underlying cause behind diseases like high blood pressure, heart disease, thyroid, diabetes, kidney disease, peptic ulcer, bleeding disorders, cancer, recurrent infections etc. 

Finding out the reason of stress and removal of cause of stress should be the main line of treatment of such diseases.

Stress - Good and Bad

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