Ankylosing spondylitis (AS) is a type of arthritis that affects the spine. This chronic disease is caused due to inflammation of the joints in the spine and usually affects young men. It causes the vertebrae to grow or fuse together, causing a rigid spine. Actually, it affects the discs in between the vertebral column. These discs get swollen, causing a limitation of spine motility. It is an autoimmune disorder and its symptoms are lower back pain and stiffness, which usually moves to the legs.

The deformity due to AS can be mild or severe. In extreme cases, the patient gets a stooped spine. 
Early diagnosis can prevent significant deformity as well as help in controlling the pain and stiffness.
Allopathy doesn t really know the real reasons for this disease and here is where Ayurveda scores.
According to Ayurveda, AS is caused due to aggravated vata or wind, which causes an imbalance in vata dosha.
Ayurvedic treatment
Ayurvedic treatment starts with detoxification and elimination of toxins. It relies heavily on the right diet and lifestyle as well as Ayurvedic herbal preparations. The panchakarma techniques called kati vasti, sarvangadhara and patrapinda svedana are very beneficial too. The basic explanation for the disorder is that AS occurs due to an accumulation of ama or toxins in the body. Where ever ama deposits in the body, pain is caused. Ayurvedic treatments aim at digesting the ama by using herbs as medicine and balancing the aggravated vata.

Herbs used in the treatment of AS are dry ginger (saunth), guggul, turmeric, fenugreek, ashwagandha and giloy. Gugul, curcumin, amlaki, haritaki, and ashwagandha are all very effective in treating AS.
Avoid getting constipated and ensure proper evacuation of bowels.
Include ghee in your diet for lubrication and for lowering the vata dosha.
Apply heat on the affected areas to control the pain and stiffness.
Eat light foods and strictly avoid oily foods and curd which increase ama.
Avoid sleeping during the daytime.
Yoga asanas like pawana muktasana, bhujangasana, dhanurasana, paschimottanasana and vakrasana should be practised regularly.
The practice of pranayamas such as and shodhana, chandrabhedi sheethali and bhramari also helps.
Chewing 2 3 raw garlic buds on an empty stomach in the morning with water helps in alleviating lumbar pain in AS.
Use a powdered preparation of dried ginger root, celery seeds and cumin seeds in equal quantities with rock salt for taste, and have one teaspoon of this mixture with warm water at bedtime to reduce flatulence as well as lumbar stiffness.

Ankylosing Spondylitis (AS) - Ayurvedic Remedies That Help You Treat It!

Carpal Tunnel Syndrome can be said to be one of the most painful disorders to have. There is a high likelihood that a lot of people can agree with this statement as the number of people who suffer from this issue is just so high! Yet, a funny thing to take note of is the fact that even people who are experts on CTS, which is the abbreviation of Carpal Tunnel Syndrome, are not really aware as to what its causes are!

That being said, it really does not mean that a person whose life has been affected negatively by it does not make a conscious effort to get better so that the condition is not as painful. In order to do this, what he or she would do is to commit to doing some exercises which directly address the problem at hand.

To start with the exercises, it makes sense, to begin with, the one which is the simplest and this happens to be an exercise which is often known as the shake. What this requires the person to do is to shake his or her hands while making sure to keep them flexible. This action is pretty much the same as a person would do, if he or she were to try to air dry his or her hands without making use of a towel.
Another simple exercise which is prescribed by quite a lot of doctors who are accomplished experts when it comes to Carpal Tunnel Syndrome is one in which the person who has the condition makes his or her hands a fist. After this is done, what he or she needs to do is to release the fist and go on to stretch the fingers out as wide as possible. The extension should attempt to be in the shape of a fan.
It may be surprising, but it can be said that the ill effects of something which is as troublesome as Carpal Tunnel Syndrome can be improved if these simple exercises are done with regularity. However, if a person is looking for a drastic change, it can be expected that he or she would have to do more by the way of complex exercises, at least on a relative scale.

One of these exercises is to join the hands in a prayer position and then separate the palms, but make sure the fingers stay pressed to each other; an act known as steepling the fingers. With these simple exercises in place, you can avoid the pain of dealing with Carpal Tunnel Syndrome for good! 

Carpal Tunnel Syndrome (CTS) - How Physiotherapy Can Help?

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!

Acupressure can prove to be extremely effective if you are looking for non-medicinal solutions to treat musculoskeletal problems, such as back pain, sports injuries, arthritis, etc. Acupressure is the application of putting firm pressure on the areas on the body which are swollen, agitated or tense by massaging the acupoints (specific points in the body). Acupressure believes that relieving these areas of pressure reduces the pain.

Here are some musculoskeletal problems that can be healed by acupressure:

    Arthritis: Those who seek acupressure as an alternative treatment for pain are mostly suffering from arthritis (a disease characterised by chronic joint inflammation and cartilage degeneration). Acupressure applies pressure on the inflamed joints.
    Back pain: Back pain is a common problem that can affect anyone irrespective of his or her age. Acupressure acts to relieve the points where the muscles are too tense and helps to tone or support the muscles which have become weak with disuse.
    Chronic pain: Unrelenting pain can stem from many causes. Acupressure focuses on the pain and the pain signals when treating chronic pain. The acupoint of the pain and the nerves are gently massaged to relieve the pain.
    Fibromyalgia: Traumatic injury to the soft tissue, emotional trauma or severe illness can cause fibromyalgia. It is non-inflammatory in nature and often leads to Chronic Fatigue Syndrome (a troublesome disorder with symptoms of deep fatigue, sleeping problems, pain, etc.). Acupressure can greatly improve the fatigue and sleeplessness that fibromyalgia causes.
    Tendonitis: The tendon connects the tissue to the bone, and tendonitis is the condition when the tendon is inflamed. Acupressure helps in reducing the inflammation and easing mobility restrictions.
    Sciatica: The sciatic nerve is the longest nerve in the body, stretching from the lower spine to the back of the foot. So when this nerve is agitated, pain radiates from the lower back to the foot. This condition is called sciatica. The acupoints in sciatica are the lower back and the hip. Acupressure effectively loosens the muscles in these regions and reduces inflammation.
    Sports injuries: Strains and sprains are common sports injuries, which mostly affect athletes. Acupressure has anti-inflammatory benefits that can help heal severely injured tendons, ligaments or muscle. Acupressure also plays a huge role in restoring and retraining the body, especially if you are an athlete and play high-demand sports.
    Carpel Tunnel Syndrome: Carpal tunnel syndrome is a condition in which the pressure increases on the median nerve as it goes through the carpal tunnel, and this causes wrist pain. Acupressure involves the use of directed pressure to specific acupuncture points on the surface of the body.
    Insomnia: Insomnia is a sleep disorder. The Acupressure Points between your heel and anklebones (on both sides) have traditionally been used to relieve and prevent insomnia.
    Migraines: Acupuncture is used to effectively treat primary headaches, namely tension and migraine, which are the most common.

Acupressure: The Non Medicinal Solution to Musculoskeletal Problems

A broken nose is any crack or fracture in the bony portion of the nose. This is usually a result of external trauma.


Nasal fractures are often cited as the most common type of facial fracture, accounting for approximately half of all facial fractures in several studies.


Broken Nose Causes:


Common sources of trauma include the following:


Sports injuries
Personal fights
Motor vehicle accidents
Falls
In children, nasal fractures are most commonly due to falls.




Broken Nose Symptoms:


Tenderness when touching the nose
Swelling of the nose or face
Bruised nose
Bruising under the eyes (black eye)
Deformity of the nose (crooked nose)
Nosebleed
Pain and difficulty breathing out of the nostrils 


Broken Nose - 7 Signs You are Suffering from it

A hand fracture is a condition characterized by broken bones of the hand. The bones in the hand include the bones that are present in the fingers and the wrists. A fracture of the hand tends to occur when you bend or twist your hand in the wrong manner. It may also be caused by injuries related to sports and falls.

Symptoms
Symptoms of swelling and pain are the most common of them all. The range of motion for the affected hand will be reduced as well. The knuckle bone may appear to have been sunken in. Most obviously, it will be difficult in carrying out regular tasks which need the hands.

Therapies
The initial treatment for a hand fracture will be focused on reducing the pain. Pain relieving medications such as ibuprofen will be administered which provides relief from the pain. The next step will be to keep the affected hand immobilized so as not to hamper the recovery process. Once stability is restored, therapeutically relevant exercises are prescribed to help normalize the regular hand movements.

The following exercises are relevant in case of a hand fracture:

Wringing a towel: This is an exercise wherein you wring a towel to improve flexibility and strength in the hand. Simply grab a towel and twist it in both directions; imagine wringing water from the towel.
Rolls of the wrist: Wrist rolls aim to increase the ROM (range of motion) in your wrists and the hands. Hold the hand steady and rotate your wrists both clockwise and anticlockwise. You can also hold a light weight in your hand to make it more challenging.
Prayer stretch: A prayer stretch is another exercise that can help boost your wrist flexibility. You start by positioning the palms together like in a prayer, then hold up the elbows while pushing the hands against each other. You should feel a stretch in your wrists and hands.
Grasping: This is a technique wherein you grasp objects to improve your grip strength. Try gripping objects such as tennis ball or stress balls to get your gripping ability up to normal levels.


4 Effective Therapies Post Hand Fracture!

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